How to say "I don't know": development and evaluation of workshops for medical students and surgical residents on communicating uncertainty using the ADAPT framework.

Purpose: Uncertainty, or the conscious awareness of having doubts, is pervasive in medicine, from differential diagnoses and the sensitivity of diagnostic tests, to the absence of a single known recovery path. While openness about uncertainty is necessary for shared decision-making and is a pillar of patient-centered care, it is a challenge to do so while preserving patient confidence. The authors' aim was to develop, pilot, and evaluate an uncertainty communication curriculum to prepare medical students and residents to confidently navigate such conversations.

Opinion and Sentiment Analysis of Palliative Care in the Era of COVID-19.

During the COVID-19 pandemic, the value of palliative care has become more evident than ever. The current study quantitatively investigated the perceptions of palliative care emerging from the pandemic experience by analyzing a total of 26,494 English Tweets collected between 1 January 2020 and 1 January 2022. Such an investigation was considered invaluable in the era of more people sharing and seeking healthcare information on social media, as well as the emerging roles of palliative care.

Virtual Communication Across Differences: Development of a Workshop on Managing Patient Bias.

Problem: Despite the prevalence and detrimental effects of racial discrimination in American society and its health care systems, few medical schools have designed and implemented curricula to prepare medical students to respond to patient bias and racism.

Approach: During the summer of 2020, a virtual communication class was designed that focused on training medical students in how to respond to patient bias and racism. Following brief didactics at the start of the session, students practiced scenarios with actors in small groups and received direct feedback from faculty.

Nonalcoholic steatohepatitis is the most common indication for liver transplantation among the elderly: Data from the United States Scientific Registry of Transplant Recipients.

As the US population ages, more elderly patients may need liver transplantation. Our aim was to assess recent trends among elderly individuals requiring liver transplant in the United States. Scientific Registry of Transplant Recipients data (2002-2020) were used to select elderly (≥65 years) liver transplant candidates and assess on-list and posttransplant outcomes.

Interventions for Frailty Among Older Adults With Cardiovascular Disease: JACC State-of-the-Art Review.

With the aging of the world's population, a large proportion of patients seen in cardiovascular practice are older adults, but many patients also exhibit signs of physical frailty. Cardiovascular disease and frailty are interdependent and have the same physiological underpinning that predisposes to the progression of both disease processes. Frailty can be defined as a phenomenon of increased vulnerability to stressors due to decreased physiological reserves in older patients and thus leads to poor clinical outcomes after cardiovascular insults.

Implementation of a skills-based virtual communication curriculum for medical students interested in surgery.

Background: Communication skills are essential to providing patient-centered care. The need for standardized communication skills training is at the forefront of medical school and residency education. We aimed to design and implement a curriculum teaching virtual communications skills to medical students.

Managing Patient Bias: Teaching Residents to Navigate Racism and Bias in the Workplace.

Background: Racial inequities are infused within American society and healthcare systems; notable events in 2020 highlighted an urgent need for change. Many organizations were inspired to examine the impacts of systemic racism. The impact of physician bias on patient experiences and outcomes has been well documented; biased patient behavior is now becoming more openly discussed.

Hospice care utilisation among elderly patients who died with hepatocellular carcinoma in the United States.

Background & Aims: The benefits of hospice care in Medicare recipients with hepatocellular carcinoma (HCC) have not been fully evaluated, which we aimed to study.

Methods: We used nationally representative samples of the Medicare beneficiaries in the USA (2011-2016) to assess the impact of hospice care on the outcomes of patients with HCC. Hospice care benefits on the survival time, length of stay (LOS), 30-day readmissions, and daily charges during the last year and month of life were assessed by logistic regression and generalised linear regression.

In Traditional Medicare, Modest Growth In The Home Care Workforce Largely Driven By Nurse Practitioners.

Little is known about the characteristics of the workforce providing home-based medical care for traditional (fee-for-service) Medicare beneficiaries. We found that the number of participating home care providers in traditional Medicare increased from about 14,100 in 2012 to around 16,600 in 2016. Approximately 4,000 providers joined or reentered that workforce annually, and 3,000 stopped or paused participation.

Family Survey of Understanding and Communication of Patient Prognosis in the Intensive Care Unit: Identifying Training Opportunities.

Objective: Family members making medical decisions for critically ill patients depend on surgeons' high-quality communication. We aimed to assess family experience of communication in the trauma intensive care unit (TICU), identify opportunities for improvement, and tailor resident communication training to address deficiencies.

Design: We designed surveys based on our Conceptual Model of Surgeon Communication and Family Understanding, using items from previously validated tools to assess (1) family well-being, experiences of care, access to information, and assessment of patient condition and prognosis; and (2) surgeon and nursing assessment of patient condition and prognosis.

Building Rapport and Earning the Surgical Patient's Trust in the Era of Social Distancing: Teaching Patient-Centered Communication During Video Conference Encounters to Medical Students.

Background: Effective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely.

Surgeon Communication and Family Understanding of Patient Prognosis in Critically Ill Surgical Patients: A Qualitative Investigation Informs Resident Training.

Purpose: Surgeons treating critically ill patients must work with family members making medical decisions for the patient. These surrogate decision makers depend on providers' high-quality communication and empathy to facilitate medical decisions. There is growing evidence of poor quality of communication and delayed family engagement in the intensive care unit, and of a decline in empathy over the course of a surgeon's clinical training.