Windsor Westbrook Sherrill

Tolerance of ambiguity among MD/MBA students: Implications for management potential

Background: Health care is increasingly characterized by uncertainty and turbulence. In an environment of rapid change, flexibility is critical to the success of managers and organizations. Future physician executives must also be open to change and must be able to deal with the uncertainties of management; they must be able to tolerate the ambiguity in management situations. Method: This study uses tolerance of ambiguity measures to analyze students at six medical schools offering dual‐degree (MD/MBA) programs. Students enrolled in dual‐degree programs were assessed and compared with a control group of traditional medical students. Results: MD/MBA students exhibit a higher tolerance of ambiguity than traditional medical students. Findings: As a characteristic associated with leadership ability, tolerance of ambiguity offers a potential indicator of future success as a physician executive. As such, tolerance of ambiguity might be used for selective admissions to medical school and as an indicator of a students potential to transition between clinical and management functions. As students match personality traits with career choices, those who serve their learning needs must anticipate differences across selected disciplines, roles, and responsibilities.

Integrating Bioterrorism Education into Nursing School Curricula

Due to the events of September 11, 2001 and the bioterrorism-related anthrax episodes, the United States has escalated efforts to better prepare the nation for terrorist attacks. Early recognition and management of a biological attack are largely dependent on the clinical expertise of frontline health care personnel. Nurses are recognized as an integral part of this team. Schools of nursing should integrate bioterrorism education into their curricula to address this growing frontier of health care management. This article outlines the necessary components of bioterrorism education for nurses, reviews examples of available resources to facilitate its inclusion, and suggests ways to integrate this material into nursing curricula.

Targeting cardiovascular risk: Early identification of insulin resistance

PurposesTo review current data regarding the known pathophysiology of insulin resistance and its associated sequelae related to cardiovascular risk, to discuss the current measures for insulin sensitivity and studies associated with measures of insulin resistance, and to summarize the impact of insulin resistance. Data sourcesCINAHL, Health and Wellness Resource Center, and Medline. FindingsInsulin resistance yields a diminished sensitivity of key target cells to the actions of insulin and is present early in the course of insulin resistance syndrome, also known as metabolic syndrome, leading to prediabetes and cardiovascular disease approximately 10 years before the diagnosis of type 2 diabetes. Implications for practiceEarly identification of insulin-resistant individuals would allow extra time for preventive measures and may alter the progression of the development of associated cardiovascular risk. A recommendation for a treatment plan of identified insulin-resistant individuals is provided.

Guidelines for public health practitioners serving as student preceptors.

Student fieldwork and service learning are valuable strategies for developing the skills of future public health professionals. Practitioners who serve as preceptors to students often receive little preparation for guiding and evaluating students. Findings from a review of fieldwork and service learning literature and a program evaluation of an undergraduate public health program at a large southern public university were used to construct guidelines for the practitioners supervising students in the field. These guidelines should aid practitioners in their role as preceptors of public health students. The guidelines address assessing student competencies, developing student competencies, writing learning objectives, evaluating students, maximizing the student precept or relationship, and managing problems.

Early Treatment for Neonatal Abstinence Syndrome: A Palliative Approach.

Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid‐exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted. Per birth, mean hospital charges were

Cutting Corners Provider Perceptions of Interpretation Services and Factors Related to Use of an Ad Hoc Interpreter

10,946.96; mean costs were

Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006–2014

5,908.93. Conclusion This study is the first to describe an early treatment model in a low‐acuity nursery to prevent severe neonatal opioid withdrawal. The described model may be safe, effective, low‐cost, and feasible for replication.

Assessing medical student cultural competence: what really matters

Introduction: This study assessed health providers’ perceptions of factors related to professional interpretation services and the association between these factors and the potential use of ad hoc interpreters. Method: Data were collected from a convenience sample of 150 health services providers at a large, regional health system in South Carolina. Results: Providers rated “ability to communicate effectively during a clinical encounter” as paramount regarding the use of interpretation services. The most important factors related to the likely use of ad hoc interpreters (cutting corners) included locating a qualified interpreter, having to wait for a qualified interpreter, and technical difficulties regarding phone and video technology. Conclusion: Health care organizations may benefit from increasing staff awareness about patient safety and legal and regulatory risks involved with the use of ad hoc interpreters.

Enhancing patient–provider communication through bibliotherapy: A brief historical review

BACKGROUND Few coordinated treatment programs address the needs of infants and families struggling with the effects of substance use. In 2003 a large Southeastern regional hospital launched the Managing Abstinence in Newborns (MAiN) program, providing multidisciplinary, coordinated, community-based care for neonatal abstinence syndrome (NAS). A hypothesis-generating study was conducted to compare the outcomes of MAiN infants to comparable NAS infants receiving traditional care from 2006 through 2014 in South Carolina. METHODS De-identified sociodemographic and clinical data on MAiN infants, as well as NAS infants not treated with MAiN, were obtained from South Carolina statewide databases. Study measures included medical and safety outcomes, health services utilization, child protective services involvement, emergency services utilization, and inpatient readmissions. RESULTS Some 110 infants were identified who received the MAiN intervention and 356 NAS infants, also in South Carolina, who were potentially MAiN eligible. Overall, there were no significant differences in the two groups regarding medical or safety outcomes or child protective services involvement. Traditional care NAS infants were more likely to be treated in a higher-level nursery (68.8% vs. 0%). MAiN infants had

Content, Placement, and Acquisition of Cancer Education for Latino Patient Care: A Qualitative Study of Medical and Nursing Students

8,204 less per birth in median charges (p <0.001) than the traditional care NAS infants. MAiN infants also had a lower percentage of ED visits (p = 0.01) assessed as possibly or likely NAS related compared to traditional care NAS infants. CONCLUSION This study demonstrates the potential value of implementing the MAiN model in eligible NAS infants. With no difference in medical and safety outcomes and a significant reduction in charges, the MAiN model can be considered safe and cost-effective.