ATS scholar最新文献

{"title":"Educational Outcomes of a New Obstetrics Rapid Response Curriculum for Internal Medicine Residents.","authors":"Diane Y Wang, Lianteng Zhi, J Daniel Hess, Andrew R Deitchman","doi":"10.34197/ats-scholar.2024-0109BR","DOIUrl":"10.34197/ats-scholar.2024-0109BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"165-168"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191280","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":"Reflections from the First 5 Years of <i>ATS Scholar</i>.","authors":"Nitin Seam, Kristin M Burkart, Patricia A Kritek","doi":"10.34197/ats-scholar.2025-0075ED","DOIUrl":"10.34197/ats-scholar.2025-0075ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 2","pages":"122-125"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531363","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":"Protecting the Future of Medical Innovation: Balancing Fiscal Responsibility with the Need for National Institutes of Health and Federal Health Funding.","authors":"Irina Petrache, Raed A Dweik, Michelle Ng Gong, Jesse Roman, M Patricia Rivera, Karen J Collishaw","doi":"10.34197/ats-scholar.2025-0036ED","DOIUrl":"10.34197/ats-scholar.2025-0036ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"117-121"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712384","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":"How I Teach Racial Categorization in Reference Equations Used to Interpret Spirometry.","authors":"Aaron D Baugh, Nirav R Bhakta, Rosemary Adamson","doi":"10.34197/ats-scholar.2024-0042HT","DOIUrl":"10.34197/ats-scholar.2024-0042HT","url":null,"abstract":"<p><p>Race has been used in medical algorithms, including reference equations for spirometry, following the assumption that race is a biological concept due to the finding that Black American and Asian populations have lower lung function (i.e., forced expiratory volume in 1 second and forced vital capacity) than White populations. Recognizing that race is a social construct and its use in medical algorithms may contribute to health disparities, this practice has been questioned. This inquiry, combined with recent evidence, led the American Thoracic Society to recommend using race-neutral reference equations for spirometry in 2023. In this article, we share our approach to teaching spirometry interpretation, focusing on the factors that determine lung function and the effects of using race-based or race-neutral reference equations. We explicitly define race as a social construct and review the likely reasons for the differences in lung function found between racial groups. We use an interactive and case-based approach to facilitate learning. As part of our interactive approach, we incorporate strategies to enhance psychological safety for the learners. This is particularly important for this topic because discussions of race and health inequities can be contentious and uncomfortable and have the potential to exacerbate the difficulties faced by learners from groups that are underrepresented in medicine. Our approach is intended for a small group of graduate medical learners and could be presented during formal didactic instruction or informally during clinical teaching.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 2","pages":"232-251"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531362","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":"Decay in Physiologic Knowledge since Medical School among Critical Care Fellows (DIP Study).","authors":"Stephanie I Maximous, Megan Acho, Jalil Ahari, Katrina Hawkins, Daniel B Jamieson, Andrew M Luks, Jason Poston, Nitin Seam, Nirav G Shah, Junfeng Sun, Christian J Woods, Burton W Lee","doi":"10.34197/ats-scholar.2024-0036OC","DOIUrl":"10.34197/ats-scholar.2024-0036OC","url":null,"abstract":"<p><p><b>Background:</b> Rapid accumulation of knowledge and skills by trainees in the intensive care unit assumes prior mastery of clinically relevant core physiology concepts. However, for many fellows, their foundational physiology knowledge was acquired years earlier during their preclinical medical curricula and variably reinforced during the remainder of their undergraduate and graduate medical training. <b>Objective:</b> We sought to assess the retention of clinically relevant pulmonary physiology knowledge among pulmonary and critical care medicine (PCCM) and critical care medicine (CCM) fellows. <b>Methods:</b> A composite examination was developed from an initial set of questions used in preclinical pulmonary physiology courses at four separate medical schools. These questions passed through multiple rounds of review by various educators to arrive at a set of 15 multiple-choice questions. The test was administered to incoming first-year PCCM and CCM fellows at seven institutions during their 2021 fellowship orientation. <b>Results:</b> Forty-one first-year PCCM (<i>n</i> = 24) and CCM (<i>n</i> = 17) fellows completed the examination, and the proportion correct among the fellows was compared with that of medical students for each item. Although all questions were deemed to be clinically relevant, preclinical medical students significantly outperformed the incoming fellows. <b>Conclusion:</b> These findings suggest considerable decay of clinically relevant pulmonary physiologic knowledge during residency training and point to a need for longitudinal retrieval practice to reinforce these concepts during the course of medical school clerkship years and postgraduate clinical training as well as consideration of dedicated pulmonary physiology curricula for PCCM and CCM fellowship programs.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"191-201"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017289","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":"Best Practices for a Competency-based Curriculum in Critical Care Ultrasonography for Fellows.","authors":"Paru Patrawalla, Frances Mae West, Navitha Ramesh, Paul Mayo, Amik Sodhi","doi":"10.34197/ats-scholar.2024-0088PS","DOIUrl":"10.34197/ats-scholar.2024-0088PS","url":null,"abstract":"<p><p>New guidelines from the Accreditation Council on Graduate Medical Education for critical care ultrasound (CCUS) training went into effect on July 1, 2024, for critical care medicine and combined pulmonary and critical care medicine fellows. Fellowship programs will need to ensure that their fellows demonstrate competence in skills that are essential to CCUS, which currently encompasses applications in basic cardiac, lung/pleural, abdominal, and vascular ultrasonography (US). This may be a challenge for fellowship programs that have nascent CCUS curricula and limited faculty expertise. In this Perspective, we share expert and evidence-based recommendations on how to implement a competency-based curriculum in CCUS. We review best practices for equipment requirements, introductory and longitudinal curricula, competency assessment and certification, faculty requirements and development, and continuous programmatic quality improvement.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 2","pages":"149-161"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531361","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":"Mitigating Burnout: The Role of Healthcare Organizations.","authors":"Marc Moss","doi":"10.34197/ats-scholar.2024-0153PS","DOIUrl":"https://doi.org/10.34197/ats-scholar.2024-0153PS","url":null,"abstract":"<p><p>Even before the coronavirus disease (COVID-19) pandemic, burnout in healthcare providers had reached crisis levels, with up to 50% of nurses and 40% of physicians experiencing symptoms of burnout. Because of the immense work-related stress during the pandemic, healthcare providers' burnout dramatically escalated, with percentages reaching as high as 70-90%, and many healthcare providers started to leave their profession. As a result, patients are beginning to experience the deleterious impact of extreme staffing shortages in healthcare facilities. Burnout interventions are defined as either organizational or individually focused. Organizational interventions address problems such as electronic medical records, documentation, or billing systems. Individual interventions provide the necessary skills to address specific job-related stressors. Ideally, the most effective interventions would combine these two categories by teaching healthcare providers to cope with job-related stressors in a safe community that is supported by the healthcare organization. The adoption of combined organizational and individual programs will improve healthcare providers' job satisfaction, decrease burnout and other forms of psychological distress, enhance job retention, and return joy to health care. The resulting decreased turnover rates would also reduce some of the skyrocketing healthcare costs, as turnover is expensive for healthcare organizations. Ultimately, enhancing healthcare providers' well-being would improve the care we deliver to our patients. In this article, I explain why it is a critical time in health care and highlight four general principles that frame the development of specific well-being interventions. Finally, I discuss several interventions that could enhance the well-being of healthcare providers and ultimately transform the culture of health care.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997916","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":"Assessment of a Continuing Education Course about Wildfire Smoke and Patient Health.","authors":"Tia C Dowling, Susan L Stone, Wayne E Cascio, Scott A Damon, Mary R Hutson, Jason D Sacks, Maria C Mirabelli","doi":"10.34197/ats-scholar.2024-0152BR","DOIUrl":"https://doi.org/10.34197/ats-scholar.2024-0152BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797195","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":"Medical Students on Their Internal Medicine Clerkship Experience Short Sleep Duration.","authors":"Derek Ge, Vraj Shah, Deborah Kim, Alla Fayngersh, Kristin Wong, Jag Sunderram, Matthew Scharf, Sugeet Jagpal, Aesha M Jobanputra","doi":"10.34197/ats-scholar.2024-0116OC","DOIUrl":"https://doi.org/10.34197/ats-scholar.2024-0116OC","url":null,"abstract":"<p><p><b>Background:</b> Third-year medical students during their internal medicine clerkship may be predisposed to short sleep duration (<7 h of sleep per night) because of rigorous clinical schedules and academic demands. <b>Objective:</b> To evaluate the prevalence of short sleep duration, its impact on performance, and perceived causes among third-year medical students on their internal medicine clerkship. <b>Methods:</b> During the 2023-2024 academic year, third-year medical students at Rutgers Robert Wood Johnson Medical School (RWJMS) and Rutgers New Jersey Medical School completed a survey at the end of their internal medicine clerkship regarding their sleep practices. The schools differed in clerkship structure and grading system. Data were analyzed and compared between schools using the Fisher exact test. Responses for an open-ended question on sleep strategies were categorized into themes by sleep physicians. <b>Results:</b> Of the 314 third-year medical students invited, 222 (70.7%) completed the survey. Short sleep duration was reported by nearly two-thirds of our cohort (143, 64.4%), with a significantly higher prevalence at RWJMS. Most reported sleep-related impairment on clinical duties or educational activities for 1-3 days per week (125, 56.3%), with more reporting ⩾4 days per week at RWJMS. About one-third of our cohort reported drowsy driving either 1-3 days (82, 36.9%) or ⩾4 days (68, 30.6%) per week. Despite high rates of short sleep duration, the overwhelming majority (196, 88.3%) had never received education on sleep management. <b>Conclusion:</b> Short sleep duration is prevalent among third-year medical students during their internal medicine clerkship, potentially impacting their clinical performance and safety.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782153","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":"High-Fidelity Simulation Curriculum for Training Residents in Noninvasive Respiratory Support.","authors":"Jeeyune Bahk, Harrindra Seepersaud, Matthew Alexander, Priscilla Loanzon, Adam Rothman, Susannah Kurtz, Joseph Mathew, James Salonia","doi":"10.34197/ats-scholar.2023-0118OC","DOIUrl":"10.34197/ats-scholar.2023-0118OC","url":null,"abstract":"<p><p><b>Background:</b> The coronavirus disease (COVID-19) pandemic highlighted the importance of physicians managing patients with noninvasive respiratory support (NIRS), including noninvasive ventilation (NIV) and high-flow nasal cannulas (HFNCs), emphasizing the need for thorough education on these modalities. <b>Objective:</b> To determine the effect of a novel simulation-based curriculum on improving the equipment familiarity and understanding of the physiology and application of NIRS among internal medicine residents. <b>Methods:</b> The curriculum consisted of a didactic session on the clinical application of NIRS, a case-based scenario on NIV using high-fidelity simulation, and a debrief session. Learners filled out surveys before and after the session to evaluate changes in objective knowledge of and subjective comfort with NIRS. <i>P</i> values were calculated using independent two-sample <i>t</i> tests. <b>Results:</b> Most residents (85.6%; <i>n</i> = 101) confirmed never having received a formal training in NIRS. At baseline, 34.7% (<i>n</i> = 41) and 24.6% (<i>n</i> = 29) felt \"comfortable\" or \"very comfortable,\" respectively, using NIRS, which improved to 91.5% (<i>n</i> = 108) and 89% (<i>n</i> = 105) after the session (<i>P</i> = 0.001). A statistically significant improvement in clinical knowledge was demonstrated after the session (<i>P</i> < 0.05), with residents correctly recognizing all three indications for bilevel positive airway pressure (BiPAP) (87.2% to 98.3%, 56% to 67.8%, and 21.2% to 55.1%), contraindications to BiPAP (81.4% to 90.7%), appropriate adjustment of BiPAP (30.5% to 73.7%), and HFNC settings (68.6% to 79.7%). Following the curriculum, postgraduate year (PGY)-1 (PGY-1)s' knowledge was increased beyond the baseline of the PGY-2/3s who trained in New York during the pandemic (mean score change 50.6% to 72.1% for PGY-1s, 61.5% to 75.7% for PGY-2/3s). Three-month retention surveys revealed consistent learner satisfaction and learner retention in all aspects. <b>Conclusion:</b> Our 1-hour high-fidelity simulation-based curriculum significantly enhanced medical residents' knowledge, skills, and confidence in using NIRS for acute respiratory failure, with particularly notable benefits for those in the early years of training. Such a simulation-based curriculum could potentially lead to better hospital resource allocation and improved patient outcomes.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"52-64"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}