Journal of graduate medical education
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Intensive care unit (ICU) use at the end of life is rising. Little research has focused on associations among critical care fellows' training, institutional support, and bedside tools with ICU use at the end of life. ⋯ We found that the quality of palliative care training in critical care medicine programs and the use of bedside tools were independently associated with reduced ICU use at the end of life.
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Morbidity and mortality (M&M) conferences provide a forum for discussing adverse events and systems-based practice (SBP) issues; however, few models for implementing multidisciplinary, systems-focused M&M conferences exist. ⋯ The implementation of a new systems-focused M&M conference resulted in a conference series focusing on adverse events and associated system issues in a nonpunitive, multidisciplinary context.
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Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. ⋯ The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage.
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Problem solving in a clinical context requires knowledge and experience, and most traditional examinations for learners do not capture skills that are required in some situations where there is uncertainty about the proper course of action. ⋯ Simulation-based assessment can differentiate between higher-order (cognitive) and lower-order (basic and technical) skills expected of relatively experienced (PGY-3 and PGY-4) anesthesiology residents. Simulation-based assessments can also highlight areas of relative strength and weakness in a resident group, and this information can be used to guide curricular modifications to address deficiencies in tasks requiring higher-order processing and cognition.