Browsing by Subject "Learning curve"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit
    (BMC, 2020-10-22) Brown, Wade; Santhosh, Lekshmi; Brady, Anna K.; Denson, Joshua L.; Niroula, Abesh; Pugh, Meredith E.; Self, Wesley H.; Joffe, Aaron M.; O’Neal Maynord, P.; Carlos, W. Graham; Medicine, School of Medicine
    Endotracheal intubation (EI) is a potentially lifesaving but high-risk procedure in critically ill patients. While the ACGME mandates that trainees in pulmonary and critical care medicine (PCCM) achieve competence in this procedure, there is wide variation in EI training across the USA. One study suggests that 40% of the US PCCM trainees feel they would not be proficient in EI upon graduation. This article presents a review of the EI training literature; the recommendations of a national group of PCCM, anesthesiology, emergency medicine, and pediatric experts; and a call for further research, collaboration, and consensus guidelines.
  • Thumbnail Image
    Item
    Transitioning from the Posterior Approach to the Direct Anterior Approach for Total Hip Arthroplasty
    (Korean Hip Society, 2022) Metzger, Cameron M.; Farooq, Hassan; Hur, Jacqueline O.; Hur, John; Orthopaedic Surgery, School of Medicine
    Purpose: Total hip arthroplasty (THA) using the direct anterior approach (DAA) is known to have a learning curve. The purpose of this study was to review cases where surgery was performed by an arthroplasty surgeon transitioning from the posterior approach (PA) to the DAA. We hypothesized similar complication rates and improvements in surgical duration over time. Materials and methods: A review of 2,452 consecutive primary THAs was conducted. Surgical duration, length of stay (LOS), surgical complications, decrease in postoperative day (POD) 1 hemoglobin, transfusion rates, POD 0 and POD 1 pain scores, incision length, leg length discrepancy (LLD), and radiographic cup position were recorded. Results: No differences in surgical duration were observed after the first 50 DAA cases. A shorter LOS was observed for the DAA, and statistical difference was appreciated after the first 100 DAA cases. There were no differences in periprosthetic fractures. A higher rate of infections and hip dislocations were observed with the PA. The PA showed an association with higher transfusion rates without significant difference in POD 1 decrease in hemoglobin over the first 100 DAA cases. Similar POD 0 and POD 1 pain scores with a smaller incision were observed for the first 100 DAA cases. The DAA cohort showed less variation in cup inclination, version, and LLD. Conclusion: DAA is safe and non-inferior in terms of reduced LOS, smaller incision, and less variation in cup position. Fifty DAA cases was noted to be the learning curve required before no differences in duration between approaches were observed.