Pandemics and Beyond: Considerations When Personal Risk and Professional Obligations Converge.

With each novel infectious disease outbreak, there is scholarly attention to healthcare providers' obligation to assume personal risk while they care for infected patients. While most agree that healthcare providers have a duty to assume some degree of risk, the extent of this obligation remains uncertain. Furthermore, these analyses rarely examine healthcare institutions' obligations during these outbreaks.

Patient Perceptions of Audio and Video Recording in the Operating Room.

Objective: The goal of this study was to determine surgical patients' perceptions of hypothetical continuous audio-video OR recording (ORR).

Summary Of Background Data: Continuous audio-video recording of the operating room (OR), akin to the aviation industry's black box, has been proposed as a means to enhance training, supplement the medical record, and allow large-scale analysis of surgical performance and safety. These recordings would include patients' bodies; yet, understanding of patient perceptions regarding such technology is limited.

The development of a current events and dialogue forum at a large U.S. academic medical center.

Background: The Vanderbilt Community Circle (VC2) was designed to provide all faculty, staff, and students within the entire Vanderbilt University Medical Center community a dedicated venue to discuss current events and ongoing societal issues.

Approach: During the 2017-18 academic year, four VC2 events were held on: "Race, identity, and conflict in America," "Gun violence in America," "Gender in the workplace," and "Immigration in America." Facilitators guided participants to share their views and perspectives on these matters with pre-developed open-ended questions.

Enabling realistic health data re-identification risk assessment through adversarial modeling.

Objective: Re-identification risk methods for biomedical data often assume a worst case, in which attackers know all identifiable features (eg, age and race) about a subject. Yet, worst-case adversarial modeling can overestimate risk and induce heavy editing of shared data. The objective of this study is to introduce a framework for assessing the risk considering the attacker's resources and capabilities.

Regional ethics of surgeon resuscitation for organ transplantation after lethal injury.

Background: Trauma patients may present with nonsurvivable injuries, which could be resuscitated for future organ transplantation. Trauma surgeons face an ethical dilemma of deciding whether, when, and how to resuscitate a patient who will not directly benefit from it. As there are no established guidelines to follow, we aimed to describe resuscitation practices for organ transplantation; we hypothesized that resuscitation practices vary regionally.

Implications of Pass/Fail Step 1 Scoring: Plastic Surgery Program Director and Applicant Perspective.

Unlabelled: As early as 2022, United States Medical Licensing Examination Step 1 results will be reported as pass or fail, rather than as 3-digit numeric scores. This survey examines the perspectives of plastic surgery applicants and program directors (PD) regarding this score reporting change.

Methods: A 24-item survey was distributed to integrated applicants from the 2018-19 and 2019-20 application cycles.

Key Physician Behaviors that Predict Prudent, Preference Concordant Decisions at the End of Life.

Background: This study introduces an empirical approach for studying the role of prudence in physician treatment of end-of-life (EOL) decision making.

Methods: A mixed-methods analysis of transcripts from 88 simulated patient encounters in a multicenter study on EOL decision making. Physicians in internal medicine, emergency medicine, and critical care medicine were asked to evaluate a decompensating, end-stage cancer patient.

Evaluation of Racial Microaggressions Experienced During Medical School Training and the Effect on Medical Student Education and Burnout: A Validation Study.

Introduction: Microaggressions in the learning environment have been documented at various levels of medical training. However, there is lack of data detailing the prevalence and effects of racial microaggressions in medical school. This limits interventions that might improve the learning environment for underrepresented minority medical students (URMMS).

Operating room time as a limited resource: ethical considerations for allocation.

Scheduling surgical procedures among operating rooms (ORs) is mistakenly regarded as merely a tedious administrative task. However, the growing demand for surgical care and finite hours in a day qualify OR time as a limited resource. Accordingly, the objective of this manuscript is to reframe the process of OR scheduling as an ethical dilemma of allocating scarce medical resources.

Comparison Is Not a Zero-Sum Game: Exploring Advanced Measures of Healthcare Ethics Consultation.

Studies across the healthcare spectrum consistently show that sharing and comparing data across institutions improves the quality of patient care. Whether comparing data about healthcare ethics consultation (HCEC) would similarly improve quality is unknown due to the lack of research on HCEC data sharing and comparison. To explore this possibility, we analyzed data from two academic medical centers in the Central-Southern United States that both employ a shared, robust coding system for ethics consultations (N = 703 cases total over 2.

Board Certification in Cosmetic Surgery: An Evaluation of Training Backgrounds and Scope of Practice.

Background: The American Board of Cosmetic Surgery (ABCS) offers a certification process for physicians desiring third-party credentials in aesthetic surgery. This study aims to examine the training backgrounds and scope of practice of ABCS-certified physicians.

Methods: The ABCS online directory was used to identify diplomates.

Thought Leader Comparisons of Risks in Precision Medicine Research.

Biomedical research is increasingly capitalizing on an array of data to illuminate the interplay between "omics," lifestyle, and health. Leveraging this information presents opportunities to advance knowledge but also poses risks to research participants. In interviews with thought leaders, we asked which data type associated with a hypothetical precision medicine research endeavor was riskiest: 42% chose ongoing access to electronic health records, 17% chose genomic analyses of biospecimens, and 15% chose streaming data from mobile devices.

Combatting human trafficking in the United States: how can medical informatics help?

Objective: Human trafficking is a global problem taking many forms, including sex and labor exploitation. Trafficking victims can be any age, although most trafficking begins when victims are adolescents. Many trafficking victims have contact with health-care providers across various health-care contexts, both for emergency and routine care.

Tools to Increase Resident Aesthetic Clinic Volume.

Introduction: Resident Aesthetic Clinics (RACs) are an important element for training in plastic surgery residency programs. RACs provide increased exposure to aesthetic surgery as well as greater autonomy in clinical decision making. In an effort to increase RAC volume and thereby enhance resident education, we made two important changes to our operations.

Influence of Radiographic Soft Tissue Findings on Clinical Entrapment in Patients With Orbital Fractures.

Introduction: Radiographic assessment of facial fractures with computed tomography (CT) scanning has become standard of care. As imaging resolution has improved, findings such as herniation of extraocular muscles (EOM) have become a means of diagnosing conditions like orbital entrapment. However, the sensitivity and specificity of these findings has not been well-studied.

Health and kinship matter: Learning about direct-to-consumer genetic testing user experiences via online discussions.

Background: Millions of people have undergone direct-to-consumer genetic testing (DTC-GT), but little is known about individuals' motivations and experiences (e.g., discussion topics and emotions after obtaining the test results) in engaging with DTC-GT services.