Browsing by Author "Litzau, Megan"

Now showing 1 - 6 of 6
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    Chylothorax after blunt trauma
    (Elsevier, 2018) Litzau, Megan; Welch, Julie L.; Emergency Medicine, School of Medicine
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    Failure of an Educational Intervention to Improve Consultation and Implications for Healthcare Consultation.
    (Cureus, Inc., 2019-02-20) Turner, Joseph; Litzau, Megan; Morgan, Zachary S.; Pollard, Katherine; Cooper, Dylan; Emergency Medicine, School of Medicine
    INTRODUCTION: Consultation of another physician for his or her specialized expertise regarding a patient's care is a common occurrence in most physicians' daily practice, especially in the emergency department (ED). Therefore, the ability to communicate effectively with another physician during a patient consultation is an essential skill. However, there has been limited research on a standardized method for a physician to physician consultation with little guidance on teaching consultations to physicians in training. The objective of our study was to measure the effect of a structured consultation intervention on both content standardization and quality of medical student consultations. METHODS: Senior medical students were assessed on a required emergency medicine rotation with a physician phone consultation during a standardized, simulated chest pain case. The intervention groups received a standard consult checklist as part of their orientation to the rotation, followed by a video recording of a good consult call and a bad consult call with commentary from an emergency physician. The intervention was given to students every other month, alternating with a control group who received no additional education. Recordings were reviewed by three second-year internal medicine residents pursuing a fellowship in cardiology. Each recording was evaluated by two of the three reviewers and scored using a standardized checklist. RESULTS: Providing a standardized consultation intervention did not improve students' ability to communicate with consultants. In addition, there was variability between evaluators in regards to how they received the same information and how they perceived the quality of the same recorded consultation calls. Evaluator inter-rater reliability (IRR) was poor on the questions of 1) would you have any other questions of the student calling the consult and 2) did the student calling the consult provide an accurate account of information and case detail. The IRR was also poor on objective data such as whether the student stated their name. CONCLUSIONS: A brief intervention may not be enough to change complex behavior such as a physician to physician consultant communication. Importantly, despite consultants listening to the same audio recordings, the information was processed differently. Future investigations should focus on both those delivering as well as those receiving a consultation.
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    Limited Data to Support Improved Outcomes after Community Paramedicine Intervention: A Systematic Review
    (Elsevier, 2019) Pang, Peter S.; Litzau, Megan; Liao, Mark; Herron, Jennifer; Weinstein, Elizabeth; Weaver, Christopher; O'Donnell, Dan; Miramonti, Charles; Emergency Medicine, School of Medicine
    Background Community paramedicine (CP) leverages trained emergency medical services personnel outside of emergency response as an innovative model of health care delivery. Often used to bridge local gaps in healthcare delivery, the CP model has existed for decades. Recently, the number of programs has increased. However, the level of robust data to support this model is less well known. Objective To describe the evidence supporting community paramedicine practice. Data sources OVID, PubMed, SCOPUS, EMBASE, Google Scholar-WorldCat, OpenGrey. Study appraisal and synthesis methods Three people independently reviewed each abstract and subsequently eligible manuscript using prespecified criteria. A narrative synthesis of the findings from the included studies, structured around the type of intervention, target population characteristics, type of outcome and intervention content is presented. Results A total of 1098 titles/abstracts were identified. Of these 21 manuscripts met our eligibility criteria for full manuscript review. After full manuscript review, only 6 ultimately met all eligibility criteria. Given the heterogeneity of study design and outcomes, we report a description of each study. Overall, this review suggests CP is effective at reducing acute care utilization. Limitations The small number of available manuscripts, combined with the lack of robust study designs (only one randomized controlled trial) limits our findings. Conclusions Initial studies suggest benefits of the CP model; however, notable evidence gaps remain.
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    Nonketotic hyperglycemia causing left sided hemiballismus
    (Elsevier, 2018) Peak, Dallas; Litzau, Megan; Emergency Medicine, School of Medicine
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    Obtaining History with a Language Barrier in the Emergency Department: Perhaps not a Barrier After All
    (eScholarship Publishing, 2018-11) Litzau, Megan; Turner, Joseph; Pettit, Katie; Morgan, Zachary; Cooper, Dylan; Emergency Medicine, School of Medicine
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    Qualities Important in the Selection of Chief Residents
    (Cureus, Inc., 2020-04-07) Turner, Joseph; Litzau, Megan; Mugele, Josh; Pettit, Katie; Sarmiento, Elisa J.; Humbert, Aloysius; Emergency Medicine, School of Medicine
    Background Chief resident selection occurs by numerous methods. Chief residents also fulfill multiple roles, requiring a broad skill set. However, there is little literature on which qualities various stakeholders value in chief resident selection. The objective of this study was to identify the qualities that residents and faculty believe are important for chief residents. Methods Following a literature review, educational experts conducted a multi-institutional survey that asked participants to name the qualities they felt were most important in chief residents and to rank-order a predefined list of 10 qualities. Associations were calculated between rank-order and participant age, gender, institutional position, and history of serving as a chief resident. Results The response rate for the survey was 43.9% (385/877). Leadership, organization, and communication skills were named by all participants among the most common responses. Residents additionally named approachability, advocacy, and listening skills among their most valued qualities, whereas faculty named strong clinical skills and integrity. Dependability and trustworthiness were the most valued qualities in the rank-order list, whereas strong clinical skills and self-reflection were the least valued. Females valued the ability to manage multiple demands more whereas males valued dependability more. The faculty valued strong clinical skills more than residents. Conclusion A variety of qualities are seen as being valuable in chief residents. Additional research is needed to understand what qualities are associated with effective chief resident performance.