Medical Education Commons^™

Starting Residency With Covid-19, Seena Khosravi, Ashish Sinha

HCA Healthcare Journal of Medicine

Introduction

By Dr. Ashish Sinha, MD, PhD, DABA, MBA, FASA

As a Program Director of a just established anesthesia program, one faces enough challenges. A curve ball that I was not expecting was one of my residents to inform me on July 3rd that he was feeling feverish with chills, had myalgia and a headache. First response in my mind, that I didn’t verbalize was, ”Anosmia too?” I arranged COVID testing ASAP in a drive-by setting, which we could avail immediately. My resident had driven from New Orleans, LA to Riverside, CA, making a few stops along the way, (food, …

Covid Intensive Care Unit Through The Eyes Of Ophthalmologists, Laura Drayer Turner, Dharshana Ramanathan, Sneha Melmane, Geeta Menon

HCA Healthcare Journal of Medicine

The disproportionate impact of COVID on the mortality and morbidity of people of black, Asian and minority ethnic (BAME) backgrounds has been recognised and is under investigation. Here we present a different impact: that on the psyche. As three doctors of BAME heritage, we shared an experience of being redeployed from ophthalmology to the COVID Intensive Care Unit. We share our reflections on the experience and lessons learned.

Little Did We Know What We Are Preparing For: Virtual Interviews Before Covid-19, Alina Popa, Scott Kubomoto, Lorra Baldes

HCA Healthcare Journal of Medicine

Current circumstances related to the COVID-19 pandemic require residency programs to conduct virtual interviews. We draw upon our experience with virtual interviews from fall 2019, prior to COVID-19, and propose a potential implementation process for virtual interviewing strategies. We also describe potential pitfalls and strategies to mitigate them.

Covid-19 Era Requires Urgent Integration Of Virtual Reality Simulations In Medical Education, Halil Tekiner, Cemal Alper Kemaloglu, Achmet Ali Tsaous

HCA Healthcare Journal of Medicine

The COVID-19 pandemic continues to cause an unprecedented level of disruption across every part of the globe. This disruption detrimentally affects the field of medical education; in particular, anatomical, surgical and clinical training, all which require hands-on experience. On the other hand, the pandemic not only brings new challenges in medical education but also opportunities for testing the validity of our old education paradigms and for developing the ability to embrace a rapid pace of change in better integrating new technologies in the medical curriculum. We contend that the future of medical education lies in the successful use of VR …

An Obstetrics And Gynecology Residency Program’S Approach To The Covid-19 Pandemic, Tiffany C. Chang, Brenda Nguyen, Chi Dola

HCA Healthcare Journal of Medicine

Background: The impact of COVID-19 on residency training nationwide has been substantial, and adapting to this unprecedented event has proven challenging for program directors throughout the United States. Here, the authors presented their initial experiences with restructuring an obstetrics and gynecology residency program during the pandemic. The authors outlined their strategies to maximize resident safety and address clinical care in outpatient and inpatient settings, resident education curriculum, resident wellness and consider the ethical dilemmas of health care providers during a pandemic.

Conclusion: With perspectives from other residency programs, the authors hope this review will serve as an initial building block …

A Perspective On Research, Education, Practice And Policy In The Covid-19 Era, Julie A. Jacko

HCA Healthcare Journal of Medicine

The coronavirus disease 2019 (COVID-19) pandemic has unleashed a global health crisis, precipitating massive efforts aimed at understanding, preventing, preparing for, treating and responding to the novel coronavirus domestically and internationally. Given the profound and ongoing impact of COVID-19, the HCA Healthcare Journal of Medicine organized this special issue of the journal as a mechanism for capturing groundbreaking studies, advances and perspectives that have the potential to shape health and health care for decades to come.

An Inexpensive Adult Lumbar Puncture Task-Trainer With Simulated Cerebrospinal Fluid, Steven Warrington, Anne Marie Warrington

HCA Healthcare Journal of Medicine

Background: Simulation is beneficial in achieving competence and success in the performance of procedures. Unfortunately, costs associated with purchasing simulation equipment is a significant barrier to implement this training. The objective was to create a model for lumbar puncture that allowed performance of the procedure using anatomic landmarks, ability to obtain cerebrospinal fluid, and measure opening pressure.

Methods: A model was built using several readily available and low-cost items and was iterated based on feedback. The task trainer was used as part of multiple educational sessions and simulations with different groups of learners, including residents and medical students.

Results: A …

Cosmetovigilance: A New Concept For Residency Curriculum, Jennifer Jones, Hale Z. Toklu

HCA Healthcare Journal of Medicine

Primary care physicians need to incorporate “cosmetovigilance” into their post-graduate curriculum to increase their residents’ awareness of the adverse reactions induced by the use of cosmetic products, as well as promoting good reporting behavior.

Evaluation Of Resident Palpation Skills In Foot And Ankle Anatomic Structures Using Bedside Ultrasound, Se Won Lee, Phuong U. Le, Craig Van Dien, Mike Hansen, Timothy Tiu

HCA Healthcare Journal of Medicine

Objective: The objective is to determine the accuracy of foot and ankle joint and soft tissue structure palpation in Physical Medicine and Rehabilitation (PM&R) residents using ultrasonography (US) verification.

Methods: PM&R residents were tested in an outpatient musculoskeletal (MSK) clinic on palpated foot and ankle anatomic structures in a human model. Once the presumed structures were localized, residents marked a 1 cm size circle on the overlying skin with a ink marker. The accuracy of the circle over the joint line and soft tissue structures was verified using US.

Results: The overall palpation accuracy for 22 joint line and soft …

An Acknowledgement To The Hca Healthcare Journal Of Medicine’S Initial Cohort Of Reviewers, Authors, Editors And Advisory Board, Bruce Deighton, Hale Z. Toklu, Graig Donini

HCA Healthcare Journal of Medicine

As the HCA Healthcare Journal of Medicine reaches the half way point of our first year in publication, we want to thank those who have provided invaluable support for the journal since the first submissions arrived in November of last year. The successful launch of our journal would not have been possible without the assistance of our reviewers, authors and board members.

The Other Epidemic, Bruce Deighton

HCA Healthcare Journal of Medicine

The epidemic level of opioid abuse in the U.S. population continues to present a major challenge to our society and to the medical profession. Medical education has a significant role in improving screening, diagnosis, appropriate treatment and management of opioid use disorder. Addressing the problem of overprescribing opioids through physician education, surveillance and opioid management has resulted in significant improvement, translating to fewer overdose deaths from prescription opioids. Graduate medical education can increase access to care by training more addiction medicine specialists, and training other physicians to prescribe buprenorphine and provide access to medically assisted care.

Nicaraguan Homeowner Showing Gratitude For Concrete Flooring As Part Of A Public Health Mission Trip, Breonna Kinnison

HCA Healthcare Journal of Medicine

I’m Bree Kinnison, a fourth-year medical student and aspiring psychiatrist. When I’m not studying, I enjoy painting using acrylics. This painting depicts a very fond memory of mine. After completing the medical portion of our mission trip in Nicaragua, we began our public health portion. Along with fellow students, I laid concrete flooring in this woman’s house. For all 76 years of her life, she had never experienced anything other than a dirt floor in her home. Traditional dirt flooring in Nicaraguan homes is responsible for many preventable illnesses. When shown the final product, she reached out and hugged the …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

A Look Back At Nrmp 2020 And The Road Ahead, Frederick M. Schiavone

HCA Healthcare Journal of Medicine

The 2020 Match has recently concluded. While the results give us some information about where the medical field is headed, the decision by the NBME and FSMB to change USMLE Step 1 score reporting to only a pass/fail outcome will also impact how residency programs navigate the NRMP in the years ahead.

Two Resident Wellness Exercises And Their Impact, Nick J. Mccauley

Emergency Medicine

How program leaders in the CORD community are implementing innovations to improve residency wellness and resident resilience.

• Define resilience and describe how it can prevent burnout.
• Discuss ways that residency programs can work to promote resilience amongst residents COURSE DESCRIPTIONS #CORDAA20 35
• Introduce ‘Resilience Rounds’ as a didactic intervention, and the literature upon which this innovation is based
• Introduce art as a tool to overcome trauma and prevent burnout
• Demonstrate how conference/didactic time can help residents combat the perceived “culture of perfection” by sharing meaningful or successful moments with each other to improve one’s general outlook on their own practice

Scheduling Like A Pro, Joseph Gibney

Emergency Medicine

Scheduling is difficult, but believe it or not, it can also be rewarding. This is one chief’s take on three years of scheduling and the highs, lows, do’s, don’ts, and novel ways to help your fellow residents live their best residency life.

• Show that resident wellness is impacted by scheduling
• Demonstrate our scheduling process, some errors we made over time, and how we learned from them
• Discuss some novel scheduling tactics, how other residencies may apply what we’ve learned, and how to adapt it to fit their needs

Behind The Scenes Of Starting A New Residency Program, Traci Wooden, Krystal D. Hernandez, Elizabeth Rashid

Teaching & Learning

During this workshop, we will split up the stages of building a new program into the following- Stage 1, Stage 2 and Stage 3. Stage 1 will focus on applying for initial accreditation, gathering faculty and sites, the first recruitment season, building/creating a curriculum, program planning and the first full cycle of GME including match, onboarding, orientation, CCC/PEC, wellness and more. Stage 2 will focus on more program planning, including building a new clinic, building electives, adding faculty, faculty development, continued accreditation site visit, building a senior curriculum and chief resident selection. Stage 3 will discuss board prep and board …

Assessing For Gender Disparities In The Selection Of Chief Residents Of Emergency Medicine Residency Programs, Emilio G. Volz, Justin Steinberg, Tony Zitek

HCA Healthcare Journal of Medicine

Introduction: Although the number of women physicians has been increasing, there may be gender disparities in the assessment of female emergency medicine residents. This study sought to determine if female emergency medicine residents are less likely to become chief residents than males.

Methods: In July 2017, an anonymous survey was distributed to the program coordinators of all accredited emergency medicine residency programs in the United States. The survey requested the number of males and females in each graduating class from 2015 to 2017. The percentage of female residents who were chief residents was calculated and compared to that for males. …

The Great Imitator Strikes Again: A Case Of A Lupus Flare-Up Presenting Like An Acute Abdomen, Emmanouil Kiriakopoulos, Vanessa Perez, Robyn Hoelle

HCA Healthcare Journal of Medicine

Systemic lupus erythematosus (SLE) is an autoimmune disease affecting all age groups and can manifest in various forms, often making the initial or successive presentations difficult to diagnose. Peritonitis secondary to lupus is a rare manifestation of this disease and the prevalence is said to be much lower in children. We present a case report of an adolescent male with a known history of lupus who presented to the emergency department with a clinical picture consistent with an acute surgical abdomen and underwent an appendectomy. Subsequent workup identified the culprit as a lupus-related peritonitis requiring corticosteroids for resolution.

Preparing For Your First Job: A Resident’S Outline To Curriculum Vitae Writing, Marissa Bournique

HCA Healthcare Journal of Medicine

A curriculum vitae (CV) is a requirement for any physician seeking employment. Writing a job-winning CV requires preparation and discipline. This article presents useful guidelines for preparing and writing a CV aimed at residents seeking their first job as full-fledged physicians.

A Brief Tutorial On Manuscript Preparation: From Journal Selection To Manuscript Review, Christopher N. Ochner, Jocelyn N. Mineo

HCA Healthcare Journal of Medicine

This article is designed to introduce the novice researcher to the process of journal selection, manuscript submission and manuscript review. PubMed indexing, journal readership, scope, focus, impact factor, fees and acceptable manuscript types are discussed in the first section. The remainder of this article focuses on manuscript preparation, submission and review, including formatting, pre-submission inquiry, submission portals, and the manuscript review process. Specific recommendations are provided to assist the reader in navigating these stages.

A Quality Intervention To Reduce Telemetry, Alina Polonsky Md, Abdullah Alcharif Md, Andrew Maiolo Md

Internal Medicine

No abstract provided.

The Role Of Mindset, Impostorism, And Irrational Beliefs In Resident Wellness: Results From The Hca Nationwide Longitudinal Resident Wellness Study, Gregory Guldner, Jason Siegel, Brendon Ellis, Anne Brafford

Teaching & Learning

Background The significant proportion of residents reporting poor levels of well-being has appropriately fueled a call for interventions. Yet the specific constructs that impact well-being have not been well researched and validated in the resident population. Mindset (fixed versus growth), impostorism (the belief that one’s success is fraudulent) and irrational beliefs (dysfunctional beliefs that contribute to emotional pain and anguish) are among individual variables postulated to relate to well-being in a high-pressure educational environment. Each of these constructs is amenable to interventions should they have causal relationships to well-being.

Objectives Our prior research resulted in a statistically validated model of …

Program Evaluation In Women's Health Integration For Podiatric Residents, Nilin M. Rao Dpm, Carol A. Stamm Md, Elizabeth Ihler Md, Dustin Kruse Dpm, Paul A. Stone Dpm, Facfas

Podiatry

As the podiatric profession strives for professional and financial parity with allopathic and osteopathic colleagues, podiatric medical education has been transformed at both undergraduate and graduate levels to more closely align in important ways. The purpose of this program evaluation is to share the benefits of including a women’s health rotation into the required graduate medical training curriculum, share the initial experience of the first resident cohort receiving this training, and provide ideas to other programs that may be interested in providing similar program implementation for their residents.

General Surgery Residency And Emergency General Surgery Service Reduces Readmission Rates And Length Of Stay In Non-Operative Small Bowel Obstruction, Sarah Waterman Manning Md, Katherine S. Mastriani

General Surgery

No abstract provided.

Reinventing The Tradition Of Morbidity And Mortality Conference: Turning Anecdotes Into Databases, Tandis Soltani Md, Key Yan Tsoi Md, Alexandra Csortan, Aidan Charles Md, Darwin Ang

General Surgery

See attached.

Should We Interview This Medical Student For General Surgery?, Phil Schertz Do, Ory Newman Do, Subhasis Misra Md

General Surgery

Introduction

Traditional interview selection has several weaknesses limited often to a number, often USMLE/COMLEX that programs use to "weed out" potential residents then look at those who meet the mark. There is no single factor that indicates a good resident, yet we seek to analyze selection criteria from 9 hospitals with general surgery residencies to figure out what selection criteria are present in certain hospitals selection and determine which factors predict acceptance for general surgery residency.

Methods

We looked at 9 hospitals and 411 ranked medical students for general surgery in the 2017-2018 cycle made up of US medical graduates …

Turning Passion Into Purpose: A Journey To Medicine Through Global Health, Laurenie Louissaint Md

Family Medicine

No abstract provided.

Development Of A Graduate Medical Education Program In Obstetrics And Gynecology In A Community-Based Hospital: Building Blocks And Rate Of Progress, Parker B. Long, Katherine M. Choi Md, Rachael Postlethwait Md, Mohamed Foda Md, Karen Harris Md

OB-GYN

Synopsis

The need for trained obstetricians and gynecologists continues to increase. The ongoing advances in women’s health care requires well trained physicians that can only be achieved by a well-structured residency program that provides a reliable training infrastructure while maintaining a patient centered care model according AGCME standards. This residency program started July 2018 with 4 PGY1 and one PGY2 residents.

Objective

To prospectively look at the rate of growth needed to begin an OBGYN residency program in a community-based hospital.

Methods

For this particular residency program, we started a new OBGYN medical practice and all residents were involved in …

Starting Simulation For New Residency Programs, Steve Warrington

Emergency Medicine

Objectives

1. Identify 3 barriers and methods to overcome them when implementing simulation in new graduate medical education programs.
2. Discuss pearls and pitfalls to use when implementing a new simulation program at an institution.