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The module has been well received, and 100% of survey respondents have agreed that after completing the activity, they had a better understanding of how to approach a recent traveler with diarrhea and abdominal pain.
While most medical students will not travel abroad for traditional global health experiences, many will encounter patients with recent travel or immigration and must therefore be prepared to treat diseases typically categorized as global health. We developed this simulation and successfully incorporated workup of a returning traveler into the medical school curriculum for clerkship students.
While most medical students will not travel abroad for traditional global health experiences, many will encounter patients with recent travel or immigration and must therefore be prepared to treat diseases typically categorized as global health. We developed this simulation and successfully incorporated workup of a returning traveler into the medical school curriculum for clerkship students.
Pediatric residencies are expected to arm trainees with skills in quality improvement (QI) that allow trainees to systematically enhance their own practice. Simulation has been shown to be effective in teaching QI, but there are no published QI simulation tools that target pediatric learners.
We adapted a previously developed QI simulation to include a case relevant for pediatric residents. Participants devised interventions using basic QI principles with iterative feedback from facilitators with knowledge of QI methodology. Changes in resident knowledge, attitudes about the curriculum, and depth of engagement in QI were assessed using pre- and posttests, surveys, and assessment of independent QI activities performed prior to graduation, respectively.
Eighty-two residents completed the simulation. Of the 76 residents who completed both the pre- and posttests, which each had a total possible score of 28 points, 68% had improved posttest scores, with an average score increase of 2.6 points (
= 0.6,
< .001). learn more Improvements were most pronounced for residents that scored in the lowest quartile on the pretest. After the simulation, residents reported greater confidence in and likelihood of completing a QI initiative. There was no difference in the level of involvement in future independent QI activities completed by residents who were simulation participants compared with nonparticipants.
Adapting a previously published QI simulation for pediatric residents was feasible and effective, and the QI simulation was well-liked by learners. Those with lower baseline QI knowledge may have the most to gain from this simulation.
Adapting a previously published QI simulation for pediatric residents was feasible and effective, and the QI simulation was well-liked by learners. Those with lower baseline QI knowledge may have the most to gain from this simulation.
The interpretation of electrocardiograms (ECGs) is a critical competency for internal medicine trainees, yet time and resources to foster proficiency are limited.
This resident-authored ECG email curriculum for first-year residents involved 129 first-year internal medicine residents at three major academic university hospitals. Residents either received the resident-authored ECG email curriculum (intervention group) or continued standard training (control group). The curriculum involved 10 multiple-choice ECG cases emailed biweekly over the 6-month study period. All participants were asked to complete a pre- and postintervention test to assess ECG interpretation competency and attitudes. The primary outcome was improvement in ECG test performance.
Among the 129 first-year residents participating, 21 of the 65 (32%) randomized to the intervention group and 13 of the 64 (20%) randomized to the control group completed both the pre- and posttests for analysis. While all participants' ECG test scores improved over the study period (
< .001), improvement did not differ between groups (
= .860). We found that the effect of the intervention on ECG test performance varied significantly by the number of cardiology rotations an intern experienced (
= .031), benefiting naïve learners the most. All intervention group participants who completed the posttest reported they would recommend it to a colleague.
While it did not improve resident performance on an ECG posttest, this resident-authored ECG email curriculum offers a scalable way to provide trainees additional practice with ECG interpretation, with particular benefit to trainees who have not yet rotated on cardiology.
While it did not improve resident performance on an ECG posttest, this resident-authored ECG email curriculum offers a scalable way to provide trainees additional practice with ECG interpretation, with particular benefit to trainees who have not yet rotated on cardiology.Inflammation-modulating nutrients and inflammatory markers are established cancer risk factors, however, evidence regarding the association between post-diagnosis diet-associated inflammation and breast cancer survival is relatively sparse. We aimed to examine the association between post-diagnosis dietary inflammatory index (DII®) and risks of all-cause and breast cancer-specific mortality. A total of 1064 female breast cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial prospective cohort, were included in this analysis if they had completed the diet history questionnaire (DHQ). Energy-adjusted DII (E-DIITM) scores were calculated based on food and supplement intake. Cox regression and competing risk models were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by E-DII tertile (T) for all-cause and breast cancer-specific mortality. With median follow-up of 14.6 years, there were 296 (27.8%) deaths from all causes and 100 (9.4%) breast cancer-specific death. The E-DII was associated with all-cause mortality (HR T3 vs T1, 1.34; 95% CI, 1.01-1.81; Ptrend, 0.049, Table 2) and breast cancer mortality (HR T3 vs T1, 1.47; 95% CI, 0.89-2.43; Ptrend, 0.13; multivariable-adjusted HR for 1-unit increment 1.10; 95% CI 1.00-1.22). Non-linear positive dose-response associations with mortality from all causes were identified for E-DII scores (Pnon-linearity less then 0.05). The post-diagnosis E-DII was statistically significantly associated with mortality risk among breast cancer survivors. Long-term anti-inflammatory diet might be a means of improving survival of breast cancer survivors.
