Browsing by Author "Cico, Stephen John"

Now showing 1 - 7 of 7
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    A Quality Improvement Initiative to Decrease Time to Analgesia in Patients With Sickle Cell and Vaso-Occlusive Crisis: A Population With Disparities in Treatment
    (Springer Nature, 2022-09-25) Arnold, Tyler; Coffee, R. Lane, Jr.; Rosenberg, Leon; Jacob, Seethal A.; Thompson, Sean; Saavedra, Heather; Cico, Stephen John; Wagers, Brian; Emergency Medicine, School of Medicine
    Introduction: Vaso-occlusive crises (VOCs) are the leading cause of emergency department (ED) visits and hospitalizations in patients with sickle cell disease (SCD). Timely administration of analgesia, within 60 minutes of patient registration, is the standard of care for SCD patients with VOCs. Patients with VOCs have longer times to initial analgesia compared to similar painful conditions. The primary aim of the project is to have 75% of patients with VOCs receive initial analgesia within 60 minutes of being registered, the current recommended time frame from the National Heart, Lung, and Blood Institute (NHLBI). Methods: A multi-disciplinary team used quality improvement (QI) methodology to develop a plan involving multiple Plan-Do-Study-Act (PDSA) cycles. A rapid evaluation process was employed which included notification of a patient with a VOC being placed in a room, rapid evaluation by all team members and use of an electronic order set. Results: The aim was met 72% of the time during our intervention period, compared to 17% pre-intervention. Average time to initial analgesia was decreased from 61 minutes to 42 minutes (p-value < 0.001), while time to disposition was also decreased when time goals were achieved. Conclusion: Using a rapid evaluation process we were able to decrease time to initial analgesia in a patient population that has previously experienced delays in care and decrease overall time to disposition.
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    GME Expansion to Community Hospitals: Residency Training Beyond the Academic Health Center
    (2020-03-06) Cico, Stephen John; Bratcher, Linda; Leveque, Emilie; Howenstine, Michelle
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    Online Program Director Toolbox
    (2020-03-06) Leveque, Emilie; Cico, Stephen John
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    Punctuated Equilibrium: COVID and the Duty to Teach for Adaptive Expertise
    (University of California, 2022-01-03) Merritt, Chris; Santen, Sally A.; Cico, Stephen John; Wolff, Margaret; Pusic, Martin; Emergency Medicine, School of Medicine
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    Rapid Adaptation to Remote Didactics and Learning in GME
    (Wiley, 2020-09-08) Hickam, Grace; Santen, Sally A.; Cico, Stephen John; Manthey, David; Wolff, Margaret; Moll, Joel; Lambert, Alexandra; Jordan, Jaime; Haas, Mary R. C.; Emergency Medicine, School of Medicine
    Weekly didactic conference in emergency medicine education has traditionally united residents and faculty for learning and fostered community within the residency program. The global pandemic Coronavirus Disease-19 (COVID-19) has fueled a rapid transition to remote learning that has disrupted the typical in-person format. To maintain ACGME educational experiences and requirements for residents in a safe manner, many residencies have moved to videoconferencing platforms such as Zoom™, Teams™, and WebEX.™ Given the importance of didactic conference as a ritual, educational experience and community-building activity, most residency programs have worked to maintain an active and robust didactic conference despite the many logistical challenges. Engaging residency program members in the transition to remote learning and utilizing opportunities for innovation can help to maintain normalcy and combat isolation resulting from the loss of weekly in-person contact. Herein, we propose practical tips for optimizing remote learning for weekly emergency medicine residency didactics.
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    Tailoring the Professional Development of Volunteer Clinical Faculty at Regional Medical Campuses: A Needs Analysis and Targeted Interventions
    (University of Minnesota Libraries, 2019-07) Hoffmann-Longtin, Krista; Torbeck, Laura; Nalin, Peter; Cico, Stephen John; Communication Studies, School of Liberal Arts
    Volunteer Clinical Faculty (VCF) are essential for the education of medical students at most medical schools with regional campuses. Indiana University School of Medicine is the largest medical school in the United States, with over 1,400 medical students experiencing part or all of their medical education at nine campuses (one academic center and eight regional medical campuses). Given the large number of students learning in the community, we surveyed our VCF in 2016 to better understand their characteristics, reasons for teaching, and professional development needs. Survey participants reported personal enjoyment from teaching as their primary reason for continuing to teach, but time pressure as a limiting factor. They identified faculty development opportunities in areas of efficient teaching, giving feedback, and adapting teaching style for various learners. Interventions were designed to create a unique, state-wide model of both face-to-face and online professional development to ensure the success of our VCF.
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    Validity evidence for an instrument for cognitive load for virtual didactic sessions
    (Wiley, 2022-02-01) Hickam, Grace; Jordan, Jaime; Haas, Mary R. C.; Wagner, Jason; Manthey, David; Cico, Stephen John; Wolff, Margaret; Santen, Sally A.; Emergency Medicine, School of Medicine
    Background: COVID necessitated the shift to virtual resident instruction. The challenge of learning via virtual modalities has the potential to increase cognitive load. It is important for educators to reduce cognitive load to optimize learning, yet there are few available tools to measure cognitive load. The objective of this study is to identify and provide validity evidence following Messicks' framework for an instrument to evaluate cognitive load in virtual emergency medicine didactic sessions. Methods: This study followed Messicks' framework for validity including content, response process, internal structure, and relationship to other variables. Content validity evidence included: (1) engagement of reference librarian and literature review of existing instruments; (2) engagement of experts in cognitive load, and relevant stakeholders to review the literature and choose an instrument appropriate to measure cognitive load in EM didactic presentations. Response process validity was gathered using the format and anchors of instruments with previous validity evidence and piloting amongst the author group. A lecture was provided by one faculty to four residency programs via ZoomTM. Afterwards, residents completed the cognitive load instrument. Descriptive statistics were collected; Cronbach's alpha assessed internal consistency of the instrument; and correlation for relationship to other variables (quality of lecture). Results: The 10-item Leppink Cognitive Load instrument was selected with attention to content and response process validity evidence. Internal structure of the instrument was good (Cronbach's alpha = 0.80). Subscales performed well-intrinsic load (α = 0.96, excellent), extrinsic load (α = 0.89, good), and germane load (α = 0.97, excellent). Five of the items were correlated with overall quality of lecture (p < 0.05). Conclusions: The 10-item Cognitive Load instrument demonstrated good validity evidence to measure cognitive load and the subdomains of intrinsic, extraneous, and germane load. This instrument can be used to provide feedback to presenters to improve the cognitive load of their presentations.