scholarly journals Focused Cardiac Ultrasound Curriculum for Internal Medicine Residents

POCUS Journal ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 29-32
Author(s):  
Dipika Gopal ◽  
Cameron Baston ◽  
Srinath Adusumalli ◽  
Dinesh Jagasia ◽  
Stuart Prenner
Keyword(s):  
Internal Medicine ◽  
Online Survey ◽  
Assessment Tool ◽  
Knowledge Score ◽  
Confidence Score ◽  
Cardiac Ultrasound ◽  
Focused Cardiac Ultrasound ◽  
Internal Medicine Residents ◽  
The Mean ◽  
The Impact

Background:  Focused cardiac ultrasound (FCU) is a safe and efficient diagnostic intervention for internal medicine physicians. FCU is a highly teachable skill, but is used in routine cardiac assessment in only 20% of surveyed training programs. We developed an FCU curriculum for internal medicine residents and an assessment tool to evaluate the impact of the curriculum on trainee knowledge and confidence. Methods: Internal medicine residents rotating through clinical cardiology services underwent 30 minutes of didactic and 60 minutes of hands-on teaching on acquisition and interpretation of FCU. A 20 item pre and post-curriculum online survey was administered (November 2018-December 2019) to assess confidence and knowledge in FCU. Results: 79 of 116 (68%) residents completed the pre-survey and 50 completed the post-survey, of whom 34 received the curriculum. The mean change in confidence score in those who received versus did not receive the curriculum was 0.99 versus 0.39 (p=0.046) on a 5-point Likert scale. Among 33 residents who had paired pre- and post-surveys the mean change in confidence score was 1.2 versus 0.85 (p<0.001) in those who received versus did not receive the curriculum. The mean increase in knowledge score was 13% versus 7% respectively (p<0.0001). Conclusions: We instituted a novel curriculum for internal medicine residents to gain experience in image acquisition and interpretation. Both confidence and knowledge in FCU improved following the curriculum, indicating that this is a highly teachable skill. Additional analysis of the of the FCU study images will be useful for informing future interventions.

scholarly journals Internal Medicine Residents’ Knowledge and Practice of Pulmonary Tuberculosis Diagnosis

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Natasha Chida ◽  
Christopher Brown ◽  
Jyoti Mathad ◽  
Kelly Carpenter ◽  
George Nelson ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Pulmonary Tuberculosis ◽  
Chart Review ◽  
Assessment Tool ◽  
Response Rate ◽  
Nucleic Acid Amplification ◽  
Internal Medicine Residents ◽  
Tuberculosis Diagnosis ◽  
The Mean ◽  
Knowledge And Practice

Abstract Background Internal medicine physicians are often the first providers to encounter patients with a new diagnosis of tuberculosis. Given the public health risks of missed tuberculosis cases, assessing internal medicine residents’ ability to diagnose tuberculosis is important. Methods Internal medicine resident knowledge and practice patterns in pulmonary tuberculosis diagnosis at 7 academic hospitals were assessed utilizing (a) a 10-item validated pulmonary tuberculosis diagnosis assessment tool and (b) a retrospective chart review of 343 patients who underwent a pulmonary tuberculosis evaluation while admitted to a resident-staffed internal medicine or infectious disease service. Our primary outcomes were the mean score and percentage of correct responses per assessment tool question, and the percentage of patients who had Centers for Disease Control and Prevention–recommended tuberculosis diagnostic tests obtained. Results Of the 886 residents who received the assessment, 541 responded, yielding a response rate of 61%. The mean score on the assessment tool (SD) was 4.4 (1.6), and the correct response rate was 57% (311/541) or less on 9 of 10 questions. On chart review, each recommended test was obtained for ≤43% (148/343) of patients, other than chest x-ray (328/343; 96%). A nucleic acid amplification test was obtained for 18% (62/343) of patients, whereas 24% (83/343) had only 1 respiratory sample obtained. Twenty patients were diagnosed with tuberculosis. Conclusions Significant knowledge and practice gaps exist in internal medicine residents’ abilities to diagnose tuberculosis. As residents represent the future providers who will be evaluating patients with possible tuberculosis, such deficiencies must be addressed.

scholarly journals Urine Microscopy for Internal Medicine Residents: A Needs Assessment & Implementation of Virtual Teaching Sessions

Kidney360 ◽  
2020 ◽  
pp. 10.34067/KID.0006282020
Author(s):  
Jorge Chancay ◽  
Meghana Eswarappa ◽  
Luis Sanchez Russo ◽  
Matthew A Sparks ◽  
Samira S Farouk
Keyword(s):  
Internal Medicine ◽  
Online Survey ◽  
Video Conferencing ◽  
Urine Sediment ◽  
Clinical Interpretation ◽  
School Of Medicine ◽  
Internal Medicine Residents ◽  
Survey Results ◽  
The Impact ◽  
Urine Microscopy

Background: Though urine microscopy is an important step in the initial evaluation of a patient with kidney disease, internal medicine residents have minimal exposure to this technique during their training. The goal of this study was to understand knowledge of and attitudes towards urine microscopy among internal medicine residents, and to implement virtual urine microscopy teaching sessions. Methods: A voluntary, anonymous, online survey was sent to all the categorical internal medicine residents training (n = 131) at the Icahn School of Medicine at Mount Sinai (ISMMS). The survey included thirteen questions to assess attitudes towards, experience with, and clinical interpretation of urine microscopy specimens. In response to the survey results, we implemented virtual urine microscopy teaching sessions using video conferencing software which incorporated real-time urine sediment analysis with nephrology fellows and attending nephrologists. Results: The survey response rate was 45% (59/131). Forty-seven percent (28/59) of respondents reported performing urine microscopy at least once during their training and 75% (44/59) of respondents did not feel comfortable performing urine microscopy. The majority of residents (92%, 54/59) reported they felt urine microscopy was very helpful or somewhat helpful in the evaluation of patients with AKI. Overall, 41% percent of responses to clinical interpretation questions were considered correct. Following survey completion, virtual urine microscopy sessions were held monthly and well received by the participants. Conclusions: Our study found that internal medicine residents perceive urine microscopy as a helpful diagnostic tool, though lack the skills to perform and interpret urine microscopy sediments. Virtual educational sessions using video conferencing software are a technically feasible approach to teaching urine microscopy to internal medicine residents. Future studies include a study of the impact of these sessions on learning of urine microscopy.

Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

2020 ◽  
Author(s):  
Mohammad Alakchar ◽  
Abdisamad M. Ibrahim ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
Nitin Tandan ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Correlation Coefficient ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resident Attitudes ◽  
Internal Medicine Residents ◽  
Life Threatening ◽  
Degree Of Participation ◽  
Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

scholarly journals Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents

2016 ◽  
Vol 8 (4) ◽  
pp. 563-568 ◽  
Author(s):  
Greg Ogrinc ◽  
Emily S. Cohen ◽  
Robertus van Aalst ◽  
Beth Harwood ◽  
Ellyn Ercolano ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Quality Improvement ◽  
Self Efficacy ◽  
Intervention Group ◽  
Educational Outcome ◽  
Free Text ◽  
Internal Medicine Residents ◽  
Late Intervention ◽  
Hands On ◽  
The Impact

ABSTRACT Background  Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. Objective  We sought to determine the clinical and educational impact of an integrated QI curriculum. Methods  This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool–Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. Results  The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0–27) increased from 13.3 at baseline to 15.3 at end point (P &lt; .01), as did the self-efficacy composite score (P &lt; .05). Satisfaction with the curriculum was rated highly by all participants. Conclusions  Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

scholarly journals Fuel economy assessment tool for auxiliary kite propulsion of merchant ship

2018 ◽  
pp. 5-7 ◽  
Author(s):  
Vincent Podeur ◽  
Damien Merdrignac ◽  
Morgan Behrel ◽  
Kostia Roncin ◽  
Caroline Fonti ◽  
...  
Keyword(s):  
Fuel Economy ◽  
Assessment Tool ◽  
Round Trip ◽  
Merchant Ship ◽  
Added Resistance In Waves ◽  
The Mean ◽  
The Impact ◽  
Engine Power

A tool dedicated to assess fuel economy induced by kite propulsion has been developed. To produce reliable results, computations must be performed on a period over several years, for several routes and for several ships. In order to accurately represent the impact of meteorological trends variations on the exploitability of the kite towing concept, a time domain approach of the problem has been used. This tool is based on the weather database provided by the ECMWF. Two sailing strategies can be selected for assessing the performance of the kite system. For a given kite area, the simulation can be run either at constant speed or at constant engine power. A validation has been made, showing that predicted consumption is close from in-situ measurement. It shows an underestimation of 11.9% of the mean fuel consumption mainly due to auxiliary consumption and added resistance in waves that were not taken into account. To conclude, a case study is performed on a 2200 TEU container ship equipped with an 800m² kite on a transatlantic route between Halifax and Le Havre. Round trip simulations, performed over 5 years of navigation, show that the total economy predicted is of around 12% at a speed of 16 knots and around 6.5% at a speed of 19 knots.

Intensive Care Nurses’ Knowledge of Pressure Ulcers: Development of an Assessment Tool and Effect of an Educational Program

2008 ◽  
Vol 17 (4) ◽  
pp. 338-346 ◽  
Author(s):  
Carol Tweed ◽  
Mike Tweed
Keyword(s):  
Intensive Care ◽  
Test Scores ◽  
Educational Program ◽  
Pressure Ulcers ◽  
Assessment Tool ◽  
Demographic Data ◽  
Intensive Care Nurses ◽  
The Mean ◽  
The Impact ◽  
Nurses Knowledge

Background Critically ill patients are at high risk for pressure ulcers. Successful prevention of pressure ulcers requires that caregivers have adequate knowledge of this complication. Objective To assess intensive care nurses’ knowledge of pressure ulcers and the impact of an educational program on knowledge levels. Methods A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed 3 times: before an educational program, within 2 weeks after the program, and 20 weeks later. Multivariate analysis was performed to determine if attributes such as length of time since qualifying or level of intensive care unit experience were associated with test scores. The content and results of the assessment test were evaluated. Results Completion of the educational program resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational program. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Conclusion Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational program, but soon returned to baseline.

Are Internal Medicine Residents Meeting the Bar? Comparing Resident Knowledge and Self-Efficacy to Published Palliative Care Competencies

2020 ◽  
pp. 104990912095480
Author(s):  
Kristen M. Moyer ◽  
Matthew S. Ellman ◽  
John Encandela ◽  
Laura J. Morrison
Keyword(s):  
Internal Medicine ◽  
Palliative Care ◽  
Self Efficacy ◽  
Rank Analysis ◽  
Cultural Aspects ◽  
Internal Medicine Residents ◽  
Significant Difference ◽  
New Instrument ◽  
The Mean ◽  
One Way Anova

Background: There is a need for improved primary palliative care (PC) education and resident comfort with providing end-of-life care. Objective: Utilize a new instrument derived from published PC competencies to assess baseline Internal Medicine (IM) resident knowledge and self-efficacy in PC to identify educational gaps and create new PC curricula. Design: We created a 2-part instrument including a Knowledge Test (KT) and a Self-Efficacy Inventory (SEI) addressing 18 PC resident competencies across 5 domains: Pain and Symptom Management (PSM), Communication (COMM), Psychosocial, Spiritual, and Cultural Aspects of Care (PSC), Terminal Care and Bereavement (TCB), and Palliative Care Principles and Practice (PCPP). Setting/Subjects: The instrument was emailed to IM residents at our institution during academic years 2015-2016 and 2016-2017. Measurements: Basic descriptive statistics were performed for the KT and SEI. Mean Rank Analysis and One-way ANOVA were utilized for the KT and SEI, respectively. Congruence was calculated between knowledge and self-efficacy. Results: The mean score on the KT was 73% (range 33-80%). There was no significant difference in knowledge among post-graduate year cohorts. Self-efficacy scores were lower for interns overall and in PCPP, TCB, and COMM domains. Knowledge was concordant with self-efficacy in 42% of participants, higher than self-efficacy in 10% of participants, and lower than self-efficacy in 48% of participants. Conclusions: For approximately half of respondents, high self-efficacy in PC did not correlate with high PC knowledge. A more focused curriculum is needed to help IM residents facilitate mastery of PC competencies by graduation.

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