Defining Advising, Coaching, and Mentoring for Student Development in Medical Education.

Medical school curricula integrate classroom academic teaching, hands-on clinical training, longitudinal professional development, and identity formation to prepare students to enter the healthcare workforce as residents. Mentorship, coaching, and advising are well-recognized approaches used by educators to help young learners accomplish their personal and professional goals and objectives. However, undergraduate medical education literature has not clearly articulated the distinctions between the roles and core responsibilities of each guidance approach. Attempts to describe each role and responsibility have generated ambiguity and steered institutions towards implementing their own role-specific functions. The purpose of this paper is to establish a functional framework that may be used to differentiate the principal duties of a mentor, coach, and advisor in the context of undergraduate medical education (UME). Four key components are necessary to achieve this goal: (1) adopting a singular definition for each form of guidance; (2) characterizing each role based on unique skills; (3) describing the interplay between learner needs and educator capabilities; (4) training educators on how to effectively distinguish each form of guidance. Creating clear distinctions between mentors, coaches, and advisors in medical education will bolster students' academic experience and improve the educator-learner relationship. These definitions may also benefit faculty members by providing a clear framework for their responsibilities, which can be used for evaluations or determining future promotions.

Investigation of the Gender Distribution of National Institutes of Health Grants Across Six Surgical Specialties From 2015 to 2020: Toward Promoting Equity in Academic Surgery.

INTRODUCTION: There is a paucity of literature evaluating research-funding differences between male and female surgeons. Our study aims to evaluate possible disparities in the National Institutes of Health (NIH) grant awards by surgeon gender, type of medical degree (MD/DO), and advanced degrees among six surgery specialties: general surgeons, neurosurgeons, urologists, obstetricians/gynecologists, plastic, and orthopedic surgeons, from 2015 to 2020. METHODS: A retrospective cohort study was performed investigating the number of NIH grants received by male and female surgeon-scientists overall and within each listed specialty, 2015-2020. As a surrogate for grants submitted, the proportion of active surgeon-scientists per specialty was used. A priori level of significance was defined as P < 0.05. RESULTS: After adjusting for confounders, male surgeons had a higher mean number of NIH grants and higher grant funding than female surgeons (P < 0.001 for both). Type of medical degree (MD/DO) was not significantly associated with NIH funding. An advanced degree was associated with NIH funding among neurosurgeons only (P < 0.05). Differences in the proportion of active surgeon-scientists and proportion of NIH grants received by male and female surgeon-scientists were found only in the fields of orthopedic surgery (5.8% female surgeons and received 20.7% of grants, P = 0.003) and plastic surgery (17.2% female surgeons and received 33.3% of grants, P = 0.01). CONCLUSIONS: Male surgeons received most of the total surgical NIH grants. However, funding for female surgeons in orthopedic and plastic surgery outpaces that of their male counterparts when compared to gender proportions in their respective field. Future studies should further investigate the effects of additional applicant demographics on securing NIH grant funding.

The Effects of COVID-19 Pandemic on Trauma Registry and Performance Improvement Operations and Workforce Nationwide: A Survey of Trauma Center Association of America Members.

BACKGROUND: Trauma Centers integrate Trauma Registrars and Performance Improvement Nurses to drive quality care. Delays in their duties could have negative impacts on outcomes and performance. We aim to investigate the impact of COVID-19 pandemic on Trauma Center operations by assessing performance of trauma registry and performance improvement processes across the United States. METHODS: A cross-sectional study was performed utilizing data from two anonymous questionnaires distributed to Trauma Center Association of America members. Descriptive statistics, Fisher's Exact Test, and multivariable logistic regression were performed with statistical significance defined as P < 0.05. RESULTS: Of 90.2% (83) of Trauma Registrars and 85.9% (67) of Performance Improvement personnel reported that their Trauma Centers have treated COVID-19 patients. Among trauma registrars, respondents did not significantly differ in the current status of completing registry cases (P> 0.05), during COVID-19 compared to prior (P> 0.05), or adjusted odds of COVID-19 delaying completion of entries (P> 0.05). Having >2 Performance Improvement Nurses was significantly associated with improved performance during the COVID-19 pandemic (P= 0.03) whereas working at a Trauma Center which treats adults-only or mixed patient population (adult and pediatric) was associated with being 1-3 months behind in closing of performance improvement cases (P= 0.02). CONCLUSIONS: The negative impact of COVID-19 on Trauma Registrars and Performance Improvement Nurses has been minimal. Adequate staffing/experience seem to mitigate delays and decreased performance. Implementation of expanded staffing, improved training, and evidenced-based revision of Trauma Center logistics may help mitigate future disruptions relating to COVID-19 and allow Trauma Centers to recover and improve their operations.

Emergency Resuscitative Thoracotomy for Civilian Thoracic Trauma in the Field and Emergency Department Settings: A Systematic Review and Meta-Analysis.

BACKGROUND: Emergency department resuscitative thoracotomy (ED-RT) or prehospital resuscitative thoracotomy (PH-RT) is performed for trauma patients with impending or full cardiovascular collapse. This systematic review and meta-analysis analyze outcomes in patients with thoracic trauma receiving PH-RT and ED-RT. METHODS: PubMed, JAMA Network, and CINAHL electronic databases were searched to identify studies published on ED-RT or PH-RT between 2000-2020. Patients were grouped by location of procedure and type of thoracic injury (blunt versus penetrating). RESULTS: A total of 49 studies met the criteria for qualitative analysis, and 43 for quantitative analysis. 43 studies evaluated ED-RT and 5 evaluated PH-RT. Time from arrival on scene to PH-RT >5 min was associated with increased neurological complications and time from the initial encounter to PH-RT or ED-RT >10 min was associated with increased mortality. ISS ≥ 25 and absent signs of life were also associated with increased mortality. There was higher mortality in all PH-RT (93.5%) versus all ED-RT (81.8%) (P = 0.02). Among ED-RTs, a significant difference was found in mortality rate between patients with blunt (92.8%) versus penetrating (78.7%) injuries (P < 0.001). When considering only blunt or penetrating injury types, no significant difference in RT mortality rate was found between ED-RT and PH-RT (P = 0.65 and P = 0.95, respectively). CONCLUSIONS: ED-RT and PH-RT are potentially life-saving procedures for patients with penetrating thoracic injuries in extremis and with signs of life. The efficacy of this procedure is time sensitive. Moreover, there appears to be a greater mortality risk for patients with thoracic trauma receiving RT in the PH setting compared to the ED setting. More studies are needed to determine the significance of PH-RT mortality.

Sab mediates mitochondrial dysfunction involved in imatinib mesylate-induced cardiotoxicity.

Imatinib mesylate is an effective treatment for chronic myelogenous leukemia and gastrointestinal stromal tumors. Although imatinib mesylate is highly tolerable, it has been implicated in severe congestive heart failure in mouse models and patients. A hallmark of imatinib mesylate-induced cardiotoxicity is mitochondrial dysfunction. The mitochondrial scaffold Sab has been implicated in facilitating signaling responsible for mitochondrial dysfunction in a c-Jun N-terminal Kinase (JNK)-dependent manner. We examined the impact of Sab-mediated signaling on imatinib mesylate cardiotoxicity in H9c2 rat cardiomyocyte-like cells. Silencing Sab increased the LD50 of imatinib mesylate 4-fold in H9c2 cells. Disrupting Sab-mediated signaling prevented imatinib mesylate-induced apoptosis as well. Knockdown of Sab or inhibition with a small peptide prevented oxidative stress, which was indicated by decreased reactive oxygen species production, lipid peroxidation, and protein carbonylation. Further, inhibition of Sab-related signaling partially rescued deficits in mitochondrial respiration, ATP production, and membrane potential in imatinib mesylate-treated H9c2 cells. Conversely, over-expression of Sab in H9c2 cells increased the cardiotoxicity of imatinib mesylate in vitro decreasing the LD50 over 4-fold. Sab expression was induced in H9c2 cells following cardiovascular-like stress in an AP-1 dependent manner. These data demonstrate that imatinib mesylate influences mitochondrial signaling leading to mitochondrial dysfunction and cardiotoxicity.

SICODI, una propuesta de sistema para la gestión de información de reuniones y su empleo en la Unión Cuba-Petróleo / SICODI, a system proposal for management of information from meetings and its use en the Cuba-Petroleo Union

Se presenta el trabajo realizado en el desarrollo del Sistema de Información para los Órganos de Dirección (SICODI) de la Unión CubaPetróleo, para el que fue necesario plantearse como objetivos: diagnosticar el estado actual de la gestión de la información de la reuniones de dichos órganos, realizar el análisis y el diseño del sistema que garantizara el acceso, la actualización y la seguridad de la información y observar los resultados de su implantación. Se utilizaron los métodos teóricos de análisis y síntesis y el inductivo-deductivo con el fin de analizar el flujo de trabajo actual de los órganos de dirección de la Oficina Central de CUPET. Se realizaron entrevistas a las personas implicadas en el proceso de gestión de reuniones de los órganos de dirección y se utilizó el procedimiento de desarrollo de software del grupo de Sistemas de Información de la Oficina Central de CUPET. En el desarrollo del sistema fue utilizada una arquitectura Cliente-Servidor. Se empleó el lenguaje de programación C# y el Gestor de Base de Datos MS SQL Server. La implementación de esta aplicación resultó novedosa teniendo en cuenta el aporte a la gestión de información referente a las reuniones de los órganos de dirección y otras de la Oficina Central de CUPET, ya que no se conocía de otra en el mercado nacional con similares prestaciones. La realización del sistema constituye un ahorro significativo para la entidad, teniendo en cuenta los altos precios de las herramientas disponibles en el mercado para la gestión de información de reuniones.(AU)

This is a paper carried out in the development of Information Systems of the Management Organs (SICODI) of the CubaPetroleo Union, being necessary to propose the following objectives: to diagnose the current status of the information management from meetings of such organs, to made an analysis and a design of the system assuring the access, updating and safety of information and to observe the results of it implantation. Authors used the theoretical methods of analysis and synthesis and the inductive-deductive to analyze the flow of current work of management organs of the Central Office of CUPET, as well as interviews to staff involved in management process from meetings of management organs and the use of procedures of development of software of the group of Information System of the above mentioned central office. In the development of system authors used a client-supplier structure. Implementation of this application was novel taking into account the contribution to information management referring to meeting of management organs and other from the Central Office of CUPET, since there was not another known in the national market with a similar provision. The carrying out of system is a significant saving for the entity, considering the high prices of tools available in market for the information management from meetings.(AU)

SICODI, una propuesta de sistema para la gestión de información de reuniones y su empleo en la Unión Cuba-Petróleo / SICODI, a system proposal for management of information from meetings and its use en the Cuba-Petroleo Union

Se presenta el trabajo realizado en el desarrollo del Sistema de Información para los Órganos de Dirección (SICODI) de la Unión CubaPetróleo, para el que fue necesario plantearse como objetivos: diagnosticar el estado actual de la gestión de la información de la reuniones de dichos órganos, realizar el análisis y el diseño del sistema que garantizara el acceso, la actualización y la seguridad de la información y observar los resultados de su implantación. Se utilizaron los métodos teóricos de análisis y síntesis y el inductivo-deductivo con el fin de analizar el flujo de trabajo actual de los órganos de dirección de la Oficina Central de CUPET. Se realizaron entrevistas a las personas implicadas en el proceso de gestión de reuniones de los órganos de dirección y se utilizó el procedimiento de desarrollo de software del grupo de Sistemas de Información de la Oficina Central de CUPET. En el desarrollo del sistema fue utilizada una arquitectura Cliente-Servidor. Se empleó el lenguaje de programación C# y el Gestor de Base de Datos MS SQL Server. La implementación de esta aplicación resultó novedosa teniendo en cuenta el aporte a la gestión de información referente a las reuniones de los órganos de dirección y otras de la Oficina Central de CUPET, ya que no se conocía de otra en el mercado nacional con similares prestaciones. La realización del sistema constituye un ahorro significativo para la entidad, teniendo en cuenta los altos precios de las herramientas disponibles en el mercado para la gestión de información de reuniones.

This is a paper carried out in the development of Information Systems of the Management Organs (SICODI) of the CubaPetroleo Union, being necessary to propose the following objectives: to diagnose the current status of the information management from meetings of such organs, to made an analysis and a design of the system assuring the access, updating and safety of information and to observe the results of it implantation. Authors used the theoretical methods of analysis and synthesis and the inductive-deductive to analyze the flow of current work of management organs of the Central Office of CUPET, as well as interviews to staff involved in management process from meetings of management organs and the use of procedures of development of software of the group of Information System of the above mentioned central office. In the development of system authors used a client-supplier structure. Implementation of this application was novel taking into account the contribution to information management referring to meeting of management organs and other from the Central Office of CUPET, since there was not another known in the national market with a similar provision. The carrying out of system is a significant saving for the entity, considering the high prices of tools available in market for the information management from meetings.

Actitudes frente a la Eutanasia en los Hospitalaes Cayetano Heredia-Piura y Almanzor Aguinaga Asenjo-Chiclayo

Con el objetivo de determinar los conocimientos, actitudes y prácticas de la eutanasia de los médicos y enfermeras de las áreas críticas de los Hospitales Cayetano Heredia-Piura y Almazor Aguinaga Asenjo-Chiclayo, ambos pertenencientes al IPSS, se realizo un estudio transversal descriptivo, comparativo,observacional y prospectivo, mediante una encuesta anónima con items de filiación, conocimientos, actitudes y prácticas, preguntas de alternativa única y subpreguntas abiertas. Se entrevistaron 80 médicos y 70 enfermeras de ambos hospitales. El nível de conocimientos es adecuado, tanto para enfermeras 66.8 por ciento en Piura y 68 por ciento en Chiclayo; como en los médicos: 66.8 por ciento en Piura y 68.9 por ciento en Chiclayo. La actitud predominante es la aceptación. La práctica fue reconocida en médicos: 11 por ciento en Piura y 25 por ciento en Chiclayo; y en enfermeras 0 por ciento en ambos hospitales. Existe un adecuado nivel de conocimiento entre enfermeras y médicos, aunque la actitud es de aceptación son pocos los que reconocen la práctica.