129 results match your criteria Continuing Education in Anaesthesia Critical Care & Pain [Journal]


Focused transthoracic echocardiography curriculum for advanced practice providers assures good concordance with intensivists at echocardiography.

Heart Lung 2018 11 11;47(6):622-625. Epub 2018 Jun 11.

Department of Critical Care Medicine, Echocardiography Laboratory, Mayo Clinic, Jacksonville, Florida, USA.

Objective: To describe a focused transthoracic echocardiography (FoTE) curriculum for advanced practice providers (APPs) for echocardiography-driven diagnosis of shock in critically ill patients.

Methods: Twelve APPs in 4 intensive care units at an academic medical center received didactic sessions on FoTE, including 1-on-1 proctorship with a registered cardiac sonographer. For a period of 6 months the trainees performed individual studies, then they performed FoTE examinations on critically ill patients; their diagnoses were compared with those of experienced intensivists for the same patients. Read More

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http://dx.doi.org/10.1016/j.hrtlng.2018.05.017DOI Listing
November 2018

Strategic proposal for a national trauma system in France.

Anaesth Crit Care Pain Med 2019 Apr 29;38(2):121-130. Epub 2018 May 29.

Grenoble Alps Trauma centre, Grenoble University Hospital, Grenoble Alps University, 38000 Grenoble, France. Electronic address:

In this road map for trauma in France, we focus on the main challenges for system implementation, surgical and radiology training and upon innovative training techniques. Regarding system organisation: procedures for triage, designation and certification of trauma centres are mandatory to implement trauma networks on a national scale. Data collection with registries must be created, with a core dataset defined and applied through all registries. Read More

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http://dx.doi.org/10.1016/j.accpm.2018.05.005DOI Listing
April 2019
23 Reads

Does the age of acute care physicians impact their (1) crisis management performance and (2) learning after simulation-based education? A protocol for a multicentre prospective cohort study in Toronto and Ottawa, Canada.

BMJ Open 2018 04 21;8(4):e020940. Epub 2018 Apr 21.

Department of Anesthesia, University of Manitoba, Winnipeg, Canada.

Introduction: The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-020940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914762PMC
April 2018
7 Reads

Performance and skill retention of five supraglottic airway devices for the pediatric difficult airway in a manikin.

Eur J Pediatr 2018 Jun 5;177(6):871-878. Epub 2018 Apr 5.

Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Supraglottic airway devices (SADs) have been introduced to assist medical professionals in emergency situations with limited experience in securing airways via conventional endotracheal intubation (ETI). Literature on the use of SADs for securing an airway during pediatric critical settings is scarce, and there is a lack of studies comparing different SADs to each other and to conventional ETI. We conducted a study comparing five different SADs to ETI with regard to success rate, time to first ventilation, and personal rating in a pediatric manikin under simulated physiologic and pathologic airway conditions in 41 pediatricians of varying clinical experience and training. Read More

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http://dx.doi.org/10.1007/s00431-018-3134-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958163PMC
June 2018
12 Reads

Medical Simulation as a Vital Adjunct to Identifying Clinical Life-Threatening Gaps in Austere Environments.

J Natl Med Assoc 2018 Apr 15;110(2):117-123. Epub 2018 Feb 15.

Anesthesiology and Critical Care Medicine-Global Alliance of Perioperative Professionals, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Background: Maternal mortality and morbidity are major causes of death in low-resource countries, especially those in Sub-Saharan Africa. Healthcare workforce scarcities present in these locations result in poor perioperative care access and quality. These scarcities also limit the capacity for progressive development and enhancement of workforce training, and skills through continuing medical education. Read More

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http://dx.doi.org/10.1016/j.jnma.2017.12.003DOI Listing
April 2018
14 Reads

Anesthesia Development in Mongolia: Strengthening Anesthesia Practice in Mongolia Through Education and Continuing Professional Development.

Anesth Analg 2018 Apr;126(4):1287-1290

La Trobe University, Melbourne, Victoria, Australia.

Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care. Read More

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http://Insights.ovid.com/crossref?an=00000539-201804000-0003
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http://dx.doi.org/10.1213/ANE.0000000000002566DOI Listing
April 2018
9 Reads

Should ongoing airway education be a mandatory component of continuing professional development for College of Intensive Care Medicine Fellows?

Anaesth Intensive Care 2018 03;46(2):190-196

Director Professional Affairs, College of Intensive Care Medicine; Melbourne, Victoria.

This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Read More

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http://dx.doi.org/10.1177/0310057X1804600208DOI Listing
March 2018
1 Read

Evaluating the effectiveness of the Emergency Neurological Life Support educational framework in low-income countries.

Int Health 2018 03;10(2):116-124

Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.

Background: The Emergency Neurological Life Support (ENLS) is an educational initiative designed to improve the acute management of neurological injuries. However, the applicability of the course in low-income countries in unknown. We evaluated the impact of the course on knowledge, decision-making skills and preparedness to manage neurological emergencies in a resource-limited country. Read More

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http://dx.doi.org/10.1093/inthealth/ihy003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856183PMC
March 2018
7 Reads

Residual Neuromuscular Blockade in the Critical Care Setting.

AACN Adv Crit Care 2018 ;29(1):15-24

Nicole Stawicki is an Acute Care Nurse Practitioner, University of Illinois Hospital and Health Sciences System, 1740 W Taylor St, Chicago, IL 60612 Patty Gessner is a Critical Care Nurse Practitioner, Suburban Lung Associates, Elk Grove Village, Illinois.

Residual neuromuscular blockade is a widespread challenge for providers in the acute care setting that, if left unrecognized or untreated, places patients at higher risk for morbidity and mortality. The condition is estimated to occur in 26% to 88% of patients undergoing general anesthesia. The role of the advanced practice nurse in the acute care setting is to facilitate a safe recovery process by identifying early signs of deterioration and supporting the patient until full muscular strength has returned. Read More

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http://dx.doi.org/10.4037/aacnacc2018384DOI Listing
October 2018
7 Reads

Building and Maintaining Organizational Infrastructure to Attain Clinical Excellence.

Anesthesiol Clin 2017 Dec;35(4):559-568

Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6th Floor Dulles Building, Philadelphia, PA 19104, USA. Electronic address:

Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non-operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S19322275173007
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http://dx.doi.org/10.1016/j.anclin.2017.07.002DOI Listing
December 2017
14 Reads

A roadmap for acute care training of frontline Healthcare workers in LMICs.

J Crit Care 2017 10 12;41:313-317. Epub 2017 Jul 12.

Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.

This 10-step roadmap outlines explicit procedures for developing, implementing and evaluating short focused training programs for acute care in low and middle income countries (LMICs). A roadmap is necessary to develop resilient training programs that achieve equivalent outcomes despite regional variability in human capacity and infrastructure. Programs based on the roadmap should address shortfalls in human capacity and access to care in the short term and establish the ground work for health systems strengthening in the long term. Read More

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http://dx.doi.org/10.1016/j.jcrc.2017.07.028DOI Listing
October 2017
2 Reads

End-of-life perceptions among physicians in intensive care units managed by anesthesiologists in Germany: a survey about structure, current implementation and deficits.

BMC Anesthesiol 2017 07 11;17(1):93. Epub 2017 Jul 11.

Universitätsklinik für Anästhesiologie, op. Intensivmedizin, Rettungsmedizin, Schmerztherapie der Ruhr-Universität Bochum, Klinikum Herford, Herford, Germany.

Background: Structural aspects and current practice about end-of-life (EOL) decisions in German intensive care units (ICUs) managed by anesthesiologists are unknown. A survey among intensive care anesthesiologists has been conducted to explore current practice, barriers and opinions on EOL decisions in ICU.

Methods: In November 2015, all members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthesiologists (BDA) were asked to participate in an online survey to rate the presence or absence and the importance of 50 items. Read More

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http://dx.doi.org/10.1186/s12871-017-0384-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504988PMC
July 2017
10 Reads

Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial.

Intensive Care Med 2017 Nov 2;43(11):1602-1612. Epub 2017 May 2.

Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany.

Purpose: Guidelines recommend administering antibiotics within 1 h of sepsis recognition but this recommendation remains untested by randomized trials. This trial was set up to investigate whether survival is improved by reducing the time before initiation of antimicrobial therapy by means of a multifaceted intervention in compliance with guideline recommendations.

Methods: The MEDUSA study, a prospective multicenter cluster-randomized trial, was conducted from July 2011 to July 2013 in 40 German hospitals. Read More

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http://dx.doi.org/10.1007/s00134-017-4782-4DOI Listing
November 2017
27 Reads

In-hospital airway management training for non-anesthesiologist EMS physicians: a descriptive quality control study.

Scand J Trauma Resusc Emerg Med 2017 Apr 26;25(1):45. Epub 2017 Apr 26.

Norwegian Air Ambulance, Bergen, Norway.

Background: Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. Read More

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http://dx.doi.org/10.1186/s13049-017-0386-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405543PMC
April 2017
28 Reads

Anesthesiologists and Disaster Medicine: A Needs Assessment for Education and Training and Reported Willingness to Respond.

Anesth Analg 2017 05;124(5):1662-1669

From the *Division of Cardiac Anesthesiology, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; †Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; ‡Independent Contractor at Natasha Shallow MD SC, Brookfield, Wisconsin; §Department of Anesthesiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; ‖Johns Hopkins Bloomberg School of Public Health Biostatistics Center, Baltimore, Maryland; ¶Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington Medical Center, Seattle, Washington; and #Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Maryland.

Background: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described.

Methods: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002002DOI Listing
May 2017
5 Reads

Anesthesia Lost in Translation: Perspective and Comprehension.

J Educ Perioper Med 2017 Jan-Mar;19(1):E505. Epub 2017 Jul 1.

Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care and Pain Medicine.

Background: Care of non-English speaking patients poses a unique challenge to the anesthesiologist in the perioperative setting. Communication limitations can be frustrating to both the patient and provider, and at times can compromise the quality of care, resulting in health care disparities. An often overlooked, but critical component is the interaction between the anesthesia provider and the interpreter. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327869PMC
July 2017
3 Reads

Drug Infusion Systems: Technologies, Performance, and Pitfalls.

Anesth Analg 2017 05;124(5):1493-1505

From the *Department of Anesthesia, Critical Care and Pain Medicine, St. Elizabeth's Medical Center, Boston, Massachusetts; and †Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

This review aims to broadly describe drug infusion technologies and raise subtle but important issues arising from infusion therapy that can potentially lead to patient instability and morbidity. Advantages and disadvantages of gravity-dependent drug infusion are described and compared with electromechanical approaches for precise control of medication infusion, including large-volume peristaltic and syringe pumps. This review discusses how drugs and inert carriers interact within infusion systems and outlines several complexities and potential sources of drug error. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001707DOI Listing
May 2017
9 Reads

[Risk management in anesthesia and critical care medicine].

Authors:
C Eisold A R Heller

Med Klin Intensivmed Notfmed 2017 Mar;112(2):163-176

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, 01307, Dresden, Deutschland.

Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. Read More

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http://dx.doi.org/10.1007/s00063-017-0264-2DOI Listing
March 2017
1 Read

Using High-Technology Simulators to Prepare Anesthesia Providers Before Implementation of a New Electronic Health Record Module: A Technical Report.

Anesth Analg 2017 06;124(6):1815-1819

From the Departments of *Anesthesiology and Critical Care Medicine; ‡Center for Simulation, Advanced Education and Innovation; §Biomedical Engineering, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and †ECRI Institute, Plymouth Meeting, Pennsylvania.

Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001775DOI Listing
June 2017
31 Reads

Can Early Rehabilitation on the General Ward After an Intensive Care Unit Stay Reduce Hospital Length of Stay in Survivors of Critical Illness?: A Randomized Controlled Trial.

Am J Phys Med Rehabil 2017 Sep;96(9):607-615

From the Department of Physical Medicine and Rehabilitation, Medical University of Vienna, General Hospital Vienna (WG, KP, CH, TP-S); Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna (IS); Department of Anaesthesia and Intensive Care, Medical University of Vienna, General Hospital Vienna (JMH); and Department of Physical Medicine and Rehabilitation, Danube Hospital Vienna, Vienna Hospital Association (TP-S), Vienna, Austria.

Objective: The aim of this study was to evaluate if an early rehabilitation program for survivors of critical illness improves functional recovery, reduces length of stay, and reduces hospital costs.

Design: This was a prospective randomized controlled trial. Fifty-three consecutive survivors of critical illness were included in the study. Read More

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http://dx.doi.org/10.1097/PHM.0000000000000718DOI Listing
September 2017
10 Reads

Continuing Medical Education Speakers with High Evaluation Scores Use more Image-based Slides.

West J Emerg Med 2017 Jan 5;18(1):152-158. Epub 2016 Dec 5.

University of California, San Francisco, Department of Emergency Medicine, San Francisco, California.

Introduction: Although continuing medical education (CME) presentations are common across health professions, it is unknown whether slide design is independently associated with audience evaluations of the speaker. Based on the conceptual framework of Mayer's theory of multimedia learning, this study aimed to determine whether image use and text density in presentation slides are associated with overall speaker evaluations.

Methods: This retrospective analysis of six sequential CME conferences (two annual emergency medicine conferences over a three-year period) used a mixed linear regression model to assess whether post-conference speaker evaluations were associated with image fraction (percentage of image-based slides per presentation) and text density (number of words per slide). Read More

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http://dx.doi.org/10.5811/westjem.2016.10.31484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226752PMC
January 2017
1 Read

Welfare of anaesthesia trainees survey.

Anaesth Intensive Care 2017 01;45(1):73-78

Staff Specialist Anaesthetist, Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, New South Wales.

This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress. Read More

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http://dx.doi.org/10.1177/0310057X1704500111DOI Listing
January 2017
3 Reads

EMpowerment of PArents in THe Intensive Care Questionnaire: Translation and Validation in Italian PICUs.

Pediatr Crit Care Med 2017 02;18(2):e77-e85

1Department of Anesthesia and Intensive Care, Children's Hospital V Buzzi-Istituti Clinici di Perfezionamento, Milan, Italy. 2Pediatric Intensive Care Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. 3Child and Adolescent Neuropsychiatric Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. 4Professional Development Continuing Education and Nursing Research Service-Medical Direction, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. 5Department of Anesthesia and Intensive Care, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. 6Department of Pediatric Medical Surgical Cardiology, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. 7Institute of Biomedical Technologies, National Research Council, Milan, Italy. 8School of Nursing and Midwifery, Faculty of Health and Human Sciences, Plymouth University, Plymouth, United Kingdom. 9School of Nursing, Midwifery and Paramedicine, Faculty of Human Science, Curtin University, Perth, Australia.

Objectives: To translate and validate the EMpowerment of PArents in THe Intensive Care questionnaire to measure parent satisfaction and experiences in Italian PICUs.

Design: Prospective, multicenter study.

Setting: Four medical/surgical Italian PICUs in three tertiary hospitals. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001031DOI Listing
February 2017
16 Reads

An Association Between Pain and American Association of Respiratory Care 2010 Guidelines During Tracheal Suctioning.

Dimens Crit Care Nurs 2016 Sep-Oct;35(5):283-90

Alberto Lucchini, RN, is nurse chief, General Intensive Care Unit, San Gerardo University Hospital, Monza, and is coordinator, Anesthesia and Intensive Care, University of Milano-Bicocca, Milan, Italy. Marta Canesi, RN-MSN, Pediatric Oncohematology Ward/BMTC, Fondazione MBBM, Monza, Italy. Gaia Robustelli, RN-MSN, is a staff nurse, Intensive Care Unit, Treviglio-Caravaggio Hospital, Treviglio, Italy. Roberto Fumagalli, MD, is a director, Department of Experimental Medicine, University of Milano-Bicocca, Milan. Stefano Bambi, PhD, MSN, RN, is a staff nurse, Intensive Care Unit, Azienda Ospedaliero Universitaria Careggi, and is PhD student in nursing science, University of Florence, Florence, Italy.

Introduction: Tracheal suctioning is recalled by mechanically ventilated patients as the most painful procedure during their stay in the intensive care unit.

Aim: The aim of this study was to evaluate whether the implementation of American Association of Respiratory Care suction guidelines positively affects the levels of patients' pain.

Materials And Methods: This is a prospective observational study on adult patients admitted to 2 general intensive care units. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000200DOI Listing
March 2018
11 Reads

[ULTRASOUND IN ANESTHESIOLOGY AND INTENSIVE CARE: WHAT TO TEACH?]

Authors:
R E Lakhin

Anesteziol Reanimatol 2016 Jul;61(4):263-265

Despite the fact that there is a wealth of experience of using ultrasound in medicine, its application in anesthesiology and critical care began relatively recently Ultrasound navigation can improve the quality of the invasive procedures. There were developed special protocols for critically ill patients, which helps to obtain the diagnosis at the bedside. Therefore all the world's leading societies and associations recommend to include the training of ultrasound technology in the education program for anesthesiologists and intensive care specialists. Read More

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July 2016
1 Read

[Risk management in anesthesia and critical care medicine].

Authors:
C Eisold A R Heller

Anaesthesist 2016 Jun;65(6):473-88

Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, 01307, Dresden, Deutschland.

Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. Read More

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http://dx.doi.org/10.1007/s00101-016-0189-9DOI Listing
June 2016
1 Read

No Pain Labor & Delivery: A Global Health Initiative's Impact on Clinical Outcomes in China.

Anesth Analg 2016 06;122(6):1931-8

From the *Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; †Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical Center, Stanford, California; ‡Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center at Harvard Medical School, Boston, Massachusetts; §Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas; ‖Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts; ¶Department of Anesthesiology, Ohio State University, Wexner Medical Center, Columbus, Ohio; #Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital at Harvard Medical School, Boston, Massachusetts; **Department of Anesthesiology, Stony Brook University, Stony Brook, New York; ††Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland; ‡‡Amherst College, Amherst, Massachusetts; and §§Department of Anesthesia, University of Iowa, Iowa City, Iowa.

The availability of labor analgesia is highly variable in the People's Republic of China. There are widespread misconceptions, by both parturients and health care providers, that labor epidural analgesia is harmful to mother and baby. Meanwhile, China has one of the highest cesarean delivery rates in the world, exceeding 50%. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001328DOI Listing
June 2016
12 Reads

Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

J Crit Care 2016 06 8;33:19-25. Epub 2016 Mar 8.

Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address:

Purpose: Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs.

Methods: We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Read More

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http://dx.doi.org/10.1016/j.jcrc.2016.01.030DOI Listing
June 2016
38 Reads

Training Pathways in Pediatric Cardiac Intensive Care: Proceedings From the 10th International Conference of the Pediatric Cardiac Intensive Care Society.

World J Pediatr Congenit Heart Surg 2016 Jan;7(1):81-8

The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA.

The increase in pediatric cardiac surgical procedures and establishment of the practice of pediatric cardiac intensive care has created the need for physicians with advanced and specialized knowledge and training. Current training pathways to become a pediatric cardiac intensivist have a great deal of variability and have unique strengths and weaknesses with influences from critical care, cardiology, neonatology, anesthesiology, and cardiac surgery. Such variability has created much confusion among trainees looking to pursue a career in our specialized field. Read More

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http://dx.doi.org/10.1177/2150135115614576DOI Listing
January 2016
18 Reads

Chronic pain management in dermatology: pharmacotherapy and therapeutic monitoring with opioid analgesia.

J Am Acad Dermatol 2015 Oct;73(4):575-82; quiz 583-4

Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

A number of chronic dermatologic conditions may necessitate long-term adjunctive pain management in addition to treatment of the primary skin disease, such as hidradenitis suppurativa, lichen planus, and other systemic diseases associated with significant pain. Adequate management of chronic pain can represent a unique challenge, but remains an integral component of clinical treatment in relevant contexts. For nociceptive pain of moderate to severe intensity, opioid analgesics can be beneficial when other pain management strategies have failed to produce adequate relief. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01909622150009
Publisher Site
http://dx.doi.org/10.1016/j.jaad.2014.11.038DOI Listing
October 2015
4 Reads

Chronic pain management in dermatology: a guide to assessment and nonopioid pharmacotherapy.

J Am Acad Dermatol 2015 Oct;73(4):563-73; quiz 573-4

Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Pain is a central component of illness and suffering, yet unfortunately it is frequently undertreated. In dermatology, many acute and chronic conditions are characterized by pain that may require therapeutic intervention in addition to medical treatment aimed at treating the primary disease. To date, however, there are limited recommendations or evidence in the published literature on pain and pain management strategies for patients with skin disease. Read More

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http://dx.doi.org/10.1016/j.jaad.2014.11.039DOI Listing
October 2015
2 Reads

Residents' scholarly activity: a cost analysis with regard to its effects on departments.

Authors:
Tetsuro Sakai

Curr Opin Anaesthesiol 2015 Apr;28(2):180-5

Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: Current financial strain on training departments may have a significantly negative impact on continuing support for residents' scholarly activity. A cost analysis with regard to residents' scholarly activity effects on anesthesiology training departments is performed.

Recent Findings: The Accreditation Council for Graduate Medical Education has issued a new outcome-focused scholarly activity requirement. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000162DOI Listing
April 2015
1 Read

The role of simulation in continuing medical education for acute care physicians: a systematic review.

Crit Care Med 2015 Jan;43(1):186-93

1Department of Anesthesia, Mount Sinai Hospital, Toronto, Ontario, Canada. 2Department of Anesthesia, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 3Department of Anesthesthesiology, The Ottawa Hospital, Ottawa, Ontario, Canada. 4Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada. 5Department of Anesthesiology, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 6The Academy for Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Objectives: We systematically reviewed the effectiveness of simulation-based education, targeting independently practicing qualified physicians in acute care specialties. We also describe how simulation is used for performance assessment in this population.

Data Sources: Data source included: DataMEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL Database of Controlled Trials, and National Health Service Economic Evaluation Database. Read More

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http://dx.doi.org/10.1097/CCM.0000000000000672DOI Listing
January 2015
2 Reads

[Evaluation of the impact and efficiency of high-fidelity simulation for neonatal resuscitation in midwifery education].

Arch Pediatr 2014 Sep 19;21(9):968-75. Epub 2014 Jul 19.

Service de réanimation et médecine néonatales, CHU d'Angers, faculté de médecine d'Angers, 4, rue Larrey, 49933 Angers, France; Service de gynécologie et obstétrique, CHU d'Angers, faculté de médecine d'Angers, 49933 Angers, France; Centre de simulation en anesthésie et réanimation (CeSAR), CHU d'Angers, 49933 Angers, France.

Background: Prompt initiation of appropriate neonatal resuscitation skills is critical for the neonate experiencing difficulty transitioning to extra-uterine life. Expertise in neonatal resuscitation is essential for personnel involved in the care of newborns, above all for midwives who are sometimes alone to initiate the first resuscitation. The use of simulation training is considered to be an indispensable tool to address these challenges, not only in continuing education but also in midwifery education. Read More

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http://dx.doi.org/10.1016/j.arcped.2014.06.010DOI Listing
September 2014
9 Reads

Utilization of exploration-based learning and video-assisted learning to teach GlideScope videolaryngoscopy.

Teach Learn Med 2014 ;26(3):285-91

a Neonatal-Perinatal Medicine, Yale University School of Medicine , New Haven , Connecticut , USA.

Background: GlideScope (GS) is used in pediatric endotracheal intubation (ETI) but requires a different technique compared to direct laryngoscopy (DL).

Purposes: This article was written to evaluate the efficacy of exploration-based learning on procedural performance using GS for ETI of simulated pediatric airways and establish baseline success rates and procedural duration using DL in airway trainers among pediatric providers at various levels.

Methods: Fifty-five pediatric residents, fellows, and faculty from Pediatric Critical Care, NICU, and Pediatric Emergency Medicine were enrolled. Read More

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http://dx.doi.org/10.1080/10401334.2014.910462DOI Listing
April 2015
2 Reads
1.120 Impact Factor

Using a situational awareness global assessment technique for interprofessional obstetrical team training with high fidelity simulation.

J Interprof Care 2015 Jan 9;29(1):13-9. Epub 2014 Jul 9.

Department of Anesthesia, Women's College Hospital , University of Toronto, Toronto, ON , Canada .

Evidence suggests that breakdowns in communication and a lack of situation awareness contribute to poor performance of medical teams. In this pilot study, three interprofessional obstetrical teams determined the feasibility of using the situation awareness global assessment technique (SAGAT) during simulated critical event management of three obstetrical scenarios. After each scenario, teams were asked to complete questionnaires assessing their opinion of how their performance was affected by the introduction of questions during a SAGAT stop. Read More

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http://dx.doi.org/10.3109/13561820.2014.936371DOI Listing
January 2015
37 Reads

An assessment of basic pain knowledge and impact of pain education on Indian Anaesthesiologists - a pre and post questionnaire study.

Indian J Anaesth 2014 Mar;58(2):127-31

CRS, ACTREC. Tata Memorial Centre, Mumbai, Maharashtra, India.

Background And Aim: Under-treatment of pain is a global phenomenon and the basic knowledge of pain amongst health care providers continues to be deficient. The aim of this study was to determine the basic prevalent knowledge of pain among Indian anaesthesiologists and the impact of a pain educational programme on their existing knowledge.

Methods: A nine lectures pain continuing medical education (CME) program was conducted for 114 young anaesthesiologists. Read More

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http://dx.doi.org/10.4103/0019-5049.130805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050926PMC
March 2014
3 Reads

Glycemic control in cardiac surgery: implementing an evidence-based insulin infusion protocol.

Am J Crit Care 2014 May;23(3):250-8

Joelle D. Hargraves is a critical care clinical nurse specialist at AtlantiCare Regional Medical Center, Mainland Campus, Pomona, New Jersey.

Background: Acute hyperglycemia following cardiac surgery increases the risk of deep sternal wound infection, significant early morbidity, and mortality. Insulin infusion protocols that target tight glycemic control to treat hyperglycemia have been linked to hypoglycemia and increased mortality. Recently published studies examining glycemic control in critical illness and clinical practice guidelines from professional organizations support moderate glycemic control. Read More

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http://dx.doi.org/10.4037/ajcc2014236DOI Listing
May 2014
7 Reads

Delivering interprofessional care in intensive care: a scoping review of ethnographic studies.

Am J Crit Care 2014 May;23(3):230-8

Elise Paradis is an assistant professor and Scott Reeves is a professor in the Department of Social and Behavioral Sciences, Kathleen Puntillo is a professor emerita, Physiological Nursing, and Michael Gropper is professor and executive vice chair, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California. Myles Leslie is a faculty research associate and Hanan J. Aboumatar is a member of the core faculty, Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland. Simon Kitto is director of research, Office of Continuing Education and Professional Development, University of Toronto, Toronto, Ontario.

Background: The sustained clinical and policy interest in the United States and worldwide in quality and safety activities initiated by the release of To Err Is Human has resulted in some high-profile successes and much disappointment. Despite the energy and good intentions poured into developing new protocols and redesigning technical systems, successes have been few and far between, leading some to argue that more attention should be given to the context of care.

Objective: To examine the insights provided by qualitative studies of interprofessional care delivery in intensive care. Read More

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http://dx.doi.org/10.4037/ajcc2014155DOI Listing
May 2014
4 Reads

Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care.

Pediatr Pulmonol 2015 Jul 7;50(7):691-7. Epub 2014 Apr 7.

Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.

Objectives: To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV).

Background: Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges.

Working Hypothesis: Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience. Read More

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http://dx.doi.org/10.1002/ppul.23040DOI Listing
July 2015
11 Reads

High-stakes assessment of the non-technical skills of critical care trainees using simulation: feasibility, acceptability and reliability.

Crit Care Resusc 2014 Mar;16(1):6-12

University of Queensland, Brisbane, QLD, Australia.

Objective: To evaluate the use of high-fidelity simulation for summative high-stakes assessment of intensive care trainees, focusing on non-technical skills (NTS), testing feasibility and acceptability of simulation assessment, and the reliability of two NTS rating scales.

Design, Setting And Participants: Prospective observational study of senior intensive care trainees in a simulated specialist examination.

Methods: Participants undertook a simulated patient management scenario and were assessed using two rating scales: the Anaesthesia Non-technical Skills (ANTS) scale and the Ottawa Global Rating Scale (GRS). Read More

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March 2014
11 Reads

Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial.

Br J Anaesth 2014 Jun 20;112(6):1042-9. Epub 2014 Feb 20.

Department of Medicine, University of Otago, Christchurch, New Zealand.

Background: Sharing information with the team is critical in developing a shared mental model in an emergency, and fundamental to effective teamwork. We developed a structured call-out tool, encapsulated in the acronym 'SNAPPI': Stop; Notify; Assessment; Plan; Priorities; Invite ideas. We explored whether a video-based intervention could improve structured call-outs during simulated crises and if this would improve information sharing and medical management. Read More

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http://bja.oxfordjournals.org/content/112/6/1042.full.pdf
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http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aet579
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http://dx.doi.org/10.1093/bja/aet579DOI Listing
June 2014
2 Reads

The development of an internet-based knowledge exchange platform for pediatric critical care clinicians worldwide*.

Pediatr Crit Care Med 2014 Mar;15(3):197-205

1Division of Critical Care Medicine, Department of Anesthesia, Perioperative and Pain Management, Boston Children's Hospital, Boston, MA. 2Department of Anesthesia, Harvard Medical School, Boston, MA. 3Division of Critical Care, Child and Family Research Institute, British Columbia's Children's Hospital, Vancouver, BC, Canada. 4Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

Objectives: Advances in Internet technology now enable unprecedented global collaboration and collective knowledge exchange. Up to this time, there have been limited efforts to use these technologies to actively promote knowledge exchange across the global pediatric critical care community. To develop an open-access, peer-reviewed, not-for-profit Internet-based learning application, OPENPediatrics, a collaborative effort with the World Federation of Pediatric Intensive and Critical Care Societies, was designed to promote postgraduate educational knowledge exchange for physicians, nurses, and others caring for critically ill children worldwide. Read More

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http://dx.doi.org/10.1097/PCC.0000000000000051DOI Listing
March 2014
3 Reads

Simulation-based otorhinolaryngology emergencies boot camp: Part 3: Complex teamwork scenarios and conclusions.

Laryngoscope 2014 Jul 29;124(7):1570-2. Epub 2014 Apr 29.

Department of Anesthesia and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

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http://dx.doi.org/10.1002/lary.24570DOI Listing
July 2014
2 Reads

Early mobilization of mechanically ventilated patients: a 1-day point-prevalence study in Germany.

Crit Care Med 2014 May;42(5):1178-86

1Nursing Research, Nursing and Patient Service, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. 2Outcomes After Critical Illness and Surgery (OACIS) Group, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 3Critical Care Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD. 4Faculty of Nursing Science, University of Witten-Herdecke, Witten, Germany. 5Department of Anaesthesiology and Operative Intensive Care Medicine, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany. 6Department of Physiotherapy, University Hospital of Gießen and Marburg GmbH, Marburg, Germany. 7Work and Life Educational Association, Göttingen, Germany. 8Department of Continuing Education of Critical Care Nursing, District Hospital of Reutlingen, Reutlingen, Germany. 9Department of Anaesthesiology and Intensive Care Medicine, Alb Fils Kliniken GmbH, Klinik am Eichert, Göppingen, Germany. 10Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Hospital of Göttingen, Göttingen, Germany. 11Department of Anaesthesia and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. 12Department of Medicine, University Hospital Tübingen, Tübingen, Germany. 13Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.

Objectives: There is growing evidence to support early mobilization of adult mechanically ventilated patients in ICUs. However, there is little knowledge regarding early mobilization in routine ICU practice. Hence, the interdisciplinary German ICU Network for Early Mobilization undertook a 1-day point-prevalence survey across Germany. Read More

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https://insights.ovid.com/crossref?an=00003246-201405000-000
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http://dx.doi.org/10.1097/CCM.0000000000000149DOI Listing
May 2014
75 Reads

Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams.

Ann Surg 2014 Mar;259(3):403-10

*Brigham and Women's Hospital, Department of Surgery, Boston, MA; †Brigham and Women's Hospital, Department of Anesthesiology, Pain, and Perioperative Medicine, Boston, MA; ‡Harvard School of Public Health, Department of Health Policy and Management, Boston, MA; §Ariadne Labs, Boston, MA; ¶Brigham and Women's Hospital, Center for Surgery and Public Health, Boston MA; ‖Massachusetts General Hospital, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA; **The Center for Medical Simulation, Cambridge, MA; ††Beth Israel Deaconess Medical Center, Department of Surgery, Boston, MA; ‡‡Beth Israel Deaconess Medical Center, Carl J. Shapiro Simulation and Skills Center, Boston, MA; §§Brigham and Women's Hospital, STRATUS Center for Medical Simulation, Boston, MA; ¶¶Boston Children's Hospital, Department of Anesthesia, Division of Critical Care Medicine, Boston, MA; ‖‖Boston Children's Hospital Simulator Program, Boston, MA; ***Risk Management Foundation of the Harvard Medical Institutions (CRICO/RMF), Cambridge, MA; †††Brigham and Women's Hospital, Department of Medicine, Boston, MA; ‡‡‡University of Rochester, Department of Surgery, Rochester, NY; §§§Beth Israel Deaconess Medical Center, Department of Anesthesia and Critical Care, Boston, MA; ¶¶¶Massachusetts General Hospital, Department of Surgery, Boston, MA; ‖‖‖Harvard Medical School, Gilbert Program in Medical Simulation, Boston, MA; and ****Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA.

Objective: To test the feasibility of implementing a standardized teamwork training program with full operating room teams in multiple institutions, driven by malpractice insurer support and incentives.

Background: Failures in intraoperative teamwork are among the leading causes of preventable patient injury and death in surgical patients. Teamwork training, particularly using simulation, can be an effective intervention but is difficult to scale. Read More

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http://pdfs.journals.lww.com/annalsofsurgery/2014/03000/Pilo
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http://pdfs.journals.lww.com/jcraniofacialsurgery/2014/09000
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
Publisher Site
http://dx.doi.org/10.1097/SLA.0000000000000342DOI Listing
March 2014
21 Reads

Aligning academic continuing medical education with quality improvement: a model for the 21st century.

Acad Med 2013 Oct;88(10):1437-41

Dr. Nancy Davis is director, Practice Based Learning and Improvement, Association of American Medical Colleges, Washington, DC. Dr. David Davis is senior director, Continuing Education and Improvement, Association of American Medical Colleges, Washington, DC. Mr. Johnson was research associate, Association of American Medical Colleges, Washington, DC. Dr. Grichnik is associate dean for continuing medical education and associate professor, Division of Cardiothoracic Anesthesia and Critical Care Medicine, Duke University School of Medicine, Durham, North Carolina. Dr. Headrick is senior associate dean for education, Helen Mae Spiese Distinguished Faculty Scholar, and professor of medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri. Dr. Pingleton is associate dean of continuing education/professional development and Joy McCann Professor of Women in Medicine and Science, University of Kansas School of Medicine, Kansas City, Kansas. Dr. Bower is assistant dean of continuing medical education and associate professor of medicine, Oregon Health & Science University School of Medicine, Portland, Oregon. Dr. Gibbs is associate dean of continuing medical education and professor, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.

The recent health care quality improvement (QI) movement has called for significant changes to the way that health care is delivered and taught in academic medical centers (AMCs). This movement also has affected academic continuing medical education (CME). In January 2011, to better align the CME and QI efforts of AMCs, the Association of American Medical Colleges (AAMC) launched a pilot initiative called Aligning and Educating for Quality (ae4Q). Read More

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http://dx.doi.org/10.1097/ACM.0b013e3182a34ae7DOI Listing
October 2013
6 Reads