TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE最新文献

{"title":"Fellows Escap-ED: A Novel Amalgam of Gamification and Simulation","authors":"F. Khalid, I. Lalani, Z. Shaman","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1531","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1531","url":null,"abstract":"","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128540355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Fellows EBUS Workshop Improves Procedural Knowledge and Confidence","authors":"M. New, M. Rustici, A. Neumeier, T. Huie","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1527","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1527","url":null,"abstract":"Introduction: Bronchoscopy is a skill learned by pulmonologists during the course of their fellowship training. Endobronchial ultrasound (EBUS), which is performed to visualize airway-adjacent lesions or lymph nodes in the hila and mediastinum, is a skill that is frequently utilized by pulmonologists and increasingly standard of care for diagnosing patients with certain conditions, including lung cancer and sarcoidosis. A needs assessment of bronchoscopy education for our Pulmonary and Critical Care fellowship program revealed that EBUS is a skill that most fellows wanted to learn and be able to perform independently, but most fellows felt they were not receiving sufficient training to accomplish this goal. Bronchoscopy education in our program has traditionally used an apprenticeship model of instruction, however when a validated objective assessment tool, the EBUS-STAT, was used to evaluate our upper-level fellows, this confirmed that fellows are not adequately trained to perform EBUS independently. Simulation has been shown to improve procedural education, including for EBUS, and is now a recommended approach. We endeavored to create a workshop to teach fellows necessary skills to be able to perform EBUS.","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129605251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Ontario Bronchoscopy Assessment Tool to Enhance Post Procedural Feedback for Pulmonary Fellows","authors":"J. Chambers, L. Keenan","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1522","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1522","url":null,"abstract":"","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121602919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Impact of the COVID-19 Pandemic on Graduate Medical Education and Burnout- A Community Hospital Experience","authors":"I. Ahmad, N. Dandawate, S. Lakshman, C. Cubbison, M. Basciotta","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1524","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1524","url":null,"abstract":"Background:The COVID-19 pandemic brought with it unprecedented changes to graduate medical education (GME) in order to meet the demands of the healthcare system while minimizing exposure towards trainees. Shifting to a virtual didactics model, cancelling elective rotations and ambulatory practice were some of the changes experienced by internal medicine residents across the United States. Despite literature focused on how changes affected undergraduate medical education, there is limited data on how these changes affected resident training. Objectives:Given the current increase in COVID-19 cases, residents perceptions(of their training, and burnout)will be vital when planning and preparing for future crises, all the while aiming to maintain the integrity of GME.Methods:Eighteen Internal medicine residents at a community hospital completed a non-validated Likertscale survey on how they perceived the COVID-19 pandemic and associated changes in their residency program had affected their training, paying special attention to critical care and palliative care skills. Sixteen residents also completed the Stanford Physician Wellbeing Index, which was compared to data from the same survey administered to residents in 2019 to assess perceived resident appreciation and burnout. Qualitative feedback was further elicited from respondents regarding how a similar situation could be managed differently in a future state to preserve the integrity of GME.Results:Over 60% of respondents (n=11) felt the COVID pandemic and its associated changes in their program negatively affected their medical training. Residents felt significantly more frustrated at work (n=14, 75%, p <0.001). Residents reported feeling more confident working with interdisciplinary teams (n=13, 72%) and leading rounds (n=11, 61%). Confidence in critical care management soared as managing ventilators, sedation and vasopressors all increased after the pandemic. Nevertheless, residents viewed the amount of time spent caring for critically ill patients as a detriment to their general training, and two thirds of residents did not feel an improvement in their procedural skills, including bedside ultrasound and line placement. Replacing didactics with virtual meetings and shifting work schedules to four days on and one day off were perceived as helpful for resident wellbeing, while daily email updates were not. Conclusion:Should a similar crisis arise in the future, maintaining a broader scope of learning opportunities for residents by caring for a multitude of illnesses, engaging at the bedside via procedures, and limiting the amount of e-mail communications could help preserve the perceived value of GME for residents and decrease their frustration and burnout.","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"79 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127177336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Simulation-Based Curriculum for Paracentesis and Thoracentesis","authors":"A. Jobe, A. Clark, T. Johnson, K. Joyce, L. Thomas","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1536","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1536","url":null,"abstract":"RATIONALE: Despite the decline in the number and variety of procedures performed by general internal medicine (IM) physicians, procedural training remains an integral part of IM residency training. With previous success in improving the education and comfort of central venous catheter (CVC) placement among graduating 3rd year IM residents due to the development of a robust simulation-based curriculum for CVC placement, we desired to also develop a similar curriculum for paracentesis and thoracentesis. The aim of this project was to develop a simulation-based curriculum for paracentesis and thoracentesis to adequately train residents to safely and independently perform these common bedside procedures. METHODS: Using the CVC simulation-based curriculum as a framework, review of simulation literature and local facility protocols, a comprehensive checklist, pre-learning document and instructional video were developed for each procedure. Each checklist included details for procedural planning (supplies, informed consent, imaging review, time out), sterile preparation and procedure steps. The checklists were submitted to IM, Hepatology, and Pulmonary content experts for review. Residents were provided with the checklists, pre-learning documents and videos prior to a scheduled point-ofcare ultrasound (POCUS) workshop. Residents were also asked to complete pre-and post-workshop knowledge assessments. The workshop allowed for direct application of the checklists to safely complete each procedure in a simulation environment under the instruction of experienced physicians. RESULTS: Thirteen IM residents (9 PGY-1s, 3 PGY-2s, and 1 PGY-3) attended the POCUS workshop in March 2020. Prior to the workshop, residents self-reported, on average, 3.4 observed paracenteses with 1.6 performed and 2 observed thoracenteses with 0.33 performed. Ten residents completed a 12-question pre-workshop knowledge assessment with an average score of 50.8%. Twelve residents completed the same assessment after the workshop, and the average score improved to 68.2%. Resident perceived skill rating in using ultrasound and in performing bedside paracentesis and thoracentesis improved after the workshop (Table 1). Due to COVID-19, the workshop scheduled for May 2020 was cancelled and transitioned to a virtual platform which limited further data collection. CONCLUSIONS: Structured, simulation-based procedural education that teaches best practice and allows for deliberate practice and feedback has consistently been shown to improve the procedural skills of trainees. After completion of the paracentesis and thoracentesis workshop, residents demonstrated improvement in procedure knowledge, ultrasound use, and procedural skills, and we believe that our structured curriculum will provide residents with the necessary framework to perform these procedures safely at the bedside.","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130396557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Moonlighting During Pulmonary and Critical Care Medicine Fellowship","authors":"H. Carmona, J. Richards, J. Town","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1541","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1541","url":null,"abstract":"Rationale Moonlighting is defined as optional extra work for extra compensation. Moonlighting (ML) during medical training is likely variable among residency and fellowship types and programs. To our knowledge, there have been no studies of ML in Pulmonary and Critical Care Medicine or Critical Care Medicine (PCCM/CCM) trainees therefore we sought to understand the types of moonlighting being performed by current PCCM/CCM fellows, as well as their motivations, and the perceived educational and burnout impacts related to ML. Methods Fourteen academic, university-based PCCM fellowship programs distributed geographically across the United States (U.S.) were recruited to participate in an online survey. Eight of these programs also had CCM fellows, which were included. Due to delays from the COVID-19 pandemic, two programs were unable to participate so twelve programs ultimately continued in the study. Using an iterative process of editing among the authors, focus groups with clinician educators, and cognitive interviewing among fellows, a survey was created that focused on characterizing ML practices. Descriptive statistics were generated to characterize results. Results A total of 258 current PCCM/CCM fellows were recruited and 144 fellows completed the survey (response rate: 59%), from twelve U.S. programs across the U.S. (East: 2;South: 3;Midwest: 4;West: 3). Respondents were predominantly in PCCM fellowships (87%). The majority of all respondents were second-year fellows or higher (72%). More than half of respondents (54%) had participated in ML while in fellowship, predominantly providing critical care (82%). A minority of respondents had no interest in ML (9%). Among those that did moonlight, it frequently occurred at a different hospital from their training hospital (53% of respondents). The most common motivations were financial (97%), gaining extra clinical experience (72%), and practicing with more autonomy (56%). A majority agreed or strongly agreed that ML increased their confidence as a physician (89%), and helped establish professional identity (62%). However, a majority also reported that ML worsened sleep hygiene (70%) and reduced time or energy spent on personal activities (56%). Despite this, 100% stated they would do it again or recommend ML to a colleague. Conclusion Moonlighting among trainees in academic PCCM/CCM fellowship programs is a common activity. Fellows generally find ML a positive experience. Although motivated primarily by extra compensation, they note ML offers additional educational value to their training. Moonlighting might also contribute to symptoms of burnout. More research is needed to understand the impact of moonlighting on PCCM/CCM fellows.","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131128401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Ward Rounds Offer Effective Teaching and Training? Obstacles to Learning and What Makes Good Teaching in a Large Tertiary Care Hospital from Trainee Doctor's Perspective","authors":"A. Khan, H. Al-Jahdali, A. Alharbi, S. Alabdulaali, R. Rajendram, M. Obaidi, N. Shirbini","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1528","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1528","url":null,"abstract":"","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"403 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115610146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Big Sigh: Trainee Comfort with and Knowledge About Sleep-Related Hypoventilation Evaluation and Management","authors":"Z. Strumpf, A. May","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1520","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1520","url":null,"abstract":"","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122676708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilator Education Response Team (VERT): A Novel, Interactive, Longitudinal Mechanical Ventilation Curriculum to Improve Fellow Skill and Confidence","authors":"D. Patadia, P. Patrawalla","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1530","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1530","url":null,"abstract":"","PeriodicalId":234316,"journal":{"name":"TP12. TP012 MEDICAL EDUCATION IN PULMONARY AND CRITICAL CARE MEDICINE","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127160198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}