Baylor University Medical Center Proceedings最新文献_第4页

Leveraging just-in-time simulation to train ad hoc teams. 利用即时模拟来培训特别团队。

Baylor University Medical Center Proceedings Pub Date : 2025-06-12 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2515550

Matthew G Tung, Catherine F Jerman, Michael G Healy, Yoon Soo Park, Bobbie Ann Adair White, Britlyn D Orgill

{"title":"Leveraging just-in-time simulation to train ad hoc teams.","authors":"Matthew G Tung, Catherine F Jerman, Michael G Healy, Yoon Soo Park, Bobbie Ann Adair White, Britlyn D Orgill","doi":"10.1080/08998280.2025.2515550","DOIUrl":"10.1080/08998280.2025.2515550","url":null,"abstract":"Background: Simulation prepares clinicians for managing healthcare emergencies in ad hoc teams. However, simulation curricula are often resource, personnel, and time intensive. Applying \"just-in-time\" (JIT) methodology to simulation training for ad hoc teams may provide similar benefits with fewer resources, although its effectiveness and perceived benefit remain unknown.Methods: To determine if JIT teamwork simulation for ad hoc teams is perceived to increase confidence in managing emergencies and improve teamwork during a call shift, anesthesiology residents participated in JIT teamwork simulation training immediately prior to their overnight call shift from 2020 to 2022. After the call shift, residents completed a survey gathering feedback about the simulation, its impact on their confidence managing the simulated emergencies, and their perception of the call team's dynamic and management of real emergencies overnight.Results: Of 109 participants, 66 (60.5%) completed the survey. Confidence in managing emergencies rose from 39.8 (SD = 20.7) to 66.4 (SD = 17.9) out of 100 after simulation (P < 0.001, Cohen's d = 1.38). Content analysis of the open-ended responses focusing on the residents' perception of the call team's dynamic and management of real emergencies overnight resulted in two categories: (1) improved ad hoc teaming and (2) improved use of crisis resource management skills by the overnight team.Conclusions: After a single session before an overnight shift, JIT teamwork simulation increased anesthesia residents' self-reported confidence in managing emergencies, and residents perceived an improvement in ad hoc teamwork and use of crisis resource management skills overnight.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"666-672"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871167","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}

引用次数: 0

Should transjugular intrahepatic portosystemic shunt be first-line therapy for preventing esophageal variceal rebleeding? A meta-analysis of clinical outcomes. 经颈静脉肝内门静脉系统分流术应作为预防食管静脉曲张再出血的一线治疗方法吗？临床结果荟萃分析。

Baylor University Medical Center Proceedings Pub Date : 2025-06-11 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2514978

Rutaab Kareem, Aimen Nadeem, Noor Us Sehar, Zuha Majid, Tehniat Fatima, Rahma Anwar

{"title":"Should transjugular intrahepatic portosystemic shunt be first-line therapy for preventing esophageal variceal rebleeding? A meta-analysis of clinical outcomes.","authors":"Rutaab Kareem, Aimen Nadeem, Noor Us Sehar, Zuha Majid, Tehniat Fatima, Rahma Anwar","doi":"10.1080/08998280.2025.2514978","DOIUrl":"10.1080/08998280.2025.2514978","url":null,"abstract":"Introduction: According to Baveno VII guidelines, endoscopic band ligation (EBL) plus nonselective beta-blockers (NSBB) is first-line therapy for preventing esophageal variceal rebleeding, with transjugular intrahepatic portosystemic shunt (TIPS) being used in cases of treatment failure. Our study aimed to compare TIPS with EBL plus NSBB in terms of overall mortality and rate of variceal rebleeding.Methods: We conducted a comprehensive search on Medline, Google Scholar, Embase, and the Cochrane Library up to January 25, 2025. Randomized control trials (RCTs) comparing TIPS with EBL plus NSBB for variceal bleeding were included in the study.Results: Eight RCTs with 629 patients, 336 receiving TIPS and 293 receiving EBL + NSBB, were included. TIPS had significantly lower rates of variceal rebleeding (odds ratio 0.30, 95% confidence interval 0.19-0.49, P < 0.00001), all-cause rebleeding (P < 0.0001), total episodes of rebleeding (P < 0.0001), new/worsening ascites (P < 0.0001), and peritonitis (P = 0.01). No significant differences were found in mortality, sepsis/pneumonia, hepatic encephalopathy, or hepatocellular carcinoma.Conclusion: TIPS offers significant advantages over EBL plus NSBB in reducing variceal rebleeding and other complications but does not improve mortality. Further high-powered trials are needed to refine management strategies for variceal rebleeding in cirrhotic patients.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"627-636"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871238","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}

引用次数: 0

Variance in state Medicaid coverage of hedgehog pathway inhibitors in the treatment of basal cell carcinoma. 刺猬通路抑制剂在治疗基底细胞癌的国家医疗补助覆盖范围的差异。

Baylor University Medical Center Proceedings Pub Date : 2025-06-09 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2508066

Neha Arora, Elena Skaggs, Lindsay Bicknell

引用次数: 0

Optimizing rectal cancer surgery. 优化直肠癌手术。

Baylor University Medical Center Proceedings Pub Date : 2025-06-05 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2512496

Warren E Lichliter

引用次数: 0

Renal artery stent thrombosis as a complication of percutaneous renal artery revascularization and stent placement. 肾动脉支架内血栓形成是经皮肾动脉血管重建术和支架置入的并发症。

Baylor University Medical Center Proceedings Pub Date : 2025-06-05 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2510058

Siddhant Passey, Shubhi Pandey, Aryan Mehta, Joyce Meng, Michael Azrin

引用次数: 0

Clinical approach to respiratory failure in the obstetric patient: a comprehensive clinical review. 产科患者呼吸衰竭的临床方法：一项全面的临床回顾。

Baylor University Medical Center Proceedings Pub Date : 2025-06-04 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2506960

Daniel Feuer, Vinita Shivakumar, Muhammad Abu-Rmaileh, Adan Mora

引用次数: 0

Authentic leadership in clinical practice: barriers and benefits for female academic physician leaders. 临床实践中的真实领导力：女性学术医师领导者的障碍与益处。

Baylor University Medical Center Proceedings Pub Date : 2025-06-02 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2510044

Lindsay Mathys, Michael Dewsnap, Medha Narwankar

{"title":"Authentic leadership in clinical practice: barriers and benefits for female academic physician leaders.","authors":"Lindsay Mathys, Michael Dewsnap, Medha Narwankar","doi":"10.1080/08998280.2025.2510044","DOIUrl":"10.1080/08998280.2025.2510044","url":null,"abstract":"Background: Female academic physician leaders (FAPLs) encounter challenges in their leadership roles, including gendered leadership expectations or fear of judgment, impacting their ability to express authenticity. This study examined FAPLs' perceptions of authentic leadership, factors shaping their leadership behaviors, and how authenticity influences their effectiveness as a leader.Methods: Using a convergent mixed-methods design, 40 FAPLs at Texas A&M University College of Medicine were invited to participate. Nine completed the Authentic Leadership Questionnaire (ALQ), and 10 participated in semi-structured interviews.Results: Quantitative analysis revealed the strongest alignment with moral/ethical leadership dimensions, with a significant difference (P < 0.05) in decision-making based on core values. Qualitative thematic analysis emphasized authenticity's role in fostering trust, empowerment, and a positive workplace culture. However, participants reported suppressing authentic behaviors due to hierarchical constraints or fear of being perceived as weak. Authenticity was easier with career experience and mentorship from female leaders. While authenticity promoted collaboration and psychological safety, maintaining professional boundaries remained a challenge.Conclusion: FAPLs value authenticity but face various barriers. Experience, mentorship, and institutional support are crucial in fostering environments where FAPLs can thrive. Future research could explore the impact of authentic leadership on workplace cultures within academic medicine.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"684-689"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871125","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}

引用次数: 0

Insights on the rising epidemic of early onset gastric cancer. 关于早发性胃癌日益流行的见解。

Baylor University Medical Center Proceedings Pub Date : 2025-05-30 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2500241

Masen Ragsdale, Catherine H Davis

引用次数: 0

Piloting the first pediatric-specific serious illness conversation program training at Baylor Scott & White. 在贝勒·斯科特·怀特医院试行首个儿科重症对话项目培训。

Baylor University Medical Center Proceedings Pub Date : 2025-05-28 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2508062

Jessica Justus Kurian, Jennifer N Fan, Autumn Stratton, Stephanie Blasick

{"title":"Piloting the first pediatric-specific serious illness conversation program training at Baylor Scott & White.","authors":"Jessica Justus Kurian, Jennifer N Fan, Autumn Stratton, Stephanie Blasick","doi":"10.1080/08998280.2025.2508062","DOIUrl":"10.1080/08998280.2025.2508062","url":null,"abstract":"Background: The need for advanced care planning in pediatrics is becoming more recognized as children live longer with chronic illnesses. In April 2023, the first cohort of pediatric residents in the Baylor Scott & White system underwent Serious Illness Conversation Program (SICP) training. This quality improvement project aimed to increase pediatric residents' confidence in conducting serious illness conversations and increase the number of conversations led by pediatric residents within 6 months of undergoing SICP training.Methods: An in-person half-day SICP training session was conducted by the palliative care team. Fourteen pediatric residents attended the session. A posttraining survey was taken to assess participants' impressions before and after the training, rating SICP elements on a Likert scale of confidence from 1 (low) to 7 (high). The same questionnaire was administered 6 months later to determine the longitudinal effect of the training.Results: After the training session, residents' self-perceived confidence levels of starting a serious illness conversation significantly increased from an average of 2.1 to 4.9 (P < 0.01). Confidence levels of eliciting a patient's thoughts and goals increased from 3.5 to 6.1 (P < 0.01). Six months later, confidence ratings remained significantly increased compared to pretraining levels, with averages of 4.5 and 5.3, respectively (P < 0.01). The quantity of serious illness conversations conducted remained low.Conclusion: Pediatric residents' self-perceived confidence levels increased significantly immediately after SICP training and remained elevated 6 months later; however, the number of SICP conversations taking place did not change.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"652-655"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871171","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}

引用次数: 0

The importance of physician advocacy. 医生倡导的重要性。

Baylor University Medical Center Proceedings Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2507547

A Jimmy Widmer

引用次数: 0