ATS scholar最新文献

{"title":"A Multidisciplinary Educational Intervention to Improve the Health of Appalachian Coal Miners.","authors":"Drew A Harris, Brad Johnson, Jessica Rasnick, Wendy Sewack, David Driscoll, Theresa Burriss, Margaret M Tomann, Kathleen Meneses, Melodye Farrar","doi":"10.1093/atsscholar/aapag046","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag046","url":null,"abstract":"<p><strong>Introduction: </strong>Coal Mine Dust Lung Disease (CMDLD, often referred to as Black Lung) is associated with social, economic and emotional impacts for miners, their families and Appalachian communities. Effective care for coal miners requires a multidisciplinary approach centered on collaboration between physicians, behavioral health specialists, epidemiologists, federal regulators, attorneys, journalists, community advocates, and policy experts. These partnerships are essential for clinical management, disease prevention, benefits navigation, and worker protections. Despite this complexity, most health professionals receive little formal training in occupational surveillance programs, benefits navigation, or policy advocacy relevant to coal miners. To address these needs, on September 17, 2025 we convened the Central Appalachian Coal Miner Summit, a multidisciplinary continuing education conference.</p><p><strong>Methods: </strong>Speakers were selected for subject matter expertise across clinical care, public health, law, journalism, social sciences and policy. The plenary session, delivered by a New York Times journalist was entitled, \"Why journalism matters to coal miners and Appalachia.\" Additional sessions addressed CMDLD epidemiology, mental health of coal miners, CDC prevention programs, mine safety regulations, and black lung benefits. Conference effectiveness was evaluated by pre- and post- conference surveys assessing self-reported confidence across five competency domains.</p><p><strong>Results: </strong>Forty in-person participants completed both a pre- and post-conference survey and were included in the paired analysis. Participants demonstrated statistically significant improvements in confidence across four of the five assessed domains, particularly in areas underrepresented in traditional medical education, including benefits navigation and occupational health policy.</p><p><strong>Discussion: </strong>Conference participation was associated with significant improvements in confidence across multiple domains central to coal miner health, particularly in areas underrepresented in traditional medical education, including benefits navigation and occupational health policy. In the immediate aftermath of the conference, participants also joined collaborative advocacy efforts and formed new research partnerships to work towards improved coal miner health. Future work will assess whether these gains translate into sustained changes in clinical practice, surveillance participation, and benefits utilization.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698508","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 Perspectives: Rebalancing Learner-Educator Dynamics in Modern Medical Education.","authors":"Rebecca Scherzer, Nancy Liao, Shauna Schord","doi":"10.1093/atsscholar/aapag043","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag043","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698458","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":"Reply to Scherzer et al: Bridging Perspectives: Rebalancing Learner-Educator Dynamics in Modern Medical Education: Generational Differences Amongst Educators: An Overlooked Influence on the Learning Environment.","authors":"Hitesh H Patel, Erica Lin","doi":"10.1093/atsscholar/aapag045","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag045","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690353","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":"Effectiveness of Simulation-Based Training for Thoracentesis - A Systematic Review and Meta-Analysis.","authors":"Nikolay Pavlov, Marc von Gernler, Sabina A Guler, Sebastian Haubitz, Hans-Joachim Kabitz","doi":"10.1093/atsscholar/aapag042","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag042","url":null,"abstract":"<p><strong>Background: </strong>Thoracentesis is a common bedside procedure. Complication rates are, among other factors, associated with the clinicians' skills. Simulation-based training (SBT) for teaching procedural skills is widely recommended in medical education. However, the current evidence on the effectiveness of SBT for thoracentesis and the impact of different instructional features has not yet been comprehensively reviewed.</p><p><strong>Objective: </strong>To summarize and critically appraise the current evidence on the effectiveness of SBT for thoracentesis in improving educational and patient outcomes, and to examine the instructional characteristics of effective training programs.</p><p><strong>Methods: </strong>A systematic review of the published literature on effectiveness of SBT for thoracentesis was performed and is reported according to PRISMA guidelines. Methodological quality was assessed using the MERSQI and the risk of bias of the included studies was evaluated. Extracted data were analyzed descriptively and random-effects meta-analyses were used to calculate the pooled correlation for self-confidence and performance scores.</p><p><strong>Results: </strong>Of the 17 studies included in the review, 14 used a pretest-posttest design and 15 investigated the effectiveness of high-fidelity simulation. Instructional features and outcome measures varied considerably across studies and no association was recognized. The majority of the reported outcomes were positive. The pooled correlation for self-confidence was 1.59 (95% confidence interval [CI] 0.94-2.24; n = 5 studies), and for performance scores 23.94 (95% CI 8.83-39.05, n = 5).</p><p><strong>Conclusion: </strong>SBT for thoracentesis using high-fidelity simulators is effective in improving procedural skills and self-confidence. More evidence is needed to demonstrate a potential positive impact on behavioral and patient-related outcomes.</p><p><strong>Protocol registration: </strong>PROSPERO; No.: CRD420251064566; URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251064566.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671402","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":"Physician-Scientist Training and the Future of Academic Medicine.","authors":"James Frank, Başak Çoruh, Jeremy Katzen, Dean Sheppard, Kristin M Burkart, Maryl Kreider","doi":"10.1093/atsscholar/aapag041","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag041","url":null,"abstract":"<p><p>Physician-scientists bring a critical perspective to scientific discovery and contribute to a significant proportion of medical breakthroughs that improve patient care; however, recent reductions in the proportion of pulmonary and critical care medicine fellows pursuing careers as physician-scientists, mirroring trends in other medical specialties, raise concern about the long-term viability of the current training paradigm. Numerous factors potentially contribute to the drop in trainees pursuing research careers, including reduced availability of research training opportunities during residency and fellowship, increasing clinical and research training complexity, a longer timeline to career independence, and funding uncertainties. Increasing educational debt, an often rigid training structure, and declining resources also contribute. This 2025 American Thoracic Society International Conference symposium provided an overview of these challenges, as well as potential solutions to preserve this vital career path, including the need for critical evaluation of the current training model, reexamination of success metrics, and focused efforts to create more supportive, fair, and collaborative training environments. In response to growing concerns about the sustainability of the physicians-scientist training pathway, education leaders and physician-scientists from around the country presented a special symposium at the 2025 American Thoracic Society International Conference. Content selection was developed through iterative discussion among the presenting authors. The session highlighted important recent trends reflecting decreased engagement with this pathway, challenges faced by trainees, and the potential roles that administrative and education leaders might play in reimagining the physician-scientist training paradigm. This paper summarizes key elements and messages of the session and highlights the opportunity for stakeholders to collaboratively develop a clearer vision of the future for this critical career path. This session highlighted new opportunities, including maximizing competency-based training, enhancing organizational supports, a sharper focus on professional identity formation, and reframing our understanding of what constitutes high-value research contributions by physicians (Table).</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649760","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":"Impact of Narrative-Focused Feedback Forms in a Pulmonary and Critical Care Medicine Fellowship.","authors":"Emily M Olson, Jason M Arnold, Priya G Jain, Clara Schroedl","doi":"10.1093/atsscholar/aapag038","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag038","url":null,"abstract":"<p><strong>Background: </strong>Existing formal feedback systems in graduate medical education often rely heavily on intangible Likert Scales linked to ACGME milestones as an end-of-rotation summative assessment. However, more frequent, actionable, formative feedback based on observations is essential to personal growth.</p><p><strong>Objective: </strong>To evaluate the impact of changing from a milestone-based evaluation form to a brief narrative-based feedback form in a Pulmonary Disease and Critical Care Medicine (PCCM) fellowship as an exploratory pilot project. Our aim was to describe change in perception of feedback quality and the impact on Clinical Competency Committee (CCC) decisions.</p><p><strong>Methods: </strong>We compared the quality of written rotation feedback before and after implementing a shorter feedback form on January 1, 2024 for 15 PCCM fellows at a single large academic institution using the Quality of Assessment for Learning (QuAL) score, (July 2023-December 2023 compared to January 2024-July 2024), fellow pre- and post-surveys (December 2023 and June 2024) and a CCC focus group (June 2024).</p><p><strong>Results: </strong>Overall QuAL score improved significantly after narrative-based feedback form implementation (2.71 pre [n = 75] vs 3.70 post [n = 85], p < 0.001). Surveys had 13/14 (92.8%) fellows respond pre-intervention and 8/14 (57.1%) post-intervention. There was significant improvement in the number of fellows indicating they could identify new learning goals based on written feedback after implementation of the new form (23.1% pre vs 75.0% post, p = 0.03). The CCC focus group with 5 of 8 eligible faculty participating described milestone decisions were better supported by more detailed narratives.</p><p><strong>Conclusions: </strong>Implementing a brief narrative-based form improved feedback quality and the number of trainees able to create learning goals. The CCC identified that the new form provided better details to support milestone recommendations.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632958","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":"Pulmonary Hypertension Training in Pulmonary & Critical Care Medicine Fellowship: A National Survey.","authors":"Jonika M Weerasekare, Jared Rosen, Elizabeth J Kopras, Jean Elwing, Namita Sood","doi":"10.1093/atsscholar/aapag040","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag040","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary Hypertension (PH) is a heterogeneous disease with high morbidity and mortality. Despite advances in therapeutics, delays in diagnosis and misclassification of patients remain prevalent, leading to harm. Pulmonary and Critical Care Medicine (PCCM) physicians play an essential role in treatment of PH. However, the adequacy of PH education in PCCM fellowship has not been rigorously investigated.</p><p><strong>Objective: </strong>To evaluate contemporary training of PCCM fellows including training environment, attitudes, and self-reported proficiency in core and advanced PH competencies.</p><p><strong>Methods: </strong>We conducted a national, cross-sectional survey of PCCM fellows and Program Directors (PDs) between October 2024 and December 2025. The survey assessed demographics, training environment, clinical exposure, preparedness across core and advanced PH competencies, and attitudes toward PH education. Preparedness was measured using a 5-point Likert scale and dichotomized as proficient versus not proficient. An exploratory descriptive analysis was performed with results from a 2007 survey.</p><p><strong>Results: </strong>70 fellows and 42 PDs completed our 2024-2025 survey. Among core competencies, fellows reported high proficiency in PH classification (85.7%) and diagnosis (81.0%), with moderate proficiency in risk stratification (62.9%) and initial therapeutic strategy (55.7%). Proficiency was lower for right heart catheterization (RHC) interpretation (42.9%) and management of medication side effects (37.1%). There were low levels of proficiency in performing RHC (20.0%) and managing infusion therapies (<30%). Increasing fellowship training year was associated with improved self-reported proficiency in most competencies; however, only half of senior fellows reported competency in right heart catheterization (RHC) and initiation of PAH therapy. In descriptive analysis, fellows in both eras reported low levels of competency in RHC and management of infusion therapy.</p><p><strong>Conclusion: </strong>Despite broad access to PH expertise, contemporary PCCM fellows reported limited preparedness to provide comprehensive PH care. There was low proficiency in advanced competencies including performing RHC and titration of infusion therapy, and modest proficiency in core competencies such as risk stratification and management of PAH medication side effects. Our study highlights a need to improve PCCM training through standardized curriculum to improve the care of PH patients.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649845","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":"Procedural Training in Canadian Respirology Programs: A Survey of Residents and Program Directors.","authors":"Fanny Gabrysz-Forget, Pascalin Roy, Christopher A Hergott, Nha Voduc, Stéphane Beaudoin","doi":"10.1093/atsscholar/aapag037","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag037","url":null,"abstract":"<p><strong>Background: </strong>A prior survey of procedural exposure in Canadian respirology programs revealed insufficient exposure for complex procedures. Since then, competence-based education was implemented, and shifts in practice may have impacted procedural training.</p><p><strong>Objective: </strong>This study aimed to determine the current state of procedural training in Canadian adult respirology residency programs.</p><p><strong>Methods: </strong>A web-based survey was sent by email to the 15 Canadian adult respirology program directors (PDs), who transferred the survey to PGY4, PGY5 residents, and first-year graduates (as of June 2023). Procedural volumes, learning and assessment methods, and residents' perspectives were assessed. PDs were also invited to complete a survey.</p><p><strong>Results: </strong>Forty-four residents completed the survey (37% response), and 16 PDs or assistant PDs completed the survey. Procedural volumes were variable. The proportion of residents who agreed or strongly agreed to receiving adequate training was 98% for bronchoscopy, 53% for transbronchial biopsy, 37% for foreign body removal, 93% for thoracentesis, and 63% for chest drain insertion. PGY5s and first-year graduates agreed or strongly agreed with feeling confident to perform procedures independently in a proportion of 100% for bronchoscopy, 100% for thoracentesis, 73% for transbronchial biopsy, 53% for foreign body removal, and 67% for drain insertion. Access to longitudinal simulation is not universal, particularly for pleural procedures. The use of validated assessment tools is infrequent, and procedural outcomes are not tracked by residents or programs consistently.</p><p><strong>Conclusions: </strong>Canadian respirology residents and PDs report variable procedural exposure, learning methods, and assessment methods. The results highlight possible areas for improvement in procedural training.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610784","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":"Simulation-Based Training: Perspective from the Learner.","authors":"Felix W Wireko, Usha Asirvatham, Diana J Kelm","doi":"10.1093/atsscholar/aapag035","DOIUrl":"https://doi.org/10.1093/atsscholar/aapag035","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537794","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":"Prevention and Treatment of High-altitude Pulmonary Edema.","authors":"Allison L Arai, James P Maloney, Edward D Chan","doi":"10.1093/atsscholar/aapag034","DOIUrl":"10.1093/atsscholar/aapag034","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400087","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}