Resident Perceptions of Competency and Comfort Before and After Telemedicine-ICU Implementation.

OBJECTIVES: The purpose of this study was to examine the impact telemedicine in the intensive care unit (ICU) has on the competency, satisfaction, and education of resident physicians. METHODS: Telemedicine in the ICU was implemented in 2014 at a community hospital with 24 family medicine residents. Comfort with the performance of various common procedures; management of major medical diseases in the ICU; and level of comfort, attitudes, and satisfaction in work relationships with various staff members in the ICU were assessed before and 1 year after the telemedicine implementation. This was done by the residents' respective training year and by all year groups combined. The Likert scores for each category were averaged by year group and by the three year groups combined, and these averages were compared pre- and posttelemedicine implementation using the t test method. RESULTS: All of the residents in the program participated voluntarily in the study, a 100% response rate. The results showed significant positive effects on resident education and satisfaction among ICU nurses and residents after the implementation of telemedicine-ICU. There were negative effects on residents' learning opportunities with the family medicine attending physicians, feelings of being a valued team member, and comfort with ventilator management. CONCLUSIONS: Telemedicine-ICU implementation had mixed effects on residents' perceptions of their ICU experience and training. Further studies should be conducted to assess how to maximize resident training in this setting.

Single-Point Acupuncture for Treatment of Urge Incontinence in Women: A Pilot Nonrandomized Trial.

Objectives: Urinary incontinence (UI) is common in middle- and old-age. Previous studies have shown that multiple-point and multiple-frequency acupuncture are efficacious treatment modalities for UI. This study investigated the efficacy of single-point acupuncture for the treatment of UI in women. Materials and Methods: Twelve female subjects, ages 40-75, participated in the trial. Acupuncture at CV 2 was performed. Before needle insertion, each subject completed the Revised Urinary Incontinence Scale (RUIS). After treatment, subjects were contacted at 2 and 8 weeks to assess treatment effects using the RUIS questionnaire again. Results: Statistically significant improvements were seen with respect to symptoms of urgency, stress incontinence, impact of urine leakage, quantity of urine leakage, and the total score at 2 weeks postintervention. A statistically significant increase in impact of urine leakage was found at the 8-week follow-up, compared to the 2-week results. Conclusions: In this pilot trial, single-point acupuncture was associated with significant but short-term improvements in UI symptoms. Future trials should include a control group and an increased sample size for a more-rigorous examination of this potential adjunctive treatment for UI.