Effects of Aligning Residency Note Templates with CMS Evaluation and Management Documentation Requirements.

Background The Centers for Medicare & Medicaid Services (CMS) introduced changes in outpatient and inpatient evaluation and management (E/M) current procedural terminology (CPT) codes in 2021 and 2023, which were intended to streamline providers' clinical documentation. Objectives To study the effects of aligning inpatient and outpatient note templates with updated CMS guidelines on character length and documentation time per note at an internal medicine residency program in the southeastern United States. Methods In April 2023, the Atrium Health Wake Forest Baptist Internal Medicine Residency Program's inpatient and outpatient note templates were updated according to the most recent CMS guidelines.

Writing Is Thinking: Implementation and Evaluation of an Internal Medicine Residency Clinical Reasoning and Documentation Curriculum.

Unlabelled: With increasingly complicated patients and faster throughput, time for thorough critical thinking and thoughtful clinical documentation is limited, especially in the training environment. Advocating for the value of clinical documentation as a robust opportunity for critical thinking, we describe the implementation and evaluation of a clinical reasoning and documentation curriculum for internal medicine residents. Our curriculum employed facilitated discussion, practical application, and a resident-as-teacher model.

Integrating the Electronic Health Record Into Patient Encounters: An Introductory Standardized Patient Exercise for Preclinical Medical Students.

Introduction: Increasingly, use of the electronic health record (EHR) is interwoven into even the most basic patient care tasks. Accordingly, learning how to utilize the EHR during patient encounters is important for medical students as they develop their clinical skills. Existing EHR curricula have focused primarily on doctor-patient relationship skills.

Automated Frailty Screening At-Scale for Pre-Operative Risk Stratification Using the Electronic Frailty Index.

Background: Frailty is associated with numerous post-operative adverse outcomes in older adults. Current pre-operative frailty screening tools require additional data collection or objective assessments, adding expense and limiting large-scale implementation.

Objective: To evaluate the association of an automated measure of frailty integrated within the Electronic Health Record (EHR) with post-operative outcomes for nonemergency surgeries.

The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction.

Introduction: The ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter.

Methods: Of third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data.

Educational priorities of students in the entrustable professional activity era.

Background: The Association of American Medical Colleges (AAMC) guidelines on the entrustable professional activities (EPAs) expected of graduating medical students were recently published. Although perceptions of educators, residents and programme directors have been described, the voice of senior medical students is lacking.

Methods: A single-institution cross-sectional study of senior medical students was performed.

Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intra-abdominal implantation in a rabbit.

Background: Effective laparoscopic ventral herniorrhaphy usually mandates the use of an intraperitoneal prosthetic. Visceral adhesions and changes in textile characteristics of prosthetics may complicate repairs, especially long-term. The aim of this study was to compare the adhesion formation, tissue ingrowth, and textile characteristics one year after intra-abdominal placement of the commonly used prosthetic meshes.

Prospective histologic evaluation of intra-abdominal prosthetics four months after implantation in a rabbit model.

Background: Placement of an intraperitoneal prosthetic is required for laparoscopic ventral hernia repair. The biocompatibility of these prosthetics determines the host's inflammatory response, scar plate formation, tissue ingrowth, and subsequent mesh performance, including prosthetic compliance and prevention of hernia recurrence. We evaluated the host response to intraperitoneal placement of several prosthetics currently used in clinical practice.

Retained foreign bodies after surgery.

Background: Medical errors during surgery are not well studied. To define risk factors associated with this type of error, we performed a case control analysis.

Methods: We retrospectively reviewed medical records involving the ICD-9 code (998.

Prospective evaluation of adhesion formation and shrinkage of intra-abdominal prosthetics in a rabbit model.

Laparoscopic ventral hernia repair requires an intraperitoneal prosthetic; however, these materials are not without consequences. We evaluated host reaction to intraperitoneal placement of various prosthetics and the functional outcomes in an animal model. Mesh (n = 15 per mesh type) was implanted on intact peritoneum in New Zealand white rabbits.