scholarly journals Perceptions of Residents on the Microlearning Environment in Postgraduate Clinical Training

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Muhammad Zafar Iqbal ◽  
Mohammad Alaskar ◽  
Yazeed Alahmadi ◽  
Badran Abdullah Alhwiesh ◽  
Abdullah Abdulrahman Mahrous
Keyword(s):  
Clinical Training ◽  
Tertiary Care ◽  
Mean Value ◽  
Teaching Hospitals ◽  
Limited Attention ◽  
Survey Tool ◽  
Level Of Satisfaction ◽  
Internal Medicine Residents ◽  
Collection Data ◽  
And Gender

Background. Teaching hospitals are the primary locus of training for residents, and the afforded microlearning environments can affect their level of satisfaction, competence, and learning processes. Since limited attention has been directed towards evaluating the microlearning environment, how Saudi postgraduate residents perceive it remains unknown. Objectives. This study evaluated the microlearning environments for major clinical specialties in a tertiary care teaching hospital. It also investigated the association between satisfaction levels and the age and gender of the participants, as well as their stage and specialty. Methods and Methods. A questionnaire-based, observational study was conducted using a prevalidated HEMLEM tool for data collection. Data were collected using the QuestionPro® survey tool and analyzed using SPSS version 23 software. A one-way ANOVA and t-test were performed to compare different subgroups. Results. In total, 129 residents participated in the study, representing a response rate of 87.16%. The overall mean value for microlearning environment satisfaction was 50.21. Females scored higher relative to males. Maximum satisfaction with the microlearning environment was observed in the age group 25–30 years and among internal medicine residents. Conclusion. Overall, a satisfactory score on the HEMLEM tool was recorded, suggesting the majority of residents are satisfied with the microlearning environment at KFHU. Supervisors, program directors, and curriculum planners could use our findings to further improve the educational climates within their training specialties.

Detection of Circulating Tissue Factor and Factor VII in a Normal Population

1996 ◽  
Vol 75 (05) ◽  
pp. 772-777 ◽  
Author(s):  
Sybille Albrecht ◽  
Matthias Kotzsch ◽  
Gabriele Siegert ◽  
Thomas Luther ◽  
Heinz Großmann ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Normal Population ◽  
Mean Value ◽  
Factor Vii ◽  
Significant Difference ◽  
Age Dependent ◽  
The Mean ◽  
Highly Correlated ◽  
And Gender

SummaryThe plasma tissue factor (TF) concentration was correlated to factor VII concentration (FVIIag) and factor VII activity (FVIIc) in 498 healthy volunteers ranging in age from 17 to 64 years. Immunoassays using monoclonal antibodies (mAbs) were developed for the determination of TF and FVIIag in plasma. The mAbs and the test systems were characterized. The mean value of the TF concentration was 172 ± 135 pg/ml. TF showed no age- and gender-related differences. For the total population, FVIIc, determined by a clotting test, was 110 ± 15% and the factor VIlag was 0.77 ± 0.19 μg/ml. FVII activity was significantly increased with age, whereas the concentration demonstrated no correlation to age in this population. FVII concentration is highly correlated with the activity as measured by clotting assay using rabbit thromboplastin. The ratio between FVIIc and FVIIag was not age-dependent, but demonstrated a significant difference between men and women. Between TF and FVII we could not detect a correlation.

Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions

2021 ◽  
Vol 12 (02) ◽  
pp. 355-361
Author(s):  
Kinjal Gadhiya ◽  
Edgar Zamora ◽  
Salim M. Saiyed ◽  
David Friedlander ◽  
David C. Kaelber
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Medical Center ◽  
Internal Medicine Resident ◽  
Clinical Decision ◽  
University Of Pennsylvania ◽  
Teaching Hospitals ◽  
Medicine Resident ◽  
Internal Medicine Residents ◽  
The University

Abstract Background Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.

Establishment of Primary Care Continuity Experiences in Community Pediatricians' Offices: Nuts and Bolts

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1185-1189
Author(s):  
Janice R. Sargent ◽  
Lucy M. Osborn ◽  
Kenneth B. Roberts ◽  
Thomas G. DeWitt
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Professional Education ◽  
Primary Care Physicians ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Tertiary Care ◽  
Ambulatory Training ◽  
Lengths Of Stay ◽  
Tertiary Care Centers

During the past 30 years, there has been an increasing awareness of the importance of ambulatory care training in medical education. The discrepancy between education and practice was pointed out in the General Professional Education Panel report that indicated training was based largely in hospital settings even though the vast majority of doctor-patient encounters do not result in hospitalization.1 Perkoff,2 noting changes in hospital care such as shorter lengths of stay, increased outpatient care, and the need for well-trained primary care physicians, stated that programs need to make a major effort to emphasize clinical teaching in outpatient settings. Recognizing the need for these changes, the Accreditation Council on Graduate Medical Education (ACGME) has increased dramatically the requirement in primary care specialties for clinical ambulatory training.3 For pediatrics, these requirements have progressed from the suggestion that clinical training should be obtained in outpatient clinics (1961) to requiring clinical training in primary care clinics weekly for 3 years (1985). The problems in providing good training in ambulatory settings have been well described.2-4 In comparison inpatient teaching, training students and residents in an outpatient clinic is inefficient and costly. One of the methods suggested to address these problems has been to move ambulatory training out of tertiary care centers to community sites.5-9 Many pediatric programs are now using community sites for at least a portion of resident education.10 Alpert et al10 and Greenberg et al,11 although encouraging the use of these sites to reduce the gap between pediatric education and the service delivery system, pointed out that there are no standards for use of community sites.

Distribution of age, gender and body weight in AMI patients in a tertiary care center of Eastern India

2021 ◽  
Vol 12 (6) ◽  
pp. 75-58
Author(s):  
Tanushri Khatua ◽  
Tanima Mandal ◽  
Mita Saha ◽  
Biswajit Majumder
Keyword(s):  
Body Weight ◽  
Family History ◽  
Care Center ◽  
Tertiary Care ◽  
Positive Family History ◽  
Premenopausal Women ◽  
Care Hospital ◽  
Risk Of Mortality ◽  
And Gender ◽  
Risk Predictors

Background: The leading cause of death in the world is coronary heart disease (CHD). In India, CHD manifests almost a decade earlier than in Western countries. Gender differences play an important role in the pathophysiology of AMI. Body weight and family history are claimed to be the indicators of relative risk of mortality. Aims and Objective: To look for the age and gender distribution pattern in patients with recent diagnosed AMI and to find out the association of some of the risk factors like BMI, family history. Materials and Methods: A descriptive study was conducted in a tertiary care hospital with 50 recent diagnosed AMI patients of either sex as cases after considering the inclusion and exclusion criteria. The biochemical parameters were measured by validated methods. Results: On statistical analysis, 58% of total AMI cases occurred before 50 years of age; out of which 18% belong to 31 - 40 years, 40% belong to 41- 50 years. Out of total 50 AMI cases, 60% is male and 40% is female. Obesity seen in 14% cases and 56% is overweight; 16% having positive family history. Conclusion: The study indicates a trend of early age onset AMI. Increased body weight and positive family history can be the risk predictors. It is suggested that younger age males and premenopausal women should not be ignored regarding the risk of MI. Further studies are required for verification.

scholarly journals A Comparative Study of the Effect of Institutional Ownership, Audit Committee, and Gender on Audit Report Lag in Indonesia, Malaysia and Singapore

2018 ◽  
Vol 8 (2) ◽  
pp. 131
Author(s):  
Yulia Frischanita
Keyword(s):  
Audit Committee ◽  
Institutional Ownership ◽  
Mean Value ◽  
Audit Report ◽  
Mining Company ◽  
Purposive Sampling ◽  
Mining Companies ◽  
Negative Effect ◽  
The Difference ◽  
And Gender

The purpose of this research are to analyst the negative effect of institutional ownership, audit committee and gender to audit report lag of mining company in Indonesia, Malaysia and Singapore for 2012-2016. Gender is proxied by gender of CEO and gender of Committee Audit’s Head. Not only that, the research also analyst the difference mean value of audit report lag in Indonesia, Malaysia and Singapore. This research use random purposive sampling technique because the amount company gap after purposive sampling between three counties are high. Total of population of three countries are 67 companies and mining company which fulfill the criteria of purposive sampling is 43 companies. That are consist of 34 Indonesia’s mining companies, 3 Malaysia’s mining companies and 6 Singapore’s mining companies. The final sample is 13 companies consist of 5 Indonesia’s company, 5 Singapore’s company and 3 Malaysia’s Company. Multiple Linear Regression is used to examine the effect of independent variable to dependent variable, while One Way-Anova is used to examine the difference mean value of audit report lag. The result of this research are institutional ownership have negative effect to audit report lag, while audit committee and gender don’t have effect to audit report lag. Beside that, there is no difference mean value of audit report lag in Indonesia, Malaysia and Singapore because they have same regulation about maximal day of company to publish their financial report.

scholarly journals An innovative resident-driven mortality case review curriculum to teach and drive system-based practice improvements in the United States

2018 ◽  
Vol 15 ◽  
pp. 31
Author(s):  
Nila S. Radhakrishnan ◽  
Margaret C. Lo ◽  
Rohit Bishnoi ◽  
Subhankar Samal ◽  
Robert Leverence ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Systems Of Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
The United States ◽  
Case Review ◽  
Failure To Rescue ◽  
Internal Medicine Residents ◽  
Mortality Case

Purpose: Traditionally, the morbidity and mortality conference (M&MC) is a forum where possible medical errors are discussed. Although M&MCs can facilitate identification of opportunities for systemwide improvements, few studies have described their use for this purpose, particularly in residency training programs. This paper describes the use of M&MC case review as a quality improvement activity that teaches system-based practice and can engage residents in improving systems of care. Methods: Internal medicine residents at a tertiary care academic medical center reviewed 347 consecutive mortalities from March 2014 to September 2017. The residents used case review worksheets to categorize and track causes of mortality, and then debriefed with a faculty member. Selected cases were then presented at a larger interdepartmental meeting and action items were implemented. Descriptive statistics and thematic analysis were used to analyze the results. Results: The residents identified a possible diagnostic mismatch at some point from admission to death in 54.5% of cases (n= 189) and a possible need for improved management in 48.0% of cases. Three possible management failure themes were identified, including failure to plan, failure to communicate, and failure to rescue, which accounted for 21.9%, 10.7 %, and 10.1% of cases, respectively. Following these reviews, quality improvement initiatives proposed by residents led to system-based changes. Conclusion: A resident-driven mortality review curriculum can lead to improvements in systems of care. This novel type of curriculum can be used to teach system-based practice. The recruitment of teaching faculty with expertise in quality improvement and mortality case analyses is essential for such a project.

scholarly journals URETHRAL CATHETERIZATION

2011 ◽  
Vol 18 (02) ◽  
pp. 246-250
Author(s):  
SHAHID MEHMOOD ◽  
KHALID FAROUK ◽  
ZEESHAN QADEER ◽  
Iram Batool Nadeem
Keyword(s):  
Practical Knowledge ◽  
Tertiary Care ◽  
Senior Resident ◽  
Teaching Hospitals ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Urethral Catheterization ◽  
Care Teaching ◽  
Level Of Confidence ◽  
Tertiary Care Centers

Objectives: (1) To assess the theoretical and practical knowledge of young doctors about urethral catheterization. (2) To evaluate the experience and level of confidence of young doctors regarding the urethral catheterization in various tertiary care centers of Rawalpindi and Islamabad. Period: Sep 2009 to Feb 2010. Setting: Tertiary Care Centre, Fauji Foundation Hospital, Rawalpindi. Subjects and methods: A questionnaire was distributed among 400 young doctors working as interns in various tertiary care teaching hospitals of Rawalpindi and Islamabad. We obtained the information about observation, assistance, performance and knowledge of young doctors about urethral catheterization. Results: Questionnaire was distributed to about 400 young doctors working as interns in different teaching hospitals of Rawalpindi and Islamabad. Among the 400 doctors, 20 (5%) doctors never observed the male urethral catheterization and 35 (8.75%) doctors never observed female urethral catheterization. While among these 400 doctors 159 (38.75%) doctors never assisted male urethral catheterization and 175 (43.75%) doctors never assisted female urethral catheterization. Moreover 205 (51.25%) doctors never performed the male urethral catheterization and 185 (46.25%) doctors never performed female urethral catheterization. Conclusions: Training of young doctors about UC is not adequate. There is a need to train the young interns properly on this aspect. A senior resident or registrar of department should demonstrate the procedure in front of young interns before they are allowed to practice and first few catheterizations should be supervised by senior residents. Other alternate is the use of manikens for training of house officers.

scholarly journals Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Eleni Papalekas ◽  
Jay Fisher
Keyword(s):  
Robotic Surgery ◽  
Training Program ◽  
Teaching Hospital ◽  
Community Hospital ◽  
Tertiary Care ◽  
Monitoring Program ◽  
Teaching Hospitals ◽  
Robotic Training ◽  
Abdominal Approach ◽  
National Trends

Objective. To evaluate trends in surgical approach for hysterectomy following the introduction and implementation of a comprehensive robotic surgery program. Methods. A retrospective review of all hysterectomies done at two institutions, a community hospital and a suburban, tertiary-care teaching hospital, in the same health system over a five-year period, January 2010 through December 2014. A robotic surgery training program was implemented during the first year of the study and trends in route of hysterectomy were evaluated in the subsequent years. Results. A total of 5175 patients undergoing hysterectomy, for both benign and malignant indications, were included in the study. There was a significant decrease in the percent of cases performed through an abdominal approach at both the community and teaching hospitals (19.3% decline at each institution). There was an inversely related significant increase in the percent of robotic procedures at both the community and teaching hospitals (44.5% and 17%, respectively). A decrease in number of cases performed vaginally over this period was only noted in the community hospital site (25.2% decrease), and there was a slightly higher rate of vaginal hysterectomies at the teaching hospital over this study period (21.9% in 2010, 24.1% in 2014). Conclusion. The decrease in number of abdominal and laparoscopic hysterectomies and increase in number of robotic hysterectomies that was seen are consistent with national trends. The initiation of a robotic training program did not prevent the proliferation of use of the robot but did aim to ensure proficiency on the robot prior to gaining privileges for patient use. This type of comprehensive training and monitoring program could be applied to future technologic advances to ensure a standard level of surgical proficiency. Trends in route of hysterectomy are clearly multifactorial and involve patient, provider, and location-specific factors that are likely to continue to change.

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