ATS scholar最新文献

{"title":"Impact of a Competency-based Mechanical Ventilation Course Using Virtual Simulation.","authors":"Bruno Rocha de Macedo, Carolina Saldanha Lima, Ahmed Haydar, Marcelo Alcantara Holanda, Fatima Kiyoko Hayashi, Juliana Carvalho Ferreira","doi":"10.34197/ats-scholar.2024-0083OC","DOIUrl":"10.34197/ats-scholar.2024-0083OC","url":null,"abstract":"<p><p><b>Background:</b> Mechanical ventilation (MV) skills are crucial for clinicians who care for critically ill patients; however, few training programs incorporate structured curricula and appropriate assessments. The use of virtual simulators for teaching and assessments has not been evaluated and can offer advantages. <b>Objective:</b> To create an MV competency-based course for internal medicine residents using a virtual simulator and to evaluate course impact. <b>Methods:</b> We developed an online, 8 month, competency-based MV course for internal medicine residents, including virtual simulation. Each module included a 1-hour session (20 min of lecture, 40 min of virtual simulation) and self-directed learning material. Engagement was reinforced through live meetings, an online platform, and group chats. To evaluate competency, we adapted a validated simulation-based assessment to a virtual MV simulator (virtual simulation-based assessment [SBA]). Course impact was evaluated using the four-level Kirkpatrick model, including surveys for satisfaction and confidence (level 1), knowledge assessment with a multiple-choice examination (level 2), and deliberate practice with the simulator and clinical competence on the virtual SBA (level 3). <b>Results:</b> Eighty-one residents out of 103 completed the course and rated it as effective, with a net promoter score of 9.2. The use of virtual simulation was rated as very useful by most participants. Confidence in caring for patients under MV in different scenarios before and after the course significantly increased. On a 10-point scale, the multiple-choice examination score increased 1.19 points (95% confidence interval, 0.91-1.47; <i>P</i> < 0.001) from baseline to the end of the course, and the virtual SBA score at the end of the course was 6.15 ± 1.26 for post-graduate year 1 residents and 6.48 ± 1.56 for post-graduate year 2 residents (<i>P</i> = 0.33). Performance on different competencies varied, with lower scores on tasks such as asynchrony correction. Ninety-nine percent of residents reported a very positive (58%) or positive (41%) impact of the course in their practice. <b>Conclusion:</b> We developed a satisfactory and effective MV course including virtual simulation for internal medicine residents during the COVID-19 pandemic. Confidence and knowledge increased by the end of the course, although performance on complex MV skills was suboptimal. The use of virtual simulators for teaching and assessment are valuable new tools for teaching MV.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"202-216"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442713","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":"Bridging Artificial Intelligence and Medical Education: Navigating the Alignment Paradox.","authors":"Laurah Turner, Michelle I Knopp, Eneida A Mendonca, Sanjay Desai","doi":"10.34197/ats-scholar.2024-0086PS","DOIUrl":"10.34197/ats-scholar.2024-0086PS","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into medical education presents both unprecedented opportunities and significant challenges, epitomized by the \"alignment paradox.\" This paradox asks: How do we ensure AI systems remain aligned with our educational goals? For instance, AI could create highly personalized learning pathways, but this might conflict with educators' intentions for structured skill development. This paper proposes a framework to address this paradox, focusing on four key principles: ethics, robustness, interpretability, and scalable oversight. We examine the current landscape of AI in medical education, highlighting its potential to enhance learning experiences, improve clinical decision making, and personalize education. We review ethical considerations, emphasize the importance of robustness across diverse healthcare settings, and present interpretability as crucial for effective human-AI collaboration. For example, AI-based feedback systems like i-SIDRA enable real-time, actionable feedback, enhancing interpretability while reducing cognitive overload. The concept of scalable oversight is introduced to maintain human control while leveraging AI's autonomy. We outline strategies for implementing this oversight, including directable behaviors and human-AI collaboration techniques. With this road map, we aim to support the medical education community in responsibly harnessing AI's power in its educational systems.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"135-148"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671886","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":"Bronchoscopic Lung Volume Reduction with Endobronchial Valves for Emphysema.","authors":"Yaron B Gesthalter, Julia Maheshwari","doi":"10.34197/ats-scholar.2024-0078PE","DOIUrl":"10.34197/ats-scholar.2024-0078PE","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"252-254"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665593","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":"Effect of Interventional Pulmonology Fellowships on Pulmonary Critical Care Fellows' Core Bronchoscopy Competencies.","authors":"Samiksha Gupta, Christopher Ghiathi, David DiBardino, Enambir S Josan, Bertin D Salguero, Udit Chaddha, Max T Wayne, Jose De Cardenas, Maroun Matta, Benjamin Young, Andrew Dunatchik, Christopher Di Felice, Sameer K Avasarala","doi":"10.34197/ats-scholar.2024-0079OC","DOIUrl":"10.34197/ats-scholar.2024-0079OC","url":null,"abstract":"<p><p><b>Background:</b> Currently, there is significant variability in bronchoscopy training across pulmonary and critical care medicine (PCCM) programs nationwide, including procedural volume and exposure to simulation training. Despite the increased number of interventional pulmonology (IP) fellowship programs in the United States, their direct educational impact on PCCM fellows' bronchoscopy training is unknown. <b>Objective:</b> To identify and quantify the differences in flexible bronchoscopy competency among PCCM fellows from institutes with IP fellowships compared with those without IP fellowships. <b>Methods:</b> This multicenter, prospective cohort study included the assessment of PCCM fellows from two groups, using the Ontario Bronchoscopy Assessment Tool (OBAT): <i>1</i>) PCCM fellowships with a coexistent IP fellowship program and <i>2</i>) PCCM fellowships without an IP fellowship program. The primary outcome was the difference in mean score between the two groups; secondary outcomes included the mean OBAT score of first, second, and third-year (or above) fellows in the two groups and the percentage of fellows in the two groups who were capable of independently performing the procedure. <b>Results:</b> There were five participating training sites: two with IP fellowships and three without IP fellowships. A total of 50 OBAT assessments were performed (25 in each group) by the supervising attending physician. The mean OBAT score was 3.58 ± 0.65 in the IP group compared with 4.33 ± 0.61 in the non-IP group (<i>P</i> < 0.001). The mean (standard deviation) OBAT scores of the first, second, and third-year (or above) fellows were 3.36 (0.5), 3.48 (0.4), and 4.53 (0.5) in the IP group and 3.75 (0.8), 4.25 (0.5), and 4.7 (0.3) in the non-IP group, respectively. The mean OBAT score was directly proportional to the number of procedures done by the fellows. <b>Conclusion:</b> There was a statistically significant difference in the mean OBAT scores between the two groups; the mean OBAT score was higher in the non-IP fellowship group. Although a more comprehensive study is needed to fully account for the various factors that can impact bronchoscopy training, this study highlights a key difference in basic bronchoscopy training among PCCM trainees. The presence of IP fellowship is one of the many factors that can affect the basic bronchoscopy skills of PCCM fellows.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"179-190"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442045","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":"The Alchemy of Pain.","authors":"Rana L A Awdish","doi":"10.34197/ats-scholar.2025-0022SN","DOIUrl":"10.34197/ats-scholar.2025-0022SN","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"162-164"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008363","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":"Evaluation of a Narrative Medicine Workshop for Pulmonary Critical Care Fellows.","authors":"Matthew R Dettmer, Gayathri K Kumar, Gaurav U Manek, Apoorwa Thati, Michael Philippone, Nicole Robinson, Neal F Chaisson, Rendell W Ashton","doi":"10.34197/ats-scholar.2024-0108BR","DOIUrl":"10.34197/ats-scholar.2024-0108BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"169-174"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525358","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 and Validity of a Simulation Program for Assessment of Clinical Teaching Skills.","authors":"Lydia I Healy, Luciana Rodriguez-Guerineau, Briseida Mema","doi":"10.34197/ats-scholar.2024-0112IN","DOIUrl":"10.34197/ats-scholar.2024-0112IN","url":null,"abstract":"<p><p><b>Background:</b> Teaching competence is expected of all intensivists, yet experts rarely supervise or assess trainees' teaching skills. Simulation offers an attractive solution. <b>Objective:</b> Develop and validate a simulation-based assessment of clinical teaching skills in pediatric critical care medicine (CCM). <b>Methods:</b> Participants were 128 pediatric CCM trainees, registered nurses, and respiratory therapists. Medical education experts used literature review and consensus to design three scenarios to assess teaching skills. Scenarios were piloted before use, and raters were trained. Teams completed one of three teaching scenarios, followed by a communication scenario. Raters were faculty members and trainees. Evidence for validity was collected and analyzed using Messick's unifying framework under the following domains: content, response processes, internal structure, relationship to other variables, and consequences of the assessment. <b>Results:</b> The scenarios and assessment tools were designed to capture the characteristics of a good teacher as described in the literature. Raters provided feedback that the tools were easy to use. Internal consistency of the scores measured by Cronbach's α was high. Rater agreement measured by interclass correlation was moderate for one of three scenarios. The relationship to other variables was investigated by correlating teaching scores with communication. Pearson's correlation was moderate for two of three scenarios. Consequences evidence was gathered using a retrospective self-assessed learning gain before versus after the training, which was significant for all scenarios. <b>Conclusion:</b> We developed a three-station simulation program for the assessment of teaching skills in pediatric CCM. The validity evidence collected is moderate, which indicates that it is effective for training and feedback on teaching skills.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"217-231"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112886","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":"Tools, Training, and Transformation: The Synergistic Impact of Interventional Pulmonary Programs in Pulmonary and Critical Care Fellowship Training.","authors":"Carla Lamb","doi":"10.34197/ats-scholar.2025-0024ED","DOIUrl":"10.34197/ats-scholar.2025-0024ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 2","pages":"126-129"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531366","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":"Stories Make for Better Letters of Recommendation and Award Nominations.","authors":"Theodore J Iwashyna, Kelly C Vranas","doi":"10.34197/ats-scholar.2024-0117PS","DOIUrl":"10.34197/ats-scholar.2024-0117PS","url":null,"abstract":"<p><p>Letters of recommendation and nomination play an essential role in the distribution of many key positions, prizes, awards, and grants, particularly for early career nominees. There is very little scientific evidence about how to write such letters most effectively when the goal is to win in a competitive field. When writing a nomination letter, we believe a compelling narrative is a powerful and sometimes underused tool to make a more effective nomination. This article presents an approach to a narrative-centered nomination letter that places the nominee's achievements in the context of a simplified storytelling arc. We emphasize that effective letters use classic, well-understood tropes to allow readers to efficiently understand, retain facts about, and root for ongoing successes of nominees. We argue that this can be done without exaggeration or distortion and that providing a coherent tale, supported by evidence, is a crucial and distinctive component of effective letter writing.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"130-134"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112851","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":"An Interdisciplinary Pulmonary Hypertension Curriculum for Fellows.","authors":"Cassondra Cramer-Bour, Preeya Prakash, Divya Venkat, Luis Afonso, Ghulam Saydain, Abdulghani Sankari","doi":"10.34197/ats-scholar.2024-0089BR","DOIUrl":"10.34197/ats-scholar.2024-0089BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"175-178"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525323","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}