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Article ; Online: Symptomatic morgagni hernia misdiagnosed as chilaiditi syndrome.

Vallee, Phyllis A

The western journal of emergency medicine

2010 Volume 12, Issue 1, Page(s) 121–123

Abstract: Chilaiditi syndrome, symptomatic interposition of bowel beneath the right hemidiaphragm, is uncommon and usually managed without surgery. Morgagni hernia is an uncommon diaphragmatic hernia that generally requires surgery. In this case a patient with a ... ...

Abstract	Chilaiditi syndrome, symptomatic interposition of bowel beneath the right hemidiaphragm, is uncommon and usually managed without surgery. Morgagni hernia is an uncommon diaphragmatic hernia that generally requires surgery. In this case a patient with a longstanding diagnosis of bowel interposition (Chilaiditi sign) presented with presumed Chilaiditi syndrome. Abdominal computed tomography was performed and revealed no bowel interposition; instead, a Morgagni hernia was found and surgically repaired. Review of the literature did not reveal similar misdiagnosis or recommendations for advanced imaging in patients with Chilaiditi sign or syndrome to confirm the diagnosis or rule out other potential diagnoses.
Language	English
Publishing date	2010-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Symptomatic Morgagni Hernia Misdiagnosed As Chilaiditi Syndrome

Vallee, Phyllis A

Western Journal of Emergency Medicine, Vol 12, Iss 1, Pp 121-

2011 Volume 123

Abstract	Chilaiditi syndrome, symptomatic interposition of bowel beneath the right hemidiaphragm, is uncommon and usually managed without surgery. Morgagni hernia is an uncommon diaphragmatic hernia that generally requires surgery. In this case a patient with a longstanding diagnosis of bowel interposition (Chilaiditi sign) presented with presumed Chilaiditi syndrome. Abdominal computed tomography was performed and revealed no bowel interposition; instead, a Morgagni hernia was found and surgically repaired. Review of the literature did not reveal similar misdiagnosis or recommendations for advanced imaging in patients with Chilaiditi sign or syndrome to confirm the diagnosis or rule out other potential diagnoses. [West J Emerg Med. 2011;12(1):121-123.]
Keywords	Chilaiditi sign ; Chilaiditi syndrome ; bowel interposition ; Morgagni hernia ; diaphragmatic hernia ; congenital diaphragmatic hernia ; Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Language	English
Publishing date	2011-02-01T00:00:00Z
Publisher	eScholarship Publishing, University of California
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Clerkships in Emergency Medicine.

Garmel, Gus M / Pettis, Heather M / Lane, David R / Darvish, Amir / Winters, Michael / Vallee, Phyllis / Mattu, Amal / Haydel, Micelle J / Cheaito, Mohamad Ali / Bond, Michael C / Kazzi, Amin

The Journal of emergency medicine

2020 Volume 58, Issue 4, Page(s) e215–e222

Abstract: Planning for clerkships in emergency medicine (EM) can be stressful, prolonged, and challenging. Therefore, medical students should start planning for them early. In this article, we offer guidance regarding several issues pertinent to the EM clerkship, ... ...

Abstract	Planning for clerkships in emergency medicine (EM) can be stressful, prolonged, and challenging. Therefore, medical students should start planning for them early. In this article, we offer guidance regarding several issues pertinent to the EM clerkship, such as the best time to schedule one (or more) during medical school, the most appropriate institution or program to schedule it, the process of selecting and applying for the clerkship, and the number of EM clerkships to consider. We will explain why an EM clerkship should be scheduled between June and October and the reason that 2 EM clerkships at different sites are sufficient for the majority of students. Additionally, we emphasize that clerkships in emergency departments associated with EM residency programs or with reputations for outstanding student teaching tend to be most beneficial. Above all, students interested in EM should attempt to leave a great impression after completing their clerkships by providing stellar patient care, demonstrating enthusiasm at all times, and maintaining professionalism. In turn, they will gain knowledge and clinical experiences that should prove valuable in their future.
MeSH term(s)	Clinical Clerkship ; Emergency Medicine/education ; Emergency Service, Hospital ; Humans ; Schools, Medical ; Students, Medical
Language	English
Publishing date	2020-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2019.11.024
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Article ; Online: "They're Doing Their Job": Women's Acceptance of Emergency Department Contraception Counseling.

Caldwell, Martina T / Hambrick, Nanci / Vallee, Phyllis / Thomas, Celia S D / Sutton, April / Daniels, Gwendolyn / Goyal, Nikhil / Manteuffel, Jacob / Joseph, Christine L M / Guetterman, Timothy C

Annals of emergency medicine

2020 Volume 76, Issue 4, Page(s) 515–526

Abstract: Study objective: We explore reproductive-aged women's acceptance of contraception counseling in the emergency department (ED).: Methods: This study is phase 1 of an exploratory sequential mixed methods study. We purposively interviewed 31 ... ...

Abstract	Study objective: We explore reproductive-aged women's acceptance of contraception counseling in the emergency department (ED). Methods: This study is phase 1 of an exploratory sequential mixed methods study. We purposively interviewed 31 participants with the following criteria: black, white, or Latina race/ethnicity; nonpregnant; aged 15 to 44 years; receiving nonemergency care; not using highly effective contraception; and did not intend to become pregnant. We conducted semistructured interviews with a piloted interview guide until reaching thematic saturation. We coded transcripts with an iteratively developed codebook, maintaining intercoder agreement greater than 80%. Qualitative acceptance of ED contraception counseling was grouped into 3 categories: acceptable, unacceptable, and equivocal. We conducted a thematic text analysis to assess themes expressing support and concern for ED contraception counseling. Qualitative findings were stratified by age, race, and frequency of ED use. Using components of grounded theory, we developed a conceptual model. Results: Most participants (81%) accepted ED contraception counseling. Themes expressing support and concern for ED contraception counseling included opportunity to address women's unmet contraception needs, contraception is within the scope of ED practice, the ED is a convenient setting with competent providers, contraception is a sensitive topic, and the ED may be an inappropriate setting for some women. Latina participants had lower acceptance of ED contraception counseling. Dominant subthemes varied slightly by race, age, and frequency of ED use. Conclusion: Diverse women had high acceptance of contraception counseling in the ED. Perspectives expressing both support and concern in regard to ED contraception counseling were explored in detail.
MeSH term(s)	Adolescent ; Adult ; Continental Population Groups/statistics & numerical data ; Contraception Behavior/psychology ; Contraception Behavior/statistics & numerical data ; Contraceptive Agents/therapeutic use ; Counseling/methods ; Counseling/standards ; Counseling/statistics & numerical data ; Emergency Service, Hospital/organization & administration ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Interviews as Topic/methods ; Patient Acceptance of Health Care/psychology ; Patient Acceptance of Health Care/statistics & numerical data ; Qualitative Research ; Surveys and Questionnaires
Chemical Substances	Contraceptive Agents
Language	English
Publishing date	2020-01-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2019.10.014
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Article ; Online: WIREd for Milestones.

Goyal, Nikhil / Vallee, Phyllis A / Folt, Jason / Jaskulka, Bradley / Baliga, Sudhir / Nagarwala, Jumana / Slezak, Michelle

Journal of graduate medical education

2016 Volume 8, Issue 3, Page(s) 445–446

MeSH term(s)	Education, Medical, Graduate ; Emergency Medicine ; Evaluation Studies as Topic ; Humans ; Internship and Residency/organization & administration ; Software
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2578612-X
ISSN	1949-8357 ; 1949-8349
ISSN (online)	1949-8357
ISSN	1949-8349
DOI	10.4300/JGME-D-15-00638.1
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Article ; Online: Clinician Absences and Contributing Factors During a COVID-19 Surge: Potential Areas for Intervention and Planning.

Grahf, Daniel / Dandashi, Jad / Deledda, John / Vallee, Phyllis / Vohra, Taher

The western journal of emergency medicine

2022 Volume 23, Issue 2, Page(s) 124–128

Abstract: Introduction: Our goal was to quantify healthcare clinician (HCC) absenteeism in the emergency department (ED) during the coronavirus disease 2019 (COVID-19) surge and to identify potential interventions that may mitigate the number of absences.: ... ...

Abstract	Introduction: Our goal was to quantify healthcare clinician (HCC) absenteeism in the emergency department (ED) during the coronavirus disease 2019 (COVID-19) surge and to identify potential interventions that may mitigate the number of absences. Methods: This was a retrospective, descriptive record review that included 82 resident physicians, physician assistants, and staff physicians who were scheduled to work more than three clinical shifts during March 2020 in an urban, academic ED that received a high number of coronavirus disease 2019 (COVID-19) patients. Exposure was defined as a healthcare clinician who was not wearing appropriate personal protective equipment (PPE) having contact with a confirmed COVID-19 positive patient in the ED. The main outcome was the number of HCC absences secondary to exposure to or symptoms concerning for COVID-19. Results: During March 2020, of 82 ED HCCs, 28 (34%) required an absence from clinical duties, totaling 152 absentee calendar days (N = 13 women [46%]; N = 15 men [54%]). Median HCC age was 32 years (interquartile range 28-39), and median number of days absent was four (interquartile range 3-7). While 16 (57%) of the total absences were secondary to a known exposure, 12 (43%) were symptomatic without a known exposure. A total of 25 (89%) absent HCCs received COVID-19 testing (N = 5 positive [20%]; N = 20 negative [80%]) with test results returning in 1-10 days. Eleven (39%) symptomatic HCCs had traveled domestically or internationally in the prior 30 days. Conclusion: Emergency departments should anticipate substantial HCC absences during the initial surge of a pandemic. Possible interventions to mitigate absences include early and broad use of PPE, planning for many asymptomatic HCC absences secondary to exposures, prioritizing HCC virus testing, and mandating early travel restrictions.
MeSH term(s)	Absenteeism ; Adult ; COVID-19 ; COVID-19 Testing ; Female ; Humans ; Male ; Personal Protective Equipment ; Retrospective Studies
Language	English
Publishing date	2022-02-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
DOI	10.5811/westjem.2021.11.52715
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Article ; Online: Reformatted images of the thoracic and lumbar spine following CT of chest, abdomen, and pelvis in the setting of blunt trauma: are they necessary?

Carter, Britton / Griffith, Brent / Mossa-Basha, Feras / Zintsmaster, Stephen A / Patel, Suresh / Williams, Todd R / Patton, Pat / Vallee, Phyllis A

Emergency radiology

2015 Volume 22, Issue 4, Page(s) 373–378

Abstract: Injuries involving the thoracic and lumbar (TL) spine in the setting of blunt trauma are not uncommon. At our institution, CT of the chest, abdomen, and pelvis (CT CAP) with dedicated reformatted images of the thoracolumbar spine (CT TL) is part of the ... ...

Abstract	Injuries involving the thoracic and lumbar (TL) spine in the setting of blunt trauma are not uncommon. At our institution, CT of the chest, abdomen, and pelvis (CT CAP) with dedicated reformatted images of the thoracolumbar spine (CT TL) is part of the standard work-up of patients following significant blunt trauma. The purpose of this study was to compare the detection rate of TL spine fractures on routine trauma CT CAP with reformatted CT TL spine images and determine whether these reformatted images detect additional fractures and if these altered patient management. The imaging records of 1000 consecutive patients who received blunt trauma protocol CT CAP with CT TL spine reformats were reviewed to determine identification of TL spine fracture in each report. Fracture type and location were documented. Of the 896 patients, 66 (7.4 %) had fractures of the TL spine identified on either CT CAP or CT TL spine. Of these 66 patients, 40 (60.6 %) had fractures identified on both CT CAP and CT TL spine and 24 (36.4 %) had fractures identified on CT TL spine images alone. Fourteen patients required treatment with surgery or bracing, 4 (28.6 %) of which had fractures identified on reformatted TL spine imaging only. In conclusion, a significant number of fractures are detected on TL spine reformats that are not identified on CT CAP alone, altering patient management in a few cases and suggesting that dedicated TL spine reformats should be a standard part of the work-up of blunt trauma patients.
MeSH term(s)	Adult ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/injuries ; Male ; Radiographic Image Interpretation, Computer-Assisted/methods ; Retrospective Studies ; Spinal Fractures/diagnostic imaging ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries ; Tomography, X-Ray Computed/methods ; Wounds, Nonpenetrating/diagnostic imaging
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-015-1295-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 4880: Show issues

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Article: A multicenter study of the family educational rights and privacy act and the standardized letter of recommendation: impact on emergency medicine residency applicant and faculty behaviors.

Diab, Jessica / Riley, Stephanie / Downes, Andrew / Gaeta, Theodore / Hern, H Gene / Hwang, Eric / Kass, Lawrence / Kelly, Michael / Luber, Samuel D / Martel, Marc / Minns, Alicia / Patterson, Leigh / Pazderka, Philip / Sayan, Osman / Thurman, Jason / Vallee, Phyllis / Overton, David

Journal of graduate medical education

2014 Volume 6, Issue 2, Page(s) 292–295

Abstract: Background: Residency applicants have the right to see letters of recommendation written on their behalf. It is not known whether applicants are affected by waiving this right.: Objectives: Our multicenter study assessed how frequently residency ... ...

Abstract	Background: Residency applicants have the right to see letters of recommendation written on their behalf. It is not known whether applicants are affected by waiving this right. Objectives: Our multicenter study assessed how frequently residency applicants waived their FERPA rights to view their letters of recommendation, and whether this affected the ratings they were given by faculty. Methods: We reviewed all ERAS-submitted letters of recommendation to 14 ACGME-accredited programs in 2006-2007. We collected ERAS ID, program name, FERPA declaration, standardized letter of recommendation (SLOR) use, and SLOR Global Assessment ranking. The percentage of applicants who waived their FERPA rights was determined. Chi-square tests of independence assessed whether applicants' decision to waive their FERPA rights was associated with their SLOR Global Assessment. Results: We examined 1776 applications containing 6424 letters of recommendations. Of 2736 letters that specified a Global Assessment, 2550 (93%) applicants waived their FERPA rights, while 186 did not. Of the applicants who chose not to waive their rights, 45.6% received a ranking of Outstanding, 35.5% Excellent, 18.3% Very Good, and 1.6% Good. Of applicants who waived their FERPA rights, 35.1% received a ranking of Outstanding, 49.6% Excellent, 13.7% Very Good, and 1.6% Good. Applicants who did not waive their FERPA rights were more likely to receive an Outstanding Assessment (P = .003). Conclusions: The majority (93%) of residency applicants waived their FERPA rights. Those who did not waive their rights had a statistically higher chance of receiving an Outstanding Assessment than those who did.
Language	English
Publishing date	2014-05-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2578612-X
ISSN	1949-8357 ; 1949-8349
ISSN (online)	1949-8357
ISSN	1949-8349
DOI	10.4300/JGME-D-13-00179.1
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Article ; Online: Assessment methods and resource requirements for milestone reporting by an emergency medicine clinical competency committee.

Goyal, Nikhil / Folt, Jason / Jaskulka, Bradley / Baliga, Sudhir / Slezak, Michelle / Schultz, Lonni R / Vallee, Phyllis

Medical education online

2018 Volume 23, Issue 1, Page(s) 1538925

Abstract: Background: The Accreditation Council for Graduate Medical Education (ACGME) introduced milestones for Emergency Medicine (EM) in 2012. Clinical Competency Committees (CCC) are tasked with assessing residents on milestones and reporting them to the ... ...

Abstract	Background: The Accreditation Council for Graduate Medical Education (ACGME) introduced milestones for Emergency Medicine (EM) in 2012. Clinical Competency Committees (CCC) are tasked with assessing residents on milestones and reporting them to the ACGME. Appropriate workflows for CCCs are not well defined. Objective: Our objective was to compare different approaches to milestone assessment by a CCC, quantify resource requirements for each and to identify the most efficient workflow. Design: Three distinct processes for rendering milestone assessments were compared: Full milestone assessments (FMA) utilizing all available resident assessment data, Ad-hoc milestone assessments (AMA) created by multiple expert educators using their personal assessment of resident performance, Self-assessments (SMA) completed by residents. FMA were selected as the theoretical gold standard. Intraclass correlation coefficients were used to analyze for agreement between different assessment methods. Kendall's coefficient was used to assess the inter-rater agreement for the AMA. Results: All 13 second-year residents and 7 educational faculty of an urban EM Residency Program participated in the study in 2013. Substantial or better agreement between FMA and AMA was seen for 8 of the 23 total subcompetencies (PC4, PC8, PC9, PC11, MK, PROF2, ICS2, SBP2), and for 1 subcompetency (SBP1) between FMA and SMA. Multiple AMA for individual residents demonstrated substantial or better interobserver agreement in 3 subcompetencies (PC1, PC2, and PROF2). FMA took longer to complete compared to AMA (80.9 vs. 5.3 min, p < 0.001). Conclusions: Using AMA to evaluate residents on the milestones takes significantly less time than FMA. However, AMA and SMA agree with FMA on only 8 and 1 subcompetencies, respectively. An estimated 23.5 h of faculty time are required each month to fulfill the requirement for semiannual reporting for a residency with 42 trainees.
MeSH term(s)	Accreditation ; Adult ; Advisory Committees ; Clinical Competence ; Educational Measurement/methods ; Emergency Medicine/education ; Female ; Health Resources ; Humans ; Male ; Middle Aged
Language	English
Publishing date	2018-10-30
Publishing country	United States
Document type	Journal Article
ISSN	1087-2981
ISSN (online)	1087-2981
DOI	10.1080/10872981.2018.1538925
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Assessment methods and resource requirements for milestone reporting by an emergency medicine clinical competency committee

Nikhil Goyal / Jason Folt / Bradley Jaskulka / Sudhir Baliga / Michelle Slezak / Lonni R. Schultz / Phyllis Vallee

Medical Education Online, Vol 23, Iss

2018 Volume 1

Abstract	Background: The Accreditation Council for Graduate Medical Education (ACGME) introduced milestones for Emergency Medicine (EM) in 2012. Clinical Competency Committees (CCC) are tasked with assessing residents on milestones and reporting them to the ACGME. Appropriate workflows for CCCs are not well defined. Objective: Our objective was to compare different approaches to milestone assessment by a CCC, quantify resource requirements for each and to identify the most efficient workflow. Design: Three distinct processes for rendering milestone assessments were compared: Full milestone assessments (FMA) utilizing all available resident assessment data, Ad-hoc milestone assessments (AMA) created by multiple expert educators using their personal assessment of resident performance, Self-assessments (SMA) completed by residents. FMA were selected as the theoretical gold standard. Intraclass correlation coefficients were used to analyze for agreement between different assessment methods. Kendall’s coefficient was used to assess the inter-rater agreement for the AMA. Results: All 13 second-year residents and 7 educational faculty of an urban EM Residency Program participated in the study in 2013. Substantial or better agreement between FMA and AMA was seen for 8 of the 23 total subcompetencies (PC4, PC8, PC9, PC11, MK, PROF2, ICS2, SBP2), and for 1 subcompetency (SBP1) between FMA and SMA. Multiple AMA for individual residents demonstrated substantial or better interobserver agreement in 3 subcompetencies (PC1, PC2, and PROF2). FMA took longer to complete compared to AMA (80.9 vs. 5.3 min, p < 0.001). Conclusions: Using AMA to evaluate residents on the milestones takes significantly less time than FMA. However, AMA and SMA agree with FMA on only 8 and 1 subcompetencies, respectively. An estimated 23.5 h of faculty time are required each month to fulfill the requirement for semiannual reporting for a residency with 42 trainees.
Keywords	Accreditation ; graduate medical education ; milestones ; assessment ; cost ; clinical competency committee ; Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	710
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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