Medicine and Health Sciences Commons^™

What Regenerative Agriculture Can Teach Medical Students About Human Health, David Ebbott, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

No abstract provided.

Dental Hygiene And Dental Assistant Students' Simulated Dvi Radiographic Match Accuracy: A Pilot Study, Samantha C. Vest, Brenda T. Bradshaw, Marsha A. Voelker, Ann M. Bruhn, Tara L. Newcomb, Sinjini Sikdar

Dental Hygiene Faculty Publications

Purpose Allied dental health care professionals have served on disaster victim identification (DVI) teams; however, the literature is void of statistical measures regarding transferable skills and disaster preparedness. The purpose of this study was to assess second year dental hygiene and dental assistant students’ match accuracy for simulated DVI radiographs and compare the match accuracy between the student groups.

Methods Five patient cases were chosen at random to retrospectively collect sets of digital bitewing radiographs from two time periods. The five retrospectively selected sets of images served as simulated antemortem (AM) and postmortem (PM) radiographs. A convenience sample of second …

A Consensus List Of Ultrasound Competencies For Graduating Emergency Medicine Residents, David A Haidar, William J Peterson, Patrick G Minges, Jennifer Carnell, Jason T Nomura, John Bailitz, Jeremy S Boyd, Megan M Leo, E Liang Liu, Youyou Duanmu, Josie Acuña, Ross Kessler, Marco F Elegante, Mathew Nelson, Rachel B Liu, Resa E. Lewiss, Arun Nagdev, Rob D Huang

Department of Emergency Medicine Faculty Papers

Objectives: Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there is no consensus list of competencies for EUS training, and graduating residents have varying levels of skill and comfort. The objective of this study was to define a widely accepted comprehensive list of EUS competencies for graduating EM residents through a modified Delphi method.

Methods: We developed a list of EUS applications through a comprehensive literature search, the American College of Emergency Physicians list of core EUS benchmarks, and the Council of Emergency Medicine Residency-Academy of Emergency Ultrasound consensus document. We assembled a multi-institutional …

Informal And Incidental Learning In The Clinical Learning Environment: Learning Through Complexity And Uncertainty During Covid-19, Dimitrios Papanagnou, Karen E Watkins, Henriette Lundgren, Grace A Alcid, Deborah Ziring, Victoria J Marsick

Department of Emergency Medicine Faculty Papers

In the time of the COVID-19 pandemic, where clinical environments are plagued by both uncertainty and complexity, the importance of the informal and social aspects of learning among health care teams cannot be exaggerated. While there have been attempts to better understand the nuances of informal learning in the clinical environment through descriptions of the tacit or hidden curriculum, incidental learning in medical education has only been partially captured in the research. Understood through concepts borrowed from the Cynefin conceptual framework for sensemaking, the early stages of the pandemic immersed clinical teams in complex and chaotic situations where there was …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Bridging Mental Healthcare, Kristin L. White

MSN Capstone Projects

Nurses have an important role in the care given to mental health patients presenting to the emergency department (ED). Without expectations or encouragement toward growth or continued education, the quality of care and the therapeutic ability for care are crippled, as evidenced by nurses' knowledge/competency deficits and negative attitudes. Through ongoing/continued education, the cultivation of a therapeutic culture toward patients that present to the ED for mental health complaints could result. Additionally, these improvements in care, in turn, could promote not only the closure of gaps that exist for quality mental healthcare but may also lead to an increase in …

Intermediate Care Technicians-A Novel Workforce For Veterans Affairs Geriatric Emergency Departments, Kristina T. Snell, Thomas Edes, Colleen M. Mcquown

Journal of Geriatric Emergency Medicine

No abstract provided.

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

Consensus Guidelines For Digital Scholarship In Academic Promotion., Abbas Husain, Zachary Repanshek, Manpreet Singh, Felix Ankel, Jennifer Beck-Esmay, Daniel Cabrera, Teresa M Chan, Robert Cooney, Michael Gisondi, Michael Gottlieb, Jay Khadpe, Jennifer Repanshek, Jessica Mason, Dimitrios Papanagnou, Jeff Riddell, N Seth Trueger, Fareen Zaver, Emily Brumfield

Department of Emergency Medicine Faculty Papers

INTRODUCTION: As scholarship moves into the digital sphere, applicant and promotion and tenure (P&T) committee members lack formal guidance on evaluating the impact of digital scholarly work. The P&T process requires the appraisal of individual scholarly impact in comparison to scholars across institutions and disciplines. As dissemination methods evolve in the digital era, we must adapt traditional P&T processes to include emerging forms of digital scholarship.

METHODS: We conducted a blended, expert consensus procedure using a nominal group process to create a consensus document at the Council of Emergency Medicine Residency Directors Academic Assembly on April 1, 2019.

RESULTS: We …

Social Media And The Modern Scientist: A Research Primer For Low- And Middle-Income Countries, Junghwan Kevin Dong, Colleen Saunders, Benjamin Wachira, Brent Thoma, Teresa M. Chan

Emergency Medicine, East Africa

Social media has changed the way we communicate. Wherever you are in the world, various forms of social media are being used by individuals to share information and connect without borders. Due to its ubiquity, social media holds great promise in linking clinicians, scientists, investigators, and the public to change the way we conduct scientific discourse. In this paper, we present a step-by-step guide on optimizing your social media strategy with regards to: research/scholarly practice (discourse, collaboration, recruitment), knowledge translation, dissemination, and education. This guide also highlights key readings that provide guidance to those interested in incorporating social media into …

Patient Safety Escape Room: A Graduate Medical Education Simulation For Event Reporting., Gretchen Diemer, Rebecca Jaffe, Dimitrios Papanagnou, Xiao Chi Zhang, Jillian Zavodnick

Department of Emergency Medicine Faculty Papers

Introduction: Although residents are on the front lines of patient care, they enter few formal patient safety reports on the adverse events and near misses they witness. Demonstrating the rationale and mechanics of reporting may improve this.

Methods: We designed and implemented an escape room patient safety simulation to incorporate active learning, gamification, and adult learning theory into intern patient safety onboarding. Interns from all sponsoring institution programs participated, identifying, mitigating, and reporting a range of patient safety hazards. Props and faculty time were the major resources required.

Results: One hundred twenty interns participated in this simulation in June 2018. …

Quality Assurance In Telehealth: Adherence To Evidence-Based Indicators., Daniel Halpren-Ruder, Anna Marie Chang, Judd E. Hollander, Anuh Shah

Department of Emergency Medicine Faculty Papers

Background: Value enhancing telehealth (TH) lacks a robust body of formal clinically focused quality assessment studies. Innovations such as telehealth must always demonstrate that it preserves or hopefully advances quality. Introduction: We sought to determine whether adherence to the evidence-based Choosing Wisely (CW) recommendations (antibiotic stewardship) for acute sinusitis differs for encounters through direct-to-consumer (DTC) telemedicine verses "in-person" care in an emergency department (ED) or an urgent care (UC) center.

Materials and Methods: Study design was a retrospective review. Patients with a symptom complex consistent with acute sinusitis treated through DTC were matched with ED and UC patients, based upon …

Assessing The Use Of Social Media In Physician Assistant Education., Gregory K. Wanner, Andrew W. Phillips, Dimitrios Papanagnou, Md

Department of Emergency Medicine Faculty Papers

Objectives: This study aims to assess physician assistant (PA) students' experiences with social media (SM) as a part of their medical education.

Methods: The study is split into two phases: Phase 1- A cross-sectional survey emailed to all PA students at four PA school campuses to assess students' prior SM experiences (226 responses, 71.1% response rate); and Phase 2- Inclusion of SM educational resources, via Twitter, within lectures performed at two PA schools. A phase-2 survey assessed students' opinions of educational SM (50 responses, 59.5% response rate) and SM usage was tracked.

Results: The phase-1 survey respondents indicated that 97.3% …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Teaching Children Road Safety Through Storybooks: An Approach To Child Health Literacy In Pakistan, Haris Ahmad, Rubaba Naeem, Nukhba Zia, Asher Feroze, Amarah Shakoor, Uzma R. Khan, Asad Mian

Department of Emergency Medicine

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.
Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a …

A Novel Biosimulation Task Trainer For The Deliberate Practice Of Resuscitative Hysterotomy., Lawrence Lau, Dimitrios Papanagnou, Elaine Smith, Crystal Waters, Elizabeth Teixeira, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

Resuscitative hysterotomy is a daunting and rarely performed procedure in the emergency department (ED). Given the paucity of clinical exposure to this intervention, resuscitative hysterotomy is an ideal opportunity for simulation-mediated deliberate practice. The authors propose a novel training program using a homegrown, realistic, simulation device as a means to practice resuscitative hysterotomy. Two high-fidelity, tissue-based task-trainer models were constructed and tested on a convenience sample of 14 emergency medicine (EM) residents. The simulated human placenta, bladder, amniotic sac, and uterus were constructed through the use of porcine skin, porcine stomach, transparent plastic bag, Foley tubing, and squid mantle, all …

Exploring The Preparedness Of Novice (Student) Paramedics For The Mental Health Challenges Of The Paramedic Profession: Using The Wisdom Of The Elders, Lisa Holmes

Theses: Doctorates and Masters

This study investigates the preparedness of novice (student) paramedics for the mental health challenges of the paramedic profession and identifies the coping strategies used by veteran paramedics to successfully meet these challenges. The lived experience of veteran paramedics is utilised to provide this important assistance.

Initially, two surveys were developed and administered to 16 course coordinators and 302 students of the 16 accredited undergraduate degree paramedicine courses across Australia and New Zealand, to identify the perceived need (for preparation) within the curriculum. In addition, the anticipations, confidence and fears of novice (student) paramedics, course coordinators and veteran paramedics were also …

Are Audience Response Systems Worth The Cost? Comparing Question-Driven Teaching Strategies For Emergency Medical Technician Education, Lauren M. Maloney, James P. Dilger, Paul A. Werfel, Linda M. Cimino

Internet Journal of Allied Health Sciences and Practice

Purpose: As Emergency Medical Technician educators develop curricula to meet new national educational standards, effective teaching strategies validated for course content and unique student demographics are warranted. Three methods for answering multiple choice questions presented during lectures were compared: a) Audience Response System (ARS, clickers), b) hand-raising-with-eyes-closed (no-cost option), and c) passive response (no-cost option). The purpose was to determine if using the ARS resulted in improved exam scores. Method: 113 Emergency Medical Technician (EMT) students participated in this cross-over, block randomized, controlled trial, which was incorporated into their Cardiac Emergencies and Pulmonary Emergencies course lectures. Students took …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Marna R Greenberg DO, MPH, FACEP

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Bryan G Kane MD

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Why Is Education Important In Ems?, Adriana Goad

A with Honors Projects

In EMS, education is vital. As prehospital healthcare providers, we must constantly be educating ourselves on the advances and changes that are made within our protocols and by research. Frequent renewal deadlines for the licenses we hold are put in place so that we remain competent in our skills and are up to date to the most current of standards. There is another factor to our professional need for education, and that is community education. By educating those around us, we can be a means of prevention. While EMS is our career and passion, we want nothing more than to …

Characteristics Of Real-Time, Non-Critical Incident Debriefing Practices In The Emergency Department., Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Uchunguzi (Journal Watch/Montre De Journal) March 2016, Benjamin Wachira

Emergency Medicine, East Africa

Increasing demand on emergency healthcare systems throughout Africa means there is a need to develop and harmonise standards of emergency care for the benefit of African populations. This can potentially be achieved by developing guidelines for appropriate and high quality education to prepare future generations of emergency healthcare providers for their role in all regions of Africa. With this in mind, the African Emergency Nursing Curriculum was developed by emergency nurses, academics and researchers from Africa and the rest of the world to provide a consensus document to guide the development of harmonised standards of emergency nursing theory and practice …

Social Media Guidelines And Best Practices: Recommendations From The Council Of Residency Directors Social Media Task Force., Malford T Pillow, Laura Hopson, Michael Bond, Daniel Cabrera, Leigh Patterson, David Pearson, Harsh P. Sule Md, Felix Ankel, Madonna Fernández-Frackelton, R. Hall, Jason A Kegg, Donald Norris, Katrin Takenaka

Department of Emergency Medicine Faculty Papers

Social media has become a staple of everyday life among over one billion people worldwide. A social networking presence has become a hallmark of vibrant and transparent communications. It has quickly become the preferred method of communication and information sharing. It offers the ability for various entities, especially residency programs, to create an attractive internet presence and "brand" the program. Social media, while having significant potential for communication and knowledge transfer, carries with it legal, ethical, personal, and professional risks. Implementation of a social networking presence must be deliberate, transparent, and optimize potential benefits while minimizing risks. This is especially …

A Retrospective Analysis Of Paramedic Student Performance Under Simulated Stress, Nicholas Franklin Miller

Online Theses and Dissertations

The paramedic profession is an inherently difficult, dangerous and stressful profession. The paramedic is constantly barraged with acute stressors during the performance of his duties. These stressors have predictable, documented, negative effects on performance. The acute and chronic exposure to stress can negatively impact the safety and the well being of the paramedic. These stressors, if not successfully managed, can also result in negative effects to patients. Despite the overwhelming presence of stress in the paramedic environment, most paramedics receive little or no training to successfully perform under stress. One exception was a program called Trauma Lanes that was held …

Identifying Inaccuracies On Emergency Medicine Residency Applications., Eric D Katz, Lee Shockley, Lawrence Kass, David Howes, Janis P Tupesis, Christopher Weaver, Osman R Sayan, Victoria Hogan, Jason Begue, Diamond Vrocher, Jackie Frazer, Timothy Evans, Gene Hern, Ralph Riviello, Antonio Rivera, Keith Kinoshita, Edward Ferguson

Department of Emergency Medicine Faculty Papers

BACKGROUND: Previous trials have showed a 10-30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. METHODS: This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans …