1
|
Growdon AS, Oñate A, Staffa SJ, Berger S, Callas C, Chitkara MB, Crook TW, Daniel DA, Huth K, Lehmann S, Len KA, Murray AM, Neeley M, Devon EP, Pingree E, Rose S, Weinstein A, Wolbrink TA. The Effect of Providing Protected Time for Utilization of Video-Based Learning in the Pediatric Clerkship: A Randomized Trial. Acad Pediatr 2024; 24:139-146. [PMID: 37148969 DOI: 10.1016/j.acap.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/19/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Amanda S Growdon
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass.
| | - Alma Oñate
- Harvard Medical School (A Oñate), Boston, Mass
| | - Steven J Staffa
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Stephanie Berger
- Department of Pediatrics (S Berger), University of Alabama at Birmingham Heersink School of Medicine
| | - Christina Callas
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Maribeth B Chitkara
- Department of Pediatrics (MB Chitkara), Renaissance School of Medicine at Stony Brook University, NY
| | - Travis W Crook
- Department of Pediatrics (TW Crook and M Neeley), Vanderbilt Children's Hospital and Vanderbilt University School of Medicine, Nashville, Tenn
| | - Dennis A Daniel
- Department of Anesthesiology (DA Daniel and TA Wolbrink), Critical Care and Pain Medicine, Boston Children's Hospital, Department of Anaesthesia, Harvard Medical School, Mass
| | - Kathleen Huth
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass
| | - Sonja Lehmann
- Department of Anesthesiology (SJ Staffa, C Callas, and S Lehmann), Critical Care and Pain Medicine, Boston Children's Hospital, Mass
| | - Kyra A Len
- Department of Pediatrics and Office of Medical Education (KA Len), University of Hawai'i John A. Burns School of Medicine, Honolulu
| | - Ann M Murray
- Department of Pediatrics (AM Murray), Massachusetts General Hospital and Harvard Medical School, Boston
| | - Maya Neeley
- Department of Pediatrics (TW Crook and M Neeley), Vanderbilt Children's Hospital and Vanderbilt University School of Medicine, Nashville, Tenn
| | - Erin Pete Devon
- Department of Pediatrics (EP Devon and S Rose), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | - Elizabeth Pingree
- Department of Pediatrics (AS Growdon, K Huth, and E Pingree), Boston Children's Hospital and Harvard Medical School, Mass
| | - Stacey Rose
- Department of Pediatrics (EP Devon and S Rose), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | - Adam Weinstein
- Department of Pediatrics and Medical Education (A Weinstein), Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Traci A Wolbrink
- Department of Anesthesiology (DA Daniel and TA Wolbrink), Critical Care and Pain Medicine, Boston Children's Hospital, Department of Anaesthesia, Harvard Medical School, Mass
| |
Collapse
|
2
|
Walsh DP, Wong VT, Mitchell JD. Resident Engagement With a Web- and App-based Journal Club Curriculum Utilizing Email and Text Notifications. THE JOURNAL OF EDUCATION IN PERIOPERATIVE MEDICINE : JEPM 2023; 25:E713. [PMID: 37720368 PMCID: PMC10502580 DOI: 10.46374/volxxv_issue3_walsh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Background High learner engagement is important for the success of asynchronous and online learning for graduate medical education. Medical trainees have recently reported using medical mobile apps. App-based interactions may provide more participation than email-based interactions. We sought to investigate (1) if there were higher levels of engagement with an online curriculum using notifications sent via email as compared with via text, and (2) if there were higher levels of engagement with the mobile app or website format. Methods We implemented an online Journal Club curriculum with weekly topics for anesthesiology residents (postgraduate years 2-4) from July 2020 to June 2021. Weekly notifications were sent to residents via email for weeks 1-10, text for weeks 11-20, then email for weeks 21-49. Based on activity logs, we compared (1) the weekly numbers of interactions when email notifications were sent with the weekly numbers of interactions when text notifications were sent, and (2) the weekly numbers of interactions via the app with the weekly numbers of interactions via the website. Results Thirty-eight of the 54 anesthesiology residents in our department at the time of the study (70.4%) interacted with the online Journal Club at least once throughout the study. The weekly numbers of interactions with email notifications (median [interquartile range (IQR)]: 13 [7-28]) were significantly higher than with text notifications (median [IQR]: 6 [4-8]) (P = .023). The weekly numbers of interactions via the website (median [IQR]: 9 [4-24]) were significantly higher than via the app (median [IQR]: 0 [0-1]) (P < .001). Conclusions Although mobile technology may increase engagement and participation for some educational resources, learners may prefer accessing others through more conventional methods.
Collapse
Affiliation(s)
- Daniel P. Walsh
- Daniel P. Walsh is Associate Residency Program Director in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA; Medical Director of the Intensive Care Unit at Beth Israel Deaconess Hospital–Plymouth, Plymouth, MA; and Instructor in Anesthesia at Harvard Medical School, Boston, MA. Vanessa T. Wong is Project Manager, Center for Education Research, Technology, and Innovation (CERTAIN) in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA. John D. Mitchell is Vice Chair for Academic Affairs in the Department of Anesthesiology, Pain Management and Perioperative Medicine at Henry Ford Health, Jackson, MI, and a Professor and Vice Chair in the Department of Anesthesiology at Michigan State University, East Lansing, MI
| | - Vanessa T. Wong
- Daniel P. Walsh is Associate Residency Program Director in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA; Medical Director of the Intensive Care Unit at Beth Israel Deaconess Hospital–Plymouth, Plymouth, MA; and Instructor in Anesthesia at Harvard Medical School, Boston, MA. Vanessa T. Wong is Project Manager, Center for Education Research, Technology, and Innovation (CERTAIN) in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA. John D. Mitchell is Vice Chair for Academic Affairs in the Department of Anesthesiology, Pain Management and Perioperative Medicine at Henry Ford Health, Jackson, MI, and a Professor and Vice Chair in the Department of Anesthesiology at Michigan State University, East Lansing, MI
| | - John D. Mitchell
- Daniel P. Walsh is Associate Residency Program Director in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA; Medical Director of the Intensive Care Unit at Beth Israel Deaconess Hospital–Plymouth, Plymouth, MA; and Instructor in Anesthesia at Harvard Medical School, Boston, MA. Vanessa T. Wong is Project Manager, Center for Education Research, Technology, and Innovation (CERTAIN) in the Department of Anesthesia, Critical Care and Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA. John D. Mitchell is Vice Chair for Academic Affairs in the Department of Anesthesiology, Pain Management and Perioperative Medicine at Henry Ford Health, Jackson, MI, and a Professor and Vice Chair in the Department of Anesthesiology at Michigan State University, East Lansing, MI
| |
Collapse
|
3
|
Jung FU, Luppa M, Riedel-Heller SG. [Physician working hours and effects on health, satisfaction and healthcare]. ZENTRALBLATT FUR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2023; 73:1-7. [PMID: 37361962 PMCID: PMC10141868 DOI: 10.1007/s40664-023-00503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 06/28/2023]
Abstract
Changes in the working environment with respect to innovative working time models are also increasingly affecting patient care. The number of physicians working part-time, for example, is continuously rising. At the same time, a general increase in chronic diseases and multimorbid conditions as well as the growing shortage of medical staff, leads to more workload and dissatisfaction among this profession. This short overview summarizes the current study situation and associated consequences regarding working hours of physicians and gives a first explorative overview of possible solutions.
Collapse
Affiliation(s)
- F. U. Jung
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - M. Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - S. G. Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Ph.-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| |
Collapse
|
4
|
Miller KA, Auerbach M, Bin SS, Donoghue A, Kerrey BT, Mittiga MR, D'Ambrosi G, Monuteaux MC, Marchese A, Nagler J. Coaching the coach: A randomized controlled study of a novel curriculum for procedural coaching during intubation. AEM EDUCATION AND TRAINING 2023; 7:e10846. [PMID: 36936084 PMCID: PMC10014969 DOI: 10.1002/aet2.10846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
Background Videolaryngoscopy allows real-time procedural coaching during intubation. This study sought to develop and assess an online curriculum to train pediatric emergency medicine attending physicians to deliver procedural coaching during intubation. Methods Curriculum development consisted of semistructured interviews with 12 pediatric emergency medicine attendings with varying levels of airway expertise analyzed using a constructivist grounded theory approach. Following development, the curriculum was implemented and assessed through a multicenter randomized controlled trial enrolling participants in one of three cohorts: the coaching module, unnarrated video recordings of intubations, and a module on ventilator management. Participants completed identical pre and post assessments asking them to select the correct coaching feedback and provided reactions for qualitative thematic analysis. Results Content from interviews was synthesized into a video-enhanced 15-min online coaching module illustrating proper technique for intubation and strategies for procedural coaching. Eighty-seven of 104 randomized physicians enrolled in the curriculum; 83 completed the pre and post assessments (80%). The total percentage correct did not differ between pre and post assessments for any cohort. Participants receiving the coaching module demonstrated improved performance on patient preparation, made more suggestions for improvement, and experienced a greater increase in confidence in procedural coaching. Qualitative analysis identified multiple benefits of the module, revealed that exposure to video recordings without narration is insufficient, and identified feedback on suggestions for improvement as an opportunity for deliberate practice. Conclusions This study leveraged clinical and educational digital technology to develop a curriculum dedicated to the content expertise and coaching skills needed to provide feedback during intubations performed with videolaryngoscopy. This brief curriculum changed behavior in simulated coaching scenarios but would benefit from additional support for deliberate practice.
Collapse
Affiliation(s)
- Kelsey A. Miller
- Department of PediatricsHarvard Medical SchoolBostonMassachusettsUSA
| | - Marc Auerbach
- Departments of Pediatrics and Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Steven S. Bin
- Departments of Pediatrics and Emergency MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Aaron Donoghue
- Department of Anesthesiology and Critical CarePerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Benjamin T. Kerrey
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | | | | | | | - Ashley Marchese
- Department of PediatricsHarvard Medical SchoolBostonMassachusettsUSA
| | - Joshua Nagler
- Department of PediatricsHarvard Medical SchoolBostonMassachusettsUSA
| |
Collapse
|
5
|
Daniel D, Wolbrink TA. Online educational interventions in pediatric intensive care medicine. Front Pediatr 2023; 11:1127754. [PMID: 36969296 PMCID: PMC10033549 DOI: 10.3389/fped.2023.1127754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/14/2023] [Indexed: 03/29/2023] Open
Abstract
Background Online education has experienced explosive growth, particularly in the wake of the COVID-19 pandemic. We explored the current state of the evidence base for online education targeted towards healthcare professionals working in pediatric intensive care units (PICUs), to report how we are using online education in our field. Materials and Methods We performed a literature review by systematically generating a list of publications indexed in PubMed describing online educational interventions in the PICU, using Medical Subject Header (MeSH)-based search terms and the following inclusion criteria: studies published after 2005 that describe online educational interventions aimed at healthcare professional working in the PICU. We reviewed the full text of all included articles, and summarized the study aims, design, and results. Results Our initial search yielded 1,071 unique articles. After screening abstracts and titles, then full texts, eight articles were included in the review. Many online learning modalities are represented, including websites, self-study modules, videos, videoconferencing, online self-assessment with feedback, virtual patient cases, screen-based simulation, and podcasts. Three studies focused on residents, two studies on nurses, two studies on a multidisciplinary team, and one study on transport nurses and paramedics. Most studies utilized participant surveys to assess satisfaction, and half included pre- and post-intervention multiple-choice question tests. Only one study included a patient-related outcome measure. Conclusions Despite growth in online medical educational intervention research, there are relatively few published studies in pediatric critical care, and only one study evaluated the impact of online learning on patient outcomes. There remain significant opportunities for PICU educators to assess the impact of online educational interventions, especially related to clinician behaviors and patient outcomes.
Collapse
|
6
|
Bjorklund A, Slusher T, Day LT, Yola MM, Sleeth C, Kiragu A, Shirk A, Krohn K, Opoka R. Pediatric Critical Care in Resource Limited Settings-Lessening the Gap Through Ongoing Collaboration, Advancement in Research and Technological Innovations. Front Pediatr 2022; 9:791255. [PMID: 35186820 PMCID: PMC8851601 DOI: 10.3389/fped.2021.791255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/21/2021] [Indexed: 12/02/2022] Open
Abstract
Pediatric critical care has continued to advance since our last article, "Pediatric Critical Care in Resource-Limited Settings-Overview and Lessons Learned" was written just 3 years ago. In that article, we reviewed the history, current state, and gaps in level of care between low- and middle-income countries (LMICs) and high-income countries (HICs). In this article, we have highlighted recent advancements in pediatric critical care in LMICs in the areas of research, training and education, and technology. We acknowledge how the COVID-19 pandemic has contributed to increasing the speed of some developments. We discuss the advancements, some lessons learned, as well as the ongoing gaps that need to be addressed in the coming decade. Continued understanding of the importance of equitable sustainable partnerships in the bidirectional exchange of knowledge and collaboration in all advancement efforts (research, technology, etc.) remains essential to guide all of us to new frontiers in pediatric critical care.
Collapse
Affiliation(s)
- Ashley Bjorklund
- Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, United States
- Global Pediatric Program, Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Tina Slusher
- Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, United States
- Global Pediatric Program, Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Louise Tina Day
- Maternal and Newborn Health Group, Department of Infectious Disease Epidemiology, London School Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Clark Sleeth
- Department of Pediatrics, Tenwek Hospital, Bomet, Kenya
| | - Andrew Kiragu
- Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, United States
- Global Pediatric Program, Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Childrens Hospital of Minnesota, Minneapolis, MN, United States
| | - Arianna Shirk
- Department of Pediatrics, Africa Inland Church Kijabe Hospital, Kijabe, Kenya
| | - Kristina Krohn
- Global Pediatric Program, Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Robert Opoka
- Department of Pediatrics, Makerere University, Kampala, Uganda
| |
Collapse
|
7
|
Ropponen A, Koskinen A, Puttonen S, Ervasti J, Kivimäki M, Oksanen T, Härmä M, Karhula K. Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study. Chronobiol Int 2021; 39:233-240. [PMID: 34724854 DOI: 10.1080/07420528.2021.1993238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians' risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1-3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68-3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61-4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44-3.21) and a higher number of short (<11 h) shift intervals (OR for ≥5 versus none: 12.61, 95% CI 8.88-17.90) were all associated with the increased risk of short sickness absence. These associations did not differ between male and female physicians or between age groups. To conclude, the findings from objective working hour records show that long work shifts, on-call shifts and short shift intervals are related to the risk of short (1-3 days) sickness absence among hospital physicians.
Collapse
Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Tuula Oksanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kati Karhula
- Finnish Institute of Occupational Health, Helsinki, Finland
| |
Collapse
|
8
|
An Online Curriculum in the PICU-Do You Have Plans Tonight? Pediatr Crit Care Med 2020; 21:1005-1006. [PMID: 33136988 DOI: 10.1097/pcc.0000000000002530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|