RESUMO
OBJECTIVES: We sought to evaluate the effectiveness of a novel Internal Medicine (IM) transition to residency (TTR) curriculum. METHODS: We performed a paired pre-/postsurvey evaluation of graduating fourth-year medical students' perceived preparedness and medical knowledge after participating in a recently developed IM TTR course. RESULTS: The response rate was 51% (24 of 47). There was a significant improvement in 15 of 17 perceived preparedness items and significant improvement in the medical students' performance on the 8-question medical knowledge test. CONCLUSIONS: The IM TTR curriculum improved medical students' medical knowledge and perceived preparedness for internship on a variety of high-yield clinical topics. The curriculum may be appealing to other institutions that are developing or revamping TTR courses.
Assuntos
Educação de Graduação em Medicina , Internato e Residência , Estudantes de Medicina , Humanos , Competência Clínica , Currículo , Medicina Interna/educaçãoRESUMO
In the last decade, boot camp residency preparatory courses for fourth-year medical students have become increasingly popular in medical schools across the USA; however, the curricular content of these courses varies widely. The authors surveyed internal medicine interns at a large academic medical center regarding clinical and non-clinical topics that would be useful for an internal medicine residency preparatory curriculum. The response rate was 79% (64/81). A rational approach to antibiotics (42%) and electrolyte management (41%) were the most frequent clinical topics and cross-cover (69%) was the most frequent non-clinical topic selected by interns.
RESUMO
OBJECTIVES/HYPOTHESIS: To determine if the amount of opioid prescribed and postoperative outcomes after adenotonsillectomy changed following implementation of mandated opioid consent forms. STUDY DESIGN: Retrospective cohort study. METHODS: Patients undergoing adenotonsillectomy 6 months before and after implementation of mandated opioid consent forms at a tertiary-care pediatric hospital were studied. Demographics, operative data, weight-based opioid dosage, and postoperative outcome measures, including nursing calls, emergency department (ED) visits, hospital readmission, and bleed rates, were collected and analyzed. RESULTS: Of 300 patients, opioid prescription was provided for 211 patients (70.3%), 112 preconsent (74.7%) and 99 postconsent (66.0%). Mean (standard deviation) total opioid prescribed (milligrams/kilogram) was significantly higher preconsent 4.8 (5.6) than postconsent 3.2 (4.7), (P = .003). There were no differences between number of nursing calls (P = .134) or ED visits (P = .083). Interestingly, preconsent patients had more hospital readmission for pain/dehydration (odds ratio OR: 368, P = .016) and bleeding concerns (OR: 244, P = .003). CONCLUSIONS: A mandated consent form prior to opioid prescription was associated with decreased overall opioid prescription without resultant increase in postoperative complications in pediatric patients. These data provide support for minimizing opioid prescription on a systems-based level. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:1477-1481, 2019.
