ATS scholar最新文献

{"title":"Consequences of Fellow Participation in Advanced Diagnostic Bronchoscopy.","authors":"Hans J Lee, Gaurav Ajmani","doi":"10.34197/ats-scholar.2025-0026ED","DOIUrl":"10.34197/ats-scholar.2025-0026ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 1","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756180","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}

{"title":"Acquisition and Maintenance of Expertise on Burn Patient Management in the Pediatric Intensive Care Unit.","authors":"Nicole K McKinnon, Joel Fish, Eduardo Gus, Briseida Mema","doi":"10.34197/ats-scholar.2023-0153CM","DOIUrl":"10.34197/ats-scholar.2023-0153CM","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"13-18"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256093","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}

{"title":"How I Teach: Heart-Lung Interactions during Mechanical Ventilation. Positive Pressure and the Right Ventricle.","authors":"Eugene Yuriditsky, Eduardo Mireles-Cabodevila, Carlos L Alviar","doi":"10.34197/ats-scholar.2024-0059HT","DOIUrl":"10.34197/ats-scholar.2024-0059HT","url":null,"abstract":"<p><p>The provision of positive pressure ventilation has the potential to provoke hemodynamic deterioration. The subject of heart-lung interactions is both complex and critical yet often obscure and fraught with misconception among trainees and seasoned clinicians alike. In this article, we focus on the impact of positive pressure ventilation on the right heart, providing a teaching approach composed of didactic sessions and simulated cases. We split our didactics and cases into two 30-minute sessions: \"How the right heart fills\" and \"How the right heart empties.\" Within each session, our framework highlights key concepts with respect to circulatory physiology, respiratory system mechanics, and an amalgam of the two subjects as it pertains to managing clinical scenarios encountered during a trainee's intensive care unit rotation.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"94-108"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256557","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}

{"title":"Breath of Knowledge: An Interactive Computer-Based Program and Group Exercise to Teach Gas Exchange.","authors":"Bryan Broderick, Sarah Kulkarni, Charles Wiener, David Shade, Jeff Day, Henry Fessler","doi":"10.34197/ats-scholar.2024-0065OC","DOIUrl":"10.34197/ats-scholar.2024-0065OC","url":null,"abstract":"<p><p><b>Background:</b> Foundational principles of pulmonary gas exchange are complicated and can be difficult for trainees to master. Computer-based programs can provide opportunities for interactive instruction, but previous literature has not demonstrated the impact of such programs on learning this topic. <b>Objective:</b> To evaluate whether the addition of an interactive, clinically relevant computer-based gas exchange program and small-group exercise to reinforce principles of gas exchange improves medical student learning as measured by performance on relevant multiple-choice exam questions. <b>Methods:</b> This was a pre-post study design surrounding the implementation of a gas exchange program used during a small-group session with students working through a manual of prepared experiments during the 2023-2024 academic year at the Johns Hopkins University School of Medicine. Student examination scores before program implementation (academic year 2022-23) were compared with student examination scores after program implementation. Questions were dichotomized <i>a priori</i> based on their relevance to the principles reinforced by the program. Student perceptions of the program were assessed by a postcourse survey. <b>Results:</b> When comparing the control (<i>n</i> = 106) and intervention (<i>n</i> = 114) groups, scores improved for both non-gas exchange questions (<i>P</i> < 0.001) and gas exchange questions (<i>P</i> < 0.001). Although the improvement in gas exchange questions was greater than in other questions, this difference did not reach statistical significance (<i>P</i> = 0.09 for the interaction term). Most students were satisfied with the program and rated it more useful than a traditional didactic lecture. <b>Conclusion:</b> At a time when medical school instruction is dominated by lectures with few laboratory-based exercises, we offer this interactive, computer-based program as a strategy to reinforce principles of gas exchange. By tailoring accompanying cases and exercises to different groups of learners, this resource can be implemented in diverse settings.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"74-84"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256486","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}

{"title":"Gastroesophageal Balloon Tamponade Tube Placement for Acute Variceal Hemorrhage.","authors":"Christopher J Mowry, Cody McIlvain, Michael S Kriss, Anna T Neumeier, Maria E Moreira","doi":"10.34197/ats-scholar.2024-0066VO","DOIUrl":"10.34197/ats-scholar.2024-0066VO","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 1","pages":"111-112"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756184","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}

{"title":"Silicosis: A Chronic Work-related Lung Disease.","authors":"Jane C Fazio, Amy Heinzerling, Sheiphali A Gandhi, Carrie A Redlich, Kristin J Cummings","doi":"10.34197/ats-scholar.2024-0118PE","DOIUrl":"10.34197/ats-scholar.2024-0118PE","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"113-116"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442718","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}

{"title":"Mapping Pediatric Pulmonary Milestones 2.0 to Entrustable Professional Activities.","authors":"Erica L Stevens, Laura E Chiel, Melanie S Collins, Jennifer A Rama, Charles R Esther, Kristen Richard, Benjamin A Nelson, Pnina Weiss, Brenda Nuncio, David A Turner, Debra Boyer","doi":"10.34197/ats-scholar.2024-0105BR","DOIUrl":"10.34197/ats-scholar.2024-0105BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"30-35"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191281","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}

{"title":"Improving Leadership Handling of Student Concerns about Faculty Benefits Both Students and Faculty.","authors":"John A Rankin","doi":"10.34197/ats-scholar.2024-0034PS","DOIUrl":"10.34197/ats-scholar.2024-0034PS","url":null,"abstract":"<p><p>For centuries, students have had minimal power in the dynamic relationship with faculty. Understandably, then, students have been reluctant to express concerns about faculty behavior believed to be counterproductive to a safe and positive learning environment. In more recent times, medical students have increasingly been encouraged to voice concerns about faculty behavior that students believe is counterproductive. However, medical students frequently are not experienced in the expression of their concerns and are uncomfortable with and reluctant to engage in direct discussions with faculty. As medical schools continue to encourage students to express their concerns, they have an opportunity to teach students to voice these concerns productively, to help students overcome their inherent reluctance to deal directly with faculty, and thereby to teach critical conflict management skills that will serve students throughout their careers. I propose two actionable and specific ways medical schools can teach students and faculty alike to work together to their mutual benefit. The first is by requiring students to be actively involved in direct discussions with faculty when concerns are expressed, and the second is for faculty to be educated more comprehensively on how to handle emotionally and practically the expressions of student concerns. In this manner, medical schools foster the building of student conflict management skills that will benefit them throughout their careers. In addition, medical schools foster the building of bonds between students and patients, as well as faculty and colleagues, who may hold different viewpoints. Both students and faculty stand to benefit from implementing these strategies. Furthermore, this evens the power differential in the dynamics of their relationship by moving the power pendulum to the more equitable middle position.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"24-29"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257271","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}

{"title":"Impact of Pulmonary and Critical Care Fellow Participation during Advanced Diagnostic Bronchoscopy.","authors":"Ara A Chrissian, Sevwandi De Silva, Erin Wiltchik, Brian Furukawa, Nico S Rizzo, Elliot Ho, Dafne Moretta, Gregory Cheek","doi":"10.34197/ats-scholar.2024-0067OC","DOIUrl":"10.34197/ats-scholar.2024-0067OC","url":null,"abstract":"<p><p><b>Background:</b> Pulmonary and critical care medicine (PCCM) fellows frequently participate in advanced diagnostic bronchoscopy (ADB) procedures. <b>Objective:</b> To investigate the impact of PCCM fellow involvement during ADB on various procedural outcomes in a real-world setting. <b>Methods:</b> This was a retrospective observational cohort study analyzing prospectively collected registry data of consecutive ADB procedures performed between February 2018 and December 2021. Procedure duration, safety, breadth, and diagnostic performance of ADBs performed by PCCM fellows supervised by interventional pulmonologists (IPs) were compared with those completed solely by IP faculty. <b>Results:</b> Among 628 ADBs, fellows participated in 379 (60.3%). With unadjusted analysis, fellow-involved cases were a median 11.5 minutes longer for convex-probe endobronchial ultrasound bronchoscopy (95% confidence interval [CI], 6.0-14.0; <i>P</i> < 0.001) and 10.5 minutes longer for peripheral bronchoscopy (95% CI, 2.0-18.0; <i>P</i> = 0.016). Compared with ADBs performed by IP faculty alone, procedures with second-year (post-graduate year 5) fellows had the largest duration differences. These included convex-probe endobronchial ultrasound bronchoscopy (+14.5 min; 95% CI, 7.0-18.0 min; <i>P</i> < 0.001), cases not using rapid on-site evaluation (+14.0 min; 95% CI, 8.0-21.0 min; <i>P</i> < 0.001) and those performed with moderate sedation (+12.0 min; 95% CI, 7.0-18.0 min; <i>P</i> < 0.001). After multivariate adjustment, fellow-involved procedures overall were 7.2 minutes longer in duration (95% CI, 3.8-10.5; <i>P</i> < 0.001), and 8.8 minutes longer when performed by post-graduate year 5 fellows-an approximate 16% decrease in efficiency. Bronchoscopies performed with fellows were also more likely to experience complications (38.7% compared with 25.8% with faculty procedures; adjusted odds ratio [OR], 2.0; 95% CI, 1.3-3.0; <i>P</i> < 0.001) and be prematurely terminated (adjusted OR, 4.95; 95% CI, 1.44-17.02; <i>P</i> = 0.011). Diagnostic performance and occurrence of major complications were similar between fellow and no-fellow bronchoscopies. <b>Conclusion:</b> Participation of PCCM fellows during ADB increases procedure duration and the risk for minor complications compared with cases completed solely by IPs. Procedures performed with fellows on the steepest portion of the ADB learning curve are the least efficient. Fellowship directors and faculty bronchoscopists should acknowledge these potential impacts on ABD practice while optimizing the approach to bronchoscopy training.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":" ","pages":"36-51"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257343","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}

{"title":"Are We There Yet? Equity in the Pulmonary and Critical Care Medicine Fellowship Application Process.","authors":"E Mirna Mohanraj","doi":"10.34197/ats-scholar.2025-0027ED","DOIUrl":"10.34197/ats-scholar.2025-0027ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"6 1","pages":"4-7"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756178","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}