A Pediatric Transgender Medicine Curriculum for Multidisciplinary Trainees.
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ABSTRACT:
SUBMITTER: Vance SR
PROVIDER: S-EPMC7187914 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Introduction:While evidence-based medicine (EBM) is an Accreditation Council for Graduate Medical Education core competency, EBM teaching in pediatric subspecialties is rarely reported. Therefore, we designed, implemented, and evaluated this focused EBM curriculum for trainees in neonatal-perinatal medicine. Methods:This EBM curriculum consists of seven weekly 1-hour sessions. Specific EBM skills taught in the sessions include formulating a structured clinical question, conducting an efficient literature search, critically appraising published literature in both intervention and diagnostic studies, and incorporating evidence into clinical decision-making. The course was evaluated by a neonatology-adapted Fresno test (NAFT) and neonatology case vignettes, which were administered to learners before and after the curriculum. This publication includes the needs assessment survey, PowerPoint slides for the seven sessions, the NAFT, and the scoring rubric for the test. Results:The NAFT was internally reliable, with a Cronbach's alpha of .74. The intraclass correlation coefficient of the three raters' variability in assessment of learners was excellent at .98. Mean test scores increased significantly (54 points, p < .001) in 14 learners after the EBM curriculum, indicating an increase in EBM-related knowledge and skills. Discussion:This focused EBM curriculum enhances trainees' knowledge and skills and fosters evidence-based practice. The curriculum can be easily adapted for learners in pediatrics, as well as family medicine, in order to enhance trainees' EBM skills and knowledge.
| S-EPMC6338140 | biostudies-other
Project description:BACKGROUND: The Pediatric Nutrition Series (PNS) consists of ten online, interactive modules and supplementary educational materials that have utilized web-based multimedia technologies to offer nutrition education for pediatric trainees and practicing physicians. The purpose of the study was to evaluate pediatric trainees' engagement, knowledge acquisition, and satisfaction with nutrition modules delivered online in interactive and non-interactive formats. METHODS: From December 2010 through August 2011, pediatric trainees from seventy-three (73) different U.S. programs completed online nutrition modules designed to develop residents' knowledge of counseling around and management of nutritional issues in children. Data were analyzed using SPSS version 19. Both descriptive and inferential statistics were used in comparing interactive versus non-interactive modules. Pretest/posttest and module evaluations measured knowledge acquisition and satisfaction. RESULTS: Three hundred and twenty-two (322) pediatric trainees completed one or more of six modules for a total of four hundred and forty-two (442) accessions. All trainees who completed at least one module were included in the study. Two-way analyses of variance (ANOVA) with repeated measures (pre/posttest by interactive/non-interactive format) indicated significant knowledge gains from pretest to posttest (p?<?0.002 for all six modules). Comparisons between interactive and non-interactive formats for Module 1 (N?=?85 interactive, N?=?95 non-interactive) and Module 5 (N?=?5 interactive, N?=?16 non-interactive) indicated a parallel improvement from the pretest to posttest, with the interactive format significantly higher than the non-interactive modules (p?<?.05). Both qualitative and quantitative data from module evaluations demonstrated that satisfaction with modules was high. However, there were lower ratings for whether learning objectives were met with Module 6 (p?<?0.03) and lecturer rating (p?<?0.004) compared to Module 1. Qualitative data also showed that completion of the interactive modules resulted in higher resident satisfaction. CONCLUSIONS: This initial assessment of the PNS modules shows that technology-mediated delivery of a nutrition curriculum in residency programs has great potential for providing rich learning environments for trainees while maintaining a high level of participant satisfaction.
| S-EPMC4179838 | biostudies-other
Project description:IntroductionThere is a recognized and articulated need for health professionals to understand the definitions, health disparities, and medical management of transgender patients. This recognition comes organically from students requesting more information, and top-down from governing bodies such as the AAMC or the Liaison Committee on Medical Education. Surveys of North American medical schools indicate that training in transgender medicine (specifically, the process of transition) is infrequent and inadequate. One problem underlying this trend may be the lack of resources to help conceptualize and roll out a transgender medicine curriculum.MethodsHere, we report the integration of training in transgender medicine into the organ system-based course Endocrine-Reproduction. This transgender curriculum includes coverage of basic science, clinical management, ethics, and clinical skills. The curriculum leverages an already existing, health care disparity-focused curriculum but adds (1) a didactic component for dissemination and discussion of basic science principles applied to transgender patients and (2) a mock initial encounter between a physician and patient with gender dysphoria.ResultsFollowing the first-time implementation of the transgender curriculum, students were surveyed, with a large majority reporting feeling more prepared to care for transgender patients.DiscussionWe conclude that including a multidisciplinary transgender medicine curriculum in medical school advances the goal of creating safe, effective physicians by providing fundamental knowledge about an underserved population of patients, as well as exampled application of that knowledge.
| S-EPMC6342291 | biostudies-literature
Project description:Introduction:Pediatric bacterial tracheitis is a rare but life-threatening upper airway infection with mortality rates estimated as high as 20%, typically affecting children between 6 months and 12 years old. Given such high mortality rates, we felt it was important to train medical personnel to evaluate and manage this condition. Methods:This simulation-based curriculum was developed for health care professionals involving the evaluation and management of an 8-year-old male with symptoms of fever, stridor, worsening barking cough, and increased work of breathing. Critical actions included identifying stridor and airway respiratory distress; monitoring and supporting airway, breathing, and circulation; administering racemic epinephrine and dexamethasone; and identifying and treating bacterial tracheitis as the underlying cause. Scenario-specific debriefing tools were put together to elicit scenario feedback and aid in formative learning. Results:The scenario was conducted with six fellows and 12 residents and medical students. Per the survey data, the case was rated as highly relevant (median = 5) and highly realistic (median = 5) by participants on a 5-point Likert scale. Discussion:Pediatric bacterial tracheitis is a low frequency, but high-risk scenario that was amenable to simulation as an educational modality and was well-received by participants. The debriefing tools were implemented as a means of helping instructors customize the scenario for learners based on respective educational backgrounds and learning styles.
| S-EPMC7449579 | biostudies-literature
Project description:IntroductionSeizures are a common complaint in the pediatric emergency department. Effective care of this potentially life-threatening medical emergency requires the ability to stabilize the patient while simultaneously identifying and treating the underlying cause. This simulation-based curriculum involves the identification and management of a generalized seizure in a 4-month-old infant secondary to hyponatremia. The target audience is pediatric and emergency medicine residents, fellows, faculty, and nurses.MethodsThere is no prerequisite preparation for the trainees prior to the case. The simulation scenario, simulation environment preparation, teamwork and communication glossary, and PowerPoint presentation are provided for the instructor in preparation for the simulation case. The setting is the emergency department (ED) resuscitation room. The simulation can be conducted in the ED resuscitation room or in the simulation lab. We used a high-fidelity infant mannequin. The debriefing tools have been tailored specifically for this scenario with advice on how the instructor can edit them for different learners.ResultsWe have used this curriculum with a group of six pediatric emergency medicine fellows at various stages of their training at our institution. The curriculum received overwhelmingly positive feedback through the evaluation form.DiscussionThis resource will help support standardization of the teaching process, assisting simulation instructors to maximize their impact. In our experience, we have found that instructors who teach intermittently can successfully foster simulation-based education using similar resources. The inclusion of a learner feedback form supports the instructor's ongoing growth while helping faculty to document their teaching efforts.
| S-EPMC6440407 | biostudies-literature
Project description:The American Thoracic Society Core Curriculum updates clinicians annually in adult and pediatric pulmonary disease, medical critical care, and sleep medicine, in a 3- to 4-year recurring cycle of topics. These topics will be presented at the 2020 International Conference. Below is the pediatric pulmonary medicine core, including pediatric hypoxemic respiratory failure; modalities in noninvasive management of chronic respiratory failure in childhood; surgical and nonsurgical management of congenital lung malformations; an update on smoke inhalation lung injury; an update on vaporizers, e-cigarettes, and other electronic delivery systems; pulmonary complications of sarcoidosis; pulmonary complications of congenital heart disease; and updates on the management of congenital diaphragmatic hernia.
| S-EPMC8015762 | biostudies-literature
Project description:IntroductionCardiac tamponade is an uncommon presentation to the pediatric emergency department and requires early recognition and emergent intervention.MethodsWe developed this patient simulation case to simulate a low-frequency, high-acuity scenario for pediatric emergency medicine fellows and resident physicians in emergency medicine, pediatrics, and family medicine. We ran the case in a pediatric emergency department using a high-fidelity pediatric mannequin and equipment found in the clinical environment, including a bedside ultrasound machine. The case involved a 10-year-old patient with Hodgkin lymphoma who presented with fever, neutropenia, and shock and was found to have a pericardial effusion with tamponade after evaluation. The providers were expected to identify signs and symptoms of shock, as well as cardiac tamponade, and demonstrate appropriate emergent evaluation and management. Required personnel included a simulation technician, instructors, and a nurse. Debriefing tools tailored specifically for this scenario were created to facilitate a formal debriefing and formative learner assessment at the end of the simulation.ResultsThis case has been implemented with 10 pediatric emergency medicine fellows during two 3-year cycles of fellow education. Session feedback reflected a high level of satisfaction with the case and an increased awareness of bedside ultrasound in the identification of cardiac tamponade.DiscussionThis resource for teaching the critical components for diagnosing and managing unstable cardiac tamponade in the pediatric patient, including use of bedside ultrasound, was well received by pediatric emergency medicine fellows.
| S-EPMC6342367 | biostudies-literature
Project description:IntroductionElectrical injuries are rare but potentially life-threatening medical emergencies that require providers to manage a critically ill patient while recognizing and treating the unique sequelae associated with the diagnosis. This simulation case is designed to give pediatric and emergency medicine residents, fellows, attendings, and nurses the opportunity to practice these skills in a realistic setting.MethodsThis simulation-based curriculum was designed for a high-fidelity mannequin in an emergency department resuscitation room but can be adapted to fit a variety of learning environments. The case featured a 16-year-old boy presenting to the emergency department after arresting in the field after sustaining an electrical injury. He developed ventricular tachycardia during the simulation and had significant hyperkalemia, requiring emergent management. The included debriefing tools assisted instructors in providing formative feedback to learners.ResultsA total of 40 residents, medical students, and fellows participated in this scenario and provided overwhelmingly positive feedback about the learning experience. Mean Likert scores for participant confidence related to learning objectives after the simulation were 4 or greater on a 5-point scale.DiscussionThis case was developed to help learners at various levels of training recognize and manage a low-frequency, high-acuity scenario in a standardized environment. Participants specifically had the opportunity to perform airway management, cardiopulmonary resuscitation, defibrillation, and management of hyperkalemia, which may present in real life from a multitude of etiologies. The included materials helped prepare and assist facilitators with debriefing, supplemental education, and bidirectional feedback.
| S-EPMC6342442 | biostudies-literature
Project description:IntroductionAltered mental status can be a challenging presenting symptom in children due to the wide differential diagnosis, which ranges from the relatively benign to the life threatening. Marijuana ingestion and unintentional intoxication are becoming an increasingly common cause of altered mental status in children as marijuana use and availability of enticing marijuana edibles increase in the United States. Because children present with altered mental status rather than the typical marijuana toxidrome, appropriately managing these patients in emergency settings can be particularly challenging.MethodsThis simulation-based curriculum involved the evaluation and management of a 6-year-old boy who presented with altered mental status from acute marijuana intoxication unbeknownst to his parents. Participants systematically evaluated a pediatric patient with a broad differential diagnosis of altered mental status and managed the patient with acute marijuana intoxication. This scenario may be modified based on trainee level (medical student vs. resident vs. fellow).ResultsA total of 20 trainees comprising six emergency medicine fellows and 14 pediatric residents and medical students participated in this simulation curriculum over three iterations. Trainees consistently rated it as an overall positive learning experience for pediatric altered mental status and toxidrome education.DiscussionLow-frequency, high-risk illnesses such as altered mental status due to marijuana intoxication require providers to be familiar with their evaluation and management. This curriculum provides instructors with the materials to successfully implement and improve the simulation over time.
| S-EPMC6342394 | biostudies-literature
Project description:Background. Adherence to Mediterranean dietary patterns reduces the incidence of cardiovascular disease and other major chronic diseases. We aimed to assess the association between participation in kitchen-based nutrition education and Mediterranean diet intake and lifestyle medicine counseling competencies among medical trainees. Methods. The Cooking for Health Optimization with Patients (CHOP) curriculum is a hands-on cooking-based nutrition education program implemented at 32 medical programs (4125 medical trainees) across the United States. Mediterranean diet intake, nutrition attitudes, and lifestyle medicine counseling competencies were assessed via validated surveys. Multivariable-adjusted logistic regression assessed the relationship of CHOP education with Mediterranean diet intake, nutrition attitudes, and lifestyle medicine counseling competencies. Results. Individuals participating in the CHOP program were 82% more likely to follow the Mediterranean diet compared with those receiving traditional nutrition education (OR = 1.82; P < .001). CHOP participants were more likely to satisfy daily intake of fruits (OR = 1.33; P = .019) and vegetables (OR = 2.06; P < .001) and agree that nutrition counseling should be a routine component of clinical care (OR = 2.43; P < .001). Kitchen-based nutrition education versus traditional curricula is associated with a higher likelihood of total counseling competency involving 25 lifestyle medicine categories (OR = 1.67; P < .001). Conclusion. Kitchen-based nutrition education is associated with cardioprotective dietary patterns and lifestyle medicine counseling among medical trainees.
| S-EPMC7092396 | biostudies-literature