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Article ; Online: Addressing unprofessional behaviors in the clinical learning environment: lessons from a multi-year virtual, intergenerational, interdisciplinary workshop.

Rose, Stacey / Kusnoor, Anita / Huynh, Phuong / Greely, Jocelyn / Rojas-Khalil, Yesenia / Kung, Doris / Gill, Anne / Ismail, Nadia / Appelbaum, Nital

Medical education online

2024 Volume 29, Issue 1, Page(s) 2316491

Abstract: Introduction: Optimizing the clinical learning environment (CLE) is a medical education priority nationwide.: Materials and methods: We developed a virtual, one-hour workshop engaging students, housestaff and faculty in small-group discussions of ... ...

Abstract	Introduction: Optimizing the clinical learning environment (CLE) is a medical education priority nationwide. Materials and methods: We developed a virtual, one-hour workshop engaging students, housestaff and faculty in small-group discussions of five case scenarios adapted from reported unprofessional behaviors in the CLE, plus didactics regarding mistreatment, microaggressions and bystander interventions. Results: Over two sessions (2021-2022), we engaged 340 students and 73 faculty/housestaff facilitators. Post-session surveys showed significant improvement in participants' ability to recognize and respond to challenges in the CLE. Discussion: Our innovative workshop, including scenarios derived from institutional reports of unprofessional behaviors, advanced participants' knowledge and commitment to improve the CLE.
MeSH term(s)	Humans ; Students, Medical ; Learning ; Faculty ; Professional Misconduct ; Education, Medical
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052877-2
ISSN	1087-2981 ; 1087-2981
ISSN (online)	1087-2981
ISSN	1087-2981
DOI	10.1080/10872981.2024.2316491
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Baylor School of Medicine.

Ismail, Nadia / Christner, Jennifer / Appelbaum, Nital / Monroe, Alicia

Academic medicine : journal of the Association of American Medical Colleges

2021 Volume 95, Issue 9S A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools, Page(s) S478–S481

Language	English
Publishing date	2021-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000003327
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Article: Characteristics of Critical Care Pharmacy Services in Saudi Arabia.

Ismail, Nadia H / Alhammad, Abdullah M / Alshaya, Abdulrahman I / Alkhani, Nada / Alenazi, Ahmed O / Aljuhani, Ohoud

Journal of multidisciplinary healthcare

2023 Volume 16, Page(s) 3227–3234

Abstract: Purpose: Critical care pharmacists (CCPs) in intensive care units (ICUs) are associated with improved patient outcomes, reduced adverse events (ADEs), and reduced mortality rates. This study aimed to describe the activities and pharmacy services ... ...

Abstract	Purpose: Critical care pharmacists (CCPs) in intensive care units (ICUs) are associated with improved patient outcomes, reduced adverse events (ADEs), and reduced mortality rates. This study aimed to describe the activities and pharmacy services provided by CCP in ICUs in hospitals in Saudi Arabia (SA). Methods: In this cross-sectional prospective study, a questionnaire was electronically sent to CCPs practicing in SA between September 2022 and January 2023. A modified version of a previously published and validated survey was sent to the Saudi Critical Care and Emergency Specialty Network. The questionnaire focused on four CCP activities: clinical, educational, scholarly, and administrative. The level of services was similarly classified into three domains: fundamental, optimal, and desirable. The responses were analyzed using descriptive statistics. Results: The study surveyed 44 CCPs in SA, with a response rate of 52.3%. These CCPs were predominantly located in the central (47.8%) and eastern (30.4%) regions. Hospitals' ICU bed capacity ranged from 10 to 100, with 82% reporting mixed medical and surgical ICUs. Most CCPs had 4-10 years of critical care experience, and 60% held advanced degrees, with a substantial portion having completed PGY-1 and PGY-2 pharmacy residencies. CCPs were actively involved in patient care, with 86.9% participating in multidisciplinary rounds five days a week. They were engaged in clinical, educational, and administrative activities, with 82.6% involved in retrospective research and educational activities. Furthermore, 78.2% were engaged in pharmacy and therapeutic committees, 56.5% in critical care committees, and 56.5% in pharmacy department policy development. Conclusion: The study reveals that CCPs in SA play integral roles in ICU patient care and contribute significantly to clinical, educational, and administrative activities. The study highlights the need for standardized CCP-to-patient ratios and further support for CCPs to expand their services, thus contributing to enhanced healthcare quality.
Language	English
Publishing date	2023-11-01
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2453343-9
ISSN	1178-2390
ISSN	1178-2390
DOI	10.2147/JMDH.S434116
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Article ; Online: Twelve tips for using the Understanding by Design

Newell, Alana D / Foldes, Cara A / Haddock, Alison J / Ismail, Nadia / Moreno, Nancy P

Medical teacher

2023 Volume 46, Issue 1, Page(s) 34–39

Abstract: Background: Health professions faculty engaged in curriculum planning or redesign can struggle with developing courses or programs that align desired learner outcomes, such as competencies to be applied in a clinical setting, with assessment and ... ...

Abstract	Background: Health professions faculty engaged in curriculum planning or redesign can struggle with developing courses or programs that align desired learner outcomes, such as competencies to be applied in a clinical setting, with assessment and instruction. Aims: Our medical school implemented the Understanding by Design (UbD) framework to achieve alignment of outcomes, assessments and teaching during the renewal of our four-year curriculum. This article shares our strategies and practices for implementing UbD with teams of faculty curriculum developers. Description: The UbD framework is a 'backward' approach to curriculum development that begins by identifying learner outcomes, followed by the development of assessments that demonstrate achievement of competencies and concludes with the design of active learning experiences. UbD emphasizes the development of deep understandings that learners can transfer to novel contexts. Conclusions: We found UbD to be a flexible, adaptable approach that aligns program and course-level outcomes with learner-centred instruction and principles of competency-based medical education and assessment.
MeSH term(s)	Humans ; Curriculum ; Problem-Based Learning ; Competency-Based Education ; Faculty
Language	English
Publishing date	2023-06-19
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.1080/0142159X.2023.2224498
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Article: Nebulized tranexamic acid for recurring hemoptysis in critically ill patients: case series.

Alabdrabalnabi, Fatimah / Alshahrani, Mohammed / Ismail, Nadia

International journal of emergency medicine

2020 Volume 13, Issue 1, Page(s) 45

Abstract: Background: Hemoptysis is a clinical condition encountered in the emergency department (ED) and must be managed and investigated urgently to maintain the patient's hemostasis. The management of hemoptysis depends on treating the underlying cause. ... ...

Abstract	Background: Hemoptysis is a clinical condition encountered in the emergency department (ED) and must be managed and investigated urgently to maintain the patient's hemostasis. The management of hemoptysis depends on treating the underlying cause. Tranexamic acid (TXA) is an anti-fibrinolytic drug used to systemically control bleeding. There are a few studies available that investigate the use of nebulized tranexamic acid for hemoptysis with contradictory results. Our paper demonstrates three cases where patients presented with significant hemoptysis and had significant improvement in symptoms following the administration of nebulized tranexamic acid. The overall need for blood transfusion was reduced. Results: Three patients presented to the emergency room for evaluation of hemoptysis. All three patients had different underlying pathologies resulting in their hemoptysis and were monitored in the ICU. Initial conventional medical therapies including the correction of coagulopathy and discontinuing offending agents were utilized for treatment. After persistent symptoms, nebulized TXA at a dose of 500 mg three times a day was administered. The patients were all discharged from the hospital with improvement in their symptoms. Conclusion: Tranexamic acid may be considered in the treatment of hemoptysis regardless of the underlying cause. This may be utilized pending further workup and investigation into the underlying source of the bleeding.
Language	English
Publishing date	2020-08-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2411462-5
ISSN	1865-1380 ; 1865-1372
ISSN (online)	1865-1380
ISSN	1865-1372
DOI	10.1186/s12245-020-00304-x
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Article ; Online: Near-peers effectively teach clinical documentation skills to early medical students.

Kusnoor, Anita Vijay / Balchandani, Rajeev / Pillow, Malford Tyson / Sherman, Stephanie / Ismail, Nadia

BMC medical education

2022 Volume 22, Issue 1, Page(s) 712

Abstract: Background: Composing the History of Present Illness (HPI), a key component of medical communication, requires critical thinking. Small group learning strategies have demonstrated superior effectiveness at developing critical thinking skills. Finding ... ...

Abstract	Background: Composing the History of Present Illness (HPI), a key component of medical communication, requires critical thinking. Small group learning strategies have demonstrated superior effectiveness at developing critical thinking skills. Finding sufficient faculty facilitators for small groups remains a major gap in implementing these sessions. We hypothesized that "near-peer" teachers could effectively teach HPI documentation skills and fill the gap of small group facilitators. Here, we present a head-to-head comparison of near-peer and faculty teaching outcomes. Methods: Second-year medical students in a single institution participated in an HPI Workshop as a clinical skills course requirement. Students were randomly assigned a near-peer or faculty facilitator for the workshop. We compared mean facilitator evaluation scores and performance assessments of students assigned to either type of facilitator. Results: Three hundred sixty-five students, 29 residents (near-peers) and 16 faculty participated. On post-session evaluations (5-point Likert scale), students ranked near-peer facilitators higher than faculty facilitators on encouraging participation and achieving the goals of the session (residents 4.9, faculty 4.8), demonstrating small, statistically significant differences between groups. Mean scores on written assessments after the workshop did not differ between the groups (29.3/30 for a written H&P and 9/10 for an HPI exam question). Conclusions: Near-peer facilitators were as effective as faculty facilitators for the HPI Workshop. Utilizing near-peers to teach HPI documentation skills provided teaching experiences for residents and increased the pool of available facilitators.
MeSH term(s)	Clinical Competence ; Documentation ; Humans ; Peer Group ; Students, Medical ; Teaching ; Thinking
Language	English
Publishing date	2022-10-08
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03790-0
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Article: Incidence and risk factors of adverse drug reactions in patients with coronavirus disease 2019: A pharmacovigilance experience utilizing an ADR trigger tool.

Alshehail, Bashayer / Al Jamea, Zainab / Chacko, Royes / Alotaibi, Fawaz / Ismail, Nadia / Alshayban, Dhafer

Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society

2022 Volume 30, Issue 4, Page(s) 407–413

Abstract: Background: Since the World Health Organization declared coronavirus disease (COVID-19) as a pandemic, most countries started treating their patients with various therapies. However, the data regarding their safety and effectiveness is still lacking.: ...

Abstract	Background: Since the World Health Organization declared coronavirus disease (COVID-19) as a pandemic, most countries started treating their patients with various therapies. However, the data regarding their safety and effectiveness is still lacking. Objectives: We aimed to evaluate the adverse drug reactions (ADRs) incidence and their predisposing factors among COVID-19 patients. Methods: A retrospective observational study that was conducted at a tertiary academic hospital from March - June 2020. Patients were included if they were ≥ 18 years old, inpatient, had a reverse transcriptase-polymerase chain reaction (PCR) positive for COVID-19, and were treated with; (lopinavir-ritonavir, hydroxychloroquine, chloroquine, favipiravir, ribavirin, or interferon-ß) either as monotherapy or combination therapy for three days or longer. The data of eligible patients were retrieved from the electronic medical records. A standardized data collection form was designed to collect patient demographics, COVID-19 severity based on the Saudi Ministry of Health management protocols, antiviral therapies, duration of therapy, and length of stay (LOS). The ADRs were identified via conducting a comprehensive review using predefined triggers and were evaluated using Naranjo Score. Results: A total of 155 patients were included of which 123 (79.4%) were males. In our sample, the incidence proportion of ADRs per patient was 72.3%. A total of 287 ADRs were identified most of them were hepatic (n = Conclusions: The ADRs are prevalent among COVID-19 patients, which assure the importance of implementing active hospital-based pharmacovigilance systems.
Language	English
Publishing date	2022-01-29
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1378024-4
ISSN	1319-0164
ISSN	1319-0164
DOI	10.1016/j.jsps.2022.01.021
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Article ; Online: Strategies for Advancing Equity in Frontline Clinical Assessment.

Onumah, Chavon M / Pincavage, Amber T / Lai, Cindy J / Levine, Diane L / Ismail, Nadia J / Alexandraki, Irene / Osman, Nora Y

Academic medicine : journal of the Association of American Medical Colleges

2023 Volume 98, Issue 8S, Page(s) S57–S63

Abstract: Educational equity in medicine cannot be achieved without addressing assessment bias. Assessment bias in health professions education is prevalent and has extensive implications for learners and, ultimately, the health care system. Medical schools and ... ...

Abstract	Educational equity in medicine cannot be achieved without addressing assessment bias. Assessment bias in health professions education is prevalent and has extensive implications for learners and, ultimately, the health care system. Medical schools and educators desire to minimize assessment bias, but there is no current consensus on effective approaches. Frontline teaching faculty have the opportunity to mitigate bias in clinical assessment in real time. Based on their experiences as educators, the authors created a case study about a student to illustrate ways bias affects learner assessment. In this paper, the authors use their case study to provide faculty with evidence-based approaches to mitigate bias and promote equity in clinical assessment. They focus on 3 components of equity in assessment: contextual equity, intrinsic equity, and instrumental equity. To address contextual equity, or the environment in which learners are assessed, the authors recommend building a learning environment that promotes equity and psychological safety, understanding the learners' contexts, and undertaking implicit bias training. Intrinsic equity, centered on the tools and practices used during assessment, can be promoted by using competency-based, structured assessment methods and employing frequent, direct observation to assess multiple domains. Instrumental equity, focused on communication and how assessments are used, includes specific, actionable feedback to support growth and use of competency-based narrative descriptors in assessments. Using these strategies, frontline clinical faculty members can actively promote equity in assessment and support the growth of a diverse health care workforce.
MeSH term(s)	Humans ; Learning ; Students ; Curriculum ; Educational Measurement/methods ; Delivery of Health Care
Language	English
Publishing date	2023-07-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000005246
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Article ; Online: Variations in Medical Students' Educational Preferences, Attitudes and Volunteerism during the COVID-19 Global Pandemic.

Appelbaum, Nital P / Misra, Sanghamitra M / Welch, Jennifer / Humphries, M Harrison / Sivam, Sunthosh / Ismail, Nadia

Journal of community health

2021 Volume 46, Issue 6, Page(s) 1204–1212

Abstract: Public health crises require individuals, often volunteers, to help minimize disasters. The COVID-19 pandemic required such activation of individuals, but little is known about medical students' preferences of such engagement. We investigated potential ... ...

Abstract	Public health crises require individuals, often volunteers, to help minimize disasters. The COVID-19 pandemic required such activation of individuals, but little is known about medical students' preferences of such engagement. We investigated potential variations in medical students' educational preferences, attitudes, and volunteerism during the COVID-19 pandemic based on socio-demographics to better prepare for future activation scenarios. A web-based, anonymous survey of U.S. medical students at a single institution was conducted in May 2020. Across four training year, 518 (68% response rate) students completed the survey. During the pandemic, 42.3% (n = 215) wanted to discontinue in-person clinical experiences, 32.3% (n = 164) wanted to continue, and 25.4% (n = 129) were neutral. There was no gender effect for engagement in volunteer activities or preference to engage in clinical activities during the pandemic. However, second-year (n = 59, 11.6%) and third-year students (n = 58, 11.4%) wanted to continue in-person clinical experiences at a greater proportion than expected, while a small proportion of fourth-year students (n = 17, 3.3%) wanted to continue, χ
MeSH term(s)	Attitude ; COVID-19 ; Humans ; Pandemics ; SARS-CoV-2 ; Students, Medical ; Volunteers
Language	English
Publishing date	2021-06-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	426631-6
ISSN	1573-3610 ; 0094-5145
ISSN (online)	1573-3610
ISSN	0094-5145
DOI	10.1007/s10900-021-01009-9
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Article ; Online: Aiming for Equity in Clerkship Grading: Recommendations for Reducing the Effects of Structural and Individual Bias.

Onumah, Chavon M / Lai, Cindy J / Levine, Diane / Ismail, Nadia / Pincavage, Amber T / Osman, Nora Y

The American journal of medicine

2021 Volume 134, Issue 9, Page(s) 1175–1183.e4

MeSH term(s)	Clinical Clerkship/methods ; Education, Medical, Undergraduate/methods ; Education, Medical, Undergraduate/organization & administration ; Educational Measurement/methods ; Educational Measurement/standards ; Faculty, Medical/organization & administration ; Humans ; Needs Assessment ; Reference Standards ; Social Environment
Language	English
Publishing date	2021-06-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2021.06.001
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