Internship In Internal Medicine Research Articles

Assessing clinical reasoning skills following a virtual patient dizziness curriculum.

Dizziness is a common medical symptom that is frequently misdiagnosed. While virtual patient (VP) education has been shown to improve diagnostic accuracy for dizziness as assessed by VPs, trainee performance has not been assessed on human subjects. The study aimed to assess whether internal medicine (IM) interns after training on a VP-based dizziness curriculum using a deliberate practice framework would demonstrate improved clinical reasoning when assessed in an objective structured clinical examination (OSCE). All available interns volunteered and were randomized 2:1 to intervention (VP education) vs. control (standard clinical teaching) groups. This quasi-experimental study was conducted at one academic medical center from January to May 2021. Both groups completed pre-posttest VP case assessments (scored as correct diagnosis across six VP cases) and participated in an OSCE done 6weeks later. The OSCEs were recorded and assessed using a rubric that was systematically developed and validated. Out of 21 available interns, 20 participated. Between intervention (n=13) and control (n=7), mean pretest VP diagnostic accuracy scores did not differ; the posttest VP scores improved for the intervention group (3.5 [SD 1.3] vs. 1.6 [SD 0.8], p=0.007). On the OSCE, the means scores were higher in the intervention (n=11) compared to control group (n=4) for physical exam (8.4 [SD 4.6] vs. 3.9 [SD 4.0], p=0.003) and total rubric score (43.4 [SD 12.2] vs. 32.6 [SD 11.3], p=0.04). The VP-based dizziness curriculum resulted in improved diagnostic accuracy among IM interns with enhanced physical exam skills retained at 6weeks post-intervention.

In Memoriam: Richard H. Grimm, Jr, MD, MPH, PhD (August 22, 1946-September 8, 2022).

In Memoriam: Richard H. Grimm, Jr, MD, MPH, PhD (August 22, 1946-September 8, 2022).

A half‐century check‐up for child neurology training

A half‐century check‐up for child neurology training

Editorial introductions.

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 9 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor and Section Editors for this issue. EDITOR IN CHIEF David M. HarlanDavid M. HarlanDr David M. Harlan is a graduate of the University of Michigan (Bachelor of Science) and the Duke University School of Medicine, USA. He completed his internal medicine internship and residency at the Duke University Medical Center. This was before serving for 4 years as a staff internist at the Navy Hospital, San Diego, CA, USA. He then returned to Duke for his fellowship training in diabetes, endocrinology, and metabolism. In 1991 he established his laboratory at the Navy Medical Research Institute, USA, where he rose to become the Director of Combat Casualty Care. He was then appointed to the faculty of the Uniformed Services University of the Health Sciences. In 1999, he moved his laboratory to the National Institutes of Health, where he became the Diabetes Branch Chief within the National Institute of Diabetes, Digestive, and Kidney Diseases. In 2010, he moved to the University of Massachusetts School of Medicine, USA, where he is the William and Doris Krupp Professor of Medicine and Diabetes Division Chief. Dr Harlan also co-directs the UMass Diabetes Center of Excellence. His research interests all relate to diabetes and include the immunopathogenesis underlying type 1 diabetes and improved care delivery models for the disease. SECTION EDITORS Matthew FreebyMatthew FreebyMatthew Freeby, MD, is Health Sciences Associate Clinical Professor of Medicine in the Division of Endocrinology, Diabetes, and Hypertension, David Geffen School of Medicine at the University of California Los Angeles, USA. Dr Freeby received his MD from Virginia Commonwealth University, USA and completed his internal medicine internship and residency training at the University of California San Diego. He subsequently completed training in an endocrinology fellowship at Columbia University Medical Center in New York, USA. Dr Freeby is involved in community leadership for the American Diabetes Association and serves on planning committees for the Endocrine Society's annual meetings. His research has focused on a number of diabetes related topics including non-invasive in vivo measurement of beta cell mass as well as the evaluation of general care and complications. He has also collaborated with researchers evaluating iPS as a method for beta cell replacement in type 1 and other rare forms of diabetes. Lynne L. LevitskyLynne L. LevitskyDr Lynne L. Levitsky is a graduate of Bryn Mawr College and Yale Medical School, USA. She received her pediatric training at the Albert Einstein College of Medicine in New York, USA, and at the Children's Hospital of Philadelphia, USA. She was trained in pediatric endocrinology at the University of Maryland in Baltimore, USA. She was a Pediatric Endocrinologist and Professor of Pediatrics at the Pritzker School of Medicine, University of Chicago, USA, until 1990. She then came to Massachusetts General Hospital, USA, as Chief of the Pediatric Endocrine Unit and Associate Professor of Pediatrics at Harvard Medical School. She is now Emeritus Chief and co-director of the Turner Syndrome Wellness Center, USA. Her research interests in carbohydrate metabolism span laboratory studies of transcriptional control of beta cell function, and a role as an investigator in the NIH-sponsored TODAY treatment study of type 2 diabetes in the young. She is a past President of the Pediatric Endocrine Society and was the first head of the Education Council for that organization.

Jeffrey Lyness, M.D., to Become President and CEO of ABPN

Jeffrey Lyness, M.D., to Become President and CEO of ABPN

Effectiveness of an Active Methodology for Learning ECG during the Internal Medicine Internship.

Studies have shown a low accuracy of urgent care physicians in interpreting electrocardiogram (ECG) in severe cardiovascular conditions. To evaluate the effectiveness of an ECG learning method in internal medicine internships and to know the perception of interns regarding learning before and after the methodology. This study used a database with the results of an ECG pre- and post-test of the classes in the internal medicine internship from 2017 to 2022. A qualitative questionnaire was sent with questions for self-assessment of perception of learning. The study included a total of 227 students, 161 of whom (70.9%) were female. The mean age was 26.4 ± 4.2 years old. The pre-test mean was 3.75 ± 2.0 points, and the post-test mean was 8.48 ± 1.5 points, showing a statistically significant difference, even after stratification by sex, age, and course period (p < 0.001 for all comparisons). Sixty-nine (30%) of the students responded to the qualitative questionnaire. The three predominant feelings prior to learning were despair, fear, and insecurity. After the Club, the predominant feelings were security, tranquility, and confidence. The level of prior knowledge regarding ECG was low among students in the medical internship, and the proposed methodology was effective for learning ECG, regardless of age, sex, or course period. It was possible to transform negative beliefs regarding ECG learning and make learning meaningful and enjoyable. A more incisive look at medical courses for learning the ECG in a more practical and contextualized way can improve this scenario.

Anxiety among undergraduate Nursing students with mandatory curricular internship during the COVID-19 pandemic

Objective: to compare the average anxiety among undergraduate Nursing students during the COVID-19 pandemic. Methods: it was a cross-sectional study conducted with 101 undergraduate Nursing students. Data collection took place through WhatsApp®, by sending a link containing a consent form, a Google Forms® instrument and State-Trait Anxiety Inventory. The analysis was carried out through central tendency, absolute and relative frequency, and analytical tests. Results: trait anxiety and state anxiety presented medium (52.5%) and high (67.3%) levels, respectively, with mean state anxiety (48.1) higher than the mean trait anxiety (42.3) and positive correlation (r=0.479) between the two scales (p&lt;0.000). They were high among students who lived with family members with risk factors for COVID-19 aggravation, underwent social isolation, without confirmatory tests for the disease, and performed an internship in internal medicine. Conclusion: significant percentages of anxiety levels were identified among undergraduate Nursing students in mandatory internship during the COVID-19 pandemic, thus revealing the need for preventive actions for this public. Contributions to practice: based on these findings, proposals to prevent mental health problems in this public can be developed seeking to change the current mental health scenario.

Design and First Impressions of a Small Private Online Course in Clinical Workplace Learning: Questionnaire and Interview Study.

BackgroundClinical workplace learning takes place in a dynamic and complex learning environment that is designated as a site for patient care and education. Challenges in clinical training can be overcome by implementing blended learning, as it offers flexible learning programs suitable for student-centered learning, web-based collaboration, and peer learning.ObjectiveThe aim of this study is to evaluate the Small Private Online Course (SPOC) by interns’ first impressions and satisfaction measures (N=20) on using the SPOC. This study describes the design process of a SPOC from a theoretical and practical perspective and how it has been integrated into a clinical internship in internal medicine.MethodsThe design of the SPOC was based on general theoretical principles that learning should be constructive, contextual, collaborative, and self-regulated, and the self-determination theory to stimulate intrinsic motivation. Interns’ impressions and level of satisfaction were evaluated with a web-based questionnaire and group interview.ResultsInterns thought the web-based learning environment to be a useful and accessible alternative to improve knowledge and skills. Peer learning and web-based collaboration through peer interaction was perceived as less effective, as student feedback was felt inferior to teacher feedback. The interns would prefer more flexibility within the course, which could improve self-regulated learning and autonomy.ConclusionsThe evaluation shows that the SPOC is a useful and accessible addition to the clinical learning environment, providing an alternative opportunity to improve knowledge and skills. Further research is needed to improve web-based collaboration and interaction in our course.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 9 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor in chief and Section Editors for this issue. EDITOR IN CHIEF David M. HarlanDavid M. HarlanDr David M. Harlan is a graduate of the University of Michigan (Bachelor of Science) and the Duke University School of Medicine, USA. He completed his internal medicine internship and residency at the Duke University Medical Center. This was before serving for 4 years as a staff internist at the Navy Hospital, San Diego, CA, USA. He then returned to Duke for his fellowship training in diabetes, endocrinology, and metabolism. In 1991 he established his laboratory at the Navy Medical Research Institute, USA, where he rose to become the Director of Combat Casualty Care. He was then appointed to the faculty of the Uniformed Services University of the Health Sciences. In 1999, he moved his laboratory to the National Institutes of Health, where he became the Diabetes Branch Chief within the National Institute of Diabetes, Digestive, and Kidney Diseases. In 2010, he moved to the University of Massachusetts School of Medicine, USA, where he is the William and Doris Krupp Professor of Medicine and co-directs the UMass Diabetes Center of Excellence. His research interests all relate to diabetes and include the immunopathogenesis underlying type 1 diabetes and improved care delivery models for the disease. SECTION EDITORS Matthew J. FreebyMatthew J. FreebyMatthew J. Freeby, MD, is Health Sciences Associate Clinical Professor of Medicine in the Division of Endocrinology, Diabetes, and Hypertension, David Geffen School of Medicine at the University of California Los Angeles, USA. Dr Freeby received his MD from Virginia Commonwealth University, USA and completed his internal medicine internship and residency training at the University of California San Diego. He subsequently completed training in an endocrinology fellowship at Columbia University Medical Center in New York, USA. Dr Freeby is involved in community leadership for the American Diabetes Association and serves on planning committees for the Endocrine Society's annual meetings. His research has focused on a number of diabetes related topics including non-invasive in vivo measurement of beta cell mass as well as the evaluation of general care and complications. He has also collaborated with researchers evaluating iPS as a method for beta cell replacement in type 1 and other rare forms of diabetes. Lynne L. LevitskyLynne L. LevitskyDr Lynne L. Levitsky is a graduate of Bryn Mawr College and Yale Medical School, USA. She received her pediatric training at the Albert Einstein College of Medicine in New York, USA, and at the Children's Hospital of Philadelphia, USA. She was trained in pediatric endocrinology at the University of Maryland in Baltimore, USA. She was a Pediatric Endocrinologist and Professor of Pediatrics at the Pritzker School of Medicine, University of Chicago, USA, until 1990. She then came to Massachusetts General Hospital, USA, as Chief of the Pediatric Endocrine Unit and Associate Professor of Pediatrics at Harvard Medical School. She is now Emeritus Chief and co-director of the Turner Syndrome Wellness Center, USA. Her research interests in carbohydrate metabolism span laboratory studies of transcriptional control of beta cell function, and a role as an investigator in the NIH-sponsored TODAY treatment study of type 2 diabetes in the young. She is a past President of the Pediatric Endocrine Society and was the first head of the Education Council for that organization.

958. A Required Infectious Diseases Rotation Improves Antimicrobial Stewardship Knowledge for Internal Medicine Interns

BackgroundExposure to Infectious Diseases (ID) education is highly variable in post-graduate medical training. We report our experience with a required one-week ID consult rotation for Internal Medicine (IM) interns with a focus on antimicrobial stewardship education.MethodsSince 2018 all IM interns at our institution have participated in a required one-week ID consult rotation. Antimicrobial stewardship is a core feature of this rotation, with educational resources on antibiotic spectrum and decision-making, and interdisciplinary rounding with ID pharmacists. Between March 2020 and May 2021 we piloted an 11-item pre-rotation and post-rotation quiz with distinct but paired questions on key stewardship topics. The quiz was administered anonymously in SurveyMonkey. Mean pre/post rotation scores were compared using a paired T-test and the McNemar test of paired proportions was used to compare the pre/post change in percentage of correct responses for each topic.ResultsAmong 47 interns who completed the rotation, 16 interns completed both pre- and post-rotation quizzes (response rate=34%). Mean scores on the pre-rotation quiz were 60%, compared to 77% on the post-rotation quiz (p=0.01), indicating significant improvement at the end of the rotation (Figure 1). Among 11 residents who scored below 65% on their pre-rotation quiz, all achieved an increased score on their post-rotation quiz (mean pre-test of 49% to mean post-test 79%). Table 1 displays the question topics and pre/post test change in percentage correct. The most difficult pre-test topics were ‘Recognition of AmpC-Expressing Organisms’ and ‘Antibiotics with activity against Pseudomonas aeruginosa,’ which improved, from 31% to 81% correct (p=0.03) and 50% to 100% correct (p=0.01), respectively. Figure 1. Mean score of interns on pre-rotation vs post-rotation antimicrobial stewardship quiz from March 2020 to May 2021 (n=16; p=0.01).Table 1. Question topics and change in percentage correct on pre-rotation and post-rotation quizzes. ConclusionA required one-week ID consult rotation for IM interns improved antimicrobial stewardship knowledge. Our experience may serve as a model for other institutions interested in increasing IM housestaff exposure to ID and antimicrobial stewardship.Disclosures Kristen Marks, MD, Gilead Sciences (Grant/Research Support)

2021 RSNA Outstanding Researcher

HomeRadiologyVol. 302, No. 1 PreviousNext CommunicationsFree AccessSpecial Communications2021 RSNA Outstanding ResearcherMary C. MahoneyMary C. MahoneyMary C. MahoneyPublished Online:Nov 30 2021https://doi.org/10.1148/radiol.219024MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Pamela K. Woodard, MDDownload as PowerPointOpen in Image Viewer A leading researcher in cardiothoracic imaging and a generous mentor, Pamela K. Woodard, MD, specializes in cardiac CT and MRI techniques and in translating novel cardiovascular PET radiotracers into human subjects.“Dr Woodard is truly an outstanding researcher,” said RSNA President Mary C. Mahoney, MD. “She is respected not only for her enormous success in funded research, but her generous mentoring of so many of our future leaders in imaging research.”Dr Woodard is the Hugh Monroe Wilson professor of radiology and professor of biomedical engineering at the Mallinckrodt Institute of Radiology, Washington University in St Louis, Mo, where she is also the senior vice chair and division director of Radiology Research Facilities. In this role, she provides administrative oversight to the directors of the department’s 10 National Institutes of Health (NIH) research facilities, including the preclinical and clinical imaging PET and MRI research facilities and the Cyclotron Facility. She is also director of the Center for Clinical Imaging Research, head of Cardiac MR/CT, director of the Radiology Research Resident Track, and the program director of the NIH-funded T32 TOP-TIER (Training Opportunities in Translational Imaging Education and Research) clinician-scientist training program in translational imaging research.Dr Woodard received her undergraduate degree from Duke University in Durham, NC, and her medical degree from the Duke University School of Medicine. She completed her internship in internal medicine at the University of North Carolina at Chapel Hill, a residency in diagnostic radiology at Duke University, and a fellowship in cardiothoracic imaging at the Mallinckrodt Institute of Radiology.Following early success in securing grant funding, including a 1996 Siemens Medical Solutions/RSNA Research Fellow Grant and a 1999 Carestream Health/RSNA Research Scholar Grant, Dr Woodard secured multiple NIH grants. Early in her career, she was a principal investigator (PI) on the landmark NIH-funded PIOPED II project, published in the New England Journal of Medicine, which established multi-detector CT as the principal method for pulmonary embolism diagnosis. She also led a key project on the Washington University NIH contract, Programs of Excellence in Nanotechnology, which developed a receptor-targeted radiotracer for atherosclerotic plaque imaging.Dr Woodard currently leads her own research program and is a PI or MPI on three NIH R01 grants for the translation of cardiovascular radiotracers into humans. She has nearly 200 peer-reviewed manuscripts, several patents, and has served as a charter member on NIH study sections, including Clinical and Integrative Cardiovascular Sciences (CICS) and Medical Imaging (MEDI), and chair of the NIH study section, Imaging Guided Interventions and Surgery. She has received numerous awards for her work, including being named an Academy of Radiology and Biomedical Imaging Research (ARBIR) Distinguished Investigator.A revered leader in organized radiology, Dr Woodard serves on the board of directors of ARBIR and the Missouri Radiological Society. She also serves on the American College of Radiology (ACR) Board of Chancellors as the ACR chair of the Commission on Research. She is a past president of the North American Society for Cardiovascular Imaging. Her expertise has informed the R&E Foundation Research Grant Study Section and the Quantitative Imaging Biomarkers Alliance.Article HistoryPublished online: Nov 30 2021Published in print: Jan 2022 FiguresReferencesRelatedDetailsRecommended Articles Linda Moy, MD, Named New Editor of RadiologyRadioGraphics2022Volume: 42Issue: 2pp. E37-E38Linda Moy, MD, Named New Editor of RadiologyRadiology2022Volume: 303Issue: 1pp. 3-4David A. Bluemke, MD, PhD, Named Editor of RadiologyRadiology2016Volume: 282Issue: 1pp. 10-11David A. Bluemke, MD, PhD, Named Editor of RadiologyRadioGraphics2017Volume: 37Issue: 1pp. 5-62020 RSNA Outstanding ResearcherRadiology2020Volume: 298Issue: 1pp. 1See More RSNA Education Exhibits Imaging of Suspected Pulmonary Embolism and Deep Venous Thrombosis in Obese PatientsDigital Posters2020Clinical Aspects Relating to Acute Pulmonary Embolism ImagingDigital Posters2018Acute Pulmonary Embolism: The Role of the Radiologist from Diagnosis to TreatmentDigital Posters2018 RSNA Case Collection Acute pulmonary embolismRSNA Case Collection2022Carotid WebRSNA Case Collection2020Pulmonary Embolism with Right Heart StrainRSNA Case Collection2020 Vol. 302, No. 1 Metrics Altmetric Score PDF download

Physician trainees’ compassion satisfaction, burnout, and self-efficacy when caring for people who inject drugs

Background: Front-line providers working with people who inject drugs (PWID) are at increased risk of experiencing burnout. Few studies have examined protective factors against burnout incurred in the care of PWID, including harm reduction counseling skills. We measured self-efficacy in harm reduction counseling, burnout, and compassion satisfaction among Internal Medicine (IM) trainees caring for PWID. Methods: In this cross-sectional study, we surveyed IM interns and residents. Self-efficacy was assessed by asking trainees about attitudes, comfort, and knowledge in harm reduction counseling on a five-point Likert scale. Burnout and compassion satisfaction were assessed via an adapted 20-question Professional Quality of Life Scale. We compared self-efficacy in harm reduction counseling, compassion satisfaction, and burnout between interns and residents using ANOVA and Mann–Whitney U tests. We used Spearman’s rho correlational analysis to examine the relationship between these three variables. Results: Seventy-nine IM trainees (36 interns, 43 residents) completed the survey for a 52% response rate. Residents reported higher self-efficacy in harm reduction counseling, similar levels of burnout, and higher compassion satisfaction compared to interns. Across training levels, we found a negative correlation between burnout and compassion satisfaction (r = −0.55, p < 0.01) and a positive correlation between compassion satisfaction and comfort counseling PWID on harm reduction (r = 0.30, p < 0.01). Conclusions: Among IM trainees at an urban institution serving a large population of PWID, self-efficacy in harm reduction counseling and compassion satisfaction increase with time in training while burnout remains similar. Strengthening trainees’ capacity to counsel PWID on harm reduction may improve their compassion satisfaction in caring for this population, potentially leading to improved care. This relationship should be explored longitudinally in larger cohorts and through evaluations of harm reduction-focused medical education.

Telehealth Attitudes, Training, and Preparedness Among First-Year Internal Medicine Residents in the COVID-19 Era.

Introduction: Telehealth, especially the use of real-time video and phone visits in ambulatory care, is increasingly important in the wake of the COVID-19 pandemic. The current state of internal medicine (IM) interns' telehealth training at the start of residency is unknown. Objective: To characterize the attitudes, training, and preparedness of IM interns regarding the use of telehealth video and phone visits in ambulatory care. Materials and Methods: We conducted a cross-sectional survey of IM interns at four IM residency programs in the United States in 2020. Results: One hundred fifty-six surveys were analyzed (response rate 82%). Seventy-five percent of interns rated training in the use of real-time video and phone visits for ambulatory care as important or very important. The vast majority received no training (74%) or clinical experience (90% no prior video visits, 81% no prior phone visits) during medical school. More interns believed that primary care may be effectively delivered via video visits compared with phone visits (77% vs. 35%). Most interns (69%) missed clinical time during medical school due to the COVID-19 pandemic; 41% felt that the pandemic negatively affected their ambulatory care preparation. Overall, the majority of interns (58%) felt prepared for primary care; only 12% felt prepared to deliver primary care using either video or phone visits. Conclusions: Although IM interns had favorable attitudes toward video and phone visits, few had training or clinical experience; most felt unprepared. Residency programs may need to close training gaps for current interns in conducting telehealth video and phone visits.

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients

BackgroundThere are limited competency-based educational curricula for transitions of care education (TOC) for internal medicine (IM) residency programs. The University of Colorado implemented a virtual interdisciplinary conference call, TEAM (Transitions Expectation and Management), between providers on the inpatient Acute Care of the Elder (ACE) unit and the outpatient Seniors Clinic at the University of Colorado Hospital. Residents rotating on the ACE unit participated in weekly conferences discussing Seniors Clinic patients recently discharged, or currently hospitalized, to address clinical concerns pertaining to TOC. Our goals were to understand resident perceptions of the educational value of these conferences, and to determine if these experiences changed attitudes or practice related to care transitions.MethodsWe performed an Institutional Review Board-approved qualitative study of IM housestaff who rotated on the ACE unit during 2018–2019. Semi-structured interviews were conducted to understand perceptions of the value of TEAM calls for residents’ own practice and the impact on patient care. Data was analyzed inductively, guided by thematic analysis.ResultsOf the 32 IM residents and interns who rotated on ACE and were invited to participate, 11 agreed to an interview. Three key themes emerged from interviews that highlighted residents’ experiences identifying and navigating some of their educational ‘blind spots:’ 1) Awareness of patient social complexities, 2) Bridging gaps in communication across healthcare settings, 3) Recognizing the value of other disciplines during transitions.ConclusionsThis study highlights learner perspectives of the benefit of interdisciplinary conference calls between inpatient and outpatient providers to enhance transitions of care, which provide meaningful feedback and serve as a vehicle for residents to recognize the impact of their care decisions in the broader spectrum of patients’ experience during hospital discharge. Educators can maximize the value of these experiences by promoting reflective debriefs with residents and bringing to light previously unrecognized knowledge gaps around hospital discharge.

In memoriam: Robert T. Leshner, MD

In memoriam: <scp>Robert T. Leshner</scp>, <scp>MD</scp>

Brigid Dwyer, MD, and Douglas I. Katz, MD.

Dr. Dwyer is Assistant Professor of Neurology at Boston University (BU) School of Medicine. She received her BS from Massachusetts Institute of Technology in Brain and Cognitive Sciences, and her MD from the Warren Alpert School of Medicine at Brown University. She did her internship in Internal Medicine, as well as her residency in Neurology, at BU. This was followed by a clinical and research fellowship in Brain Injury Medicine and Neurorehabilitation sponsored by the BU School of Medicine and the Boston Veterans Affairs Healthcare System. She joined BU's faculty in 2017, where she has served admirably. She is currently Director of the Vascular Injury/Stroke Program at Encompass Health Braintree Rehabilitation Hospital, where she also serves on the Medical Executive Committee. She serves on numerous American Congress of Rehabilitation Medicine (ACRM) committees, including the Disorders of Consciousness Working Group, the Physicians and Clinicians Working Group, and the Brain Injury Interdisciplinary Special Interest Group. She is a revered clinician and teacher, and a rising star in the field of Brain Injury Medicine.

2021 Medical Director of the Year: Leslie Eber, the Energized, Engaged, and Exemplary Leader

2021 Medical Director of the Year: Leslie Eber, the Energized, Engaged, and Exemplary Leader

Time for Clinic: Fourth-Year Primary Care Exposure and Clinic Preparedness Among Internal Medicine Interns.

Internal medicine (IM) residency graduates consistently report being less prepared for outpatient practice than inpatient medicine. Although an initial study suggested interns arriving for IM residency reported low levels of preparedness for continuity clinic, the impact of education and experience during the undergraduate medical education to graduate medical education transition on ambulatory training is unclear. To describe end of medical school primary care exposure among entering IM interns and its association with self-assessed preparedness for residency continuity clinic. Cross-sectional survey of 161 entering IM interns in 2019. Entering interns at four geographically diverse IM residency programs (University of Chicago, University of North Carolina, University of Pennsylvania, and University of Washington), representing 81 US medical schools. A total of 139 interns (86%) responded to the survey. Surveyed interns reported a median of zero days of general internal medicine (GIM) clinic (interquartile range [IQR]: 0-20days) and 2.5days of multispecialty adult primary care (IQR: 0-26.5days) during fourth year of medical school. The median last exposure to primary care was 13months prior to internship (IQR: 7-18months). Interns who rated themselves as prepared for primary care clinic reported a median of twenty more multispecialty adult primary care days (20 vs. 0days; p < 0.01) and fourteen more GIM clinic days (14 vs. 0days; p < 0.01) than their unprepared counterparts. The experiences were also more recent, with six fewer months between their last multispecialty adult primary care exposure and the start of internship (9 vs. 15months; p < 0.01). The majority of incoming IM interns had no primary care training during the fourth year of medical school. At the start of residency, IM interns who felt more prepared for their primary care clinic reported more recent and more numerous primary care experiences.

Longitudinal trends using a point-of-care gelatin-based model for ultrasound-guided central venous catheter insertion

ABSTRACT Ultrasound (US)-guided central venous catheter (CVC) insertion is a procedure that carries the risk of significant complications. Simulation provides a safe learning atmosphere, but most CVC simulators are not available outside of simulation centers. To explore longitudinal trends in US-guided CVC insertion competency in internal medicine (IM) interns, we studied the use of a low-fidelity, gelatin-based, US-guided CVC insertion simulation model combined with a simulation curriculum. This prospective observational study of IM interns was performed over the course of one academic year. Interns (n = 56) underwent model-based, US-guided procedure simulation training program and a repeated training course prior to their intensive care unit (ICU) rotation. CVC insertion competency at different timepoints was recorded. Survey data about intern experience and attitudes were also collected. Out of the 56 interns initially trained, 40 were included in the final analysis. Across all outcomes, interns experienced skill atrophy between initial training and the beginning of their ICU month. However, by the end of the month, there was a significant improvement in competency as compared to initial procedural training, which then waned by the end of the intern year. Attitudes toward the model were generally positive and self-reported confidence improved throughout the course of the year and correlated with objective measures of competency. Over the course of their intern year, which included simulation training using a gelatin-based model, interns demonstrated consistent competency trends. The use of a gelatin-based CVC insertion simulation model warrants further study as an adjunctive aid to existing simulation training.

Evaluation of Compliance of the Case-Based Multistation Electronic Internal Medicine Exam with National Core Curriculum-2014

Aim: Clinical reasoning is described as a mental process that occurs when a doctor encounter with patient in clinical environment. Clinical reasoning contains anamnesis, diagnosis, and management. Cases have been used both to teach and assess clinical reasoning. Core curriculum should be considered in the selection process of cases. The aim of this study is to evaluate the compliance with the National Core Curriculum-2014 of the questions of the case-based multistation electronic exam, which is carried out at the end of Internal Diseases internship, that is for assessing clinical reasoning skill of the Year-6 medical students in Gazi University Faculty of Medicine.Methods: The study was conducted between May-December 2019 with 289 Year-6 medical students at the end of Internal Medicine internship period. Questions of the case-based multistation electronic exam were prepared by Internist faculty members. In total, 5 exams were carried out using SocrativeTM to give immediate feedback. Every exam consisted of 3 cases. End of all the exams, questions of cases were categorized in the classes of anamnesis, physical examination, pre-diagnosis, laboratory findings, treatment. Compliance with the National Core Curriculum-2014 was evaluated.Results: In total, 14 cases and 74 questions nested in cases were evaluated. 26 (35.1%) of the questions were about laboratory findings. 16 (21.6%) of the questions were under treatment class. In 13 (92.8%) of the cases, there was at least a question expects higher levels than National Core Curriculum-2014. Out of 74 questions, 31 (41.8%) of them assessed higher levels than National Core Curriculum-2014. Mean scores of the students were significantly lower at questions that assess higher levels than National Core Curriculum-2014 (p&amp;lt;0.05).Conclusion: Faculty members do not take into consideration National Core Curriculum-2014. This poses a serious threat since assessment drives learning. Faculty development on National Core Curriculum and assessment could be a solution.