Author Interviews, Education, Memory, Pediatrics / 08.10.2020

MedicalResearch.com Interview with: Leonie Margarita Kausel, PhD Postdoctoral Researcher Development University Santiago, Chile  MedicalResearch.com: What is the background for this study? Response: As a violin teacher, I observed the positive impact on many levels that musical training has on children and as a scientist (Biochemist), I was intrigued to be able to show this with data. I thought this was very important, because in my experience childhood music education can give you so much joy and important skills for life, but it is often not considered to be important in educational settings. After attending a seminar on education and neuroscience, I discovered that this discipline could allow me to investigate this in a scientific manner. This inspired me to enter the Neuroscience PhD program at the Pontificia Universidad Católica de Chile where I was lucky to work with Dr. Francisco Aboitiz, who has vast experience in attention research (ADHD) and is an international expert in language and evolution. At that time Dr. Mary Elizabeth Sutherland was making her postdoc at the lab, and she had worked with Dr. Robert Zatorre, one of the leading researchers in music and the brain. Also, I was lucky to work with Dr. Francisco Zamorano, a pioneer of fMRI research in Chile. So together we designed the research. :)  Also, I am very grateful that I could make a research stay at the Lab of Dr. Gottfried Schalug, who is also a pioneer in the research of music and the brain, and who inspired me to do this research since he wrote the first papers that I read about this subject.  (more…)
Author Interviews, COVID -19 Coronavirus, Education / 18.09.2020

MedicalResearch.com Interview with: Thomas M. Selden Director of the Division of Research and Modeling Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality Rockville, Maryland  MedicalResearch.com: What is the background for this study? Response: Across the United States, school districts are facing decisions about whether and how to reopen elementary and secondary schools.  We conducted this study to provide evidence on the risk of severe COVID-19 among adults who are connected to schools in some way – as teachers or other school workers or as household members of school-age children or school employees. The Agency for Healthcare Research and Quality (AHRQ) collects the data we used in this study as part of its longstanding Medical Expenditure Panel Survey (MEPS), which is the nation’s most complete source of data on the cost and use of health care and health insurance coverage. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Pediatrics / 04.09.2020

MedicalResearch.com Interview with: Katherine A. S. Auger, MD, MSc Division of Hospital Medicine James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati College of Medicine Pediatric Research in Inpatient Settings Network Cincinnati, Ohio MedicalResearch.com: What is the background for this study? What are the main findings? Response: All states closed schools in the spring of 2020 to try to mitigate the spread of COVID-19. Our study demonstrated a large, significant association between school closure and fewer COVID-19 cases and deaths even when accounting for other state policies. (more…)
Author Interviews, Education / 22.06.2020

MedicalResearch.com Interview with: Shawn Loewen PhD Professor, Michigan State University Department of Linguistics & Germanic, Slavic, Asian and African Languages Second Language Studies Program Associate Editor, The Modern Language Journal East Lansing, MI  MedicalResearch.com: What is the background for this study? Response: Millions of people use language learning apps such as Babel to study a foreign language; however, very little research has been conducted to investigate the effectiveness of such apps, in spite of some grand claims that companies make about the benefits of their apps. (more…)
Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale / 24.02.2020

MedicalResearch.com Interview with: Katherine A. Hill, BA, BS Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.  (more…)
Author Interviews, Education, Gender Differences, Neurology, UC Davis / 27.01.2020

MedicalResearch.com Interview with: Allison Brashear, M.D., M.B.A. Dean, UC Davis School of Medicine MedicalResearch.com: What is the background for this study? Why is the demand for neurology services and neurologists increasing?  Response: The American Academy of Neurology estimates that by 2025 the number of neurologists in practice will increase to 18,060 but some 3,400 more will be needed to meet the demand for their services. The 58% increase in the number of residency positions in the National Resident Matching Program since 2008 also reflects the growing demand. The higher prevalence of neurologic conditions, aging U.S. population and more patients having access to the health care coverage are the major driving forces. (Note: source of NRMP neurology trend data comes from a physician/resident forum posted May 2019 https://forums.studentdoctor.net/threads/growth-trends-in-neurology-residency-positions.1375918/) MedicalResearch.com: Why is neurology included among the less desirable fields of medicine (similar to nephrology, infectious disease, endocrinology etc.) for medical students and residents to pursue?  Why is burnout and dissatisfaction so high? Response: According to the American Academy of Neurology, a minority of medical students choose to train in neurology each year, with approximately 3.1% matching into a neurology residency in 2018. The newer generations of neurologists value lifestyle and time off work more than their predecessors. According to a recent American Medical Association survey, neurology tied with critical care as the medical specialty with the highest stress levels and burnout. Too many administrative tasks, too many hours at work, increased computerization of practice and insufficient compensation were among the top causes of burnout. (more…)
Author Interviews, Education / 23.01.2020

MedicalResearch.com Interview with: Brian Piper PhD Department of Medical Education Geisinger Commonwealth School of Medicine Center for Pharmacy Innovation & Outcomes Geisinger Precision Health Center MedicalResearch.com: What is the background for this study? Response: Disclosure of funding sources is standard practice for journal articles and clinical practice guidelines in order to alert readers to potential conflicts of interest (CoI). However, CoI disclosure is uncommon for textbooks. A new edition of Goodman and Gilman’s Pharmacological Basis of Therapeutics (GG-PBT) was recently published. This is affectionately known as “the blue bible of pharmacology” because it is widely used in the training of doctors, pharmacists, dentists, scientists, and nurses. This provided an opportunity to extend upon past research2,3 and determine whether the authors and editors had undisclosed CoIs. (more…)
Author Interviews, Education, Genetic Research, PNAS / 20.01.2020

MedicalResearch.com Interview with: Per Engzell PhD Postdoctoral Prize Research Fellow Nuffield College, University of Oxford
Felix C. Tropf, PhD Assistant Professor in Social Science Genetics, CREST-ENSAE, Paris
MedicalResearch.com: What is the background for this study? Response: We know that parents and offspring often resemble each other in their socio-economic outcomes: higher-educated parents tend to have children who reach a similar level of education while children of disadvantaged families struggle in school. To the extent that this compromises equality of opportunity – that is, some children end up better educated only because of their social background – social policies aim to compensate for it and promote social mobility. At the same time, not all similarity between parents and offspring can be seen as equally troubling. A society that blocked entry to university for any child born to academics would achieve high mobility, but few of us would see it as a model of equal opportunity. So some channels of transmission then, it seems, are more fair than others. Although we may disagree where to draw the line, things like parents’ ability to pay for good neighborhoods, schools, or access to college appear clearly more troubling than the inheritance of traits that make for educational success. In this study, we ask whether societies that have achieved a high degree of intergenerational mobility have done so by limiting the reach of "nature" (inherited traits), "nurture" (other family advantages), or both. We do so by combining the rich literatures of social mobility research and behavior genetics, comparing variation across several cohorts of men and women in 10 countries.  (more…)
Author Interviews, Dermatology, Education, Gender Differences, JAMA, Race/Ethnic Diversity / 08.01.2020

MedicalResearch.com Interview with: Imam Xierali, PhD Associate Professor / UT Southwestern Medical Center Dallas, Texas MedicalResearch.com: What is the background for this study? Response: Despite the continued efforts in academic medicine to increase the representation of women and minorities underrepresented in medicine (URM), there is a lack of information on trends in dermatology department faculty diversity and how they compare with those in other clinical departments. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 02.12.2019

MedicalResearch.com Interview with: Lynn Blewett, PhD Mayo Professor, Division of Health Policy and Management Director, State Health Access Data Assistance Center (SHADAC) University of Minnesota MedicalResearch.com: What is the background for this study? Response: We used a new set of questions about patient's perspectives of cultural competence of their providers that was added to the National Health Interview Survey and accessed through the Minnesota Population Center IPUMS Health Surveys.   MedicalResearch.com: What should readers take away from your report? Response: Most patients (97%) report being treated with respect by their providers. BUT we also found important disparities.  Black or Hispanic (vs White), uninsured (vs insured), and low income (vs >200% FPL) individuals reported being treated with respect less often, viewed a shared culture as more important, and saw providers who shared culture less often. (more…)
Author Interviews, Education, ENT, Hearing Loss, JAMA, Pediatrics / 30.11.2019

MedicalResearch.com Interview with: Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Recently, more reports have been publishes about the prevalence of slight to mild hearing loss among children in the general population. These studies showed that slight hearing loss is common, also within our population-based cohort in the Netherlands. Slight hearing loss is often scored as “not relevant”. We wanted to examine if we could find associations of hearing thresholds in children with performance scores in everyday life. (more…)
Author Interviews, Education, Gender Differences, JAMA / 13.11.2019

MedicalResearch.com Interview with: Shannon Ruzycki, MD, MPH, FRCPC, (she/hers) General Internist & Clinical Lecturer Department of Medicine Department of Community Health Sciences Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: After hearing about the National Academies of Science, Engineering, and Medicine 2018 report to congress on sexual harassment of women in academia, our Department Head asked myself and Dr. Aleem Bharwani to study experiences of gender inequity or equity in our Department. We conducted an in-depth, 18-month mixed methods study of women and men in our Department, including semi-structured interviews and survey. (more…)
Author Interviews, Education, NEJM, Surgical Research / 31.10.2019

MedicalResearch.com Interview with: Ryan J. Ellis, MD MS General Surgery Resident Surgical Outcomes and Quality Improvement Center (SOQIC) Northwestern Medicine  MedicalResearch.com: What is the background for this study? Response: Burnout has emerged as a significant problem affecting the entire healthcare workforce and it has been likely to myriad downstream problems such as increases in medical errors, alcoholism, and depression. Despite the attention on clinician burnout, there are significant gaps in our understanding of how the workplace environment may lead to burnout. Moreover, there are particular concerns about the workplace environment in training, specifically with regards to abuse, discrimination, and harassment. We had the opportunity to survey all U.S. general surgery residents to comprehensively define the frequency of workplace mistreatment and its relationship with burnout and suicidal thoughts among surgical residents. (more…)
Author Interviews, Education, University of Michigan / 18.10.2019

MedicalResearch.com Interview with: Chithra R. Perumalswami, MD, MSc Research Fellow Center for Bioethics & Social Sciences in Medicine University of Michigan  Reshma Jagsi, MD, DPhil Professor, Deputy Chair, and Residency Program Director Department of Radiation Oncology and Director Center for Bioethics and Social Sciences in Medicine University of Michigan MedicalResearch.com: What is the background for this study? Response: Burnout is a syndrome characterized by a sense of decreased personal accomplishment, emotional exhaustion, and depersonalization. It can lead to increased depression, illness, suicide, and absences from work. Physician burnout has reached epidemic proportions and physician-scientists are not immune from it. They are a critical part of the healthcare workforce who are responsible for translating innovative bench research to the bedside of patients, and in recent years have faced increasing pressures.  (more…)
Author Interviews, Education, Heart Disease, Technology / 02.10.2019

MedicalResearch.com Interview with: Tiffany G. Munzer, MD Department of Pediatrics University of Michigan Medical School Ann Arbor  MedicalResearch.com: What is the background for this study? Response: There’s been such a rise in the prevalence of tablet devices and the recommendation for families of young children has been to engage in media together because children learn the most from screens when they’re shared with an adult. However, little is known about how toddlers and adults might behave and interact using a tablet. (more…)
ADHD, Author Interviews, Depression, Education, JAMA, Mental Health Research, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Jeremy Brown BA MSc RESEARCH DEGREE STUDENT IN PHARMACOEPIDEMIOLOGY London School of Hygiene & Tropical Medicine MedicalResearch.com: What is the background for this study? Response: Given the way schools typically work, children in the same year as each other can be almost a whole year apart in terms of age. We’ve known for a while that children who are young in their year at school are also more likely to be diagnosed as having hyperactivity disorders and tend to do less well academically than the older children in the year. They also seem to be at increased risk of suicide. This is thankfully an extremely rare occurrence in children, but there is little evidence about whether younger children are more likely to be diagnosed with depression. We used electronic health records for just over a million children in the UK to see if there was any association between how old the children were in their year and whether they got diagnosed with ADHD, intellectual disability and depression. (more…)
Author Interviews, Education, Exercise - Fitness, Orthopedics, Pediatrics / 24.09.2019

MedicalResearch.com Interview with: Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI  MedicalResearch.com: What is the background for this study? Response: Over past couple of decades there has been a large change in youth sports from playing different sports in each season to more and more specialization where children are playing the same sport for three or more seasons. The concern with that change is that specialization at young ages will lead to more injuries, as well as athlete burnout.   (more…)
Author Interviews, Education, JAMA, Opiods, Social Issues / 28.08.2019

MedicalResearch.com Interview with: Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes. Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups.  (more…)
Author Interviews, Education, Gender Differences, JAMA, Surgical Research / 07.08.2019

MedicalResearch.com Interview with: Maria S. Altieri, MD, MS Invasive Surgery Stony Brook, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: For majority of residents, training years coincide with prime child bearing years.  Historically, surgical residency has not been conducive for having children, as it is one of the most demanding experiences, requiring long hours, high stress levels, and the acquisition of clinical and technical skills over a short period of time. However, with recent trends towards a more favorable work-life balance and the 80-hour work week, more male and female residents are having children or considering having children during training.  Thus, the topic of parental leave during residency is becoming more fundamental.  However, there is little research on the attitudes of residents towards their pregnant peers and parental leave. We wanted to examine the perceptions of surgical trainees towards parental leave and pregnancy during residency.  Through understanding the perceptions of current residents, obstacles could be identified which could lead to potential changes in policies that could help to normalize parenthood and parental leave during surgical training.    (more…)
Author Interviews, Education, Opiods, Social Issues / 16.06.2019

MedicalResearch.com Interview with: Arline T. Geronimus Sc.D Professor, Health Behavior and Health Education School of Public Health Research Professor Population Studies Center Institute for Social Research University of Michigan Member, National Academy of Medicine  MedicalResearch.com: What is the background for this study? Response: The gap in life expectancy between less and more educated Americans grew over the last 30 years, a deeply troubling fact. We are alone among western nations in these trends. We aimed to determine what causes of death account for this growing educational gap in life expectancy and whether the gap has continued to grow in the most recent years. Disturbingly, we found the educational gap in life expectancy has continued to grow. Why? A common theory is that this growing inequality is due to the opioid epidemic. Some even speculate that the less educated are dying from a composite of what they call “deaths of despair” – opioid and other drug overdose, suicide and alcoholic liver disease – with the theory being that as less educated and working class Americans have faced job loss and stagnating wages, they experience hopelessness and despair and turn to drugs, alcohol, or even suicide to ease or end their pain and feelings of hopelessness. However, while opioid, suicide and alcoholic liver disease deaths have increased among white youth and young adults and is cause for concern, this does not imply that these deaths should be grouped together as “deaths of despair” (DOD) or that they explain the growing educational gaps in life expectancy across all groups – men, women, whites, blacks, or older as well as younger adults. (more…)
ASCO, Author Interviews, Education, Gender Differences, Surgical Research / 04.06.2019

MedicalResearch.com – Responses Marina Stasenko, MD Memorial Sloan Kettering Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sexual harassment is a form of discrimination that includes gender harassment, unwanted sexual attention, and sexual coercion. A recent report in Fortune magazine noted that over half of US women have experienced sexual harassment at some point in their lives. Until recently, much of the conversation about sexual harassment in the workplace has been relegated to private discussions behind closed doors. However, the MeToo movement has shined a spotlight on the pervasive nature of sexual harassment in various fields, like media and business world. Although there are more female physicians in practice today than ever before, with women accounting for over 50% of young physicians, sexual harassment and gender disparities continue to plague the field of medicine. Despite the large female representation, gynecologic oncology is not immune from gender disparities. The Society of Gynecologic Oncology is a professional organization of over 2000 physicians, scientists, allied health professionals, nurses, and patient advocates dedicated to the care of patients with gynecologic cancer. As of 2015, 46% of members of the SGO were women, and that number is steadily growing. SGO leadership is also increasingly female – with 2 of the last 3 presidents being women. Despite the large female representation, gynecologic oncology is not immune from gender disparities. The 2015 SGO practice survey noted that while 22% of male Gynecologic Oncologists held the rank of professor, only 11% of their female counterparts held the title. They also noted that the mean annual salary for male physicians was nearly 150,000$ greater than salary for female physicians. Given the fact that there is little objective data on sexual harassment in gynecologic oncology, the objective of our study was to evaluate perceptions of sexual harassment and gender disparities among physician members of the Society of Gynecologic Oncology. (more…)
Author Interviews, Education, Neurology, NYU / 17.05.2019

MedicalResearch.com Interview with: Dr. Rebecca Stainman Dr. Arielle Kurzweil MD Adult Neurology Program Director New York University School of Medicine NYU Langone Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physician burnout is prevalent. Neurologists have among the highest burnout rates, ranked third among specialties in a 2011 study, and over half of US Neurologists report at least 1 symptom of burnout in a 2016 survey.  Efforts to address burnout in training programs have mostly been aimed at implementing wellness curricula and offering mental health resources. Training neurology residents to effectively identify, address, and help impaired colleagues is equally crucial in these efforts, yet there is a paucity of literature on this topic. We used simulation as a means of addressing this topic, via identifying and addressing an impaired colleague through an objective structured clinical examination (OSCE).  (more…)
Author Interviews, Education, Outcomes & Safety / 08.05.2019

MedicalResearch.com Interview with: Veronica Toffolutti PhD Postdoctoral researcher working with Professor David Stuckler Department of Sociology Bocconi University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Openness has been linked with better patient safety and better understanding of patients’ care goals. In addition, more open environments appear to be linked with positively ranked quality of teamwork, which in turns lead to better health care. Yet if the expected benefits are to be achieved, it is necessary to show that greater openness actually corresponds to improvements in performance or lower mortality rates. To the best of our knowledge our is the first study to show an association between hospital mortality and openness and more precisely one point increase in the standardized openness score leads to a decrease of 6.48% in the hospital mortality rates. With the term openness we refer to an environment in which communication among patients, staff members and managers is open and transparent.  (more…)
Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States. (more…)
Addiction, Author Interviews, Education, Mental Health Research / 16.04.2019

MedicalResearch.com Interview with: Lina Begdache, PhD, RDN, CDN, CNS-S, FAND Assistant Professor Health and Wellness Studies Department GW 15 Decker School of Nursing Binghamton University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: College students engage in activities such as binge drinking, abuse of ADHD medications as "study drugs" or use of illicit drugs during a critical brain developmental window that supports maturation of the brain (the prefrontal cortex) necessary for emotional control, cognitive functions and regulation of impulsive behaviors. These activities not only affect brain function, thus mental health and cognitive functions, but may dampen brain development with potential long-lasting effects. As for findings, we were able to identify neurobehavioral patterns that associate with mental wellbeing and mental distress in young adults. Based on evidence from the literature, we constructed conceptual models that describe how one behavior may lead to another until virtuous or vicious cycles set-in.  (more…)
Author Interviews, Education, JAMA, University of Pennsylvania / 16.04.2019

MedicalResearch.com Interview with: Krisda Chaiyachati, MD, MPH, MSHP Assistant Professor Medicine, Perelman School of Medicine Clinical Innovation Manager Penn's Center for Health Care Innovation Perelman School of Medicine Medical Director, Penn Medicine's FirstCall Virtual Care   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The United States spends more than $12 billion annually on training young doctors who have rates of burnout and depression at an alarmingly high rate. Yet, we have limited evidence as to what they are doing while training in the hospital. We sought to glimpse into how their day is spent. In the largest study to date, we observed 80 first-year internal medicine physicians (“interns”) for nearly 2200 hours across 194 work shifts at 6 different sites. Our research sought to understand what medical residents did by categorizing training activities into themes such as time spent in education or patient care.  (more…)
Author Interviews, Education, Health Care Systems / 14.03.2019

MedicalResearch.com Interview with: Nicholas A. Rattray, Ph.D. Research Scientist/Investigator VA HSR&D Center for Health Information and Communication Implementation Core, Precision Monitoring to Transform Care (PRISM) QUERI Richard L. Roudebush Veterans Affairs Medical Center Indiana University Center for Health Services & Outcomes Research Regenstrief Institute, Inc. Indianapolis, Indiana on behalf of study co-authors re: Rattray NA, Flanagan ME, Militello LG, Barach P, Franks Z, Ebright P, Rehman SU, Gordon HS, Frankel RM MedicalResearch.com: What is the background for this study? What are the main findings?  Response: End-of-shift handoffs pose a substantial patient safety risk. The transition of care from one doctor to another has been associated with delays in diagnosis and treatment, duplication of tests or treatment and patient discomfort, inappropriate care, medication errors and longer hospital stays with more laboratory testing. Handoff education varies widely in medical schools and residency training programs. Although there have been efforts to improve transfers of care, they have not shown meaningful improvement. Led for the last decade by Richard Frankel, Ph.D., a senior health scientist at Regenstrief Institute and Indiana University and professor at Indiana University School of Medicine, our team has studied how health practitioners communicate during end-of-shift handoffs. In this current study, funded by VA Health Services and Research Development, we conducted interviews with 35 internal medicine and surgery residents at three VA medical centers about a recent handoff and analyzed the responses. Our team also video-recorded and analyzed more than 150 handoffs. Published in the Journal of General Internal Medicine, this study explains how the person receiving the handoff can affect the interaction. Medical residents said they changed their delivery based on the doctor or resident who was taking over (i.e., training level, preference for fewer details, day or night shift). We found that handoff communication involves a complex combination of socio-technical information where residents balance relational factors against content and risk. It is not a mechanistic process of merely transferring clinical data but rather is based on learned habits of communication that are context-sensitive and variable, what we refer to as “recipient design”. In another paper led by Laura Militello, we focus on how residents cognitively prepare for handoffs. In the paper published in The Joint Commission Journal of Quality and Patient Safety®, researchers detailed the tasks involved in cognitively preparing for handoffs. A third paper, published in BMC Medical Education, reports on the limited training that physicians receive during their residency. Residents said they were only partially prepared for enacting handoffs as interns, and clinical experience and enacting handoffs actually taught them the most.   (more…)
Author Interviews, Education, Health Care Systems, Outcomes & Safety, University of Pennsylvania / 07.03.2019

MedicalResearch.com Interview with: Jeffrey H. Silber, MD, PhD Director, Center for Outcomes Research Nancy Abramson Wolfson Endowed Chair Health Services Research Children's Hospital of Philadelphia Professor of Pediatrics, Anesthesiology and Critical Care Perelman School of Medicine, University of Pennsylvania Professor of Health Care Management Wharton School, University of Pennsylvania  MedicalResearch.com: What is the background for this study? Response: This was a year-long randomized trial that involved 63 internal medicine residency programs from around the US.  In 2015-2016, about half of the programs were randomized to follow the existing rules about resident duty hours that included restrictions on the lengths of shifts and the rest time required between shifts (the standard arm of the trial) and the other half of the programs didn’t have those shift length or rest period rules (the flexible arm of the trial).  We measured what happened to the patients cared for in those programs (the safety study), and other studies examined how much sleep the residents received, and how alert they were at the end of shifts (the sleep study), and previously we published on the educational outcomes of the interns. To measure the impact on patient outcomes when allowing program directors the ability to use a flexible shift length for their interns, we compared patient outcomes after the flexible regimen went into place to outcomes the year before in the same program. We did the same comparison for the standard arm. Then we compared the difference between these comparisons. Comparing before and after the implementation of the trial within the same program allowed us to be more confident that a particularly strong or weak program, or a program with especially sick or healthy patients, would not throw off the results of the study. The trial was designed to determine, with 95% confidence, if the flexible arm did not do more than 1% worse than the standard arm. If this were true for the flexible arm, we could say the flexible regimen was “non-inferior” to the standard regimen. (more…)
Author Interviews, Cognitive Issues, Education, Social Issues / 04.03.2019

MedicalResearch.com Interview with: Marja Aartsen, PhD Research professor at NOVA Norwegian Social Research / OsloMet Oslo Metropolitan University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study is part of a larger project “Life course influences on health trajectories at older age” conducted at the University of Geneva, of which dr. Stéphane Cullati is the principle investigator (see for more information on the project https://cigev.unige.ch/index.php?cID=887). The aim of that research project is to examine in what way retrospective life course precursors from childhood to late adulthood have long-term impacts on current health trajectories at older age. A number of studies in this project are now published among which our study on childhood conditions and cognitive functioning and cognitive decline in later life. In our research, we were particularly interested in the origins of cognitive decline in later life.  Studies among children show that the childhood is an important phase in the development of the brain. Growing up in environments in which people are cognitively stimulated stimulates the brain to develop more complex neuronal networks and larger brain reserves, which may compensate for the neuronal losses that occur when people get older. This effect is long visible, even at old age as a number of important studies recently provided quite solid evidence for the beneficial effect of advantaged childhood conditions on level of cognitive functioning in later life. However, not many studies investigated the relation between childhood conditions and the speed of cognitive decline in later life. Those that did found inconsistent results. We reasoned that part of the inconsistencies in study findings might stem from differences in the analytical approach (not sensitive enough), too little cognitive change because of a short follow-up, too young people, or too small sample (all causing too little power to find statistically significant effects) or differences in the measurement of the childhood conditions. To overcome these potential limitations, we used a large study sample with long follow-up, used a multidimensional measurement of childhood condition, and applied a powerful analytical technique.  (more…)