Medical Education Commons^™

Eliminating Unnecessary Premedications Before Outpatient Transfusions, Shraddha Patel Babariya, Md, Mary Harach, Bs, Mt(Ascp), Cqa(Asq), Ssgb, Joanne Filicko-O'Hara, Md, Lindsay Wilde, Md, Anne Delengowski, Rn, Msn, Alexis R. Peedin, Md, Julie Katz Karp, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

Our aim is to eliminate premedication prior to outpatient transfusions in patients without a prior transfusion reaction by 75% within 1 year.

Does Discharge Pharmacy Affect Outcomes After Percutaneous Coronary Intervention?, Patrick Prior, Md, Lisa Moss, Abhinav Nair, Md, Preya Simlote, Md, David Fischman, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

To reduce the rate of this institution’s readmission rate in patients discharged after PCI, by identifying the current trends in readmission in relation to prescription and medication delivery practices over the past 1 year.

Clinical Outcomes Of Utilization Of Stress Ulcer Prophylaxis In Hospitalized, Non-Icu Patients, Paige Robinson, Do, Kate Radvanski

Health Equity and Quality Improvement (HEQI) Summit

Goal

This study is a retrospective chart review that aims to measure the effect of stress ulcer prophylaxis in hospitalized non-ICU level patients to determine the clinical effect of the presence or absence of stress ulcer prophylaxis.

Optimizing Evaluation And Treatment Of Patients With Nausea And Vomiting Of Pregnancy In The Emergency Department, Danielle N. Carr, Md, Angela Carracino, Do, Alisha Sangal, Md, Madeline Smith, Md

Health Equity and Quality Improvement (HEQI) Summit

Problem Definition

• Nausea and vomiting of pregnancy (NVP). Approximately 50% prevalence rate
• Pregnant patients with NVP require special considerations for treatment
• Long ER wait times
• Possibly avoidable hospital admissions

Improving Blood Pressure Control Through Blood Pressure Measurement In An Ambulatory Urban Family Medicine Clinic, Sara Ancona, Md, Zachary Klock, Md, Aimee Mcmullin, Md, Zeynep Uzumcu, Md, Olivia Seecof, Md, Graham Stratton, Md, Alexa Waters, Md, Caitlyn Haines, Md, Brittany Hozick, Md, Jose Medina, Md, Geoffrey Mills, Md, Phd

Health Equity and Quality Improvement (HEQI) Summit

Aim Statement: To increase the percentage of patients over the age of 18 with BP controlled to a goal of <140/90 from a baseline of 58% to 68% by April 2020.

Changing Internal Medicine Residents’ Perspective On Social Determinants Of Health, Daniel Tran, Do, Hiba Ansari, Do, Layla Barrera, Do, Magdala Chery, Do

Health Equity and Quality Improvement (HEQI) Summit

Background: Social determinants of health (SDOH) shape the conditions of a person’s daily life and include factors such as housing, occupation, education, safety and income. While physicians are aware of the inequalities that exists in healthcare, not all physicians feel adequately able to address such concerns. Understanding of factors that contribute to the development and perpetuation of inequities in health care must be developed at the medical education training level.

Objectives: Evaluate internal medicine residents’ understanding of SDOH and implement a curriculum on health disparities in order to improve their comfort in addressing social needs.

Methods: A survey regarding several …

Improving Inpatient Management Of Opioid Use Disorder, Yair Lev, Md, Darius Farzad, Md, Noah Haroian, Md, Jillian Zavodnick, Md

Health Equity and Quality Improvement (HEQI) Summit

Research Question: What aspects of successful OUD treatment teams are most needed at Thomas Jefferson?

Urine Drug Screening At The Sleep Disorder Center, Rohin Saroya, Md, Karl Doghramji, Md

Health Equity and Quality Improvement (HEQI) Summit

Aim

• Introduce UDS for all patients undergoing MSLT or MWT
• Eliminate false positive and negative results
• Optimize management of disorder

Goal

• To have 100% of patients undergoing an MSLT or MWT to have a UDS

Assessing Internal Medicine Resident Comfort With Obtaining Consent For Autopsies, Zach French, Kelly Hughes, Edward Wang, Elizabeth Braden

Health Equity and Quality Improvement (HEQI) Summit

Objective

We aim to increase resident comfort and knowledge of the autopsy process by 20% based on average survey response scores

Detection Of Coronary Artery Disease On Ct Chest Imaging, K. Mirzozoda, Md, Mba, J. Vojnika, Md, R. Mohammed, Md, H. Landon, Md, C. Murphy, Md, Y. Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

Overall aim: Improve diagnosis and management of CAD based on CT chest imaging.

• Improve diagnosis of silent CAD based on CT chest imaging: more patients who have findings of CAC on CT chest imaging will be diagnosed with CAD.
• Increase the number of appropriate statin prescriptions based on CAD findings on CT chest imaging.

Time Value Analysis Of Inpatient Endoscopy Workflow, Sanaa Arastu, Md, Andrew Elden, Md, Raymond Janowski, Md, Aaron Martin, Md, Joseph Yoo, Md, Richard Denicola, Md, Amy Javia, Md, Melissa Vitolo, Md, Linda Yan, Md, Christopher Cao, Md, Scott Manski, Md, Christopher Schmoyer, Md, Brianna Shinn, Md, Mitchell Conn, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Our aim was to evaluate the variables involved in room turnover and identify any delays that lead to the time difference found between inpatient and outpatient rooms.
• We planned to design an intervention to improve efficiency in the endoscopy suite and complete more inpatient cases.
• We predicted that completion of more inpatient cases would subsequently decrease the need for cancellation and rescheduling of medically necessary cases on a daily basis.

You're In Great Hands: Building Inter-Professional Relationships To Build Confidence In Patient Referrals, Erin Kelly, Do, Kristofer Feeko, Do

Health Equity and Quality Improvement (HEQI) Summit

Objective

To increase inter-professional relationships and know at least one physician within each different specialty so that they can confidently refer patients to them and trust that it will be a good experience for the patient by knowing them personally and professionally by the end of the 2020-2021 academic year.

Fatigue In Primary Care: Doctor, Why Am I So Tired?, Nina Mingioni, Md

Clinical Education Teaching Tools

Learning Objectives:

1. Identify top causes of fatigue in women
2. Develop an evidence-based approach to assessing a patient with fatigue
3. Reflect on the evidence for available screening tools for fatigue

Jefferson Digital Commons Quarterly Report: January-March 2020, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Look for the Jefferson Digital Commons
• Articles
• COVID-19 Working Papers
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstones
• Oral Histories
• Posters and Conference Presentations
• What People are Saying About the Jefferson the Digital Commons

A Novel Case Based Approach To Icf Education For Pm&R Residents, Nick Freedman, Do, Michael Mallow, Md, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Posters

Little exists in the literature on reliable methods of ICF education. Our goal was to increase knowledge of the ICF and encourage residents to use the ICF framework to inform their clinical thinking through a case-based exercise.

Empathy As Related To Gender, Age, Race/Ethnicity, Academic Background, And Career Interest: A Nationwide Study Of Osteopathic Medical Students In The United States., Mohammadreza Hojat, Jennifer Desantis, Stephen Shannon, Mark Speicher, Lynn Bragan, Leonard H. Calabrese

Department of Psychiatry and Human Behavior Faculty Papers

CONTEXT: Research on associations between medical student empathy and demographics, academic background, and career interest is limited in number, lacks representative samples, and suffers from single institutional feature. This study was designed to fill the gap by examining associations between empathy in patient care, and gender, age, race/ethnicity, academic background, and career interest in nationwide, multi-institutional samples of medical students in the United States and to provide more definitive answers to the aforementioned associations with more confidence in the internal and external validity of the findings.

METHODS: Four nationwide samples participated in this study (n=10,751). Samples 1, 2, 3, and …

Simulation-Based Mastery Learning Compared To Standard Education For Discussing Diagnostic Uncertainty With Patients In The Emergency Department: A Randomized Controlled Trial., Danielle M. Mccarthy, Rhea E. Powell, Kenzie A. Cameron, David H. Salzman, Dimitrios Papanagnou, Amanda Doty, Benjamin E. Leiby, Katherine Piserchia, Matthew R. Klein, Xiao C. Zhang, William C. Mcgaghie, Kristin L. Rising

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: Diagnostic uncertainty occurs frequently in emergency medical care, with more than one-third of patients leaving the emergency department (ED) without a clear diagnosis. Despite this frequency, ED providers are not adequately trained on how to discuss diagnostic uncertainty with these patients, who often leave the ED confused and concerned. To address this training need, we developed the Uncertainty Communication Education Module (UCEM) to teach physicians how to discuss diagnostic uncertainty. The purpose of the study is to evaluate the effectiveness of the UCEM in improving physician communications.

METHODS: The trial is a multicenter, two-arm randomized controlled trial designed to …

Librarians As Partners In Medical Education Scholarly Activity Initiatives, Gregory Laynor, Courtney Eger, Natalie Tagge

Library Posters

Health sciences librarians can partner with medical educators to prepare residents for scholarly activity.

In addition to providing instruction in areas traditionally taught by librarians, such as database searching and citation management, librarians can teach other components of scholarly activity.

Library workshops enable residents to learn best practices for communicating and disseminating their research.

Gibbon Surgical Society

Gibbon Surgical Review

The John H. Gibbon, Jr. Surgical Society (GSS) at Sidney Kimmel Medical College (SKMC) at Thomas Jefferson University is a unique student interest group that has been working hard to increase interest in the field of surgery among medical students for the last 37 years. The society has over 400 total active members on a year to year basis, spread across the four-year curriculum. The GSS increases exposure and interest to the surgical field through a unique blend of episodic and longitudinal programming that helps bring together students, residents, and faculty in an educational setting.

Interview With Dr. Geoffrey Krampitz, Colin Yost

Gibbon Surgical Review

Geoffrey Krampitz, MD, PhD is a hepatopancreaticobiliary surgeon with an extensive background in surgical oncology, stem cell science, and cancer immunotherapy research who recently joined the faculty here at Thomas Jefferson University as an Assistant Professor of Surgery. After earning his BSE in biomedical engineering at Johns Hopkins University and before starting medical training, Dr. Krampitz worked in consulting in the San Francisco Bay Area and eventually helped launch two internet startup companies in Silicon Valley. He then went to UC San Francisco for his Master’s degree, where he investigated the role of HIF1-alpha in stem cell differentiation. Dr. Krampitz …

Primum Non Nocere: Surgeons And The Politics Of Firearm Trauma, Kaushal Desai

Gibbon Surgical Review

The crisis of firearm violence in America continues to worsen and the call to action cannot be ignored. If we are to make a real impact, we must be just as skilled policy makers as proceduralists. We must wield the pen as well as we wield the scalpel. All the clinical knowledge and surgical skills in the world will make no difference if we do not reduce the number of firearm injuries. The skillset we need is policy analysis and lobbying, which can only be developed through political activism and engagement, not more practice questions and Online MedEd.

General Surgery 101: Nissen Fundoplication, Kelley Yuan, Tyler Bauer

Gibbon Surgical Review

The first time that medical students enter the OR can be a jarring experience. Successfully maintaining sterility is hard enough, but remembering relevant patient history, answering “pimp” questions, and performing basic suturing skills can make the third year medical student experience difficult. In this article we describe a common surgery performed by both general and thoracic surgeons with a specific focus on “medical student level” understanding. This piece is the product of a collaboration between an MS1 and MS4, both of whom are interested in a career in surgery. We hope you find it helpful!

Interview With Dr. Dawn Salvatore, Preeyal Patel

Gibbon Surgical Review

A medical student’s path to surgery is notoriously long and arduous. Traditionally, students who are interested in the field begin to prepare their qualifications from day one, especially given the competitive nature of acceptance into surgical programs. For students who develop an interest in surgery during their later years of medical school, it can be a daunting task to pursue a track in which they already feel behind. Often times, these students are discouraged from applying to surgical residencies, worrying that their non-traditional path may hinder their success. However, Dr. Dawn Salvatore can reassure students that a non-traditional path to …

The Utility Of Surgical Simulation In Student Education, Jared Raikin

Gibbon Surgical Review

The use of simulation in the field of surgery has become a heavily researched topic over the last few decades, but it is by no means a new concept. The first recorded use of surgical simulation dates back 2,500 years with evidence of nasal models for flap reconstruction made of leaf and clay.1 But simulation as we know it today did not take shape until the 1980s with the invention of the Comprehensive Anesthesia Simulation Environment (CASE) mannequins. The use of nonorganic simulation tools revolutionized the field and continues to play a large role in medical education. These modalities have …

Bedside To Bench: Basic Science Research During General Surgery Residency, Signe Caksa

Gibbon Surgical Review

Clinical, basic science, and quality improvement research is becoming increasingly integrated into general surgery residency programs, providing aspiring surgeons with an avenue to engage with academia and improve patient care early on in their careers. For example, as an essential part of their training, general surgery residents at Thomas Jefferson University Hospital (TJUH) complete one to two years of research, usually between their PGY3 and PGY4 years. The goal of this protected research time is for residents to gain hands-on surgical research skills and work on translational research projects that correlate with clinical cases, while also becoming more competitive for …

Longevity In Surgery: A Conversation With Two Temple Surgeons About How They Continually Find Joy In Their Careers, Kelsey Muir

Gibbon Surgical Review

Both Dr. Daly and Dr. Pontari describe the stress and pressure that comes with a long career in patient care, however intertwined with the stress is their overwhelming gratitude and joy for surgery. Maintaining that perspective for medicine and patient care has required two things: community and an outlet. Dr. Daly and Dr. Pontari expressed the need to be able to share their anxieties and struggles with someone to process the stress, the difficulties, and the demands of a surgical career.

Surgery Myths And Facts, Heli Patel

Gibbon Surgical Review

Throughout social media, television shows, movies, and “public perception”, surgical residents and attendings are often stereotyped into a personality that is most often incorrect. Unless you are a surgeon, it is often hard to understand what exactly the life entails. Add in some Hollywood drama and social media, and what you get is a wildly disproportionate picture of what surgeons’ personalities are like. As a medical student, it is often difficult to separate fact from fiction, so here are some of the most common myths debunked.

John H. Gibbon, Jr., Md

Gibbon Surgical Review

Dr. John Heysham Gibbon, Jr. graduated from Jefferson Medical College in 1927, and in a brief series of events, he was named Fellow at Massachusetts General Hospital. In 1930, he found himself assisting Dr. Edward Churchill in an emergency pulmonary embolectomy. At that time the procedure was one of desperation, as no patient in the U.S. had survived the removal of blood clots in open-heart surgery. As Dr. Gibbon recorded the patient’s waning vital signs prior to the procedure he thought, “If only we could remove the blood from her body by bypassing her lungs, and oxygenate it, then return …

Gibbon Surgical Review, Volume 3, Issue 1, 2020

Gibbon Surgical Review

Table of Contents

4 - Interview with Dr. Geoffrey Krampitz

8 - Primum Non Nocere: Surgeons and the Politics of Firearm Trauma

10 - General Surgery 101: Nissen Fundoplication

14 - Interview with Dr. Dawn Salvatore

16 - The Utility of Surgical Simulation in Student Education

18 - Bedside to Bench: Basic Science Research During General Surgery Residency

20 - Longevity in Surgery: A Conversation with Two Temple Surgeons About How They Continually Find Joy in Their Careers

22 - Surgery Myths and Facts

24 - Gibbon Surgical Society

25 - John H. Gibbon Jr., MD

26 - Editorial Board …

Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff

Phase 1

Purpose: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. At Jefferson, acute management of SE falls to the inpatient neurologist, requiring early competency.

Methods: During a 2 week educational “bootcamp”, 9 PGY2 residents participated in a 2 hour simulation of acute SE with two clinical scenarios. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Prior to and following the simulation, residents took a survey to gauge their knowledge and confidence in managing SE.

Results and Conclusions: There was an increase in the number of residents expressing confidence in their …