Training Tomorrow's Teachers Today: a national medical student teaching and leadership retreat.

INTRODUCTION: Challenges to American academic medical centers have diverted attention and resources away from the core missions of teacher and leader development. To train the next generation of medical education leaders, substantial and institutionalized new programs are necessary. METHODS: The American Medical Student Association, with the Mount Sinai School of Medicine, designed the Training Tomorrow's Teachers Today national medical student retreat. The week-long course endeavors to enhance participants' clinical teaching and academic leadership skills. The program also trains students to execute a required medical education project. At the end of the course, attendees evaluated their baseline and post-course teaching and leadership effectiveness. Long-term follow-up was also completed. RESULTS: Attendees (n = 23) self-reported statistically significant (p < 0.05) improvement in teaching and leadership. The greatest improvements in teaching scores were in the area of communicating goals. The largest leadership score improvements were: defining goals; defining constituents, allies, and opponents; and delineating organization strengths/weaknesses. 13 participants engaged in medical education projects. CONCLUSION: This program helps fill a gap in medical education training. Program data suggest enhancement of students' teaching and leadership skills. A competitive application process demonstrates interest in such training. These results suggest that medical schools should offer and/or fund undergraduate teaching and leadership training.

Increased risk of deep venous thrombosis with endovascular cooling in patients with traumatic head injury.

Endovascular therapeutic hypothermia has been shown to preserve neurological function and improve outcomes; however, its use and potential complications have not been fully described in patients with traumatic head injuries. We believe that the use of endovascular cooling leads to deep venous thrombosis (DVT) in this high-risk population. We performed a retrospective review of 11 patients with severe head injuries admitted to our Level I trauma center surgical intensive care unit who underwent intravascular cooling. Duplex sonograms were obtained after 4 days at catheter removal or with clinical symptoms that were suspicious for DVT. Patients had a mean age of 23.2 (range, 16-42) years and an Injury Severity Score of 31.9 (range, 25-43). The overall incidence of DVT was 50 per cent. The DVT rate was 33 per cent if catheters were removed in 4 days or less and 75 per cent if removed after 4 days (risk ratio = 2.25; odds ratio = 6; P = ns). An elevated international normalized ratio upon admission was protective against DVT (no DVT = 1.26 vs DVT = 1.09; P = 0.02). Inferior vena cava filters were placed in most patients with DVT. The use of endovascular cooling catheters is associated with increased risk of DVT in patients with traumatic head injuries. Therefore, we discourage the use of endovascular cooling devices in this patient population.