Medicine and Health Sciences Commons^™

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …

Under Chiron's Care, Deethya Trivedi

HCA Healthcare Journal of Medicine

This painting depicts young Asclepius under the guidance of Chiron, the wise centaur renowned for his knowledge of healing and medicine. In Greek mythology, Asclepius was entrusted to Chiron after Apollo recognized his potential. Within the nurturing environment of Chiron’s home, Asclepius absorbed lessons on the use of medicinal herbs, wound treatment, and the foundational principles of care, skills that would eventually elevate him to become the Greek God of Medicine. The herbs symbolize hands-on learning and the practical foundation of healing, while the book signifies the accumulation and sharing of knowledge, showing how medical innovation progresses through study, collaboration, …

Ethical Use Of Artificial Intelligence For Clinical Vignettes, Henna Iqbal, Jennifer J. Park, Yelena Burklin

HCA Healthcare Journal of Medicine

The purpose of this report is to introduce a systematic process model for publishing clinical vignettes through vignette-based learning (VBL), with an emphasis on the ethical use of artificial intelligence (AI). We have provided a comprehensive walk-through outlining the process from initial case identification to the final dissemination of clinical vignettes, and we have highlighted how AI tools can support each step. This guide is intended to be especially beneficial for clinicians and early-career medical professionals aiming to develop and submit their cases for presentations, publications, and other avenues of knowledge sharing.

Artificial Intelligence In Medicine: Barriers, Solutions, And Strategies, Anil Harrison, Melissa Stradley Moreno, Caroline E. Williams, Munevver Mine Subasi, Ersoy Subasi

HCA Healthcare Journal of Medicine

The integration of artificial intelligence (AI) and machine learning (ML) into health care holds the potential to revolutionize patient care by enhancing clinical decision-making, improving diagnostic accuracy, and reducing costs. Despite this promise, adoption remains limited due to a range of technical, regulatory, educational, and cultural barriers. This paper examines these challenges and proposes strategies to support safe and effective implementation of AI in clinical practice.

Key barriers include the lack of model interpretability, often referred to as the "black box" problem, which undermines clinician trust and accountability in clinical settings, evolving regulatory frameworks and unresolved questions surrounding liability, and …

The Role Of Simulation In General Surgery Residency: Advancing Technical Proficiency And Clinical Confidence, Matthew A. Daniel, Alyssa Mcmandon, Rachel Daley, Andrew Gustetic, Alexis Howarth, Meghana Jacob, Holden Lewis, Kushali Patel, Taylor Locklear, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Surgical training has changed significantly over the past several decades, largely due to advances in technology. After the introduction of laparoscopic and robotic surgery into residency programs, simulation-based training (SBT) has become an important addition to surgical education. Simulation-based training offers a safe and structured environment to practice skills, receive feedback, and develop technical and non-technical abilities. While its benefits are well recognized, wider use of SBT continues to face challenges, including high costs, limited faculty availability, and time constraints within residency schedules. New technologies such as artificial intelligence, virtual and augmented reality, and standardized simulation frameworks may help address …

An Innovative Model For Graduate Medical Education Faculty Development Through Physician-In-Training Delivery, Daniel A. Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Background

Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.

Methods

A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs …

A Scalable Model For Resident And Faculty Well-Being: Applying Self-Determination Theory And The Job Demands-Resources Framework In Graduate Medical Education, Gregory Guldner, Adam Neufeld

HCA Healthcare Journal of Medicine

Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help …

Fostering Leadership Competency And Professional Identity Formation Through Near Peer Educator Programs, Justin Choi, Gabriela Martin Gonzalez, Tahina Ahmed, Shirley Eisner

HCA Healthcare Journal of Medicine

Introduction

Leadership competency development is a pivotal component of physician professional identity formation (PIF), and its instruction across undergraduate medical education (UME) institutions is diverse. Near-Peer Educator Programs (NPEPs) foster experiential leadership development through teaching junior learners. We evaluated the impact of participation in a structured longitudinal NPEP on medical students’ self-reflections of their leadership growth.

Methods

Medical students serving as Near-Peer Educators (NPEs) were invited to complete a baseline survey prior to facilitating any sessions and a follow-up survey after facilitating more than 1 session. The surveys, measured using a 7-point Likert scale, were modeled on a validated clinical …

Resident Scholarly Activity Plan And Scorecard Implementation In Graduate Medical Education, Michele L. Mccarroll, Afsha Rais Kaisani, Joseph Kessler, Tasaduq H. Mir

HCA Healthcare Journal of Medicine

Background

Scholarly activity (SA) is a requirement of the Accreditation Council on Graduate Medical Education (ACGME); however, many programs struggle with interpreting ACGME trainee requirements and lack standardized tools to effectively communicate, document, and track individualized, resident-centered approaches to SA. This educational project aimed to develop a universal educational graduate medical education (GME) SA plan and scorecard tool to establish shared program expectations, provide formative and summative feedback on SA progression, track SA, and support individualized SA pathways aligned with residents’ professional goals.

Methods

In May 2022, faculty, associate program directors, and program directors within the North Texas Division of …

Icare Compassionately: An Innovative Approach To Improving Nursing Education, Lori M. Brodie

HCA Healthcare Journal of Medicine

Historically, compassionate care has been briefly introduced in nursing education, without a sustained focus throughout nursing programs. Compassionate care models define the essential qualities needed to deliver meaningful care. Many of the traditional compassionate care models rely on high-level concepts that can be difficult to operationalize in academia. Further, current compassionate care models are typically limited to specific settings and are taught separately from other parts of the nursing curriculum. To address these concerns, a single purpose nursing college created and implemented the iCare Compassionately Model, which emphasizes both measurable behaviors and concepts related to compassion. As a result of …

Owning Difficult Outcomes: Navigating Medical Error Disclosure For Trainees In Accordance With Acgme Standards, Sara Andrabi, Anita Rohra, Kelly Keene, Alison Haddock, Daniela Ortiz

HCA Healthcare Journal of Medicine

Background

The American College of Graduate Medical Education (ACGME) mandates that physicians promote patient safety and high-quality care, including training trainees in disclosing adverse events to patients and families. Despite its importance, many trainees lack formal preparation in error disclosure, leading to inconsistent practices. Structured training programs are essential to meet societal expectations and professional responsibilities.

Methods

A simulation-based curriculum was integrated into our annual "Difficult Communications" simulation day in response to feedback from residents. The curriculum employs standardized patients to create realistic error disclosure scenarios. Sessions include pre-briefing with faculty facilitators and standardized patients, simulated encounters, and structured debriefings. …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

The Distinguished Humanitarian Society, Ashley Charales, Grace Desrochers, Lakshmi Tatineni, Shane Jenks, Rajeev Raghavan

HCA Healthcare Journal of Medicine

Background

The Gold Humanism Honor Society (GHHS) is a nationally recognized organization present at over 80% of medical schools in the United States to promote humanism, integrity, and volunteerism among students. There is no equivalent national honor society present at the majority of Graduate Medical Education (GME) training programs.

Methods

Our institution created the Distinguished Humanitarian Society (DHS) as a local honor society in 2022 to recognize trainees who exemplified the ideals espoused by GHHS. In January and February 2025, we conducted semi-structured interviews to extract themes regarding inductees’ experiences with the DHS. Both interviewers used the same list of …

Gamification To Improve Emergency Medical Service Personnel Knowledge Of Medical Capacity Determination, Ross Sinicrope, Nasim Motaghedi, Zackary Yates, Elliott Richardson, Stephanie Schiffert, Jacob Wright, Abigail Alorda, Jeffrey Katz, Linh Nguyen, Shayne Gue, Christine Van Dillen, Ayanna Walker

HCA Healthcare Journal of Medicine

Background

As medical education evolves, innovative techniques are being explored to enhance learning and engagement. While existing literature on gamification in medical education primarily focuses on graduate medical education, its application in other fields, such as nursing or emergency medical services (EMS), remains underexplored. This study evaluates the feasibility of using gamification to teach EMS personnel about patient capacity assessment and examines its impact on the frequency of pre-hospital transport.

Methods

A relay race with 3 stations was developed by emergency medicine residents, EMS fellows, and emergency medicine and emergency medical services teaching faculty to teach capacity assessment. Each station …

Optimizing Antibiotic Strategies With A Clinical Pathway Approach: Enhanced Initiation And De-Escalation In Community-Acquired Pneumonia, Ahmad Behzadpour

HCA Healthcare Journal of Medicine

Background

Community-acquired pneumonia (CAP) remains a leading cause of hospitalization, mortality, and health care expenditure worldwide. Inappropriate use of broad-spectrum antibiotics contributes to antimicrobial resistance, adverse drug events, and increased costs. Antibiotic stewardship and standardized clinical pathways are key strategies to improve prescribing practices.

Methods

This quality improvement (QI) initiative was conducted at a 240-bed tertiary care teaching hospital from January 2023 through January 2025. A CAP-specific digital clinical pathway was developed using Curbside Health® and integrated into the electronic health record (EHR), accessible through a structured order set to support real-time clinical decision-making. The intervention included provider education and …

Impact Of Innovative Interprofessional Practice And Education Intervention Led By Graduate Medical Education Resident Physicians With School-Based Nursing In 32 School Districts, Christoffer A. Amdahl, Hans Drawbert, Sadra Forati, Tyler Fields, James Mantil, Afsha Rais Kaisani, Marci Ayers, Michele L. Mccarroll Phd

HCA Healthcare Journal of Medicine

Background

School nurses play a critical role in student well-being, underscoring their growing importance in both education and health care systems. Research consistently demonstrates their contributions to individual student care and broader population health.

Methods

This resident-led project explored community-based partnerships to facilitate mutual learning between school nurses and graduate medical education (GME) physicians. Conducted during the 2023–2024 academic year, this quality initiative (QI) involved the Medical City Healthcare (HCA Healthcare) GME programs and North Texas school districts. Educational resources were delivered through in-person teaching sessions led by resident physicians and hands-on medical simulations. School nurses who attended the Continuing …

Establishing Nurse Innovator Competencies: A Collaborative Initiative, Lori M. Brodie, Susan B. Patton, Dara Lanman, Ismail Dilek, Noah R. Zanville, Tracy A. Ortelli

HCA Healthcare Journal of Medicine

Background

Rapid advancements in augmented and artificial intelligence (AI) are reshaping health care, necessitating a strategic approach to integrating innovation into nursing education and practice. This article details a collaborative initiative between academic and practice partners aimed at the initial steps towards establishing the required knowledge, skills, and abilities for nurses to lead change through the creation of Nurse Innovator Competencies.

Methods

After an extensive review of literature, the team identified the absence of established Nurse Innovator Competencies. Through a collaborative and iterative process involving subject matter experts (SMEs) in both innovation and academia, key domains for the competencies, including …

Improving Scholarly Activity Through A Bundled Intervention Of Resident-Faculty Connection And Research Ideas, Katie Suleta, Norman W. Gill

HCA Healthcare Journal of Medicine

Background

Residents report barriers to engaging in scholarly activity despite this being a common requirement across residency programs. Two commonly reported barriers are a lack of mentorship by faculty and a lack of ideas for projects that meet the criteria for scholarly activity. The study objective is to describe the effect of an intervention to address a lack of mentorship and a lack of ideas for scholarly activities.

Methods

A retrospective cohort design was utilized to investigate changes in scholarly activity between 2 academic years. An internal medicine residency program with 30 residents and 17 faculty members participated in an …

Enhancing Resident Preparedness For The American Board Of Surgery Certifying Exam Through Low-Stakes Mock Oral Sessions, Camila R. Guetter, Taylor Locklear, Omar Haque, P Nina Scalise, Saptarshi Biswas, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

The American Board of Surgery (ABS) requires trainees to pass both a written qualifying examination (ABSQE) and oral certifying examination (ABSCE) to achieve board certification. The high-stakes nature of the ABSCE, which assesses knowledge, clinical judgment, and decision-making, necessitates extensive preparation. To address the challenges of the ABSCE format and associated trainee stress, structured mock oral programs have been developed. Here we evaluate the impact of structured mock oral sessions on residents' comfort levels and familiarity with the ABSCE at a single institution.

Methods

A mixed-methods survey was given to 50 general surgery residents in different training years who …

Medical Education As Both Process And Environment For Innovation, Gerald Wickham

HCA Healthcare Journal of Medicine

The promise of better medicine, better health outcomes, and better lives depends on a culture of innovation and implementation in medical education. HCA Healthcare Graduate Medical Education continually strives to achieve this environment, to identify the health breakthroughs of tomorrow by fostering innovation in the daily work of the residents, scientists, and physicians of our enterprise. This special issue highlights some of this important work and shares actionable programs to elevate and inspire the next generation of physicians.

2026 Rocky Mountain Healthcare Symposium Program, Kristen Marshall

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

A “Found-Down” Non-Traumatic Compartment Syndrome Of Upper Extremity Requiring Amputation, Nicholas Ray, Aileen Ebadat

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Bilateral Intracranial Subdural Hematoma Following Epidural Anesthesia, Eric B. Cox, Adaeza Onuoha

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Polypoid Endometriosis With Endometroid Intraepithelial Neoplasia Mimicking Malignancy, Austin T. Jones, Charles M. Quick, Monique A. Spillman

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

From Hard Hat To Headache: Cryptococcal Empyema And Meningitis In A Newly Diagnosed Hiv-Positive Construction Worker, Sebastian Echegaray, Collin Vargas, Vy Ngo

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Non-Surgical Pneumoperitoneum Following Vaginal Intercourse: A Case Report, Jessica Gocinski, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Fatal Ochrobactrum Anthropi Bacteremia Following Intravenous Stem Cell Therapy In Immunocompetent Patient, Daler Kudratov, Wendy Martinez, Jonathan Barnett

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Coexisting Systemic Lupus Erythematosus And Acquired Thrombotic Thrombocytopenic Purpura In A Clinically Stable Patient With Class V Lupus Nephritis, Anabel Al Abdallah, Nimmy Joy, Rodrigo Alfaro

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Mme (Mini Medical Education): A Preliminary Study Of A Targeted Curriculum To Improve Resident Knowledge And Clinical Confidence, Andrea Francis, Andres Vivar, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

External Iliac Artery Dissection And Thrombosis After Prophylactic Uterine Artery Balloon Occlusion For Placenta Accreta Spectrum (Pas), Anna Parker, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.