Southern Medical Journal最新文献

{"title":"Inattentional Blindness as an Underappreciated Emphasis in Patient Safety Education: Need for Greater Recognition in Medical and Surgical Training.","authors":"Michael J Asken, Anas Atrash, Evelyn J Calderon Martinez","doi":"10.14423/SMJ.0000000000001806","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001806","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"229-230"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership in Equity, Diversity, and Inclusion: What Skills and Attributes Are Documented in the Literature?","authors":"Traci C Terrance, Hernan Barenboim, Adora Otiji, Julie Navarro, Donna Baluchi, Stacy A Ogbeide, A Enrique Varela, Kendall M Campbell, Julie E Lucero, José E Rodríguez","doi":"10.14423/SMJ.0000000000001815","DOIUrl":"10.14423/SMJ.0000000000001815","url":null,"abstract":"<p><strong>Objectives: </strong>Equity, diversity, and inclusion (EDI) leadership has recently been scrutinized, and many institutions have had to repurpose EDI leaders due to recent legislation. The skills or attributes of EDI leaders are not well understood. The authors sought to identify skills or attributes associated with EDI leaders.</p><p><strong>Methods: </strong>The authors searched the PubMed database using the search terms \"Diversity,\" \"Equity,\" \"Inclusion,\" \"Leadership,\" \"Chief diversity officer,\" \"Diversity leadership skills,\" and \"Diversity officer.\" The authors then reviewed titles, abstracts, and papers to identify the skills or attributes of EDI leaders.</p><p><strong>Results: </strong>The search yielded 580 items. The authors analyzed the 10 remaining papers after the abstract, title, and paper review. All of the authors reviewed the articles and constructed the following list of skills: motivating others, fostering potential, inspiring trust, thinking strategically, setting goals and expectations, giving feedback, and being authentic.</p><p><strong>Discussion: </strong>EDI leaders are well equipped for leadership in other spaces because the skills and attributes identified in this review are transferrable to assistant and associate dean positions, chair positions, and other leadership positions in academic medicine. Individual EDI leaders can use these documented skills and attributes to reposition their leadership in this ever-changing political environment. Institutional leaders also can use this information to retain talented EDI leaders in influential leadership positions.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"231-234"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-Based Knee Joint Arthrocentesis Workshop for Internal Medicine Residents.","authors":"Ujjwal Madan, Suman Manek, Muhammad Shah Miran, Kavita Jadhav, Sarah Ifteqar","doi":"10.14423/SMJ.0000000000001809","DOIUrl":"10.14423/SMJ.0000000000001809","url":null,"abstract":"<p><strong>Objectives: </strong>Knee arthrocentesis is a safe and valuable diagnostic and therapeutic primary care procedure. Enhancing Internal Medicine (IM) residents' competency in this skill is crucial for effective patient care. We implemented a simulation-based knee arthrocentesis workshop (SBKAW) to improve residents' comfort in offering knee joint arthrocentesis in primary care settings.</p><p><strong>Methods: </strong>IM residents from five clinic cohorts participated in an SBKAW that included a presentation of instructional material and hands-on training on simulation knee models, led by a rheumatologist and clinic faculty. Pre- and postintervention online surveys were administered to assess participants' comfort levels in performing knee joint arthrocentesis, before and after the workshop.</p><p><strong>Results: </strong>Sixty-four IM residents participated in the SBKAW, 62 (96.9%) of whom had no prior training on knee joint arthrocentesis. The self-reported comfort level in performing knee arthrocentesis pre- and post-SBKAW was 4.7% (very comfortable 3.1%, comfortable 1.6%) and 84.2% (very comfortable 22.8%, comfortable 61.4%), respectively. Before the SBKAW, 50 (78.1%) and 36 (56.3%) residents reported familiarity with indications and contraindications, respectively, and this improved to 56 (98.2%) residents post-SBKAW. Fifty-four (94.7%) residents reported arthrocentesis as a \"very important\" or \"important\" skill for an internist. Forty-eight (84.2%) residents expressed interest in future SB training.</p><p><strong>Conclusions: </strong>Our simulation training highlights the importance of incorporating SBKA into IM residency training curricula, which can enhance patient outcomes and satisfaction, and IM resident training by improving their self-confidence and skills for performing knee arthrocentesis.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"235-239"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of School-Enforced Step 1 Deadlines on Medical Student Well-Being and Failure Rates: Two Medical Students' Perspective.","authors":"Joseph A Lanese, Forrest Bohler","doi":"10.14423/SMJ.0000000000001805","DOIUrl":"10.14423/SMJ.0000000000001805","url":null,"abstract":"<p><p>The US Medical Licensing Examination Step 1 is a milestone assessment that evaluates a medical student's mastery of foundational medical sciences. Traditionally taken at the end of the preclinical curriculum, it now serves as a pass/fail examination before students begin clinical rotations. This transition, coupled with the enforcement of strict deadlines by various medical schools, has introduced significant challenges for students, including increased stress, potential academic delays, and financial hardship. This perspective explores the implications of these enforced deadlines to complete the US Medical Licensing Examination and how they may exacerbate the physician shortage, and it provides solutions that promote student well-being and maximize Step 1 pass rates.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"240-241"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Suicidality Is Suspected.","authors":"Raymond Pary, Steven Lippmann","doi":"10.14423/SMJ.0000000000001810","DOIUrl":"10.14423/SMJ.0000000000001810","url":null,"abstract":"<p><p>Physicians have the potential to detect a person in danger of suicide. A history of self-injury, abuse of illegal substances or alcohol, mood disorders, and schizophrenia may contribute to the risk of suicide. There are four recognized screening tools that can assist in identifying individuals at risk to commit suicide. A safety plan provides coping strategies that may alleviate suicidal behavior or a suicidal crisis. A written, mutually agreed upon safety plan can be helpful for those suspected of being in danger of suicide. Family members or friends should assist the patient with safety plans as well as closely observe the patient and ensure timely professional attention. Emergency medical services may be necessary, and firearms must either be removed from the home or locked to prevent access. The medications that have had a preventive effect against suicide include antidepressant drugs, lithium, clozapine, ketamine, and esketamine. Lithium has historical evidence in combating suicide.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"242-245"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Assessment of a Resident-Preceptor Curriculum for Internal Medicine Residents in Outpatient Continuity Clinics.","authors":"Dylan D Fortman, Rongrong Wang, Scott Rothenberger, Matthew Metzinger, Tanya Nikiforova, Deborah DiNardo","doi":"10.14423/SMJ.0000000000001811","DOIUrl":"10.14423/SMJ.0000000000001811","url":null,"abstract":"<p><strong>Objective: </strong>Opportunities for senior residents to precept junior trainees in continuity clinics have previously been explored. Faculty or junior resident perceptions of the resident-preceptor model remain understudied, however. We describe a resident-preceptor curriculum implemented with third-year Internal Medicine residents at a single institution with a multipronged evaluation. The objective was to assess the feasibility of and perceptions about a resident-preceptor curriculum for third-year Internal Medicine residents.</p><p><strong>Methods: </strong>Postgraduate year 3 (PGY-3) residents on ambulatory rotations between January and May 2023 attended a 1-hour educational workshop and then participated in up to four half-day resident-preceptor sessions. Pre- and postcurriculum surveys using Likert scales assessed the perceptions of ambulatory training among PGY-3 residents. Faculty members and junior residents completed postcurriculum surveys to assess feasibility and impact on the clinic learning environment. Survey responses were summarized using means, standard deviations, and one-sided Wilcoxon signed rank tests.</p><p><strong>Results: </strong>Fourteen PGY-3 residents participated, and 10/14 (71.4%) completed both pre- and postcurriculum surveys. PGY-3s precepted a median of two half-day sessions and five patients per session. No additional faculty, space, or clinic resources were necessary. Postcurriculum, PGY-3s were significantly more likely to view their faculty as using evidence-based practice (<i>P =</i> 0.02). Among faculty and junior residents, 15/23 (65.2%) and 13/44 (29.5%) completed the postcurriculum surveys, respectively. Faculty and junior residents provided positive ratings on the impact of the curriculum across multiple aspects of clinical training.</p><p><strong>Conclusions: </strong>Implementing a resident-preceptor curriculum in outpatient continuity clinics is feasible without additional resources and is perceived as a valuable addition to ambulatory training by faculty, resident preceptors, and junior residents.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"225-228"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural Tube Defects in South Carolina 1992-2019: A Review of Risk Factors.","authors":"Lucy Pulliam, Stephanie Trammel, Jane H Dean, Natallia Sianko","doi":"10.14423/SMJ.0000000000001812","DOIUrl":"10.14423/SMJ.0000000000001812","url":null,"abstract":"<p><strong>Objectives: </strong>Neural tube defects (NTDs) are one of the most common major birth defects, yet the reasons for occurrence of many NTDs are still not well understood. This study sought to determine the presence of seven specific NTD risk factors in a sample of 515 isolated NTD cases that occurred in South Carolina between 1992 and 2019.</p><p><strong>Methods: </strong>A total of 1351 NTD cases were ascertained in the state between 1992 and 2019 using data from the South Carolina NTD Surveillance and Prevention Program. Medical and pregnancy data were available for 723 of the children, whose mothers chose to enroll in the prevention portion of the program. This study focused on examining the presence of seven NTD risk factors in 515 (71.2%) of these 723 cases in which the NTDs were isolated birth defects and had no identified probable cause, such as a chromosome abnormality.</p><p><strong>Results: </strong>Of the 515 isolated NTD cases examined in this study, 26.3% had mothers with maternal obesity, 24.0% had exposure to maternal hyperthermia, 7.6% had Hispanic race/ethnicity, 4.7% were the product of a twin or multiple pregnancy, 4.1% had mothers with pregestational diabetes mellitus, and 1.4% had maternal exposure to drugs that affect folate metabolism. In addition, 12.2% of the mothers and 12.1% of the infants were homozygous for the <i>MTHFR C677T</i> variant allele. Of the NTD cases under review, 57.0% had one or more of the risk factors and 15.2% had two or more risk factors.</p><p><strong>Conclusions: </strong>These findings on NTD risk factors may provide focus areas for continued efforts to reduce preventable NTDs.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"201-205"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Surgical Outcomes of Older Adult Patients Undergoing a Whipple Procedure.","authors":"Daniel Hakakian, Allison J Bellaire, Jana K Elsawwah, Lawrence E Harrison, Rolando H Rolandelli, Zoltan H Nemeth","doi":"10.14423/SMJ.0000000000001800","DOIUrl":"10.14423/SMJ.0000000000001800","url":null,"abstract":"<p><strong>Objectives: </strong>The Whipple procedure, or pancreatoduodenectomy with pancreatojejunostomy, can result in adverse outcomes among older adult patients with lower physiological reserves. As such, we studied the differences in comorbidities and postoperative outcomes between older adult and younger (nonolder adult) populations following Whipple procedures.</p><p><strong>Methods: </strong>We compared clinical factors of 1553 older adult (70 years and older) and 2171 younger adult patients (18-69 years) who underwent a Whipple procedure using the 2021 American College of Surgeons National Surgical Quality Improvement Program databases.</p><p><strong>Results: </strong>The older adult cohort had higher rates of cancer diagnosis (58.02% vs 50.99%), diabetes mellitus (31.49% vs 26.07%), congestive heart failure (2.38% vs 1.29%), hypertension (67.80% vs 44.13%), and American Society of Anesthesiologists class ≥3 (89.83% vs 80.01%). The older adult cohort also had higher rates of postoperative mortality (1.35% vs 0.69), pneumonia (3.73% vs 2.12%), transfusions (20.15% vs 17.00%), and delayed gastric emptying (16.61% vs 14.19%) than the younger cohort. The older adult cohort had fewer postoperative pancreatic fistulas (11.33% vs 13.73%), however. Multivariate logistic regression revealed that older adult age (odds ratio 3.316) and hypertension (odds ratio 5.813) were significantly associated with increased odds of postoperative myocardial infarction.</p><p><strong>Conclusions: </strong>We found higher rates of mortality and postoperative myocardial infarction among older adults after Whipple procedures. Regardless of this elevated risk, a higher proportion of older adult patients presented with pancreatic cancer and required the procedure.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"184-188"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Know Your Guidelines: EULAR Management of Fatigue in Patients with Inflammatory Rheumatic and MSK Diseases Guideline Synopsis and Review.","authors":"Malvika Lall, Iman Abutineh, Christopher D Jackson","doi":"10.14423/SMJ.0000000000001793","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001793","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"174-176"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten Tips for Navigating Difficult Patient Encounters.","authors":"Amber Thacker, Anna McQueen, Emily Mai","doi":"10.14423/SMJ.0000000000001794","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001794","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 3","pages":"171-173"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}