1
|
Ortega P, Cisneros R, Park YS. Medical Spanish Graphic Activity: A MeGA Deliberate Practice Approach to Reducing Jargon Use With Spanish-Speaking Acute Care Patients. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2024; 20:11377. [PMID: 38173698 PMCID: PMC10758527 DOI: 10.15766/mep_2374-8265.11377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/25/2023] [Indexed: 01/05/2024]
Abstract
Introduction Medical Spanish courses in US medical schools aim to teach patient-centered communication, yet many existing resources focus on technical vocabulary and may inadvertently increase jargon use with patients. Graphic medicine presents an opportunity for interactive learning that centers the patient experience, yet it has never been explored in medical Spanish education. Methods We developed a Medical Spanish Graphic Activity (MeGA) for medical student deliberate practice of patient-centered verbal communication focused on three aspects: diagnosis, treatment, and follow-up care. Each 30-minute activity included a comics handout depicting a patient with a common problem. Students used voice-to-text technology to record their explanations in response to prompts. Transcripts were analyzed for jargon use, including total jargon, unexplained jargon, and problem words (non-Spanish words plus unexplained jargon), utilizing a previously published, reliable protocol for Spanish medical jargon classification. Participants voluntarily provided postactivity feedback. Results Twenty-nine fourth-year students with intermediate or greater Spanish skills participated in a series of 10 MeGA activities between January and April 2022. Unexplained jargon use and problem words progressively decreased for all transcripts (diagnosis, treatment, and follow-up; all ps < .001). Total jargon use also decreased, but this was not significant in follow-up transcripts (p = .38). All students agreed that MeGA helped them enhance communication skills applicable to patient care and self-identify strengths and limitations. Discussion MeGA is realistic to implement, engages students' active participation in the speaking domain, and reduces unexplained jargon use. Future studies should explore the broader application of this model and engage patient perspectives.
Collapse
Affiliation(s)
- Pilar Ortega
- Clinical Associate Professor, Departments of Medical Education and Emergency Medicine, University of Illinois College of Medicine; Vice President, Diversity, Equity, and Inclusion, Accreditation Council for Graduate Medical Education
| | - Rafael Cisneros
- Resident Physician, Departments of Pathology and Laboratory Medicine, University of California, San Francisco
| | - Yoon Soo Park
- Professor, Department of Medical Education, University of Illinois College of Medicine
| |
Collapse
|
2
|
Skedsmo K, Nes AAG, Stenseth HV, Hofsø K, Larsen MH, Hilderson D, Smis D, Hagelin CL, Olaussen C, Solberg MT, Bingen HM, Ølnes MA, Steindal SA. Simulation-based learning in palliative care in postgraduate nursing education: a scoping review. BMC Palliat Care 2023; 22:30. [PMID: 36991463 DOI: 10.1186/s12904-023-01149-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education. METHODS The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Meth 8(1):19-32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework. RESULTS This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one's ability to communicate during emotionally challenging situations; and impact and relevance to one's own clinical practice. CONCLUSIONS The use of SBL in palliative care in postgraduate nursing education seems to enhance students' understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students' confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students' experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.
Collapse
Affiliation(s)
- Karoline Skedsmo
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway.
- Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.
| | | | | | - Kristin Hofsø
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | | | | | | | - Carina Lundh Hagelin
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Olaussen
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
| | | | | | - Mia Alexandra Ølnes
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
3
|
Okinyi HM, Wachira CM, Wilson KS, Nduati MN, Onyango AD, Mburu CW, Inwani IW, Owens TL, Bukusi DE, John-. Stewart GC, Wamalwa DC, Kohler PK. “I Have Actually not Lost any Adolescent Since I Started Engaging Them one on one:” Training Satisfaction and Subsequent Practice among Health Providers Participating in a Standardized Patient Actor Training to Improve Adolescent Engagement in HIV Care. J Int Assoc Provid AIDS Care 2022; 21:23259582221075133. [PMID: 35068204 PMCID: PMC8793424 DOI: 10.1177/23259582221075133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Poor health care worker (HCW) interactions with adolescents negatively influence engagement in HIV care. We assessed the impact of standardized patient actor training on HCW competence in providing adolescent HIV care in Kenya. Methods: We conducted pre-post cross-sectional surveys and qualitative exit interviews during a stepped wedge randomized trial. Cross-sectional surveys assessed self-rated competence in providing adolescent services before and after the intervention, and training satisfaction. In-depth interviews with a subset of HCW participants one year after training. Results: Over 90% of HCWs reported satisfaction with the training and there was significant improvement in self-rated competence scores (mean = 4.63 [highest possible score of 5] post-training vs 3.86 pre-training, p < 0.001). One-year following training, HCWs reported using skills in patient-centered communication and structuring an adolescent clinical encounter. Conclusions: This SP training intervention improved self-rated competence and showed sustained perceived impact on HCW skills in adolescent HIV service provision one year later.
Collapse
|
4
|
Kameg B, Fradkin D, Lee H. Effect of Standardized Patient Simulation on Nursing Students' Attitudes Toward Psychiatric Nursing and Patients With Mental Health Problems. J Psychosoc Nurs Ment Health Serv 2021; 59:15-21. [PMID: 34142918 DOI: 10.3928/02793695-20210513-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to evaluate changes in attitudes toward psychiatric nursing and mental health problems in a sample of nursing students after exposure to high-fidelity standardized patient (SP) simulation scenarios. This study used a quasi-experimental, single-group pre-/post-survey approach. Immediately before and after exposure to SP simulation scenarios, undergraduate nursing students completed Attitudes to Mental Illness (AMI) and the Attitudes to Psychiatry (ATP) surveys. There were significant improvements in the following ATP domains: psychiatric career choice and psychiatric teaching (p = 0.046 and 0.007, respectively). There were no significant changes in the AMI survey, but items related to social stigma improved following the simulation. Findings of this study suggest a potential benefit of SP simulation on nursing students in developing their attitudes toward psychiatry and mental health problems. [Journal of Psychosocial Nursing and Mental Health Services, 59(8), 15-21.].
Collapse
|
5
|
Pearse W, Saxon R, Plowman G, Hyde M, Oprescu F. Continuing Education Outcomes for Advance Care Planning: A Systematic Review of the Literature. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:39-58. [PMID: 33433128 DOI: 10.1097/ceh.0000000000000323] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Advance care planning (ACP) is a process of considering future health and care needs for a time when a person may be unable to speak for themselves. Health professional continuing education programs have been proposed for facilitating patient participation in ACP; however, their impacts on participants, patient and clinical outcomes, and organizational approaches to ACP are not well understood. METHODS This systematic literature review examined interventional studies of education programs conducted with health professionals and care staff across a broad range of settings. Five electronic databases were searched up to June 2020, and a manual search of reference lists was conducted. The quality of studies was appraised by the first, second, and third authors. RESULTS Of the 7993 articles identified, 45 articles met the inclusion criteria. Program participants were predominantly medical, nursing, and social work staff, and students. Interventions were reported to improve participants' self-perceived confidence, knowledge, and skills; however, objectively measured improvements were limited. Multimodal programs that combined initial didactic teaching and role-play simulation tasks with additional activities were most effective in producing increased ACP activity in medical records. Evidence for improved clinical outcomes was limited. DISCUSSION Further studies that use rigorous methodological approaches would provide further evidence about what produces improved patient and clinical outcomes. Needs analyses and quality indicators could be considered to determine the most appropriate and effective education resources and monitor their impacts. The potential contribution of a broader range of health professionals and interprofessional learning approaches could be considered to ultimately improve patient care.
Collapse
Affiliation(s)
- Wendy Pearse
- Ms. Pearse: End of Life Care Project Manager, Nambour General Hospital, Sunshine Coast Hospital and Health Service, Queensland, Australia, and School of Health and Sports Sciences, University of the Sunshine Coast, Queensland, Australia. Dr. Saxon: Allied Health Data and Informatics, Advanced Speech Pathologist, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Queensland, Australia. Dr. Plowman: Physician, Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Queensland, Australia. Dr. Hyde: Professor, School of Education, University of the Sunshine Coast, Queensland, Australia. Dr. Oprescu: Associate Professor, School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | | | | | | | | |
Collapse
|
6
|
Li J, Li X, Gu L, Zhang R, Zhao R, Cai Q, Lu Y, Wang H, Meng Q, Wei H. Effects of Simulation-Based Deliberate Practice on Nursing Students' Communication, Empathy, and Self-Efficacy. J Nurs Educ 2019; 58:681-689. [DOI: 10.3928/01484834-20191120-02] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/21/2019] [Indexed: 01/17/2023]
|
7
|
Harrison Dening K, Scates C, McGill G, De-Vries K. A training needs analysis of admiral nurses to facilitate advance care planning in dementia. Palliat Care 2019; 12:1178224219850183. [PMID: 31258328 PMCID: PMC6585248 DOI: 10.1177/1178224219850183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/04/2019] [Indexed: 11/15/2022] Open
Abstract
Education of health and social care professionals is essential in preparation to confidently and effectively support families affected by dementia to undertake advance care planning. This article describes a training needs analysis of Admiral Nurses, dementia specialists, in facilitating advance care planning for future care. METHODS A questionnaire survey was completed by Admiral Nurses attending end-of-life care masterclasses in 2017 and 2018. Both quantitative (years registered as a nurse, years as an Admiral Nurse and subjective level of confidence in completing advance care plannings) and qualitative data (interventions perceived to increase confidence) were collected. FINDINGS There were 75 completed responses (two incomplete returns). There was no correlation between levels of confidence and years registered as a nurse. However, there was a small positive correlation between confidence and number of years as an Admiral Nurse (r = 0.23; p < 0.05). Themes identified qualitatively to enhance practice were advanced communication skills, supervised practice, resources to frame conversations and a guide and template for advance care planning. CONCLUSION Although Admiral Nurses are specialists in dementia, several educational initiatives could be employed to better enable them to support advance care planning for families affected by dementia. This training needs analysis is contributed towards developing an educational intervention for Admiral Nurses to improve advance care planning support.
Collapse
Affiliation(s)
- Karen Harrison Dening
- Dementia UK, London, UK; Faculty of Health and Life Sciences, School of Nursing and Midwifery, De Montfort University, Leicester, UK
| | | | | | - Kay De-Vries
- Faculty of Health and Life Sciences, School of Nursing and Midwifery, De Montfort University, Leicester, UK
| |
Collapse
|
8
|
Pereira-Salgado A, Philpot S, Schlieff J, O'Driscoll L, Mills A. Advance Care Planning Simulation-Based Learning for Nurses: Mixed Methods Pilot Study. Clin Simul Nurs 2019. [DOI: 10.1016/j.ecns.2018.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Weil A, Weldon SM, Kronfli M, Watkins B, Kneebone R, Bello F, Cox S. A new approach to multi-professional end of life care training using a sequential simulation (SqS Simulation™) design: A mixed methods study. NURSE EDUCATION TODAY 2018; 71:26-33. [PMID: 30218849 DOI: 10.1016/j.nedt.2018.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/20/2018] [Accepted: 08/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND A need for improved education and training for hospital staff caring for patients in the last year of life was identified at an urban UK hospital. Sequential Simulation (SqS Simulation™) is a type of simulation that recreates a patient's journey, considering the longitudinal element of care and how this might impact on the patient's experiences, wishes and needs. OBJECTIVES The aim of this study was to investigate a new end of life care training intervention for multi-professional hospital staff, and its effect on their confidence in managing patients at the end of their life. SETTING/PARTICIPANTS Based on the results of a formal Training Needs Analysis, four SqS Simulation™ specialty-based courses were designed for general medical and surgical multidisciplinary teams in an acute UK hospital. METHODS Over three months, seven SqS Simulation™ sessions were attended by fifty-seven multidisciplinary healthcare professionals. A quasi-experimental mixed-methods study was conducted using open and closed-ended questionnaires, pre and post-intervention. Changes in course attendees' confidence levels were analysed and qualitative data from free-text answers informed potential reasons for any differences identified. RESULTS Confidence improved for all professional cohorts (p < 0.001). The differences were found to be highly significant for 'doctors' (p < 0.001), significant for 'therapists' (p = 0.02) and not significant for the 'nurses' cohort (p = 0.238). This was explored further using a qualitative explanatory framework. Categories included: Communicating with Families; Teamwork; Goal Planning; Do Not Attempt Cardiopulmonary Resuscitation; Course Usefulness; Prior Training; and Clinical Experience. CONCLUSION This study has shown an overall improvement in confidence across disciplines after attending a SqS Simulation™ course. The differences in quantitative results between disciplines were explored through the qualitative data and revealed a difference in what the professionals gained from it. Further studies are required to assess its effectiveness in maintaining confidence of end of life care in practice, as well as its benefit to patient outcomes.
Collapse
Affiliation(s)
- Anna Weil
- Cicely Saunders Institute, King's College London, Bessemer Road, London SE5 9PJ, UK
| | - Sharon Marie Weldon
- University of Greenwich, Department of Adult Nursing and Paramedic Science, London, UK; Barts Health NHS Trust, London, UK.
| | - Miranda Kronfli
- Imperial College London, Department of Academic Surgery, London, UK; University College London Medical School, London, UK
| | - Ben Watkins
- Imperial College London, Department of Academic Surgery, London, UK; Lancaster University Medical School, Lancaster, UK
| | - Roger Kneebone
- Imperial College London, Department of Academic Surgery, London, UK
| | - Fernando Bello
- Imperial College London, Department of Academic Surgery, London, UK
| | - Sarah Cox
- Chelsea and Westminster Hospital, Department of Palliative Care, London, UK
| |
Collapse
|
10
|
Bond WF, Kim M, Franciskovich CM, Weinberg JE, Svendsen JD, Fehr LS, Funk A, Sawicki R, Asche CV. Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs. J Palliat Med 2018; 21:489-502. [PMID: 29206564 PMCID: PMC5867515 DOI: 10.1089/jpm.2017.0566] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. OBJECTIVE To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. DESIGN This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. SETTING/SUBJECTS Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. MEASUREMENTS The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. RESULTS We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6-54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02-1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (-0.37 admissions, 95% CI -0.66 to -0.08), and inpatient days (-3.66 days, 95% CI -6.23 to -1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI -$16,207 to -$2,793). CONCLUSIONS ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients.
Collapse
Affiliation(s)
- William F. Bond
- Jump Simulation, OSF HealthCare, Peoria, Illinois
- Department of Emergency Medicine, OSF HealthCare, Peoria, Illinois
- Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois
| | - Minchul Kim
- Center for Outcomes Research, University of Illinois College of Medicine at Peoria, Peoria, Illinois
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois
| | | | | | | | - Linda S. Fehr
- Division of Supportive Care, OSF HealthCare, Peoria, Illinois
| | - Amy Funk
- College of Nursing, Illinois Wesleyan University, Bloomington, Illinois
| | - Robert Sawicki
- Division of Supportive Care, OSF HealthCare, Peoria, Illinois
| | - Carl V. Asche
- Center for Outcomes Research, University of Illinois College of Medicine at Peoria, Peoria, Illinois
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois
| |
Collapse
|
11
|
Alkureishi MA, Lee WW, Lyons M, Wroblewski K, Farnan JM, Arora VM. Electronic-clinical evaluation exercise (e-CEX): A new patient-centered EHR use tool. PATIENT EDUCATION AND COUNSELING 2018; 101:481-489. [PMID: 29042145 DOI: 10.1016/j.pec.2017.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/04/2017] [Accepted: 10/07/2017] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Electronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool. METHODS Electronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed. RESULTS Three investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach's alpha=0.89). MS2s scored significantly higher than untrained MS3s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P=0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation=0.74, P<0.001), providing concurrent validity evidence. Item reduction suggested a three-item tool had similar explanatory power (R-squared=0.85 vs 0.86). CONCLUSION e-CEX is a reliable, valid tool to assess medical student patient-centered EHR communication skills. PRACTICE IMPLICATIONS While validation is needed with other healthcare providers, e-CEX may help improve provider behaviors and enhance patients' overall experience of EHR use in their care.
Collapse
Affiliation(s)
| | - Wei Wei Lee
- Department of Medicine, University of Chicago, Chicago, United States
| | - Maureen Lyons
- Division of General Internal Medicine, Saint Louis University School of Medicine, St. Louis, United States
| | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, United States
| | - Jeanne M Farnan
- Department of Medicine, University of Chicago, Chicago, United States
| | - Vineet M Arora
- Department of Medicine, University of Chicago, Chicago, United States
| |
Collapse
|