Medical Education Commons^™

Evaluation Of The University Of Nebraska Medical Center’S 4ms Geriatric Training Program At Nebraska Medicine Midtown, Holly M. Sesker

Capstone Experience: Master of Public Health

In 2015, the Health Resources and Services Administration (HRSA) created the Geriatrics Workforce Enhancement Program (GWEP) to address geriatric workforce challenges and improve the health outcomes of older adults. The GWEP redefines care delivery through a movement for age-friendly healthcare guided by evidence-based practices that align with the 4Ms: What Matters, Medication, Mentation, and Mobility. The 4Ms identify the key issues that should drive the decision-making and care for every older adult. 4Ms training sessions were conducted at the Nebraska Medicine Midtown Clinic and evaluated through a cross-sectional survey administered to both residents (trainees) and attendings (trainers). Data was collected …

Internal Medicine Residents' Perceptions Of Virtual Morning Report: A Multicenter Survey, Tyler J Albert, Joel Bradley, Helene Starks, Jeff Redinger, Cherinne Arundel, Albertine Beard, Laura Caputo, Jonathan Chun, Craig G Gunderson, Dan Heppe, Anand Jagannath, Kyle Kent, Michael Krug, James Laudate, Vignesh Palaniappan, Amanda Pensiero, Zaven Sargsyan, Emily Sladek, Matthew Tuck, Paul B Cornia

Faculty, Staff and Students Publications

IMPORTANCE: The COVID-19 pandemic disrupted graduate medical education, compelling training programs to abruptly transition to virtual educational formats despite minimal experience or proficiency. We surveyed residents from a national sample of internal medicine (IM) residency programs to describe their experiences with the transition to virtual morning report (MR), a highly valued core educational conference.

OBJECTIVE: Assess resident views about virtual MR content and teaching strategies during the COVID-19 pandemic.

DESIGN: Anonymous, web-based survey.

PARTICIPANTS: Residents from 14 academically affiliated IM residency programs.

MAIN MEASURES: The 25-item survey on virtual MR included questions on demographics; frequency and reason for attending; opinions …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Knowledge Of The Effect Of Synthetic Proteins On The Overall Health In Lebanese Adults: A Cross-Sectional Study, Zeina Al Shoufi, Alaa Al Bardan, Ahmad Shishnieh, Rami Asaad, Hiba Deek

BAU Journal - Health and Wellbeing

The aim of the study was to assess the knowledge of gym attendees on the effects of protein shakes on their health. A descriptive cross-sectional study involving a self-administered questionnaire was undertaken. Data were collected through a self-administered questionnaire in two ways. First method was googled form links which was sent out to acquaintances on social media (WhatsApp, Facebook, Instagram and Twitter) in both English and Arabic language. In addition, questionnaire was printed and distributed to four different gyms in Beirut. The coaches of the gyms took charge of distributing and completing the questionnaire. Reminders were issued every 2 days …

Crispr/Cas9 Genome Editing: Future Treatment Of Duane Retraction Syndrome, Muhammad Raihan Zulfikar, Editha Renesteen, Bantari W.K. Wardhani

Pharmaceutical Sciences and Research

Duane Retraction Syndrome (DRS) is characterized by limited eye movement. One of its causes is a mutation in the CHN1, MAFB, or SALL4 gene. Nowadays, the treatment for DRS is limited to glasses, occlusion, and surgery. However, this treatment has not been able to cure the disease’s hereditary issue. Another strategy to be considered for the treatment is CRISPR/Cas9, a tool for performing gene editing with a wide range of applications, including treating genetic diseases. We made sgRNA as a first step in using CRISPR/Cas9 as a treatment for DRS in silico using the CCTop website. By computing sgRNA, conducting …

Insulin Therapy Versus Oral Sitagliptin For Treatment Of Latent Autoimmune Diabetes In Adults, Sarah Nasser

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hals IK, Fiskvik Fleiner H, Reimers N, et al. Investigating optimal β-cell-preserving treatment in latent autoimmune diabetes in adults: Results from a 21-month randomized trial. Diabetes Obes Metab. 2019;21(10):2219-2227. https://doi.org/10.1111/dom.13797

for a patient with an aversion to needles.

Indications For Esophagogastroduodenoscopy In Anemic Patients Without Overt Signs Of Upper Gastrointestinal Bleeding, Geoffrey M. Ginter

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Majid S, Salih M, Wasaya R, Jafri W. Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms. BMC Gastroenterol. 2008;8:52. https://doi.org/10.1186/1471-230X-8-52

for a patient with a complicated presentation of severe anemia

Exercise Therapy Improves Quality Of Life In Patients With Postural Orthostatic Tachycardia Syndrome (Pots), Heya Batah, Scott L. Baughan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

George SA, Bivens TB, Howden EJ, et al. The international POTS registry: Evaluating the efficacy of an exercise training intervention in a community setting. Heart Rhythm. 2016;13(4):943-950. https://doi.org/10.1016/j.hrthm.2015.12.012

for exercise efficacy in patients with POTS.

An Exploration Of Psychological Trauma And Positive Adaptation In Adults With Congenital Heart Disease During The Covid-19 Pandemic, Liza Morton Dr, Calum Calderwood, Nicola Cogan, Claire Murphy, Evan Nix, Jacek Kolacz Dr

Patient Experience Journal

The growing population of adults with congenital heart disease (CHD) often have lifelong experience of dealing with potentially traumatic health crises and medical uncertainty whilst facing increased vulnerability to post-traumatic stress disorder (PTSD). The COVID-19 pandemic presents additional challenges for this population including increased risk of health complications, shielding and strict social distancing, changes to medical care provision and social stigma. Despite such challenges, adults with CHD have the potential to also experience positive changes, yet little is known as to what helps cultivate positive adaptation and post-traumatic growth (PTG) within this context. The current study comprised a cross-sectional, anonymous, …

Understanding Both Sides Of The Blood Draw: The Experience Of The Pediatric Patient And The Phlebotomist, Julie R. Piazza, Sandra Merkel, Brooke Rothberg, Joan Gargaro, Kristin Kullgren

Patient Experience Journal

A phlebotomist’s words and actions play a crucial role in success of a blood draw and in providing a supportive patient experience. This study examined use of comfort measures during a pediatric blood draw. The phlebotomist’s use of soft words, positioning, distraction, coaching/support were observed with sixty children between 3-14 years of age during a blood draw. The level of fear /anxiety before and during the blood draw was recorded by an RA. The child’s level of fear/anxiety was observed and reported by the parent/caregiver after the procedure. Comfort measures provided by phlebotomists, the parent/caregiver’s report of their child’s usual …

Isolated Optic Neuropathy As The Presenting Sign Of Neurosyphilis, Kasey Zann Od, Molly Johnson Od, James Fabian Od

Optometric Clinical Practice

Background: Detection and treatment of syphilitic ocular disease without a known history of syphilis is often difficult due to its varied presentations. Early diagnosis and treatment are the key to reducing risk of permanent vision loss, particularly with optic nerve and retinal manifestations.

Case Report: This case report describes a 44 year-old male who was diagnosed with neurosyphilis through his work-up for unilateral optic neuropathy.

Conclusion: This report illustrates the importance of including syphilis lab testing in the setting of optic nerve edema. Syphilis should be considered in any inflammatory ocular disease, especially in patients with atypical presentations and high-risk …

Factors Associated With Chronic Hepatitis C Direct-Acting Antiviral Prescriptions In Maine, Colin T. Waters, Anya K. Cutler, Kinna Thakarar, Kathleen Fairfield

Costas T. Lambrew Research Retreat 2022

Introduction -2.5 to 4.7 million people in the United States have active Hepatitis C (HCV) infections. •Chronic HCV infection is linked to substantial morbidity including cirrhosis and liver failure. •Oral direct-acting antivirals (DAA) yield sustained virologic response in 90 to 95% of individuals. •Many patients eligible for DAA therapy have not received treatment.

Music As A Treatment For Perceived Postoperative Pain In Adults: A Critically Appraised Topic, Savannah G. Mcdaniel

Honors College Theses

Clinical Question: In postoperative patients, how does listening to music affect perceived pain levels? Clinical Bottom Line: There is consistent evidence to suggest music decreases perceived pain in postoperative patients undergoing nasal septal surgery, open heart surgery, total knee replacement surgery, and general orthopedic surgeries requiring hospitalization. Athletic trainers can confidently implement music during patients’ post-operative care sessions to help reduce pain.

Acquire’Ingscholarly Activity During Residency: An Analysis Of Resident Attitudes Towards Scholarship Before And After A Curricular Intervention, Thomas Q Reynolds, Sarah Gabrielson, Amy Buczkowski, Anya K. Cutler, Gina Trachimowicz

Costas T. Lambrew Research Retreat 2022

ACQUIRE, a curriculum designed to introduce residents to scholarship and support their work, results in improvement in resident perceptions towards scholarly activity at both individual and department levels.

Cytokine Cxcl2 Concentration In The Cerebrospinal Fluid Of Patients With Aneurysmal Subarachnoid Hemorrhage Is Associated With Patient-Reported Headache Pain, Elizabeth Glisic, Joanne T. Dekay, Patricia Lerwick, David J. Gagnon, Richard Riker, Sergey Ryzhov

Costas T. Lambrew Research Retreat 2022

Subarachnoid hemorrhage (SAH) is a severe type of stroke categorized by a sharp, sudden, and persistent headache. The mechanism of headache after SAH is currently poorly understood but the neuro-inflammatory response has been identified as a target in understanding the causes of headache after SAH. A better understanding of this mechanism may lead to identification of molecular targets for therapeutic reduction of headache pain and improving outcomes after SAH. In this study, we collected cerebrospinal fluid (CSF) from patients hospitalized with SAH and conducted a cytokine array to screen for soluble factors involved in SAH-associated headache Introduction

Applying The ‘Problem And Solution Trees’ Participatory Method To Design A Public Health Program On Covid 19 Testing For Underserved Populations, Mike Kohut, Elizabeth A Jacobs, Kathleen M Fairfield, G D. Sclar, K Hudak

Costas T. Lambrew Research Retreat 2022

Here we present a case study example of how we applied qualitative research and ‘problem and solution ’trees’( to identity barriers to testing for people who are unhoused

Center For Applied Science And Technology, Robert Carlson, Scot Remick, Lindsey Gower, Sue Lapierre, Anne Breggia, Bob Carlson

Costas T. Lambrew Research Retreat 2022

The journey from basic research to its application in clinical medicine is long and often fragmented. MaineHealth, as the largest healthcare system in Maine, is uniquely situated to create synergies between research and clinical medicine. The new MMCRI Center for Applied Science and Technology is a collaborative effort between the MMC Research Institute (MMCRI) and NorDx, the MaineHealth Diagnostic Laboratory, that provides the infrastructure needed for coordinated integration of MMCRI research core facility instrumentation and data resources with NorDx clinical instrumentation, data resources and support services. The new infrastructure provided by the Center will facilitate and broaden participation in the …

Exploring Provider Attitudes Toward Falls Prevention In The Inpatient Setting, Emily Carter Md, Sarah Hallen, Gavin Welch, Nikki Gordon, Mark Parker

Costas T. Lambrew Research Retreat 2022

The rate of falls and falls with injury within Maine Medical Center are rising. •MMC’s InterprofessionalFalls Committee performed a root cause analysis to identify the factors driving this change. •This analysis highlighted the role that nursing and PT/OT’s have on fall prevention and it uncovered the lack of engagement amongst physicians and APPs. •We performed a literature review and found that there were no references identifying specific barriers to inpatient provider engagement; however, in other clinical settings such as the ED and assisted living, barriers to provider falls assessment have been identified. •We utilized the theoretical domains framework (TDF) to …

Anesthesia Non-Technical Skills In The Operating Room Clinical Learning Environment (Orcle), Denham S Ward

Costas T. Lambrew Research Retreat 2022

Anesthesia non-technical skills (ANTS) are critically important to patient safety in the operating room. The purpose of this study was to examine the global experience of ANTS in the clinical learning environment of the operating room (OR). Our goal is to answer the research question: “How are ANTS perceived by residents early in their training in the ORCLE?” Ultimately, we wish to use this information to inform curricula to teach ANTS in daily clinical practice.

The Creation Of A Sdot And Its Implementation In The 4th Year Em Clerkship, Lauren Wendell, Evan Gill, Sara Nelson

Costas T. Lambrew Research Retreat 2022

Background •Clinical assessments of EM clerkship students are variable and institution specific. •Direct observation is used in residencies •EM clerkship instituted a student SDOT using a modified National Clinical Assessment Tool for Medical Students in EM (NCAT-EM)