You know what I’m talking about. It’s a mainstay of medical education for physicians. It starts in medical school, and generally never stops. And when you finish your residency, you graduate from being pimped to being the pimper.
How did this all come to be? Is it good for education? Bad? Tune in tomorrow to learn more. In the meantime, enjoy this algorithm on how to get through a pimping session. Click to view full-size.
Source: Posted by Dr. Fizzy on The Almost Doctor’s Channel
With the implementation of resident work hour restrictions 10 years ago, resident participation in clinical care has declined. In order to make up for this loss of clinical manpower and expertise, many hospitals have added advanced clinical providers (ACPs, nurse practitioners and physician assistants). These ACPs are being given more and more advanced responsibilities, in all clinical settings. This includes performing invasive procedures on critically ill patients.
A recent study from Carolinas Medical Center in Charlotte NC compared complication rates for invasive procedures performed by ACPs vs residents in a Level I trauma center setting.
A one year retrospective study was carried out. Here are the factoids:
Bottom line: Resident and ACP performance of invasive procedures is comparable. As residents become less available for these procedures, ACPs can (and will) be hired to take their place. Although this is great news for hospitals that need manpower to assist their surgeons and emergency physicians, it should be another wakeup call for training programs and educators to show that resident education will continue to degrade.
Reference: Comparison of procedural complications between resident physicians and advanced clinical providers. J Trauma 77(1):143-147, 2014.
This 10 minute video was developed with prehospital providers in mind, but all trauma professionals may find some tidbits of interest.
Pay no attention to the hideous screenshot, though. I was not trying to look like House.
After posting yesterday, I was informed that LWW was not the first to enter the small screen arena. The British Medical Journal (BMJ) released content for the iPad platform beginning in December 2011. This journal uses the built-in Newsstand app on the iPad or iPhone.
On first look, it appears to be more robust than the LWW app for Neurosurgery. The BMJ allows access to other related content streams, such as their news, blogs, podcasts and video. It is a bit more interactive and does allow searching and bookmarking.
Bottom line: I’m sure someone will step forward with yet another earlier entry into the smartphone/tablet arena. Regardless, it’s all good. Either Newsstand or independent app works, although the Newsstand offers some pre-built functionality for developers that might make it a bit easier to create. However, the Newsstand is also Apple-specific, and won’t work for all the people with Android or Windows based phones and tablets who will be screaming for this content.
Reference: search for “BMJ” in the Apple App Store
Journals have been printed on trees since forever. Within the past 10 years, there has been a shift toward also making this content available on the publishers’ web sites. Now, Lippincott Williams & Wilkins (LWW), publisher of the journal Neurosurgery (and many others) has taken an important step forward.
Beginning with the current issue (March 2012), this journal is now available within an iPad app. One of the problems with the traditional journal was that you had to go to the library to read it. And medical libraries can’t carry every journal, so if the one of interest was not in the collection, you had to wait a few days for the librarian to get a copy.
With the onset of the internet age, journals began to appear online. Most major publishers had a web presence and made their journals available online. However, most provided full text content for free only to their subscribers. At best, a non-subscriber would get the abstract, or an occasional free article. Biomedical libraries typically subscribed to services where hundreds of journals were available as full text to medical staff members, residents and students. The downside was, and still is, that you need access to a desktop to comfortably consume the articles. The web sites were just not that friendly for the small screen.
Finally, LWW has made a concerted effort to provide this content in tablet format. More and more trauma professionals are carrying these devices and using them in their practices. This brings the content closer to the patient and provides it in a very consumable format. It also allows the publisher to add dynamic digital content (audio and video) to the material.
I’ve been using this app for about a day and am impressed. Here are some key features:
What doesn’t it do? There is currently no ability to search through an article or issue. And it would be nice to interact with one of the authors via an email link to ask questions or make suggestions. Finally, Apple is not the only tablet maker out there. Publishers will need to make sure apps are available on the Android platform as well.
Bottom line: This is a great first-try at moving journals onto a mobile platform. I expect that LWW will begin to roll out this format for all their journals since they’ve now figured out how to do it. And expect all the other publishers to jump on the bandwagon as well. Journals are eventually going to go the way of DVD movies, and we’ll end up streaming our professional content from some company with a big red logo.
Reference: Search for “Neurosurgery” in the Apple App Store.