Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs.

Objective: Demonstrate the feasibility of a multimodal, digitally enhanced remote monitoring, treatment, and tele-pulmonary rehabilitation intervention among patients with COPD.

Understanding barriers to well-child visit attendance among racial and ethnic minority parents.

Objectives: To assess racial and ethnic minority parents' perceptions about barriers to well-child visit attendance.

Methods: For this cross-sectional qualitative study, we recruited parents of pediatric primary care patients who were overdue for a well-child visit from the largest safety net healthcare organization in central Massachusetts to participate in semi-structured interviews. The interviews focused on understanding potential knowledge, structural, and experiential barriers for well-child visit attendance.

Rationale and Design of Healthy at Home for COPD: an Integrated Remote Patient Monitoring and Virtual Pulmonary Rehabilitation Pilot Study.

Chronic Obstructive Pulmonary Disease (COPD) is a common, costly, and morbid condition. Pulmonary rehabilitation, close monitoring, and early intervention during acute exacerbations of symptoms represent a comprehensive approach to improve outcomes, but the optimal means of delivering these services is uncertain. Logistical, financial, and social barriers to providing healthcare through face-to-face encounters, paired with recent developments in technology, have stimulated interest in exploring alternative models of care.

Resuscitation Quality Improvement® (RQI®) HeartCode Complete® program improves chest compression rate in real world out-of hospital cardiac arrest patients.

Background: The Resuscitation Quality Improvement® (RQI®) HeartCode Complete® program is designed to enhance cardiopulmonary resuscitation (CPR) training by using real-time feedback manikins. Our objective was to assess the quality of CPR, such as chest compression rate, depth, and fraction, performed on out-of-hospital cardiac arrest (OHCA) patients among paramedics trained with the RQI® program vs. paramedics who were not.

Threshold adjusted vagus nerve stimulation after asphyxial cardiac arrest results in neuroprotection and improved survival.

Background: Vagus nerve stimulation (VNS) has shown therapeutic potential in a variety of different diseases with many ongoing clinical trials. The role of VNS in reducing ischemic injury in the brain requires further evaluation. Cardiac arrest (CA) causes global ischemia and leads to the injury of vital organs, especially the brain.

Prioritizing Child Health: Promoting Adherence to Well-Child Visits in an Urban, Safety-Net Health System During the COVID-19 Pandemic.

Background: After discovering racial/ethnic disparities in adherence to well-child visits, UMass Memorial Health worked to identify and mitigate barriers to adherence for patients and families across 53 primary care practices in central Massachusetts.

Methods: When the systemwide goal to reduce racial/ethnic disparities in well-child visit adherence was established, a multidisciplinary team of leaders from UMass Memorial Health worked together to engage patients and stakeholders to identify obstacles to adherence. Transportation, language, and scheduling were identified as barriers.

SUPPORT-AF II: Supporting Use of Anticoagulants Through Provider Profiling of Oral Anticoagulant Therapy for Atrial Fibrillation: A Cluster-Randomized Study of Electronic Profiling and Messaging Combined With Academic Detailing for Providers Making Decisions About Anticoagulation in Patients With Atrial Fibrillation.

Background: Previous provider-directed electronic messaging interventions have not by themselves improved anticoagulation use in patients with atrial fibrillation. Direct engagement with providers using academic detailing coupled with electronic messaging may overcome the limitations of the prior interventions.

Methods And Results: We randomized outpatient providers affiliated with our health system in a 2.

A National Assessment on Patient Safety Curricula in Undergraduate Medical Education: Results From the 2012 Clerkship Directors in Internal Medicine Survey.

Objectives: Patient safety is a cornerstone of quality patient care, and educating medical students about patient safety is of growing importance. This investigation was a follow-up to a 2006 study to assess the current status of patient safety curricula within undergraduate medical education in North America with the additional goals of identifying areas for improvement and barriers to implementation.

Methods: Thirteen items regarding patient safety were part of the 2012 Clerkship Directors in Internal Medicine annual survey.

Medical student awareness of and interest in clinical informatics.

Objective: We aimed to investigate medical students' attitudes about Clinical Informatics (CI) training and careers.

Materials And Methods: We distributed a web-based survey to students at four US allopathic medical schools.

Results: Five hundred and fifty-seven medical students responded.

Quality improvement "201": context-relevant quality improvement leadership training for the busy clinician-educator.

Development of quality improvement (QI) skills and leadership for busy clinician-educators in academic medical centers is increasingly necessary, although it is challenging given limited resources. In response, the authors developed the Quality Scholars program for primary care teaching faculty. They conducted a needs assessment, evaluated existing internal and national resources, and developed a 9-month, 20-session project-based curriculum that combines didactic and hands-on techniques with facilitated project discussion.

Commentary: Medical malpractice and patient safety: tear down that wall!

Although medical malpractice influences the way that physicians learn to practice medicine, information related to malpractice cases is among the most closely guarded data in the hospital and is rarely available to training programs. In this issue, Hochberg and colleagues describe an intervention in which they used data from their hospital's closed malpractice cases as part of a training seminar for surgical residents on malpractice. The authors of this commentary believe that there is very low risk and great potential value to more openly sharing this type of information.

Using standardized patients to assess professionalism: a generalizability study.

Background: Assessment of professionalism in undergraduate medical education is challenging. One approach that has not been well studied in this context is performance-based examinations.

Purpose: This study sought to investigate the reliability of standardized patients' scores of students' professionalism in performance-based examinations.

Patient safety education at U.S. and Canadian medical schools: results from the 2006 Clerkship Directors in Internal Medicine survey.

Purpose: To describe current patient safety curricula at U.S. and Canadian medical schools and identify factors associated with adoption of these programs.

Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students.

Background: Recent data do not exist regarding fourth-year medical students' performance of and attitudes toward procedural and interpretive skills, and how these differ from third-year students'.

Method: Cross-sectional survey conducted in February 2006 of 122 fourth-year students from seven U.S.

Between two worlds: a multi-institutional qualitative analysis of students' reflections on joining the medical profession.

Background: Recent changes in healthcare system and training mandates have altered the clinical learning environment. We incorporated reflective writing into Internal Medicine clerkships (IMcs) in multiple institutions so students could consider the impact of clerkship experiences on their personal and professional development. We analyzed student reflections to inform curricula and support learning.

Disagreement between students and preceptors regarding the value of teaching behaviors for ambulatory care settings.

Background: Medical students and preceptors commonly disagree on methods of clinical instruction in ambulatory care, although the extent of the problem is not documented.

Purpose: The purpose is to identify disagreement and concordance between students and preceptors for teaching behaviors in ambulatory care.

Methods: We surveyed students and preceptors at 4 U.

Procedural and interpretive skills of medical students: experiences and attitudes of third-year students.

Background: Recent data do not exist on medical students' performance of and attitudes toward procedural and interpretive skills deemed important by medical educators.

Method: A total of 171 medical students at seven medical schools were surveyed regarding frequency of performance, self-confidence, and perceived importance of 21 procedural and interpretive skills.

Results: Of the 122 responding students (71% response rate), a majority had never performed lumbar puncture, thoracentesis, paracentesis, or blood culture, and students reported lowest self-confidence in these skills.

Learning from mistakes. Factors that influence how students and residents learn from medical errors.

Context: Trainees are exposed to medical errors throughout medical school and residency. Little is known about what facilitates and limits learning from these experiences.

Objective: To identify major factors and areas of tension in trainees' learning from medical errors.

Reconciling medications at admission: safe practice recommendations and implementation strategies.

Background: Fifty hospitals collaborated in a patient safety initiative developed and implemented by the Massachusetts Coalition for the Prevention of Medical Errors and the Massachusetts Hospital Association.

Methods: A consensus group identified safe practices and suggested implementation strategies. Four collaborative learning sessions were offered, and teams monitored their progress and shared successful strategies and lessons learned.

Participation of internal medicine department chairs in the internal medicine clerkship--results of a national survey.

Purpose: To characterize the involvement of internal medicine department chairs in the core third-year internal medicine clinical clerkship.

Method: In 2003, the Clerkship Directors in Internal Medicine (CDIM) surveyed its membership. Along with demographics, clerkship directors were asked if the department's chair participated in the clerkship, the number of hours per month the clerkship director and chair discussed clerkship issues, and if published job expectations were discussed.

Clerkship sharing on inpatient internal medicine rotations: an emerging clerkship model.

Background: "Clerkship sharing" is the coexistence of students from 2 or more medical schools rotating on the same specialty at a single clerkship site.

Purpose: Clerkship sharing was characterized by answering three related questions regarding the prevalence of clerkship sharing on internal medicine inpatient rotations, stakeholders views of the advantages and disadvantages of clerkship sharing, and the ways that clerkship sharing affects medical student outcomes at an institution.

Methods: In 2001, the Clerkship Directors in Internal Medicine (CDIM) surveyed its members; 1 section addressed clerkship sharing on inpatient rotations.