Using Performance Improvement Methods to Evaluate Processes for Writing Multiple-Choice Test Questions in the Postlicensure Clinical Environment: A Case Study.

Background: This article is the last of a four-part series to guide educators on the construction and evaluation of multiple-choice test items in the post-licensure environment. Previous articles in this series described the problem and the mechanics of test item construction and evaluation.

Method: A replicable strategy for evaluating the organizational process for constructing multiple-choice test questions is provided.

Distribution of COVID-19 Home Testing Through Community Health Centers: Results of the .

Objective: To assess acceptability and feasibility of rapid at-home COVID-19 testing and reporting of test results among individuals seeking care at community health centers (CHCs) and their household members.

Methods: Participants were recruited from 2 Community Health Centers during a clinic visit or a community event. Over-the-counter COVID-19 tests were distributed to participants for self-testing and to offer testing to household members.

An Evidence-Based Approach to Constructing Multiple-Choice Test Questions for Knowledge Assessment.

Background: This article provides nursing educators practical tips and evidence-based strategies for effective construction of multiple-choice questions (MCQs). Well-designed MCQs that align with the intended learning objectives are critical for implementing sound assessment practices.

Method: This article offers a step-by-step approach to test construction, starting with the assessment blueprint and followed by important considerations when writing the specific components of the MCQ.

Implementing Holistic Review Practices in a Pulmonary and Critical Care Fellowship.

Background: Medical schools have used holistic review in admissions to increase mission-aligned enrollment of students from backgrounds underrepresented in medicine. Graduate medical education programs have increasingly followed suit. However, there is a paucity of literature regarding holistic review at the fellowship level.

Designing a critical care solution using in-person and telemedicine approaches in the US-Mexico border area during COVID-19.

Background: UC San Diego Health System (UCSDHS) is the largest academic medical center and integrated care network in US-Mexico border area of California contiguous to the Northern Baja region of Mexico. The COVID-19 pandemic compelled several UCSDHS and local communities to create awareness around best methods to promote regional health in this economically, socially, and politically important border area.

Purpose: To improve understanding of optimal strategies to execute critical care collaborative programs between academic and community health centers facing public health emergencies during the COVID-19 pandemic, based on the experience of UCSDHS and several community hospitals (one US, two Mexican) in the US-Mexico border region.

Pulmonary Complications in Hematopoietic Stem Cell Transplant Recipients-A Clinician Primer.

Hematopoietic stem cell transplants (HSCT) are becoming more widespread as a result of optimization of conditioning regimens and prevention of short-term complications with prophylactic antibiotics and antifungals. However, pulmonary complications post-HSCT remain a leading cause of morbidity and mortality and are a challenge to clinicians in both diagnosis and treatment. This comprehensive review provides a primer for non-pulmonary healthcare providers, synthesizing the current evidence behind common infectious and non-infectious post-transplant pulmonary complications based on time (peri-engraftment, early post-transplantation, and late post-transplantation).

Decision support tool for hospital resource allocation during the COVID-19 pandemic.

The SARS-CoV-2 (COVID-19) pandemic has placed unprecedented demands on entire health systems and driven them to their capacity, so that health care professionals have been confronted with the difficult problem of ensuring appropriate staffing and resources to a high number of critically ill patients. In light of such high-demand circumstances, we describe an open web-accessible simulation-based decision support tool for a better use of finite hospital resources. The aim is to explore risk and reward under differing assumptions with a model that diverges from most existing models which focus on epidemic curves and related demand of ward and intensive care beds in general.

Career Development Strategies for the Clinical Educator.

Over the past several decades, fewer faculty members at American medical schools have engaged in an equally balanced portfolio of clinical, research, and education efforts, and increasing numbers of faculty members have become more differentiated into physician-scientists or clinician-educators. Career paths among clinician-educators are quite variable, and aspiring clinician-educators are frequently unsure of how to maximize their chances for success in a clinician-educator academic pathway. In the author's opinion, the aspiring clinician-educator should seek to develop their skill set in four main areas.

Pulmonary Hypertension.

Pulmonary hypertension is the term used to describe a group of disorders characterized by abnormally high pressures in the pulmonary arteries. Initial evaluation is focused on identifying the cause, which helps guide appropriate treatment. Pulmonary hypertension is often a feature of advanced common diseases, such as chronic obstructive pulmonary disease and left heart disease, and treatment is focused primarily on the underlying disease.

An In-Person and Telemedicine "Hybrid" System to Improve Cross-Border Critical Care in COVID-19.

Background: UC San Diego Health System (UCSDHS) is an academic medical center and integrated care network in the US-Mexico border area of California contiguous to the Mexican Northern Baja region. The COVID-19 pandemic deeply influenced UCSDHS activities as new public health challenges increasingly related to high population density, cross-border traffic, economic disparities, and interconnectedness between cross-border communities, which accelerated development of clinical collaborations between UCSDHS and several border community hospitals - one in the US, two in Mexico - as high volumes of severely ill patients overwhelmed hospitals.

Objective: We describe the development, implementation, feasibility, and acceptance of a novel critical care support program in three community hospitals along the US-Mexico border.

Assessing Patients for Air Travel.

Advising patients before air travel is a frequently overlooked, but important, role of the physician, particularly primary care providers and pulmonary specialists. Although physiologic changes occur in all individuals during air travel, those with underlying pulmonary disease are at increased risk of serious complications and require a specific approach to risk stratification. We discuss the available tools for assessment of preflight risk and strategies to minimize potential harm.

Restoring Pulmonary and Sleep Services as the COVID-19 Pandemic Lessens. From an Association of Pulmonary, Critical Care, and Sleep Division Directors and American Thoracic Society-coordinated Task Force.

In March 2020, many elective medical services were canceled in response to the coronavirus disease 2019 (COVID-19) pandemic. The daily case rate is now declining in many states and there is a need for guidance about the resumption of elective clinical services for patients with lung disease or sleep conditions. Volunteers were solicited from the Association of Pulmonary, Critical Care, and Sleep Division Directors and American Thoracic Society.

Remote Patient Monitoring Technologies for Predicting Chronic Obstructive Pulmonary Disease Exacerbations: Review and Comparison.

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death by disease worldwide and has a 30-day readmission rate of 22.6%. In 2015, COPD was added to the Medicare Hospital Readmission Reductions Program.

Dean's Perspective on Academic Communities at UC San Diego, School of Medicine.

Introduction And Background: In 2010, the UC San Diego School of Medicine launched a new curriculum, the integrated scientific curriculum. As part of this curricular redesign, the school instituted academic communities. This perspective article outlines our experience with the first 8 years of these academic communities.

Benefit of focus group discussion beyond online survey in course evaluations by medical students in the United States: A qualitative study.

In addition to online questionnaires, many medical schools use supplemental evaluation tools such as focus groups to evaluate their courses. Although some benefits of using focus groups in program evaluation have been described, it is unknown whether these in-person data collection methods provide sufficient additional information beyond online evaluations to justify them. In this study we analyze recommendations gathered from student evaluation team (SET) focus group meetings and analyzed whether these items were captured in open-ended comments within the online evaluations.

Challenging cases in rheumatic pregnancies.

This article describes three complicated cases in rheumatology and pregnancy. The first case elucidates the challenges in treating SLE in conjunction with pulmonary arterial hypertension, while the second case features an SLE-affected pregnancy with development of portal hypertension secondary to portal vein thrombosis related to APS. The third case is a pregnant woman with stable SLE who developed thrombotic microangiopathy caused by atypical haemolytic uraemic syndrome, and failed to improve despite multiple measures including biopsy and elective preterm delivery.

Physician preparedness for big genomic data: a review of genomic medicine education initiatives in the United States.

In the last decade, genomic medicine education initiatives have surfaced across the spectrum of physician training in order to help address a gap in genomic medicine preparedness among physicians. The approaches are diverse and stem from the belief that 21st century physicians must be proficient in genomic medicine applications as they will be leaders in the precision medicine movement. We conducted a review of literature in genomic medicine education and training for medical students, residents, fellows, and practicing physicians with articles published between June 2015 and January 2018 to gain a picture of the current state of genomic medicine education with a focus on the United States.

A summer prematriculation program to help students succeed in medical school.

Medical schools with a diverse student body face the challenge of ensuring that all students succeed academically. Many medical schools have implemented prematriculation programs to prepare students from diverse backgrounds; however, evidence on their impact is largely lacking. In this study, we analyzed participants' demographics as well as the impact of the prematriculation program on Year 1 performance.

Small group activities within academic communities improve the connectedness of students and faculty.

Background: The University of California, San Diego, School of Medicine implemented a curriculum change that included reduction of lectures, incorporation of problem-based learning and other small group activities. Six academic communities were introduced for teaching longitudinal curricular content and organizing extracurricular activities.

Methods: Surveys were collected from 904 first- and second-year medical students over 6 years.

Student evaluation team focus groups increase students' satisfaction with the overall course evaluation process.

Context: Most medical schools use online systems to gather student feedback on the quality of their educational programmes and services. Online data may be limiting, however, as the course directors cannot question the students about written comments, nor can students engage in mutual problem-solving dialogue with course directors. We describe the implementation of a student evaluation team (SET) process to permit course directors and students to gather shortly after courses end to engage in feedback and problem solving regarding the course and course elements.