The one cloud on a sunny day: Using emotional intelligence to manage emotions from negative written feedback.

Physician trainees receive anonymous written feedback about their clinical performance, which can be challenging to interpret. Negative written feedback can evoke a strong emotional response. An educational gap exists on how to handle receiving negative written feedback and the accompanying emotions. Teaching trainees the tenets of emotional intelligence, including emotional self-awareness and self-management, could be an avenue to improve the experience of receiving feedback. Face-to-face coaching may also help improve the emotional experience of receiving written feedback.

Was COVID-19 a heyday for education? Lessons learned from a COVID-19 "pop-up" simulation developed overnight.

Introduction: To adjust for the COVID-19 pandemic's rapidly changing guidelines and clinical needs, educators turned to simulation to create realistic yet safe environments for drilling and innovating various care strategies. Individually, institutions faced creating a pathway for deploying new behaviors and techniques widely across their populace. Methods: In response to this need, we rapidly developed an interprofessional teaching curriculum for safe intubation techniques and donning/doffing of personal protection equipment to anesthesiology clinicians and technicians. Participants were taught using Roussin's Zone 1 simulation techniques including coaching from interprofessional facilitators. Survey data were collected from participants. Results: Participants' confidence levels increased, with coaching and the use of simulation cited as the most useful elements of the training. Conclusions: We believe COVID-19 catalyzed many educational initiatives, and though teams drew their own roadmaps to create programs, sharing the learning from these endeavors may inform future similar situations. Lessons of stakeholder buy-in, use of multidisciplinary teams, and building a psychologically safe space can promote rapid uptake of new techniques and technologies.

Perioperative considerations in the management of cold agglutinin disease in laparoscopic surgery.

An 80-year-old man with idiopathic cold agglutinin disease presented with acute cholecystitis. We describe operating room and anaesthetic considerations for patients with cold agglutinin disease and measures that can be taken to prevent disease exacerbation in this case report. Multidisciplinary collaboration and planning between the operative room staff, anaesthesia team and surgical team are needed to ensure safe surgery and optimal patient outcomes.

A morphometric study of mechanotransductively induced dermal neovascularization.

BACKGROUND: Mechanical stretch has been shown to induce vascular remodeling and increase vessel density, but the pathophysiologic mechanisms and the morphologic changes induced by tensile forces to dermal vessels are poorly understood. METHODS: A custom computer-controlled stretch device was designed and applied to the backs of C57BL/6 mice (n=38). Dermal and vascular remodeling was studied over a 7-day period. Corrosion casting and three-dimensional scanning electron microscopy and CD31 staining were performed to analyze microvessel morphology. Hypoxia was assessed by immunohistochemistry. Western blot analysis of vascular endothelial growth factor (VEGF) and mRNA expression of VEGF receptors was performed. RESULTS: Skin stretching was associated with increased angiogenesis as demonstrated by CD31 staining and vessel corrosion casting where intervascular distance and vessel diameter were decreased (p<0.01). Immediately after stretching, VEGF dimers were increased. Messenger RNA expression of VEGF receptor 1, VEGF receptor 2, neuropilin 1, and neuropilin 2 was increased starting as early as 2 hours after stretching. Highly proliferating epidermal cells induced epidermal hypoxia starting at day 3 (p<0.01). CONCLUSIONS: Identification of significant hypoxic cells occurred after identification of neovessels, suggesting an alternative mechanism. Increased expression of angiogenic receptors and stabilization of VEGF dimers may be involved in a mechanotransductive, prehypoxic induction of neovascularization.