Scanning for QI: Outcomes from a Resident and Sonographer Driven Improvement of Radiology Resident Ultrasound Technique

Objective The aim of this structural quality improvement (QI) project was to improve the educational ultrasound curriculum. We created the pilot for an enduring addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust. Stakeholders included not only the radiology residency, which would benefit from improved resident education and knowledge, but also the hospital and ultimately patients, who stand to benefit from improved delivery of care

Akt kinase C-terminal modifications control activation loop dephosphorylation and enhance insulin response.

The Akt protein kinase, also known as protein kinase B, plays key roles in insulin receptor signalling and regulates cell growth, survival and metabolism. Recently, we described a mechanism to enhance Akt phosphorylation that restricts access of cellular phosphatases to the Akt activation loop (Thr(308) in Akt1 or protein kinase B isoform alpha) in an ATP-dependent manner. In the present paper, we describe a distinct mechanism to control Thr(308) dephosphorylation and thus Akt deactivation that depends on intramolecular interactions of Akt C-terminal sequences with its kinase domain. Modifications of amino acids surrounding the Akt1 C-terminal mTORC2 (mammalian target of rapamycin complex 2) phosphorylation site (Ser(473)) increased phosphatase resistance of the phosphorylated activation loop (pThr(308)) and amplified Akt phosphorylation. Furthermore, the phosphatase-resistant Akt was refractory to ceramide-dependent dephosphorylation and amplified insulin-dependent Thr(308) phosphorylation in a regulated fashion. Collectively, these results suggest that the Akt C-terminal hydrophobic groove is a target for the development of agents that enhance Akt phosphorylation by insulin

Scanning for QI: Resident and Sonographer Driven Improvement of Radiology Resident Ultrasound Technique

Objective The aim of this structural QI project is to improve the educational ultrasound curriculum , thus improving overall resident confidence and technical ability in acquiring diagnostic quality sonographic images. Comparing resident confidence levels and performance against their initial benchmarks as well as against yearly cohorts, we plan to create a long standing addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust. Stakeholders include not only the radiology residency, which would benefit from improved resident education and knowledge, but also the hospital and ultimately patients, who stand to benefit from improved delivery of care. Additionally, other residency programs at the hospital can be considered stakeholders, as success of this program raises the possibility of inter departmental educational opportunities.https://jdc.jefferson.edu/patientsafetyposters/1104/thumbnail.jp