Physician Executive Leadership: Assessing a Student-Led Approach to Healthcare Leadership Education in Medical School

Poster presented at: 14th Annual AMA Research Symposium in Orlando, Fl Objective: To investigate the effectiveness of Physican Leadership, an open access, student-led healthcare leadership program at Sidney Kimmel Medical College, in preparing to face five key emerging topics in medical practice: healthcare economics, health policy, care and quality and safety, law and medicine, and patient experience. The Problem: Gaps in Medical Education Healthcare in the US continues to evolve, and topics such as health policy, health finance, and patient experience are not central to the practice of medicine. However, the sheer volume of material students are required to learn in the preclinical years makes it challenging to introduce new subjects into traditional medical school curricula. As a result, these topics in healthcare leadership are often left out. Indeed, only 40-50% of medical student report appropriate training in the practice of medicine, including subjects as medical economics, healthcare systems, and managed care.https://jdc.jefferson.edu/pel/1002/thumbnail.jp

Physician Executive Leadership: Student-Led Curriculum to Fill Gaps in Traditional Medical Education

Students at Sidney Kimmel Medical College (SKMC) have identified a gap in the traditional medical curriculum surrounding topics such as telehealth, the patient experience, health policy, medical malpractice, and health care entrepreneurship and innovation, and in response have initiated a student-centered, student-led, student-driven program called Physician Executive Leadership (PEL). PEL provides students with a variety of avenues to engage with these topics, such as lectures from leaders in each of these fields, easy access to weekly news articles on current events in health care, targeted review sessions on the US health care system, and the opportunity to voice and develop ideas through an online publication. To identify the gaps in medical education PEL is best suited to fill, we administered a survey to 174 students at Sidney Kimmel Medical College.The survey contained 20 multiple-choice questions to assess general knowledge on health insurance and reimbursement, health care policy and reform, and care quality and patient experience. It also included a subjective self-assessment of students’ understanding of and interest in these topics. Overall, we found that although the traditional medical school curriculum improved students\u27 understanding of these topics from year to year, it is not sufficient on it\u27s own: on average, students failed to achieve a passing score of 70% in any of the categories tested. Further illustrating the importance of this program, students self-identified a gap between their current level of understanding and what they want to know. Please visit our website www.physicianexecutiveleadership.com to learn more!https://jdc.jefferson.edu/pel/1000/thumbnail.jp

Midterm Survivorship and Complications of Total Knee Arthroplasty in Patients with Dwarfism

Background Dwarfism is associated with skeletal dysplasias and joint deformities that frequently result in osteoarthritis requiring treatment with total knee arthroplasty (TKA). These surgeries can be challenging because of alignment deformities, poor bone stock, and smaller components. This study aims to compare TKA implant survivorship and complications between dwarf and nondwarf patients. Methods A retrospective case-control study was performed from 1997-2014 evaluating 115 TKAs in patients under the height threshold of 147.32 cm. This cohort was compared with 164 patients of normal height. Medical records were reviewed for demographics, surgical characteristics, and outcomes. All cases had 2-year minimum follow-up. Results The revision rate was 8.7% in dwarfs compared with 3.7% in controls (P = .08). The 2-, 5-, and 10-year implant survivorship in dwarfs was 96.4%, 92.5%, and 90.2%, respectively; and 96.6%, 95.6%, and 94.8% for controls, respectively (P = .24). Dwarfs underwent significantly more manipulations for arthrofibrosis (P = .002). There was greater femoral (17.4% vs 2.1%, P < .01) and tibial (6.5% vs 2.7%, P < .01) component overhang in dwarfs compared with controls. Conclusion Despite a 2-fold increase in the revision rate of the dwarf cohort, the midterm survivorship is comparable between the dwarf and nondwarf patients. However, dwarfs were more likely to become stiff and undergo manipulation; the increased propensity for stiffness may be associated with oversized components, as evidenced by greater component overhang. Surgeons should be aware of this increased risk and may consider using smaller or customized implants to account for the morphological differences in this patient population