scholarly journals Talking about firearm injury prevention with patients: a survey of medical residents

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rocco Pallin ◽  
Sara Teasdale ◽  
Alicia Agnoli ◽  
Sarabeth Spitzer ◽  
Rameesha Asif-Sattar ◽  
...  
Keyword(s):  
Medical Education ◽  
Injury Prevention ◽  
Medical Training ◽  
Medical Center ◽  
Academic Medical Center ◽  
Personal Exposure ◽  
Further Education ◽  
Firearm Injury ◽  
Significant Public Health ◽  
Patients At Risk

Abstract Background Firearm injury and death are significant public health problems in the U.S. and physicians are uniquely situated to help prevent them. However, there is little formal training in medical education on identifying risk for firearm injury and discussing safe firearm practices with patients. This study assesses prior education, barriers to counseling, and needs for improved training on firearm safety counseling in medical education to inform the development of future education on clinical strategies for firearm injury prevention. Method A 2018 survey administered to 218 residents and fellows at a large, academic medical center asked about medical training on firearm injury prevention, frequency of asking patients about firearm access, and perceived barriers. Results The most common barriers cited were not knowing what to do with patients’ answers about access to firearms (72.1%), not having enough time (66.2%), not feeling comfortable identifying patients at-risk for firearm injury (49.2%), and not knowing how to ask patients about firearm access (48.6%). Prior education on firearm injury prevention was more strongly associated with asking than was personal exposure to firearms: 51.5% of respondents who had prior medical education reported asking compared with who had not received such education (31.8%, p=0.004). More than 90% of respondents were interested in further education about interventions, what questions to ask, and legal mechanisms to separate dangerous people from their firearms. Conclusions Education on assessing risk for firearm-related harm and, when indicated, counseling on safe firearm practices may increase the likelihood clinicians practice this behavior, though additional barriers exist.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

scholarly journals An Examination of Resident Perspectives on Survey Participation and Methodology: Implications for Educational Practice and Research

2021 ◽  
Vol 13 (3) ◽  
pp. 390-403
Author(s):  
Colleen Y. Colbert ◽  
Andrei Brateanu ◽  
Amy S. Nowacki ◽  
Allison Prelosky-Leeson ◽  
Judith C. French
Keyword(s):  
Medical Education ◽  
Content Analysis ◽  
Survey Methodology ◽  
Survey Design ◽  
Medical Center ◽  
Academic Medical Center ◽  
Educational Practice ◽  
Program Evaluations ◽  
Academic Medical ◽  
Survey Participation

ABSTRACT Background In medical education, self-administered questionnaires are used to gather information for needs assessments, innovation projects, program evaluations, and research studies. Despite the importance of survey methodology, response rates have declined for years, especially for physicians. Objective This study explored residents' experiences with survey participation and perceptions of survey design and implementation. Methods In 2019, residents at a large Midwestern academic medical center were recruited via email to participate in mixed specialty focus groups (FGs). Narrative comments were recorded, transcribed, and then analyzed via conventional content analysis, utilizing cognitive sociology as a conceptual framework. Themes and subthemes were generated iteratively. Results Postgraduate year 1–4 residents (n = 33) from internal medicine, surgery, and neurology participated in 7 FGs (3–7 participants/group) from April–May 2019. Eight themes were generated during content analysis: Negative emotions, professionalism, accuracy, impact, survey design/implementation, biases, survey fatigue, and anonymity. Residents questioned the accuracy of survey data, given the tendency for self-selection to drive survey participation. Residents wanted survey participation to be meaningful and reported non-participation for a variety of reasons, including doubts over impact. Satisficing and breakoffs were commonly reported. Conclusions Though residency program cultures differ across institutions, the findings from this study, including potential barriers to survey participation, should be relevant to anyone in graduate medical education using survey methodology for programmatic data collection, accreditation, and research purposes.

scholarly journals COVID-19 Related Deaths in an Urban Academic Medical Center in Brooklyn – A Descriptive Case Series

2020 ◽  
Author(s):  
James Andrew McCracken ◽  
Mohamed Nakeshbandi ◽  
Jeffrey Arace ◽  
Wayne J Riley ◽  
Roopali Sharma
Keyword(s):  
New York ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Black Population ◽  
International Travel ◽  
Normal Limits ◽  
Academic Medical ◽  
Patients At Risk

Abstract Background Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease 2019 (COVID-19), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 at an academic medical center in Brooklyn, New York.Study design and methods This is a retrospective observational study of 200 patients who expired due to complications of COVID-19. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020. Results A vast majority of patients were Black Americans (89%) with no history of international travel who had more than one comorbidity (81%), with the most common comorbidities being hypertension (84·5%), diabetes mellitus (57·5%), and obesity (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57 – 12·72). Interpretation Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 infection. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.

scholarly journals Exploring the impact of tablet computers on medical training at an academic medical center

2013 ◽  
Vol 101 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Bradford A. Perez ◽  
Megan A. von Isenburg ◽  
Miao Yu ◽  
Brandi D. Tuttle ◽  
Martha B. Adams
Keyword(s):  
Medical Training ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tablet Computers ◽  
Academic Medical ◽  
The Impact

scholarly journals A hybrid heart for heart failure – how much remains to be done? An interview with Jolanda Kluin

2020 ◽  
Vol 16 (5) ◽  
pp. 357-359
Author(s):  
Jolanda Kluin
Keyword(s):  
Heart Valves ◽  
Medical Training ◽  
Aminolevulinic Acid ◽  
Medical Center ◽  
Academic Medical Center ◽  
Mitral Valve Surgery ◽  
Cardiothoracic Surgery ◽  
Total Artificial Heart ◽  
Cardiothoracic Surgeon ◽  
The University

Jolanda Kluin speaks to Julia Titova, Commissioning Editor at Future Cardiology Jolanda Kluin started her medical training at the Erasmus University Rotterdam in 1989 and obtained her medical degree cum laude in 1996. Thereafter, she worked as a PhD student on the project: “ Photodynamic therapy for Barrett’s esophagus with use of 5-aminolevulinic acid”, receiving her PhD degree cum laude in 1999. In 2006 she finished her residency in cardiothoracic surgery. From 2006 to 2014 she worked as a staff cardiothoracic surgeon at the Department of Cardiothoracic Surgery of the University Medical Center Utrecht and since 2015 she works at the Academic Medical Center, Amsterdam as congenital cardiac surgeon. In 2018 she became a professor in translational cardiothoracic surgery at the University of Amsterdam. Her main interests are grown ups with congenital heart disease cardiac surgery, mitral valve surgery, and reconstructive surgery of the aortic valve and the thoracic aorta. Alongside her clinical tasks, she has started a new line of research in translational cardiothoracic surgery, including tissue engineering of heart valves, valve pathophysiology and the development of a hybrid soft robotic total artificial heart. She is the current chair of the EACTS Women in Cardiothoracic Surgery Committee.

scholarly journals Screening for Male Osteoporosis at an Academic Medical Center

2011 ◽  
Vol 6 (1) ◽  
pp. 67-70
Author(s):  
Dedri Markita Ivory ◽  
Chokkalingam Siva ◽  
Celso Velázquez ◽  
Abdillahi Abdi Abdinoor
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Osteoporotic Fractures ◽  
The United States ◽  
Male Osteoporosis ◽  
Patterns Of Use ◽  
Health Initiatives ◽  
Patients At Risk ◽  
And Gender ◽  
Dxa Scans

Recent findings suggest that men have higher mortality rates than women after a hip fracture. Although the risk of osteoporotic fractures in men is increasing, male osteoporosis still remains underdiagnosed and undertreated. In general, male osteoporosis is given low priority by policy makers in public health initiatives. The purpose of this study is to examine the patterns of use and gender distribution of DXA (dual-energy X-ray absorptiometry) scan usage at a university medical center in the United States. The total number of DXA scans increased during the study period while the percentage of men studied actually declined. The results of this study may lead to heightened awareness among providers who are caring for male patients at risk for osteoporosis.

scholarly journals 1144. Evaluation of Procalcitnonin Usage in Neonates Presenting with Fever or Suspected Sepsis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S664-S664
Author(s):  
Hita Bhagat ◽  
Beech Burns ◽  
James Lewis ◽  
Diana Yu
Keyword(s):  
Bacterial Infections ◽  
Clinical Decision Making ◽  
Medical Center ◽  
Academic Medical Center ◽  
Further Education ◽  
Exclusion Criteria ◽  
Suspected Sepsis ◽  
Guideline Compliance ◽  
Baseline Group ◽  
Secondary Endpoints

Abstract Background Clinical evaluation alone is not effective in identifying serious bacterial infections (SBI) in neonates presenting with suspected sepsis and fever. A clinical decision making tool to aide in evaluating neonates presenting to the pediatric emergency department (PED) uses urinalysis, absolute neutrophil count (ANC), and procalcitonin (PCT) and together has high negative predictive value (NPV) for SBI. Use may decrease invasive testing, antibiotic exposure, and rates of admission. The tool was incorporated into hospital guidelines in October 2020. The purpose is to assess implementation and prediction of SBIs. Methods This is a single-center quality improvement study at an academic medical center. Neonates less than 60 days presenting with fever or suspected sepsis were included in the baseline group from October 2019- March 2020 or the post-implementation group from October 2020- March 2021. Exclusion criteria were receiving antibiotics 48 hours before PED visit, pre-existing medical conditions, indwelling devices, soft-tissue infections, and ≤ 36 weeks gestation. Implementation and guideline compliance was assessed in neonates aged 29-60 days as the primary outcome. Secondary endpoints include initiation of empiric antibiotics, rates of admission, rates of re-presentation within 30 days, and rates of lumbar punctures in all included patients. Results The baseline group had 29 patients and the post-implementation group had 35 patients who met inclusion/exclusion criteria. Baseline characteristics were similar with higher SBI rates in the post-implementation group having 8 SBIs while the baseline group had 4. There were 16 patients aged 29-60 days in the baseline (55%) and 17 in the post-implementation groups (49%). Complete labs were available for 9 patients (53%) and guideline compliance was 89%. NPV in neonates aged 0-60 days with negative urinalysis, ANC, and PCT was 100%. Rates of secondary endpoints were slightly higher in the post-implementation group along with higher rates of infections. Conclusion High NPV in this small cohort is an indication for continued use of this tool in neonates presenting to the PED with suspected sepsis or fever. Further education to increase use and expansion to all neonates should be considered based on overall NPV and previous studies. Disclosures All Authors: No reported disclosures

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