Professional development for clerkship administrators: a 16-year overview of the clerkship administrator certificate program.

Background: Increasing accreditation requirements as well as transformations in medical school curricula necessitate administrative staff who are not only invested in the clerkship coordinator role but also view what they do as a career. To date, there has been a lack of professional development opportunities for clerkship administrators.

Methods: In 2003, the Central Group on Educational Affairs of the Association of American Medical Colleges recognized a need for professional development for clerkship administrators.

Comparing sensitivity to change using the 6-item versus the 17-item Hamilton depression rating scale in the GUIDED randomized controlled trial.

Background: Previous research suggests that the 17-item Hamilton Depression Rating Scale (HAM-D17) is less sensitive in detecting differences between active treatment and placebo for major depressive disorder (MDD) than is the HAM-D6 scale, which focuses on six core depression symptoms. Whether HAM-D6 shows greater sensitivity when comparing two active MDD treatment arms is unknown.

Methods: This post hoc analysis used data from the intent-to-treat (ITT) cohort (N = 1541) of the Genomics Used to Improve DEpression Decisions (GUIDED) trial, a rater- and patient-blinded randomized controlled trial.

Breast cancer treatment in the elderly: Do treatment plans that do not conform to NCCN recommendations lead to worse outcomes?

Background: Aging remains one of the greatest risk factors for development of new breast cancer with more than 30% of breast cancers occurring after the age of 75. Elderly women have been found to not conform with all aspects of treatment recommendations. Our study compared outcomes of elderly breast cancer patients whose treatment did or did not conform to NCCN guidelines.

Return to Sport after Surgical Treatment of Lisfranc Injuries in Athletes: A Retrospective Case Series.

Introduction: A Lisfranc injury can be a devastating injury in athletes, and if inadequately treated, may lead to chronic pain and loss of function. The purpose of this study was to determine the rate and time until return to sport after surgical fixation for a ligamentous Lisfranc injury. We hypothesized that open reduction and screw fixation of a ligamentous Lisfranc injury can be a successful treatment in the athletic population and allow patients to return to sport at close to their preinjury level of play.

The Early "Unnatural" History Following Surgical Repair of Ventricular Septal Defects.

Introduction: Surgical outcomes for simple ventricular septal defects (VSD) have been excellent in the past three decades. For this project, the timing of resolution of left-sided dilation and mitral regurgitation (MR) following VSD repair was assessed.

Methods: Echocardiographic data surrounding surgery of 42 consecutive children who underwent surgical patch repair of a VSD were reviewed.

Physician Burnout in a Rural Kansas Community.

Introduction: Physician wellness and burnout are topics of intense discussion and study, however, less is known about rural physician burnout. The aim of this study was to assess levels of physician burnout in the rural Kansas community of Salina.

Methods: An electronic, confidential survey was conducted among 145 physicians with active privileges at the local health center and/or surgical center.

Nonsurgical Treatment for Acute Posttraumatic Distal Radioulnar Joint Instability: A Case Series.

Purpose: We investigated the clinical outcomes of patients with acute posttraumatic distal radioulnar joint (DRUJ) instability who were treated with our nonsurgical protocol.

Methods: The electronic database of our community-based orthopedic practice was queried to identify patients with posttraumatic wrist pain and DRUJ instability who presented for treatment less than 6 weeks after injury. Medical records review defined a cohort of 16 patients treated between November, 2000 and December, 2016 with immobilization of the wrist and elbow for 6 weeks and gradual return to full activity at 6 months after injury.

Cross-validation of the Invalid Forgetting Frequency Index (IFFI) from the Test of Memory Malingering.

Objective: To increase sensitivity of the Test of Memory Malingering (TOMM), adjustments have been proposed, including adding consistency indices. The Invalid Forgetting Frequency Index (IFFI) is the most recently developed consistency index. While strong classification accuracy rates were originally reported, it currently lacks cross-validation.

Impacts of an Alumni Association-Institutional Partnership to Invest in Educational Innovation.

An 8-year small grants program funded by an alumni association has awarded $814,356 to 50 principal investigators for educational research. The 63 projects principally concerned simulation, educational tools and techniques, interprofessional education, and pilot projects for curricular reform. Awardees identify career growth and institutional advancement of education as major outcomes.

Spinal subdural hygroma as a post-operative complication in revision spine fusion: a case report.

Lumbar spine fusion has become a common and effective procedure in orthopedic practice, and a spinal subdural hygroma development is a rare complication following this procedure. We report here the case of a revision lumbar spine fusion at levels L4-5, L5-S1, where the patient subsequently developed cauda equina syndrome 2 days post-operatively. Magnetic resonance imaging (MRI) showed a subdural, extra-arachnoid fluid collection from T12-L2, cephalad to the site of spine fusion.

Impact of Pharmacogenomics on Clinical Outcomes for Patients Taking Medications With Gene-Drug Interactions in a Randomized Controlled Trial.

Objective: The objective of the Genomics Used to Improve DEpression Decisions (GUIDED) trial was to evaluate the utility of pharmacogenomic testing to improve outcomes among patients with major depressive disorder (MDD) who had not responded to at least 1 prior medication trial. The objective of the present analysis was to assess outcomes for the subset of patients expected to benefit from combinatorial pharmacogenomic testing because they were taking medications with predicted gene-drug interactions.

Methods: Participants (enrolled from April 14, 2014, to February 10, 2017) had an inadequate response to at least 1 psychotropic medication in the current episode of MDD.

Hidradenitis Suppurativa: Rapid Evidence Review.

Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected.

Seeking Consensus on the Terminology of Value-Based Transformation Through use of a Delphi Process.

Collaboration among diverse stakeholders involved in the value transformation of health care requires consistent use of terminology. The objective of this study was to reach consensus definitions for the terms , , and . A modified Delphi process was conducted from February 2017 to July 2017.

Fluoroscopic findings in Bouveret syndrome.

Bouveret syndrome occurs when a gallstone passes into the duodenum from a fistulous communication between the gallbladder and the duodenum. This is an uncommon cause of abdominal pain which is often diagnosed following surgery. Most imaging findings of Bouveret syndrome are limited to computed tomography.

Liver fluke-induced choledocholithiasis with biliary ductal obstruction.

Liver fluke-related biliary disease is rare in the United States, as locally-acquired liver fluke infection is uncommon. Presented here is a case of biliary obstruction secondary to fluke infection in a Burmese immigrant to the United States. Imaging findings are presented using computed tomography, ultrasound, magnetic resonance imaging, and fluoroscopy which revealed severe biliary dilatation resulting from large obstructing stones.

Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder.

A man in his mid-80s presented with bilateral posterior fracture dislocations of the humerus after suffering a seizure. He had Parskinson's disease and lived with his wife at home. His left shoulder was not felt to be reconstructable.

Breast cancer risk assessment in patients who test negative for a hereditary cancer syndrome.

Background: The majority of women who undergo genetic testing due to a significant family history of breast cancer will receive a negative result. The purpose of this study was to calculate the lifetime risk of breast cancer in women undergoing genetic counseling who received an uninformative genetic test result.

Methods: A retrospective chart review of mutation-negative women presenting to a cancer risk assessment clinic was performed.

Innovative recruitment strategies for a comprehensive worksite wellness initiative.

Recruiting for wellness initiatives is challenging. WorkWell KS, a statewide worksite wellness initiative, offers unique worksite recruitment strategies that may serve as lessons. From 2012 to 2018, WorkWell KS utilized champions, well-connected local leaders, to recruit worksites.

An evaluation of blood product utilization rates with massive transfusion protocol: Before and after thromboelastography (TEG) use in trauma.

Purpose: The purpose of this study was to determine if thromboelastography (TEG) is associated with reduced blood product utilization for trauma patients undergoing massive transfusion protocol (MTP) compared to traditional coagulation tests.

Methods: A retrospective review was conducted on an intent-to-treat basis of trauma patients undergoing MTP (Pre-TEG = Period I vs. Post-TEG = Period II).

Exploring African-American womens' experiences with substance use treatment: A review of the literature.

The aim of this systematic review is to synthesize evidence on treatment barriers among African-American women who seek treatment for substance use disorders. The authors reviewed articles from 1995 to 2018 on the topic of substance use disorders among African-American women. Based on the review of 13 articles, we found African-American women were more likely to encounter treatment readiness barriers compared to access barriers and system-related barriers.

Prevalence and Etiology of Burnout in a Community-Based Graduate Medical Education System: A Mixed-Methods Study.

Background And Objectives: Burnout rates among American physicians and trainees are high. The objectives of this study were: (1) to compare burnout rates among residents and faculty members of the graduate medical education (GME) programs sponsored by the University of Kansas School of Medicine-Wichita (KUSM-W) to previously published data, and (2) to evaluate the physicians' feedback on perceived causes and activities to promote wellness.

Methods: Between April and May 2017, we surveyed 439 residents and core faculty members from 13 residency programs sponsored by the KUSM-W.

Clinical Outcomes of Transcatheter vs Surgical Aortic Valve Replacement in Patients With Chronic Liver Disease: A Systematic Review and Metaanalysis.

Chronic liver disease increases cardiac surgical risk, with 30-day mortality ranging from 9% to 52% in patients with Child-Pugh class A and C, respectively. Data comparing the outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with liver disease are limited. We searched PubMed, Cochrane Library, Web of Science, and Google Scholar for relevant studies and assessed risk of bias using the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) Cochrane Collaboration tool.

Unintended Consequences of Curricular Change: Lessons from Legacy Students.

Many students continue in traditional (legacy) curricula during curricular reform. Little is known about the impact of the reform process on legacy students or about their perspectives on any new curriculum. In focus groups conducted 7-8 months following the introduction of an innovative curriculum, legacy students reported support for the new curriculum and perceived no negative impact on their education.