ATS scholar最新文献

{"title":"Determination of Priorities for Lung Transplant Education for Pulmonary and Critical Care Medicine Fellows.","authors":"Kavya Kommaraju, Kelly Pennington, Kristopher Kolish, Casey Twining, Diana Kelm","doi":"10.34197/ats-scholar.2024-0046OC","DOIUrl":"10.34197/ats-scholar.2024-0046OC","url":null,"abstract":"<p><strong>Background: </strong>In the United States, a growing number of lung transplants are performed each year, necessitating an increased number of general and transplant pulmonologists skilled in the care of these complex patients. However, pulmonary and critical care medicine (PCCM) fellowships across the country do not universally have dedicated lung transplantation curricula, and there is scarce literature in this area. We describe the generation of a content outline for curriculum development created through modified electronic Delphi methodology.</p><p><strong>Objective: </strong>To identify \"must know\" topics in lung transplantation for a graduating PCCM fellows.</p><p><strong>Methods: </strong>We developed expert consensus on \"must know\" lung transplant topics and subtopics (\"items\") for a graduating fellow through three survey rounds from July 2023 to October 2023. Thirty-three panelists were asked to rank author-provided items as \"must know,\" \"nice to know,\" or \"not necessary to know\" and to generate new items in round 1 to be submitted for ranking in subsequent rounds. \"Must know consensus\" was defined as ≥50% must know responses.</p><p><strong>Results: </strong>Survey response and completion rates across rounds were 58-70% and 96-100%, respectively. In round 1, panelists were provided eight topics and 30 subtopics for initial ranking. Panelists generated 82 new items in this round, of which 19 were included in round 2 for ranking after author review, together with one item from round 1 that required reranking. From round 2, only two items required reranking, and these items comprised round 3. Seven topics were identified as \"must know\": transplant immunology, evaluation of a lung transplant candidate, surgical and peri/postoperative management, rejection, immunosuppression, infections, and other complications, together with 36 subtopics.</p><p><strong>Conclusion: </strong>Self-identified lung transplantation experts obtained consensus on seven \"must know\" topics and 36 subtopics in lung transplantation for graduating PCCM fellows. The findings serve as a starting point for future curriculum development.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"587-598"},"PeriodicalIF":1.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017206","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":"Moving toward Interprofessional Teaching in the Intensive Care Unit: A Mixed Methods Study.","authors":"Aahd Kubbara, Jennifer Wong, Katie Capp, Selam Woldegerima, Michael A Sundberg, Andrew P J Olson, Kathryn Pendleton","doi":"10.34197/ats-scholar.2024-0039OC","DOIUrl":"10.34197/ats-scholar.2024-0039OC","url":null,"abstract":"<p><strong>Background: </strong>There is an evolving focus on interprofessional education (IPE) to promote teamwork and collaboration in health professions education. Studies in medical students have shown that exposure to IPE leads to perceived improvements in interprofessional communication, effective work in healthcare teams, and understanding of professional limitations. Most research focuses on IPE in undergraduate medical education; less is known about how this functions in graduate medical education.</p><p><strong>Objective: </strong>To develop and implement a lecture-based intensive care unit (ICU) educational curriculum, incorporating content delivery by interprofessional team members (IPMs), and to use a mixed methods approach to explore learner and IPM perceptions surrounding the benefits and opportunities with this model of education.</p><p><strong>Methods: </strong>A standardized curriculum of core topics in critical care medicine was designed and implemented as a recurring interactive lecture series over the course of a medical ICU rotation at an academic hospital. The lectures were delivered by pulmonary and critical care attendings or fellows and IPMs, including pharmacists, dietitians, advanced practice providers, and physical therapists. Internal medicine residents' perceptions of faculty engagement in teaching, involvement in interprofessional care teams, and educational value of the rotation were analyzed quantitatively before and after intervention. Semistructured focus groups with residents and IPMs were held after implementation to explore the experience, motivations, and effectiveness of IPMs as educators. Themes were identified using a deductive approach, with coding by multiple team members.</p><p><strong>Results: </strong>Before lecture series implementation, 57 residents completed end-of-rotation evaluations. The average score for perceived faculty engagement and interest in teaching was 4.16 out of 5 (standard deviation [SD], 1.05). Forty-five residents completed evaluations after implementation, and the perception of faculty interest in teaching was not statistically different at 4.20 (SD, 0.92; <i>P</i> = 0.98). Qualitative themes emerging from the focus groups included investment, shared goals and motivation for teaching, specialized knowledge and mutual respect, improving patient care, engagement and environment, downsides, and, finally, prioritization.</p><p><strong>Conclusion: </strong>Teaching by IPMs can be integrated into a lecture-based curriculum in an academic ICU. After implementation, residents identified that engagement of IPMs as teachers may lead to improved understanding of roles and responsibilities and mutual respect. IPMs cite sharing of specialized knowledge and return on investment as motivations for teaching.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"559-574"},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017244","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":"Factors that Influence Applicant Choice of In-Person versus Virtual Interview Format.","authors":"Erin Covert, Andrew Lewis, Aparna Bhat, Lauren Moore, Rendell Ashton, Chao-Ping Wu, Aanchal Kapoor, Raed Dweik, Neal F Chaisson","doi":"10.34197/ats-scholar.2024-0027OC","DOIUrl":"10.34197/ats-scholar.2024-0027OC","url":null,"abstract":"<p><strong>Background: </strong>Governing bodies of graduate medical education recommend conducting interviews virtually. Although most programs remain compliant with this guidance, it is unclear if this is broadly supported by interviewees. Virtual interview (VI), in-person interview (IPI), and virtual interview with an optional in-person visit (VI+) formats have unique strengths and weaknesses. We sought to evaluate this process.</p><p><strong>Objective: </strong>To <i>1</i>) determine which interview format applicants prefer, <i>2</i>) identify factors that influence applicant preference, and <i>3</i>) evaluate applicants' perceived ability to evaluate a program.</p><p><strong>Methods: </strong>Applicants for the pulmonary and critical care medicine and critical care medicine fellowships were offered a choice of interview format during the 2022 interview cycle. Applicants were invited to participate in pre and postinterview questionnaires.</p><p><strong>Results: </strong>Interviews were offered to 88 applicants. Sixty-two applicants (71%) completed the preinterview questionnaire, and 53 applicants (60%) completed both questionnaires. On preinterview surveys, IPI was the most preferred interview format (57%), followed by VI (28%) and VI+ (15.5%). Thirty-eight (43%), 47 (53%), and 3 (4%) applicants attended the IPI, VI, and VI+ formats, respectively. Applicants who preferred VI most commonly cited cost, distance, and ability to arrange time away from work as influential. Applicants who preferred IPI cited the ability to assess program culture and \"fit,\" facilities, and fellowship happiness as influential. Applicants who participated in IPIs were more confident in their ability to assess all program aspects.</p><p><strong>Conclusion: </strong>Most applicants prefer an IPI format. Influential factors differ between those who choose VI versus IPI. Recognizing factors that differentiate preference for IPI versus VI is essential to mitigating potential inequity in this process.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"575-586"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017224","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":"A Practical Guide to Identifying a Supportive Work Environment for Underrepresented Faculty in Academic Medicine.","authors":"Ashley Collazo, Christen Walcher, Kendall M Campbell","doi":"10.34197/ats-scholar.2024-0031PS","DOIUrl":"10.34197/ats-scholar.2024-0031PS","url":null,"abstract":"<p><p>Much has been added to the literature to better characterize and define the experiences of faculty who are underrepresented in medicine and other health professions. Additions include approaches for faculty development and suggestions for institutions on how to create equitable environments that promote the success and advancement of this group. Despite all these additions to the literature, health professions educators still lack practical approaches to determine supportive academic health center environments that are receptive to their needs and resourced to promote their career success. To the authors' knowledge, there has not been a paper that uses a validated framework and practical approach to advise underrepresented faculty in the health professions on how to evaluate an academic health system. Adapting criteria used to determine the rigor of qualitative research, the authors propose such an evaluative approach.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"500-507"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017239","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":"Lessons Learned from Integrating Educational Technology into the Preclerkship Teaching of Pulmonary Medicine.","authors":"James M Walter, Angelique N Dueñas, Joseph P Horne, James B Brucker","doi":"10.34197/ats-scholar.2024-0032PS","DOIUrl":"10.34197/ats-scholar.2024-0032PS","url":null,"abstract":"<p><p>The structure and delivery of preclerkship undergraduate medical education has changed significantly over the past decade. Asynchronous didactic lectures are now routinely paired with in-person sessions that emphasize active and small-group learning. In this environment, educators tasked with teaching pulmonary medicine should be familiar with the growing number of educational technologies that can transform how and where content is delivered to students. In this Perspective, we review how educational technologies have been integrated into the preclerkship pulmonary module at the Northwestern University Feinberg School of Medicine. We hope our experience provides a road map for the integration of these tools in other educational settings. We cover how educational technology can facilitate asynchronous learning (prerecorded lectures and online message boards) as well as active in-person learning (audience response systems and technology-enhanced learning spaces). Throughout, we highlight best practices for the technologies discussed.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"518-530"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017227","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":"The March to Health Equity and Justice in Pulmonary and Critical Care Medicine.","authors":"Mark C Henderson, Marcos I Restrepo, David Henderson","doi":"10.34197/ats-scholar.2024-0028PS","DOIUrl":"10.34197/ats-scholar.2024-0028PS","url":null,"abstract":"<p><p>Training programs in pulmonary and critical care medicine have greatly expanded in the past decade, yet they do not reflect the racial/ethnic and economic diversity of the United States, which has significant implications for health equity. The lack of representation across medical education is likely to worsen with the recent Supreme Court decision banning affirmative action. The authors review health disparities in pulmonary and critical care medicine, the relationship of the workforce to health equity, and 10 tactics for addressing this urgent public health issue.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"492-499"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017285","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":"Pediatric Pulmonary Fellowship Interviews: The More Options, the Better.","authors":"Kristen Richard, Stephen Kirkby, Lara Bishay, Tanya M Martinez-Fernandez, Kensho Iwanaga, Beverley J Sheares, Aliva De, Benjamin A Nelson","doi":"10.34197/ats-scholar.2024-0052BR","DOIUrl":"10.34197/ats-scholar.2024-0052BR","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"531-537"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017245","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":"Accuracy of Echocardiographic Cardiac Output Assessment by Critical Care Fellows.","authors":"Jordan Talan, Keshav Mangalick, Deepak Pradhan, Harald Sauthoff","doi":"10.34197/ats-scholar.2024-0030OC","DOIUrl":"10.34197/ats-scholar.2024-0030OC","url":null,"abstract":"<p><strong>Background: </strong>Advanced critical care echocardiography comprises a specific set of qualitative and quantitative point-of-care echocardiography skills, including a reliable, noninvasive method to measure cardiac output. This technique requires echocardiographic measurement of left ventricular outflow tract (LVOT) diameter and LVOT velocity time integral (VTI). Although there is a demand among critical care fellows to learn these advanced techniques, there are no data describing the acquisition of mastery in these skills.</p><p><strong>Objective: </strong>This pilot study aims to describe the accuracy of echocardiographic measurement of LVOT diameter and LVOT VTI obtained by critical care fellows after an educational intervention, as well as to enhance validation evidence for an image scoring assessment that is applicable to these measurements.</p><p><strong>Methods: </strong>We implemented a brief mastery learning intervention to teach the measurement of LVOT diameter and VTI. Fellow measurements of these parameters, along with the corresponding echocardiographic images, were compared with a gold standard of measurements obtained by professional echocardiography technicians and interpreted by cardiologists.</p><p><strong>Results: </strong>Seven fellows performed 35 echocardiograms on 32 patients. The average fellow-reported LVOT VTI was 17.0 ± 4.37 cm, whereas the average cardiologist-reported VTI was 17.3 ± 5.19 cm. The correlation (<i>r</i>) between fellow and cardiologist-reported VTI was 0.73 (<i>P</i> < 0.001), with a mean percent difference of 19.5 ± 12.0%. The average fellow-reported LVOT diameter was 2.07 ± 0.23 cm, whereas the average cardiologist-reported LVOT diameter was 2.08 ± 0.22 cm. The correlation (<i>r</i>) between fellow and cardiologist-reported LVOT diameter was 0.51 (<i>P</i> = 0.004), with a mean percent difference of 8.05 ± 7.0%. The sensitivity for fellows to detect an abnormal LVOT VTI was 91%, with a specificity of 43%.</p><p><strong>Conclusion: </strong>Critical care fellow measurement of LVOT VTI and LVOT diameter demonstrated strong and moderate positive correlations with cardiologist-reported values, respectively, with acceptable clinical agreement. However, interrater reliability and percent differences showed room for improvement. Education in these advanced skills is resource intensive, and additional research is needed to determine the most effective approach to training fellows.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"547-558"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017243","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":"Reflections on a Respiratory Therapy Postgraduate Certificate Program in Chile.","authors":"Eduardo Kattan, Roque Basoalto, Jaime Retamal, Vanessa Oviedo, Alejandro Bruhn, Guillermo Bugedo","doi":"10.34197/ats-scholar.2024-0025PS","DOIUrl":"10.34197/ats-scholar.2024-0025PS","url":null,"abstract":"<p><p>Chile is a South American country that spans 4,300 km from north to south. Population density and access to critical care are highly concentrated in Santiago's metropolitan region. After the educational challenges posed by the 2009 H1N1 influenza pandemic, our critical care department at the Pontificia Universidad Católica de Chile in Santiago created the Respiratory Therapy Postgraduate Certificate as an educational intervention to address the shortage of healthcare professionals with knowledge and skills in performing respiratory support in critically ill patients. Throughout this Perspective, we aim to delineate the program design, major educational results, implementation of educational innovations that allowed us to adapt to the geographical challenges of the country and those imposed by the coronavirus disease (COVID-19) pandemic, and future challenges identified for the next decade.</p>","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 4","pages":"508-517"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017247","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":"Competency in Communication Skills: Curriculum Is Just the Beginning.","authors":"Erica Lin","doi":"10.34197/ats-scholar.2024-0098ED","DOIUrl":"10.34197/ats-scholar.2024-0098ED","url":null,"abstract":"","PeriodicalId":72330,"journal":{"name":"ATS scholar","volume":"5 3","pages":"348-350"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382601","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}