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Staff Physicians (staff + physician)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Knowledge to action: Scholarship for faculty and staff

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 1 2009
FAAPArticle first published online: 13 MAR 200, FRCPC, Savithiri Ratnapalan MBBS
Abstract Introduction: This study was undertaken to evaluate the influence of a continuing education course in facilitating the development and implementation of educational projects of course participants. Methods: This is a case study evaluating a full-year course that consisted of 11 monthly seminars, each 4 hours in length, including practice in a computer laboratory. The class size was limited to 12 participants. Needs-assessment surveys at the beginning of the course, student evaluations, and midterm and final progress reports were analyzed. Results: Seven staff physicians, 3 clinical fellows, a nurse educator, and a research assistant enrolled in the course. Initial needs-assessment surveys indicated that most people had adequate computer skills,11 (90%),but only 2 (17%) were able to type well, 11 (90%) had no statistical knowledge, and 10 (83%) had limited literature-searching skills. The mean score on speaker evaluations for lectures was 4.5 on a scoring scheme of 1,5 where 1 was poor and 5 was outstanding. Ten participants (83%) had a complete proposal for an educational project written by midterm. Nine participants applied for external grants and 2 of them received external funding for their projects. Five participants (42%) completed a publishable educational project by the end of the 11-month course, and submitted it for presentation at scientific meetings. Discussion: Like many adults, health care professionals experience limited time for involvement in formal education. This study shows that a limited-time-commitment course could facilitate health care professionals to develop and successfully implement educational projects translating ideas into action. [source]

Trends in Midlevel Provider Utilization in Emergency Departments from 1997 to 2006

ACADEMIC EMERGENCY MEDICINE, Issue 10 2009
Michael D. Menchine MD
Abstract Objectives:, The objective was to quantify the expansion of midlevel provider (MLP) practice in U.S. emergency departments (EDs) over the past decade. Specifically, we sought to quantify the absolute number of patients seen by MLPs, the annual growth rate of patients seen by MLPs, and the expansion in the proportion of EDs using MLPs. Methods:, Data were analyzed from the ED portion of the 10 most recent years (1997 to 2006) National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative survey of ED visits compiled by the Centers for Disease Control and Prevention (CDC). The main outcomes of interest were the proportion and absolute numbers of ED patients seen by MLPs during the 10-year study period. National estimates derived from sample weights are reported. In addition, a multivariate logistic regression model was created with "seen by midlevel provider" as the dependent variable to determine factors associated with being seen by a MLP. Results:, Between 1997 and 2006, 8.23% (95% confidence interval [CI] = 7.31% to 9.15%) of ED patients were seen by a MLP. The proportion of ED patients seen by MLPs increased from 5.5% (95% CI = 3.8% to 7.1%) in 1997 to 12.7% (95% CI = 10.5% to 14.9%) in 2006 (13% annual growth). This corresponds to an increase in the number of ED patients seen by MLPs from 5.2 million in 1997 to 15.2 million in 2006. The proportion of hospitals using MLPs in the ED increased from 28.3% (95% CI = 22.4% to 34.1%) in 1997 to 77.2% (95% CI = 71.2% to 83.3%) in 2006 (17% annual growth). Slightly over half of MLP cases (54.9%; 95% CI = 49.1% to 60.7%) were also seen by staff physicians. On multivariate regression, younger patient age, non,southern geographic region, and triage acuity were associated with increased MLP use. Conclusions:, The number of ED patients seen by MLPs has increased sharply, from 5.2 million in 1997 (5.5% of all ED cases) to 15.2 million in 2006 (12.7% of all ED cases). Similarly, the proportion of EDs reporting use of MLPs has increased from 28.3% in 1997 to 77.2% in 2006. [source]

Building a Simulation-based Crisis Resource Management Course for Emergency Medicine, Phase 1: Results from an Interdisciplinary Needs Assessment Survey

ACADEMIC EMERGENCY MEDICINE, Issue 11 2008
Christopher M. Hicks BSc
Abstract Introduction:, Emergency department (ED) resuscitation requires the coordinated efforts of an interdisciplinary team. Human errors are common and have a negative impact on patient safety. Although crisis resource management (CRM) skills are utilized in other clinical domains, most emergency medicine (EM) caregivers currently receive no formal CRM training. Objectives:, The objectives were to compile and compare attitudes toward CRM training among EM staff physicians, nurses, and residents at two Canadian academic teaching hospitals. Methods:, Emergency physicians (EPs), residents, and nurses were asked to complete a Web survey that included Likert scales and short answer questions. Focus groups and pilot testing were used to inform survey development. Thematic content analysis was performed on the qualitative data set and compared to quantitative results. Results:, The response rate was 75.7% (N = 84). There was strong consensus regarding the importance of core CRM principles (i.e., effective communication, team leadership, resource utilization, problem-solving, situational awareness) in ED resuscitation. Problems with coordinating team actions (58.8%), communication (69.6%), and establishing priorities (41.3%) were among factors implicated in adverse events. Interdisciplinary collaboration (95.1%), efficiency of patient care (83.9%), and decreased medical error (82.6%) were proposed benefits of CRM training. Communication between disciplines is a barrier to effective ED resuscitation for 94.4% of nurses and 59.7% of EPs (p = 0.008). Residents reported a lack of exposure to (64.3%), yet had interest in (96.4%) formal CRM education using human patient simulation. Conclusions:, Nurses rate communication as a barrier to teamwork more frequently than physicians. EM residents are keen to learn CRM skills. An opportunity exists to create a novel interdisciplinary CRM curriculum to improve EM team performance and mitigate human error. [source]

Scholarship in Emergency Medicine in an Environment of Increasing Clinical Demand: Proceedings from the 2007 Association of American Medical Colleges Annual Meeting

ACADEMIC EMERGENCY MEDICINE, Issue 6 2008
Chet Schrader MD
Abstract Academic emergency medicine can benefit by broadening the way in which scholarship is defined to include teaching, integration of knowledge, application of knowledge to practical clinical problems and as discovery of new knowledge. A broad view of scholarship will help foster innovation and may lead to new areas of expertise. The creation of a scholarly environment in emergency medicine faces the continued challenge of an increasing clinical demand. The solution to this dilemma will likely require a mix of clinical staff physicians and academic faculty who are appreciated, nurtured and rewarded in different ways, for the unique contributions they make to the overall success of the academic program. [source]