Pre-to-post COVID-19 pandemic trends in time from emergency department arrival to inpatient floor arrival: Door to floor time.

Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. We find a sustained increase as well as significant seasonal and day-of-the-week variation in DTF times.

Understanding the role of coaches in supporting the mental health of elite athletes.

Objectives: Elite sport coaches often rely on their discretion when assisting athletes struggling with mental health, with clear guidelines yet to be broadly adopted. This study aimed to explore how coaches perceive their role in athlete mental health and their role clarity.

Design: This study employed a descriptive qualitative approach with semi-structured interviews.

A Qualitative Study on the Outcomes of Participation in a Longitudinal Clinician Educator Curriculum During Internal Medicine Residency.

Background: Despite increasing prevalence of longitudinal clinician educator tracks (CETs) within graduate medical education (GME) programs, the outcomes of these curricula and how participation in these tracks affects early career development remains incompletely understood.

Objective: To describe the experience and outcomes of participating in a CET and its effects on recent internal medicine residency graduates' perceived educator skills and early career development.

Methods: We conducted a qualitative study between July 2019 and January 2020 using in-depth semi-structured interviews of recently graduated physicians from 3 internal medicine residencies at one academic institution who had participated in a CET, the Clinician Educator Distinction (CED).

Addressing Cognitive Biases in Interpreting an Elevated Lactate in a Patient with Type 1 Diabetes and Thiamine Deficiency.

We present the case of a young woman admitted for diabetic ketoacidosis with persistent, asymptomatic lactic acid (LA) elevation during the evolving COVID-19 pandemic. Cognitive biases in interpreting an elevated LA in this patient's care resulted in an extensive infectious workup instead of the low-cost and potentially diagnostic provision of empiric thiamine. We discuss clinical patterns and etiologies of LA elevation and the role of thiamine deficiency.