Implementation of a "Best Self" Exercise to Decrease Imposter Phenomenon in Residents.

Imposter phenomenon (IP) is common in medicine. An intervention from the business world, the Reflected Best Self Exercise (RBSE), in which an individual elicits stories of themselves at their best, has not been studied in medical residents. To determine the feasibility of implementing the RBSE and its potential for reducing IP in residents.

Leadership and Impostor Syndrome in Surgery.

Background: Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine.

Study Design: A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations.

Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model.

Purpose: Using a cadaveric model simulating clinical situations experienced during open reduction and internal fixation of proximal phalangeal fractures, the aim of this study was to evaluate the relationship between level of training and the rates of short, long, and ideal screw length selection based on depth gauge use without fluoroscopy assistance.

Methods: A dorsal approach to the proximal phalanx was performed on the index, middle, and ring fingers of 4 cadaveric specimens, and 3 drill holes were placed in each phalanx. Volunteers at different levels of training then measured the drill holes with a depth gauge and selected appropriate screw sizes.

Simplified Cable Nerve Grafting with Nerve-Cutting Guides and Fibrin Glue.

Cable nerve grafting is the recommended surgical treatment for large peripheral nerve defects. Traditionally, this is performed by bridging a gap in the nerve with multiple autologous nerve cables, repairing the epineurium of each cable to the perineurium of a fascicle of the injured nerve that is similar in size to the graft. The authors present a new technique in which they used nerve-cutting guides to aid in the placement of fibrin glue to secure the sides of the cabled nerve graft together to facilitate handling of the cabled nerve graft and to expedite repair.

Response to Video Capture of Plastic Surgery Procedures Using the GoPro HERO 3+: Patient Privacy and Compliance.

Supplemental Digital Content is available in the text.

Meeting American Geriatrics Society Competencies: Are Residents Meeting Expectations for Quality Care of Older Adults?

In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%.

Teaching medical students the art of the 'write-up'.

Background: The creation of a complete 'write-up' continues to be essential to the clinical learning experience for medical students. The ability to document a clinical encounter is a key communication skill and Core Entrustable Professional Activity for entering residency.

Methods: We developed a guide to the comprehensive write-up, a grading rubric, and a videotaped encounter with a standardised doctor and patient.

Bicolumnar intercarpal arthrodesis: minimum 2-year follow-up.

Purpose: To determine greater than 2-year outcomes for combined lunate-capitate and triquetrum-hamate arthrodeses.

Methods: We identified 16 patients who underwent scaphoid excision and combined arthrodeses of the lunate-capitate and triquetrum-hamate joints (bicolumnar arthrodesis) from 2007 to 2010. Eleven patients returned for follow-up evaluation, which included measurement of operative and contralateral control wrist flexion, extension, and grip strength, and completion of a patient-reported outcomes questionnaire, visual analog scale pain assessment, and Disabilities of the Arm, Shoulder, and Hand questionnaire.

Biomechanical effects of steroid injections used to treat pyogenic flexor tenosynovitis.

Background: A recent study from our laboratory has demonstrated improved range of motion in the toes of broiler chickens afflicted with pyogenic flexor tenosynovitis when treated with local antibiotic and corticosteroid injections, without surgical drainage. However, the use of corticosteroids as an adjunct treatment raised peer concern, as steroids are thought to have deleterious effects on tendon strength. The purpose of this study was to compare the tensile strength of the aforementioned steroid treated tendons, to a group of tendons administered with the current standard treatment: systemic antibiotics, surgical drainage and no corticosteroids.

Differential expression and cellular localization of novel isoforms of the tendon biomarker tenomodulin.

Tenomodulin (Tnmd, also called Tendin) is classified as a type II transmembrane glycoprotein and is highly expressed in developing as well as in mature tendons. Along with scleraxis (scx), Tnmd is a candidate marker gene for tenocytes. Its function is unknown, but it has been reported to have anti-angiogenic properties.

Flexor tendon sheath infections of the hand.

Flexor tendon sheath infections of the hand must be diagnosed and treated expeditiously to avoid poor clinical outcomes. Knowledge of the sheath's anatomy is essential for diagnosis and to help to guide treatment. The Kanavel cardinal signs are useful for differentiating conditions with similar presentations.

Down syndrome: national conference on patient registries, research databases, and biobanks.

A December 2010 meeting, "Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks," was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome.

Gap junctions in IL-1β-mediated cell survival response to strain.

Mechanical stimuli play important roles in proliferation and differentiation of connective tissue cells, and development and homeostatic maintenance of tissues. However, excessive mechanical loading to a tissue can injure cells and disrupt the matrix, as occurs in tendinopathy. Tendinopathy is a common clinical problem in athletes and in many occupational settings due to overuse of the tendon.

Corticosteroids as an adjunct to antibiotics and surgical drainage for the treatment of pyogenic flexor tenosynovitis.

Background: Many similarities exist between pyogenic flexor tenosynovitis and other closed-space infections such as septic arthritis. Previous studies have demonstrated that corticosteroids in conjunction with antibiotics considerably improve treatment outcomes in patients with septic arthritis. Using a chicken model, we investigated whether or not corticosteroids in combination with antibiotics and/or surgical drainage could minimize the loss of range of motion typically associated with pyogenic flexor tenosynovitis.

A quality improvement project to reduce the complications associated with indwelling urinary catheters.

The indwelling urinary (Foley) catheter is a widely utilized device in the modern hospital environment in the United States. Under certain established medical conditions, these devices serve as a valuable tool in patient care. However, many indwelling urinary catheters are either placed inappropriately or are left in place longer than their intended use.

Pediatric scaphoid fractures.

Fractures of the immature carpal scaphoid can be challenging to manage. The diagnosis may be missed or delayed because of absent or minimal symptoms. Once diagnosed, most pediatric scaphoid fractures can be successfully treated with cast immobilization.

Lessons learned from the CRUSADE National Quality Improvement Initiative.

The CRUSADE National Quality Improvement Initiative was created to track national care patterns, facilitate process improvement, and improve patient outcomes among patients with acute coronary syndromes (ACS). CRUSADE found that patients in community practice were sicker than those in randomized clinical trials and often failed to receive evidence-based therapies. Dosing regimens of antithrombotic therapy were also suboptimal, raising safety concerns.

Management of intra-articular metacarpal base fractures of the second through fifth metacarpals.

Intra-articular fractures of the second through fifth metacarpal bases are uncommon injuries but can result in serious morbidity if improperly managed. These injuries usually occur because of forced flexion of the wrist with simultaneous extension of the arm, as occurs with a punch or a fall. As there are few large series of reports for these injuries, there is no consensus in the current literature on the most appropriate treatment for them.

Association of evidence-based care processes and outcomes among patients with acute coronary syndromes: performance matters.

The American College of Cardiology and American Heart Association publishes evidence-based guideline recommendations, yet the degree to which these guidelines are followed and the association between hospital guideline adherence and patient outcomes are unknown. Using data from 350 US centers participating in the "Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines" Quality Improvement Initiative, we evaluated the in-hospital treatment and outcomes from 64,775 patients with non-ST-segment elevation acute coronary syndromes. Overall, guideline-recommended treatments were followed in 74% of eligible instances.