Teaching Professionalism: For Us, For Them or Just the LCME

At the conclusion of this presentation the participant should be able to: Understand current definitions of professionalism Understand how we are teaching professionalism at Jefferson Have a basic idea of the importance and requirements of the LCME visit Presentation: 30 minute

The Effect of the Surgery Rotation Sequence on Surgery and Emergency Medicine NBME Scores

Purpose: Within a school, the formerly fourth year emergency medicine clerkship was added to the third year curriculum in a sequence with general surgery and surgical subspecialty clerkships. Together, a student can be placed in any permutation of the three clerkships, but a student will take the Surgery and EM NBME exam after the completion of the respective clerkship regardless of the order of clerkships. The purpose of this project was to look to see if there was a significance difference in NBME scores between four different sequences of clerkships and to see if sequence of a third year student’s clerkship affects NBME scores. Methods: The study cohort consisted of medical students graduating in 2021 (n = 125). The primary measure of interest and data collected was the sequence of three clerkships (emergency medicine, general surgery, and surgical subspecialty), Surgery NBME subject exam score, and Emergency Medicine NBME subject exam score. We reported the descriptive statistics and conducted a one-way ANOVA analysis to answer the research question. Results and Conclusions: Completion of emergency medicine, general surgery, and surgery subspecialties clerkships in the four possible sequences offered at this school had no significant difference in the means of Surgery NBME and Emergency Medicine NBME subject exam scores. The order in which students complete the three clinical clerkships were not associated with any difference in NBME subject exam scores for Surgery and Emergency Medicine. The findings may be taken into consideration for curriculum re-design at other medical schools

Medical Student and Resident Foley Catheterization training program to decrease Post-Operative Catheter Associated Urinary Tract Infections

Objective: Determine whether a more comprehensive medical student urinary catherer training curriculum can be successful in decreasing post-operative CAUTI rates in general and vascular surgery patient populations. Primary target: Reduce post-operative UTI rates by 0.5% over 6 months Secondary targets: Achieve 100% medical student confidence in Foley catheter placement, understanding indications and contraindications to urinary catheterization. Improve objective performance of urinary catheterization skills as determined by objective clinical skills exam (OSCE) scores.https://jdc.jefferson.edu/patientsafetyposters/1000/thumbnail.jp

Evidence-Based Medicine Breaking the Borders - The European Union as a Paradigm

Evidence-based medicine has instigated a shift in medical paradigms over the last decade. Systematic reviews and meta-analyses in particular have a strong impact on the way we practice medicine today. Although evidence-based medicine focuses on results at an individual patient level, the assumption that an increase in the practicing of evidence-based medicine will lead to health improvements of the general population seems to be a causal chain. The influence of evidence-based medicine is continually extending beyond clinical decision- making to act as a foundation for health policy decisions. The European Union has realized the potential benefits of evidence-based health care. Under the umbrella of thee-Health initiative, the European Union plans to implement a telematic (telecommunication and informatics) health network by the end of 2004. The objective of this network is to facilitate information exchange and to provide databases of the best evidence available in health care. Health care providers and the general public will be able to access these databases through the internet free of charge. Evaluations of the network will have to focus on the extent and depth health care decision makers accept, use and apply not only the databases but clinical guidelines as well. The only substantial official publication of the EU regarding this program is a report by the European Commission on evidence-based health care. The document mentions three components to improve evidence-based health care in the European Union: (1) Evidence-based medicine; (2) Clinical practice guidelines and; (3) Health technology assessment. However, no official information about the structure of a telematic health network has become available yet. The challenge though is unique - to link 15 different health systems with 11 different languages. This paper first gives some background information about the practice of evidence-based medicine - a description of the status quo; a review of its development; and a critical appraisal of its usage - including benefits and risks of evidence-based medicine and a detailed look at its influence on health policy in general. Next, the paper provides an overview of the health systems of the European Union and the political and theoretical framework of a telematic health network. Based on these premises, a hypothetical structure of evidence-based databases is proposed. This concept takes the heterogeneity of the European Union into consideration and examines factors that will be crucial for the acceptance of evidence-based databases and clinical practice guidelines by health care decision makers. It discusses lessons that could be learned from existing databases on national and internationill levels. It also describes the necessity of a parallel evaluation program and outlines methods of evaluation that could be successfully used to assess the impact and effectiveness of the program and provide a base for cybernetic decision - making.Master of Public Healt

Practice Management Guidelines for the Diagnosis and Management of Injury in the Pregnant Patient: The EAST Practice Management Guidelines Work Group

Trauma during pregnancy has presented very unique challenges over the centuries. From the first report of Ambrose Pare of a gunshot wound to the uterus in the 1600s to the present, there have existed controversies and inconsistencies in diagnosis, management, prognostics, and outcome. Anxiety is heightened by the addition of another, smaller patient. Trauma affects 7% of all pregnancies and requires admission in 4 of 1000 pregnancies. The incidence increases with advancing gestational age. Just over half of trauma during pregnancy occurs in the third trimester. Motor vehicle crashes comprise 50% of these traumas, and falls and assaults account for 22% each. These data were considered to be underestimates because many injured pregnant patients are not seen at trauma centers. Trauma during pregnancy is the leading cause of nonobstetric death and has an overall 6% to 7% maternal mortality. Fetal mortality has been quoted as high as 61% in major trauma and 80% if maternal shock is present. The anatomy and physiology of pregnancy make diagnosis and treatment difficult

Metabolic similarity of plant and human : implications for efficacy and regulatory compliance of herbal therapies

Forecasting what biological effects an active metabolite compartmentalized in a medicinal plant may have on human health requires intensive research and clinical trials. There are inconsistencies in the application of herbal medicine in the treatment of disease mostly due to the metabolic composition. Different herbal strains, growing media and environmental conditions will alter the metabolite composition of herbal extracts. A modeling approach to identify the genes, enzymes and signaling pathways involved in the biosynthesis of the medicinal plant metabolites could harmonize the process of predicting the metabolite composition. The structural similarity of primary and secondary plant herbal metabolites does not always provide complete assurance of what pharmacological effect they may have on the respective human metabolic system. Many of the medicinal plant metabolites are either unknown or not searchable through current computational resources. In this review, we have discussed that a system based biological approach comparing human and plant metabolic signaling networks that could be additionally productive to ascertain the regulatory and biological processes conferred by a metabolite and their bioactivity pathways in living systems. A combination of a both systems and structural based approaches can generate new models that render a better metabolite composition bioactivity reduction, thereby enhancing the efficacy, safety, and toxicity of herbal medicine processing