Street Smarts and a Scalpel: Emotional Intelligence in Surgical Education.

OBJECTIVE: To evaluate trends of emotional intelligence (EI) in surgical education and to compare the incorporation of EI in surgical education to other fields of graduate medical education. DESIGN: A MEDLINE search was performed for publications containing both surgery and emotional intelligence with at least one term present in the title. Articles were included if the authors deemed EI in surgical education to be a significant focus. A separate series of MEDLINE searches were performed with the phrase emotional intelligence in any field and either surg*, internal medicine, pediatric, neurology, obstetric, gynecology, OBGYN, emergency, or psychiat* in the title. Articles were included if they discussed resident education as the primary subject. Next, a qualitative analysis of the articles was performed, with important themes from each article noted. SETTING: Lehigh Valley Health Network in Allentown, PA. RESULTS: Eight articles addressed surgical resident education and satisfied inclusion criteria with 0, 1, and 7 articles published between 2001 and 2005, 2005 and 2010, and 2010 and 2015, respectively. The comparative data for articles on EI and resident education showed the following : 8 in surgery, 2 in internal medicine, 2 in pediatrics, 0 in neurology, 0 in OBGYN, 1 in emergency medicine, and 3 in psychiatry. CONCLUSIONS: Integration of EI principles is a growing trend within surgical education. A prominent theme is quantitative assessment of EI in residents and residency applicants. Further study is warranted on the integration process of EI in surgical education and its effect on patient outcomes and long-term job satisfaction

Systematic Review of Emotional Intelligence in Surgical Education

Introduction: Emotional intelligence (EI) was first coined in 1990 as a successful leadership skillset comprised of self-management, social awareness, and empathy. EI has wide-reaching applications to the surgical field including teamwork, patient care, and job satisfaction. Positive linkage has been made between higher EI levels in both the patient-doctor relationship and physicians in a leadership role. The purpose of our systematic review was to evaluate the use of EI in surgical education and assess whether its prevalence has grown with the general acceptance of EI in many fields including medicine. A secondary aim was to compare the incorporation of EI in surgical education to other fields of graduate medical education. Methods: A MEDLINE search was performed for publications containing both “surgery” and “emotional intelligence” with at least one term present in the title. Articles were included if EI in surgical education was considered a significant focus. The results were grouped by publication date in 5-year increments to identify temporal trends. A separate series of MEDLINE searches were performed with the phrase “emotional intelligence” in any field and either “surg*”, “internal medicine”, “pediatric”, “neurology”, “obstetric”, “gynecology”, “OBGYN”, “emergency”, and “psychiatr*” in the title with no constraints on publication date. OBGYN articles were combined in one category. Articles were included if they discussed resident education as the primary subject. Results: A total of 25 articles satisfied the MEDLINE search criteria and 7 articles satisfied inclusion criteria. These were sorted by publication date with 0, 1, and 6 articles published between 2001-2005, 2005-2010, and 2010-2015, respectively. Notable trends include: 1) EI is partially inborn, but proven to be learned; 2) Surgical residents have higher EI than the national average; 3) Educational shifts are needed to improve outcomes for the surgeon, patient, health network, and community at large. The comparative data for articles on EI and resident education showed 8 in surgery, 2 in internal medicine, 0 in pediatrics, 0 in neurology, 0 in OBGYN, 0 in emergency, and 4 in psychiatry. Conclusion: Integration of EI principles is a growing trend within surgical education. Emphasis has been placed on quantitative assessment of EI in residents and residency applicants. Further study is warranted on the integration process of EI in surgical education and its impact on patient outcomes and long-term job satisfaction

Reducing salt intake by urine chloride self-measurement in non-compliant patients with chronic kidney disease followed in nephrology clinics: a randomized trial

Adherence to low salt diets and control of hypertension remain unmet clinical needs in chronic kidney disease (CKD) patients

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo