We're all about children!
 July 2006
This edition:
Letter From Our Chair
Residency training has always concentrated on turning out residents who are competent in carrying out patient care; however, it is becoming clear that physicians need to learn other skills to apply their knowledge and experience. Up until the present, we have assumed that by the end of 33 months of exhaustive--if not exhausting--training, we would have taught not only the knowledge, but also the values necessary for practicing medicine. However, with new residency duty hours reducing the training period by 30 to 50 percent, it is no longer clear whether residents will receive adequate training in three years. It's likely that additional competencies will help ensure residents can make up for the lost time by working on their own knowledge acquisition. For instance, they must learn how to continue learning. [read more] Feature Story The Evidence-based Medicine Program: Safety, quality and life-long learning in action In an exciting, cutting-edge program initiated last year, interns in the pediatric department have been actively learning to put evidence-based medicine (EBM) practices into action. "This integrated EBM program is the offspring of Dr. Lyndon Key's vision to make EBM a part the culture of the department of pediatrics," explains Dr. Gautham Suresh, leader of the EBM team for pediatrics. "Very few pediatric departments in the country have such a program. It's intensive, and it's on the forefront." It's a hands-on teaching program in which interns generate clinical questions based on their experience, explains Dr. Suresh. [read more] Message From Our Medical Director
With a new set of interns entering training this month, it seems appropriate to follow up on last month's article about the role trainees play in caring for our patients. I used to hear it said that one should never buy a car manufactured on a Monday. Similarly, many people fear coming to the hospital in July, when many of the residents, or "house staff," have recently started. A patient or family might ask, "How can we be sure the trainee knows what he or she is doing?" In the past, one often heard the phrase, "See one, do one, teach one," when it came to medical procedures. That is no longer the case. Due to a variety of factors, including a national emphasis on safety in the hospital, there are now multiple safeguards in place to assure that trainees are competent at performing the care they deliver. [read more] Update From Our Administrator
We are about a year away from starting a new chapter in the life of the MUSC Medical Center. When the new Phase I replacement hospital opens, it will provide an incredible facility for cardiac and digestive disease services. It takes a tremendous amount of planning to move into a new hospital, and we are already seeing preparation and changes. In the existing Medical Center and Children's Hospital, plans are underway to fill soon-to-be-vacated areas with needed services for our patients. In the Children's Hospital, the new hospital will free up space on the fifth floor, allowing us to begin moving services in preparation for a new Neonatal Intensive Care Unit. We are also hoping to gain a unit in the Medical Center, which will increase the number of our beds as well as eliminate the need for semi-private rooms. The MUSC Medical Center is very excited about the beautiful new hospital; we are all waiting its opening next year. We are also looking forward to the additional space, which will help us provide new and expanded services to children and their families in the Children's Hospital. Darby Children's Research Institute News
Nurturing young clinicians in their formative years is the future of academic medicine, says Carol Wagner, MD, professor in pediatrics. And MUSC is putting support systems in place to ensure the success of these future researchers. As associate director of MUSC's General Clinical Research Center (GCRC), Dr. Wagner is part of a 20-member, university-wide work group helping to develop ways to transition MUSC from a GCRC model to a Clinical and Translational Sciences Award (CTSA). "The MUSC campus is undergoing a transition period that takes clinicians out of an environment of conducting research in isolation, and integrates them with departments campus-wide, making research more relevant," explains Dr. Wagner. "That means that if someone has an interest in science- basic, clinical, or translational - there will be a university-wide infrastructure to support that from the very beginning," she adds. [read more] Evidence-Based Tip
Evidence Based Medicine (EBM) is a patient-centered approach incorporating the best available evidence into clinical practice. Based on the patient's full history and current medical condition, the physician forms a clinical question about the patient's treatment, diagnosis or prognosis. After finding and evaluating the evidence from well-conducted studies and trials, the physician considers the best course of action for the patient, taking into account the patient's specific condition, as well as his or her religious and cultural values. Rather than setting rigid rules that dictate treatment, EBM begins and ends with the specific needs of a particular patient. EBM Tip: The Clinical Question Formulating a good clinical question is critical to the process. Examples include questions about the best diagnostic tool to use for a given disease, or the association of certain foods or diets with morbidity or mortality (prognosis). The majority of questions that can be answered with evidence, however, are therapy questions, which compare the effectiveness of one treatment to another treatment or placebo. When stating your question, include the population, the intervention, the comparison and the outcomes. Here is an example: In children with recurrent otitis media, are grommets (ventilation tubes) more effective than antibiotics or no treatment (placebo), in reducing the frequency of episodes and the duration of the episodes? A good clinical question will give you both the concepts for your evidence search, and the criteria to evaluate the evidence you find. * The MUSC Library is very happy to be a part of the Department of Pediatrics EBM team, and proud to show our support for their efforts. A special thanks to the following individuals for their efforts in putting together Kids Connection each month. Managing Editor: Bernard L. Maria, MD, MBA Publisher: Jennifer Cherock (Trio Solutions Inc.) and Jessica Munday (Trio Solutions Inc.) Web design: Brian Dadin (Trio Solutions Inc.) Feature Writer: Mary Sue Lawrence, Trio Solutions Inc Contributing Writers: Lyndon Key, Bernard Maria, John Sanders, Phil Saul Inderjit Singh, Laura Cousineau |
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