Browsing by Author "Hobgood, Cherri"
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Item The 2016 Model of the Clinical Practice of Emergency Medicine(Elsevier, 2017-06) Counselman, Francis L.; Babu, Kavita; Edens, Mary Ann; Gorgas, Diane L.; Hobgood, Cherri; Marco, Catherine A.; Katz, Eric; Rodgers, Kevin; Stallings, Leonard A.; Wadman, Michael C.; Beeson, Michael S.; Keehbauch, Julia N.; Emergency Medicine, School of MedicineItem Adaptive change in simulation education: Comparison of effectiveness of a communication skill curriculum on death notification using in-person methods versus a digital communication platform(Wiley, 2021-07) Hughes, Mary; Gerstner, Brett; Bona, Anna; Falvo, Lauren; Schroedle, Karen; Cooper, Dylan; Sarmiento, Elisa; Hobgood, Cherri; Ahmed, Rami; Emergency Medicine, School of MedicineBackground Mandates to social distance and “shelter in place” during the COVID-19 pandemic necessitated the exploration of new academic content delivery methods. Digital communication platforms (DCP; e.g., Zoom) were widely used to facilitate content delivery, yet little is known about DCP’s capacity or effectiveness, especially for simulation. Objective The objective was to compare the experience, outcomes, and resources required to implement a simulation-based communication skill curriculum on death notification to a cohort of learners using in-person versus DCP delivery of the same content. Methods We used the GRIEV_ING mnemonic to train students in death notification techniques either in person or utilizing a DCP. For all learners, three measures were collected: knowledge, confidence, and performance. Individual learners completed knowledge and confidence assessments pre- and postintervention. All performance assessments were completed by standardized patients (SPs) in real time. Wilcoxon rank-sum test was used to identify differences in individual and between-group performances. Results Thirty-four learners participated (N = 34), 22 in person and 12 via DCP. There was a statistically significant improvement in both groups for all three measures: knowledge, confidence, and performance. Between-group comparisons revealed a difference in pretest confidence but no differences between groups in knowledge or performance. More preparation and prior planning were required to set up the DCP environment than the in-person event. Conclusions The in-person and DCP delivery of death notification training were comparable in their ability to improve individual knowledge, confidence, and performance. Additional preparation time, training, and practice with DCPs may be required for SPs, faculty, and learners less familiar with this technology.Item Closing the gender gap in medicine: the impact of a simulation-based confidence and negotiation course for women in graduate medical education(BMC, 2023-04-14) Bona, Anna; Ahmed, Rami; Falvo, Lauren; Welch, Julie; Heniff, Melanie; Cooper, Dylan; Sarmiento, Elisa; Hobgood, Cherri; Emergency Medicine, School of MedicineBackground: Currently, 75-80% of the medical workforce worldwide consists of women. Yet, women comprise 21% of full professors and less than 20% of department chairs and medical school deans. Identified causes of gender disparities are multifactorial including work-life responsibilities, gender discrimination, sexual harassment, bias, lack of confidence, gender differences in negotiation and leadership emergence, and lack of mentorship, networking, and/or sponsorship. A promising intervention for the advancement of women faculty is the implementation of Career Development Programs (CDPs). Women physician CDP participants were shown to be promoted in rank at the same rate as men by year five, and more likely to remain in academics after eight years compared to both men and women counterparts. The objective of this pilot study is to investigate the effectiveness of a novel, simulation-based, single-day CDP curriculum for upper-level women physician trainees to teach communication skills identified as contributing to medicine's gender advancement gap. Methods: This was a pilot, pre/post study performed in a simulation center implementing a curriculum developed to educate women physicians on 5 identified communication skills recognized to potentially reduce the gender gap. Pre- and post-intervention assessments included confidence surveys, cognitive questionnaires, and performance action checklists for five workplace scenarios. Assessment data were analyzed using scored medians and descriptive statistics, applying Wilcoxon test estimation to compare pre- versus post-curriculum intervention scores, with p < 0.05 considered statistically significant. Results: Eleven residents and fellows participated in the curriculum. Confidence, knowledge, and performance improved significantly after completion of the program. Pre-confidence: 28 (19.0-31.0); Post-confidence: 41 (35.0-47.0); p < 0.0001. Pre-knowledge: 9.0 (6.0-11.00); Post knowledge: 13.0 (11.0-15.0); p < 0.0001. Pre-performance: 35.0 (16.0-52.0); Post-performance: 46.0 (37-53.00); p < 0.0001. Conclusion: Overall, this study demonstrated the successful creation of a novel, condensed CDP curriculum based on 5 identified communication skills needed for women physician trainees. The post-curriculum assessment demonstrated improved confidence, knowledge, and performance. Ideally, all women medical trainees would have access to convenient, accessible, and affordable courses teaching these crucial communication skills to prepare them for careers in medicine to strive to reduce the gender gap.Item Computer-facilitated review of electronic medical records reliably identifies emergency department interventions in older adults(Society for Academic Emergency Medicine, 2013-06) Biese, Kevin J.; Forbach, Cory R.; Medlin, Richard P.; Platts- Mills, Timothy F.; Scholer, Matthew J.; McCall, Brenda; Shofer, Frances S.; LaMantia, Michael; Hobgood, Cherri; Kizer, J. S.; Busby-Whitehead, Jan; Cairns, Charles B.; Emergency Medicine, School of MedicineOBJECTIVES: An estimated 14% to 25% of all scientific studies in peer-reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time-consuming and error-prone. Computer-based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer-facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer-facilitated review was completed. METHODS: Clinical data from consecutive ED patients age 65 years or older were collected retrospectively by manual and computer-facilitated medical record review. The frequency of three significant ED interventions in older adults was determined using each method. Performance characteristics of each search method, including sensitivity and positive predictive value, were determined, and the overall sensitivities of the two search methods were compared using McNemar's test. RESULTS: For 665 patient visits, there were 49 (7.4%) Foley catheters placed, 36 (5.4%) sedative medications administered, and 15 (2.3%) patients who received positive pressure ventilation. The computer-facilitated review identified more of the targeted procedures (99 of 100, 99%), compared to manual review (74 of 100 procedures, 74%; p < 0.0001). CONCLUSIONS: A practical, non-resource-intensive, computer-facilitated free-text medical record review was completed and was more efficient and accurate than manually reviewing ED records.Item Death notification: a digital communication platform for simulated patient-based training with medical students(BMJ Publishing Group, 2020-09-25) Hughes, Mary; Gerstner, Brett; Bona, Anna; Falvo, Lauren; Hobgood, Cherri; Ahmed, Rami A.; Emergency Medicine, School of MedicineMedical simulation experiences, focused on enhancing essential communication skills, provide high value to trainees. These communication-based simulations often require little equipment and instead use trained faculty facilitators who can impart clinical significance and expertise to trainees. Teaching communication skills and techniques remotely is theoretically possible but has been largely unexplored in medical education.1 The COVID-19 pandemic and the subsequent restrictions imposed by shelter-in-place orders and social distancing created a need to expand traditional training methods and experiment with remote simulation training for communication skills. In this brief report, we explore the experience, outcomes and barriers to implementing a simulated communication skill curriculum focused on death notification to a cohort of remote medical students.Item Experience introducing physician assistant students into a medical student emergency medicine clerkship(Elsevier, 2019-03) Turner, Joseph; Corson-Knowles, Daniel; Besinger, Bart; Rebman, Rebecca; Hobgood, Cherri; Palmer, Megan; Emergency Medicine, School of MedicineBackground Physician assistants continue to play an increasingly important role in our healthcare system, including a growing role in the emergency department. Introducing physician assistant students into an existing emergency department learning environment makes efficient use of resources and provides an opportunity for interprofessional education, but the success of such a strategy and the resultant impact on medical student education have not been previously described. The goals of our study were to determine the impact of the introduction of physician assistant students into a learning environment that already serves medical students and residents, and to assess the readiness of physician assistant students to participate in an established medical student emergency medicine clerkship. Methods A survey was completed by emergency medicine faculty and residents shortly after the introduction of physician assistant students into an emergency department learning environment. The survey contained 18 questions in two sections: 11 questions asking about the effect of physician assistant students on the emergency department learning environment and 7 questions comparing the skills of physician assistant students with medical students. Data from medical student evaluations of the clerkship were also collected. Results and Discussion: Forty-six physician preceptors (43%) responded to the survey. The majority of preceptors felt that the presence of physician assistant students offered valuable interprofessional education and overall was a positive experience, though some expressed concerns about the effect on the education of other learners. Most preceptors felt that physician assistant students had comparable skills with medical students, though some concerns were expressed regarding knowledge base and variability of skill level. Medical student evaluations of the clerkship were similar before and after the introduction of physician assistant students. These results, however, must be viewed with caution as we were able replace a medical student with a physician assistant student, keeping the total number of students at the study sites constant, which some institutions may not be able to do. Conclusions The impact of introducing physician assistant students to a medical student emergency medicine clerkship is viewed as being positive overall, though more research is needed to understand and optimize the learning involvement for all learners.Item Gender Differences in Experiences of Leadership Emergence Among Emergency Medicine Department Chairs(American Medical Association, 2022-03-01) Hobgood, Cherri; Draucker, Claire; Emergency Medicine, School of MedicineImportance: The number of women entering medicine continues to increase, but women remain underrepresented at all tiers of academic rank and chair leadership in EM. The proportion of female chairs in EM has not exceeded 12% in 2 decades. Objective: To compare how male and female EM chairs experience leadership emergence, with attention to factors associated with support of the emergence of female chairs. Design, setting, and participants: This qualitative descriptive study was conducted between April 2020 and February 2021 at 36 US academic EM departments. Eligible participants were all current and emeritus female EM academic department chairs (with a possible cohort of 20 individuals) and an equal number of randomly selected male chairs. Interventions: Semistructured interviews were conducted via teleconferencing with an 11-item interview guide. Main outcomes and measures: Qualitative findings identifying similarities and gender differences in leadership emergence were collected. Results: Among 20 female chairs in EM, 19 women (mean [SD] age, 56.2 [7.1] years) participated in the study (95.0% response rate). There were 13 active chairs, and 6 women were within 5 years of chair leadership. Among 77 male chairs in EM identified and randomized, 37 men were invited to participate, among whom 19 individuals (51.4%) agreed to participate; 18 men (mean [SD] age, 52.2 [7.5] years) completed their interviews. Reflecting upon their experiences of leadership emergence, male chairs saw leadership as their destiny, were motivated to be chairs to gain influence, were dismissive of risks associated with chairing a department, and were sponsored by senior male leaders to advance in leadership. Female chairs saw leadership as something they had long prepared for, were motivated to be chairs to make a difference, were cautious of risks associated with chairing a department that could derail their careers, and relied on their own efforts to advance in leadership. Conclusions and relevance: This study found that experiences of leadership emergence differed by gender. These results suggest that leadership development strategies tailored to women should promote early internalization of leadership identity, tightly link leadership to purpose, cultivate active sponsorship, and encourage women's risk tolerance through leadership validation to support women's development as leaders and demonstrate a commitment to gender equity in EM leadership.Item How to HEEAL: A Patient and Peer-Centric Simulation Curriculum for Medical Error Disclosure(AAMC, 2024-04-02) Falvo, Lauren; Bona, Anna; Heniff, Melanie; Cooper, Dylan; Moore, Malia; Doos, Devin; Sarmiento, Elisa; Hobgood, Cherri; Ahmed, Rami; Emergency Medicine, School of MedicineIntroduction: Medical errors are an unfortunate certainty with emotional and psychological consequences for patients and health care providers. No standardized medical curriculum on how to disclose medical errors to patients or peers exists. The novel HEEAL (honesty/empathy/education/apology-awareness/lessen chance for future errors) curriculum addresses this gap in medical education through a multimodality workshop. Methods: This 6-hour, two-part curriculum incorporated didactic and standardized patient (SP) simulation education with rapid cycle deliberate practice (RCDP). The morning focused on provider-patient error disclosure; the afternoon applied the same principles to provider-provider (peer) discussion. Summative simulations with SPs evaluated learners' skill baseline and improvement. Formative simulations run by expert simulation educators used RCDP to provide real-time feedback and opportunities for adjustment. Medical knowledge was measured through pre- and postintervention multiple-choice questions. Learners' confidence and attitude towards medical errors disclosure were surveyed pre- and postintervention with assistance of the Barriers to Error Disclosure Assessment tool, revised with the addition of several questions related to provider-provider disclosure. Results: Fourteen medical students participated in this pilot curriculum. Statistical significance was demonstrated in medical knowledge (p = .01), peer-disclosure skills (p = .001), and confidence in medical error disclosure (p < .001). Although there was improvement in patient-disclosure skills, this did not reach statistical significance (p = .05). Discussion: This curriculum addresses the need for designated training in medical error disclosure. Learners gained knowledge, skills, and confidence in medical error disclosure. We recommend this curriculum for medical students preparing for transition to residency.Item Presence and Comprehensiveness of Antibullying Policies for Faculty at US Medical Schools(American Medical Association, 2022-08-01) Iyer, Maya S.; Choi, Yujung; Hobgood, Cherri; Emergency Medicine, School of MedicineThis cross-sectional study assesses the presence and comprehensiveness of antibullying policies at top US medical schools.Item The role of women's consortia in the advancement of women in academic emergency medicine(Wiley, 2021-12) Madsen, Tracy; Hobgood, Cherri; Emergency Medicine, School of Medicine