Medical Education Commons^™

Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske

Graduate Medical Education Research Journal

Background: Code status orders are important features of patient-centered clinical decisions, patient autonomy, and end-of-life care. Despite proper documentation of “do not resuscitate” (DNR) code status, hospitalized patients may be subjected to cardiopulmonary resuscitation (CPR) efforts that go against their wishes.

Purpose: The objective of this study was to identify and describe the population of hospitalized patients receiving discordant resuscitation efforts at a Midwest academic medical center utilizing electronic health records (EHR).

Method: The study included EHR records between 01/01/2011 and 01/01/2021 for hospitalized patients 19 years and older who experienced cardiac arrest (ICD-10 I46) and were documented as DNR. …

Making Decisions "In The Dark": Learning Through Uncertainty In Clinical Practice During Covid-19, Urvashi Vaid, Henriette Lundgren, Karen E. Watkins, Deborah Ziring, Grace A. Alcid, Victoria J. Marsick, Dimitrios Papanagnou

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

PURPOSE: The purpose of this study was to explore how decision making and informal and incidental learning (IIL) emerged in the clinical learning environment (CLE) during the height of the Covid-19 pandemic. The authors' specific interest was to better understand the IIL that took place among frontline physicians who had to navigate a CLE replete with uncertainty and complexity with the future goal of creating experiences for medical students that would simulate IIL and use uncertainty as a catalyst for learning.

METHOD: Using a modified constructivist, grounded theory approach, we describe physicians' IIL while working during times of heightened uncertainty. …

Microaggressions: Investigating Physical Therapy Student Perspectives During Clinical Experiences, Dakota Studley, Jocelin Friedman, Ashley H. Campbell, Laurie Shimko, Megan B. Flores

Physical Therapy Faculty Articles and Research

Purpose: Microaggressions are “brief and commonplace daily verbal, behavioral, and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory or negative racial slights and insults to the target person or group” (Gilliam & Russel, 2021). The effect of microaggressions has been explored among medical students, however, there is limited literature identifying the frequency and effect of microaggressions on Doctor of Physical Therapy (DPT) students. The purpose of this study is to explore the experiences of DPT students on clinical experiences to determine: 1) the frequency that students experience microaggressions, and 2) the impact of microaggressions on self-efficacy.

Methods: …

Professional Virtue Of Civility And The Responsibilities Of Medical Educators And Academic Leaders, Laurence B Mccullough, John Coverdale, Frank A Chervenak

Center for Medical Ethics and Health Policy Staff Publications

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical …

How Risk Perceptions And Level Of Trust Of Information Influence Individuals’ Health Services Usage, Wan-Lin Chang

Research Symposium

Background: When facing health-related issues, decision-making is not an easy thing. Some people look for advice from health care professionals, and some people trust their family members' and friends’ experiences more. Previous studies in health communication have suggested differences across various demographic groups in information seeking access and skills, including variables related to the knowledge gap assumption and individuals' risk perceptions.

Methods: Multiple linear regression and logistic regression are used to examine how individuals’ health risk perceptions influence their health service usage by analyzing the Health Information National Trends Survey (HINTS) 5 Cycle 4. HINTS conducts national surveys to monitor …

Expanding Health Professional Education In The Rio Grande Valley During The Covid-19 Pandemic, Sabrina R. Orta, Samantha G. Alvarado, Shuchita Jhaveri

Research Symposium

Purpose: The COVID-19 Pandemic has prompted innovation in health professional education, such that learners are able to recognize and mitigate healthcare disparities in the outcomes of vulnerable populations. The objective of our project was to increase education on preventing, preparing for, and responding to COVID-19 and other locally prevalent infectious diseases that disproportionately affect RGV communities.

Description: This project had 3 goals: (1) provide learners with virtual patient-interaction simulations (2) provide interactive training modules on the identification, prevention, and treatment of infectious diseases affecting South TX and strategies to increase child vaccinations, and (3) provide learners an opportunity to coordinate …

The Fortify Resilience Initiative, Nausheen Jamal, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. In order to address the multitude of threats to physician wellness and to mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this Initiative from the Office of GME will strengthen existing wellbeing pathways while expanding additional solutions that will work to sustain wellbeing. Utilizing a combination of prevention, promotion, and intervention strategies …

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I²PBH) initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I²PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality Integrated Behavioral Health (IBH) clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students …

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) is a workforce development pipeline project aimed at permanently augmenting UTRGV’s institutional capacity to address shortage of an Integrated Behavioral Health (IBH) competent workforce locally, regionally and nationally. Our initiative, aligned with UTRGV strategic priorities and key initiatives, will integrate basic(model specific strategy and operational elements), mid-level (role identity and profession specific behavioral competencies specific to each health profession), and advanced (behavioral medicine clinical skills) applications of the evidence based PCBH model of delivery. A PCBH focused delivery system (clinical and educational), in which primary care providers …

Does Social Media Matter When It Comes To Rank Lists? A Survey Of Applicants For General Surgery Residency During Covid-19, Justin M. Greco, Alessandra Storino, Priyanka V. Chugh, Tara S. Kent, Donald Hess, Dmitry M. Nepomnayshy, Kimberly M. Ellis, Jonathan S. Abelson

The Lahey Journal

Abstract:

Introduction: The COVID-19 pandemic greatly disrupted traditional social interactions between residency applicants and General Surgery programs. There is no previous research on the influence of social media in General Surgery residency recruiting.

Methods: We performed a multi-institutional survey of General Surgery residency applicants from the Northeast United States about the effect social media had on their decision to interview and rank programs, after the results of the 2021 National Resident Matching Program. The survey was sent to 311 e-mail addresses. The 22-question survey consisted of multiple choice, Likert Scale, and free text responses.

Results: 66 applicants completed the survey …

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

Healthcare Providers’ Perceptions Of Deaf-Hearing Interpreter Teams: Impact Of Interpreting Approaches, Julayne Feilbach

Journal of Interpretation

This study explores the perceptions and preferences of healthcare providers who work with Deaf Interpreter-Hearing Interpreter (DI-HI) teams. Healthcare providers depend on interpreters' ability to bridge the communication and cultural gap to assess and treat patients accurately. Although there have been studies on healthcare providers’ perceptions of interpreters to date, none of the research explores the impact of healthcare providers’ perceptions on their experiences with DI-HI teams. To address this, interviews with nine healthcare practitioners were conducted. As part of the interview, participants were shown a video of two interpreting samples to illustrate different approaches to interpreting. Data were analyzed …

The Effect Of An Intersectionality Elective On The Perceived Self-Efficacy Of Medical Students In Addressing Health Inequity, Patrick Rollo, Noel Higgason, Kaitlyn Stark, Amina Aslam, Mason Motakef, Olivia Kerr, Asia Mccleary-Gaddy

Teaching in Clinics

Background: Intersectionality is a theoretical framework that contextualizes an individual’s experience as more than the sum of their cultural identifiers.

Aims: The current study investigates the effect of a 10-week intersectionality curriculum supplemented with student-led discussions on medical students’ self-efficacy in addressing bias and health inequity.

Methods: First- and second-year medical students volunteered to participate in a ten-week pilot elective entitled “Intersectionality in Medicine.” Participants enrolled in the course were required to complete a ten-minute online pre-elective and post-elective survey.

Results: Results showed that after completing the elective, medical students were significantly more confident in identifying their personal biases, assessing …

Uthealth Quality Symposium 2023 Abstracts-2, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts

Uthealth Quality Symposium 2023 Abstracts-1, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts

A Review Of Recent Update In Acgme Faculty Qualifications, Salih Selek

Teaching in Clinics

A Review on Update of ACGME Faculty Qualifications

Factors Affecting The Healthcare Of Adults With Communication Difficulties Due To Autism Spectrum Disorder And/Or Intellectual And Developmental Disability, Kathryn L. Shady

MUSC Theses and Dissertations

Purpose: This dissertation explores the healthcare barriers and facilitators experienced by autistic adults and adults with intellectual and developmental disabilities (IDD) who have communication difficulties (CD).

Problem: Approximately 5-10% of Americans have CD, including difficulties such as stuttering, aphasia, apraxia, and other forms of language impairment(1,2). Communication difficulties are present in about 25-30% of autistic individuals and 57.9% of those with IDD, which accounts for a large and poorly studied portion of those with CD(3,4). Individuals with CD report negative healthcare experiences and decreased levels of satisfaction with healthcare providers secondary to practices such as communication solely with a …

Estimation Of Health Risks Caused By Metals Contained In E-Cigarette Aerosol Through Passive Vaping, Wei-Chung Su, Jinho Lee, Kai Zhang, Su-Wei Wong, Anne Buu

Faculty, Staff and Student Publications

It is expected that secondary exposure to e-cigarette aerosol (passive vaping) will soon become an issue of public health. Passive vaping inhales e-cigarette aerosol containing similar harmful substances as active vaping. However, parallel studies on passive vaping are minimal. Therefore, there is a need for passive vaping-related health risk studies to assess the impact of vaping on public health. This research conducted a series of experiments in a room using a puffing machine and the Mobile Aerosol Lung Deposition Apparatus (MALDA) to study e-cigarette aerosol respiratory deposition through passive vaping. The experimental data acquired were applied to estimate the deposited …

Juvenile Nasopharyngeal Angiofibroma - A Case Report, Dr Godha Keesara Reddy Dr, Dr Anupama Chandrappa Dr, Dr Deepak K S

Radiology Teaching Files

15 year old male who presented with a 6 month history of nasal obstruction and recurrent nasal bleeding. He had had about ten episodes of epistaxis in the 3 months. Examination revealed that vital signs were essentially within normal limits.The nasal cavity revealed fresh blood in the right nasal cavity but the bleeding site could not be visualized. An impression of epistaxis secondary rhinosinusitis was made.

Unmasking Structural Racism In U.S. Medical Education: Advancing Equity For Underrepresented Medical Students, Daryl O. Traylor, Eboni E. Anderson, Destiney Kirby, Asia Nichole Hodges, Brianna Clark, Stephen Sinatra Jr.

Journal of Social, Behavioral, and Health Sciences

The COVID pandemic cast a harsh light on the structural and systemic health inequalities that exist in American society and in U.S. medical education. Black and Brown communities were disproportionately affected, and the pandemic highlighted the need for a diverse physician and healthcare workforce. Both the lack of equitable, high-quality healthcare in underrepresented communities and the obstacles that students who are underrepresented in medicine (URiM) experience in medical school are direct consequences of the structural racism that flourishes in U.S. medical schools and healthcare institutions. In this article, we explain structural racism and how it has manifested itself in medical …

Playing Well With Others: Evaluating An Intervention To Prepare Students For Interprofessional Collaborative Learning, Kelli S. Fox

Social Work Faculty Publications

National trends in health care delivery focus on quality team-based care, patient safety, reducing costs and improving practitioner satisfaction (Interprofessional Education Collaborative, 2016). Health profession students, including social workers, are expected to be workforce ready for a complex interprofessional work environment. Educators are charged with developing effective ways to teach collaborative team skills as part of the curriculum (Rubin et al., 2018; Thistlethwaite et al., 2014). Educators across health professions recognize the importance of providing opportunities to immerse students in experiential, person-centered interprofessional teamwork to adequately prepare them for the workforce. (Cohen Konrad et al., 2017; Mokler, 2020). Planned interprofessional …

Disparities In The Operative Experience Between Female And Male General Surgery Residents: A Multi-Institutional Study From The Us Rope Consortium, Leah K Winer, Sarah Kader, Jonathan S Abelson, Austin C Hammaker, Chukwuma N Eruchalu, James C Etheridge, Nancy L Cho, Darci C Foote, Felicia A Ivascu, Savannah Smith, Lauren M Postlewait, Kathriena Greenwell, Katherine M Meister, Kelsey B Montgomery, Polina Zmijewski, Samuel E Byrd, Mary K Kimbrough, Stephen J Stopenski, Jeffry T Nahmias, Jalen Harvey, Deborah Farr, Zachary M Callahan, Joshua A Marks, Christopher C Stahl, Motaz Al Yafi, Jeffrey M Sutton, Ali Elsaadi, Samuel J Campbell, Shah-Jahan M Dodwad, Sasha D Adams, Matthew R Woeste, Robert C G Martin, Purvi Patel, Michael J Anstadt, Bilal Waqar Nasim, Ross E Willis, Jitesh A Patel, Melisa R Newcomb, Brian C George, Ralph C Quillin, Alexander R Cortez

Faculty, Staff and Student Publications

OBJECTIVE: To examine differences in resident operative experience between male and female general surgery residents.

BACKGROUND: Despite increasing female representation in surgery, sex and gender disparities in residency experience continue to exist. The operative volume of male and female general surgery residents has not been compared on a multi-institutional level.

METHODS: Demographic characteristics and case logs were obtained for categorical general surgery graduates between 2010 and 2020 from the US Resident OPerative Experience Consortium database. Univariable, multivariable, and linear regression analyses were performed to compare differences in operative experience between male and female residents.

RESULTS: There were 1343 graduates from …

Improving Communication Access With Deaf People Through Nursing Simulation: A Cross-Disciplinary Collaboration, Jamie L. Mccartney Ph.D., Tracy Gidden, Jennifer Biggs, Kathy Geething, Karl Kosko Ph.D.

Journal of Gender, Ethnic, and Cross-Cultural Studies

Baccalaureate nursing and sign language interpreting students participated in a pediatric discharge simulation with a deaf person playing the role of the baby’s parent. At the conclusion of the simulation, participants were emailed a consent letter and a link to a 17-item questionnaire developed by the authors. Responses were analyzed both quantitatively and qualitatively, whereby nonparametric statistics were calculated to examine Likert-scale items. A Mann-Whitney test statistic was calculated, instead of an independent samples t-test, given the smaller sample in the current study (n = 26). A question was posed to participants that evaluated their self-perception of the effectiveness of …

The Herlyn-Werner-Wunderlich (Hww) Syndrome– A Rare Case Report, Dr Harisha H L Dr, Dr Vishal Natarajan Dr, Dr Rudresh Hiremath Dr

Radiology Teaching Files

A 20-year-old unmarried female, student by occupation, well built and nourished presented with intermenstrual spotting from past 1 month. No h/o pelvic pain/ mass/ fever. No h/o of similar complaints in the past. Attained menarche at 14 years. Menstrual history otherwise normal.Known case of right renal agenesis (diagnosed incidentally at the age of 8 years).

Pelvic examination by gynecologist revealed a cystic bulge to the anterior wall of vagina. On MRI, our case is right sided renal agenesis; uterus didelphys with obstructed hemi vagina and to infected collection along the vaginal wall.

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Nurse Practitioner's Perspectives On Human Trafficking In The Emergency Department; A Narrative Inquiry, Ann Gerhart

Dissertations

Background: Human trafficking (HT) is a global and domestic concern that impacts individuals, families, and communities. Over the last ten years, HT has become a significant public health concern intersecting with the health care community in various settings. HT abuse and oppression have both short- and long-term health consequences. Approximately 50 to 88% of trafficked individuals visit a health care provider, and 63% of those visits are evaluated in the emergency department (ED). Nurse practitioners (NPs) working in the ED interact with HT individuals but have not been represented in recent research scholarship.

Purpose: The purpose of this qualitative …

Using Critical Incident Debriefing After Code Blue Events To Support Registered Nurses, David L. Boyd

Doctor of Nursing Practice (DNP) Projects

Using Critical Incident Debriefing after Code Blue Events to Support Registered Nurses

Section I: Abstract

Background: During a code blue event (CBE), the environment becomes highly stressful and intense. Nurses rapidly transition from performing life-saving procedures on their patients to carrying out their usual duties. Without proper debriefing, nurses cannot properly process their emotions leading to increased burnout and secondary traumatic stress (Stamm, 2010).

Local Problem: In 2021, the nurses at Providence Saint John’s Health Center (2021a) responded to 110 CBEs, a 43% increase from 2020. Without a process for critical incident debriefing (CID), these nurses were exposed to trauma …

Empathy And The Medical Student House Call: The Effect Of Clinical Settings On Empathy In Third Year Medical Students, Philip B. Collins, Thomas Dinzeo, Jennifer C. Sepede, John F. Bertagnolli, Christian White

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: This study measured the effect the experience of house calls might have on third-year medical students.

METHODS: Students were surveyed via an anonymous online survey at the start of their geriatrics clerkship, again at the end of their clerkship, and once more three months later. Empathy was measured using the Jefferson Scale of Empathy - Student version (JSE) and student attitudes towards the geriatrics population was measured using the UCLA Geriatrics Attitudes Scale (GAS). Data were analyzed using SPSS version 27.0.

RESULTS: No changes in empathy were found when comparing students who completed house calls versus those who did …