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1. Smoking Cessation Counseling in the Inpatient Unit: A Survey of Pediatric Hospitalists

Author

Edward J. Gracely, Karen M. Wilson, E. Douglas Thompson, and Blair Dickinson

Subjects
Counseling, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Pediatrics, 03 medical and health sciences, Third-hand smoke, 0302 clinical medicine, Pharmacotherapy, McNemar's test, 030225 pediatrics, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Child, Asthma, Inpatients, business.industry, General Medicine, medicine.disease, Former Smoker, Test (assessment), Hospitalists, Family medicine, Pediatrics, Perinatology and Child Health, Smoking cessation, Smoking Cessation, Tobacco Smoke Pollution, business
Abstract

OBJECTIVES: To determine practices and beliefs of pediatric hospitalists regarding smoking cessation counseling for caregivers of hospitalized children. METHODS: An electronic survey was distributed to 249 members of the Pediatric Research in Inpatient Settings Network over 6 weeks in 2017 (83 responses [33%]). Questions explored beliefs regarding the impact of tobacco smoke exposure (TSE) and practices in TSE screening, provision of counseling, resources, and pharmacotherapy. Nonparametric tests were used to compare groups on numeric variables, χ2 tests were used to compare groups on nominal variables, and McNemar’s test was used to compare dichotomous responses within subjects. RESULTS: All respondents were familiar with the term “secondhand smoke,” and >75% were familiar with “thirdhand smoke” (THS). Familiarity with THS was associated with more recent completion of training (P = .04). Former smokers (7%) were less likely to agree that THS has a significant impact on a child’s health (P = .04). Hospitalists ask about TSE more often than they provide counseling, resources, or pharmacotherapy to caregivers who want to quit smoking. Hospitalists are more likely to ask about TSE and provide cessation counseling when patients have asthma as opposed to other diseases. Time was identified by 41% of respondents as a barrier for providing counseling and by 26% of respondents as a barrier for providing resources. Most respondents never prescribe pharmacotherapy (72%), nor do they follow-up with caregivers after hospitalization regarding cessation (87%). CONCLUSIONS: Although most respondents ask about TSE, opportunities are missed for counseling and providing support to caregivers who want to quit smoking. Providers should be educated about THS, and systems should be streamlined to facilitate brief counseling sessions.

Published
2021

2. Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study

Author

Amy Guiot, Joseph O. Lopreiato, Glenn Rosenbluth, Elizabeth Kruvand, Sharon Cray, Kate Langrish, H. Shonna Yin, Briana M. Garcia, Dale Ann Micalizzi, Theodore C. Sectish, Shilpa J. Patel, Amy J. Starmer, Maitreya Coffey, Nancy D. Spector, Brian Good, Alisa Khan, Catherine Yoon, Helen Haskell, Daniel C. West, Lauren Destino, Katherine P. Litterer, Christopher P. Landrigan, Sharon Calaman, Aarti Patel, Irene Kocolas, Jennifer L. Everhart, Michele Ashland, Clifton E. Yu, Kheyandra Lewis, Jayne Rogers, Rajendu Srivastava, Jennifer Hepps, E. Douglas Thompson, Zia Bismilla, Jennifer Baird, Benard P. Dreyer, Stuart R. Lipsitz, Rebecca Blankenburg, Jennifer K. O'Toole, Anupama Subramony, Nicholas Kuzma, Wilma Alvarado-Little, Katherine R. Zigmont, and Anuj K. Dalal

Subjects
Adult, Male, medicine.medical_specialty, Health literacy, Family centered care, 03 medical and health sciences, Patient safety, symbols.namesake, 0302 clinical medicine, Professional-Family Relations, 030225 pediatrics, Intervention (counseling), Patient-Centered Care, Health care, Medicine, Humans, Family, 030212 general & internal medicine, Poisson regression, Prospective Studies, Patient participation, Child, Patient Care Team, Inpatients, Medical Errors, business.industry, Research, Communication, General Medicine, Confidence interval, 3. Good health, Family medicine, Child, Preschool, North America, symbols, Female, Patient Safety, Patient Participation, business, Program Evaluation
Abstract

Objective To determine whether medical errors, family experience, and communication processes improved after implementation of an intervention to standardize the structure of healthcare provider-family communication on family centered rounds. Design Prospective, multicenter before and after intervention study. Setting Pediatric inpatient units in seven North American hospitals, 17 December 2014 to 3 January 2017. Participants All patients admitted to study units (3106 admissions, 13171 patient days); 2148 parents or caregivers, 435 nurses, 203 medical students, and 586 residents. Intervention Families, nurses, and physicians coproduced an intervention to standardize healthcare provider-family communication on ward rounds (“family centered rounds”), which included structured, high reliability communication on bedside rounds emphasizing health literacy, family engagement, and bidirectional communication; structured, written real-time summaries of rounds; a formal training programme for healthcare providers; and strategies to support teamwork, implementation, and process improvement. Main outcome measures Medical errors (primary outcome), including harmful errors (preventable adverse events) and non-harmful errors, modeled using Poisson regression and generalized estimating equations clustered by site; family experience; and communication processes (eg, family engagement on rounds). Errors were measured via an established systematic surveillance methodology including family safety reporting. Results The overall rate of medical errors (per 1000 patient days) was unchanged (41.2 (95% confidence interval 31.2 to 54.5) pre-intervention v 35.8 (26.9 to 47.7) post-intervention, P=0.21), but harmful errors (preventable adverse events) decreased by 37.9% (20.7 (15.3 to 28.1) v 12.9 (8.9 to 18.6), P=0.01) post-intervention. Non-preventable adverse events also decreased (12.6 (8.9 to 17.9) v 5.2 (3.1 to 8.8), P=0.003). Top box (eg, “excellent”) ratings for six of 25 components of family reported experience improved; none worsened. Family centered rounds occurred more frequently (72.2% (53.5% to 85.4%) v 82.8% (64.9% to 92.6%), P=0.02). Family engagement 55.6% (32.9% to 76.2%) v 66.7% (43.0% to 84.1%), P=0.04) and nurse engagement (20.4% (7.0% to 46.6%) v 35.5% (17.0% to 59.6%), P=0.03) on rounds improved. Families expressing concerns at the start of rounds (18.2% (5.6% to 45.3%) v 37.7% (17.6% to 63.3%), P=0.03) and reading back plans (4.7% (0.7% to 25.2%) v 26.5% (12.7% to 7.3%), P=0.02) increased. Trainee teaching and the duration of rounds did not change significantly. Conclusions Although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved after implementation of a structured communication intervention for family centered rounds coproduced by families, nurses, and physicians. Family centered care processes may improve safety and quality of care without negatively impacting teaching or duration of rounds. Trial registration ClinicalTrials.gov NCT02320175 .

Published
2018

3. Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program

Author

Amy J. Starmer, Nancy D. Spector, Daniel C. West, Rajendu Srivastava, Theodore C. Sectish, Christopher P. Landrigan, Aravind Ajakumar Menon, Arshia Ali, Brenda K. Allair, April D. Allen, Nureddin Almaddah, Claire Alminde, Wilma Alvarado-Little, Elizabeth Anson, Michele Ashland, Marisa Atsatt, Megan Aylor, Jennifer D. Baird, James F. Bale, Dorene Balmer, Aisha Barber, Kevin Barton, Kimberly Bates, Carolyn Beck, Kathleen Berchelmann, Renuka Bhan, Zia Bismilla, Rebecca L. Blankenburg, Aileen Boa-Hocbo, Talya Bordin-Wosk, Michelle Brooks, Sharon Calaman, Julie Campe, Maria Lucia Campos, Debra Chandler, Yvonne Cheung, Amanda Choudhary, Eileen Christensen, Katherine Clark, Maitreya Coffey, Sally Coghlan-McDonald, Ellen Cohen, F. Sessions Cole, Elizabeth Corless, Sharon Cray, Roxi Da Silva, Devesh Dahale, Anuj K. Dalal, Lauren A. Destino, Jonathan Doroshow, Benard Dreyer, Katharine duPont, Steven Eagle, Courtney Edgar-Zarate, Angie Etzenhouser, Jennifer L. Everhart, Angela M. Feraco, Alexandra Ferrer, Paul Galardy, Briana M. Garcia, Maria Gaspar-Oishi, Jenna Goldstein, Brian P. Good, Dionne A Graham, Amanda S. Growdon, LeAnn Gubler, Amy Guiot, Charin Hanlon, Mona Hanna-Attisha, Roben Harris, Helen Haskell, Melvyn Hecht, Rebecca S Hehn, Justin Held, Jennifer H. Hepps, Debra Hillier, Mark Hiraoka, Eric Howell, Christine Hrach, Helen Hughes, Charles Huskins, Scott Kaatz, Vishnu Kanala, Michael Kantrowitz, Peter Kaplan, Deanne Kashiwagi, Rajat Kaul, Carol A. Keohane, Jeremy Kern, Alisa Khan, Nazia Naz S. Khan, Barry Kitch, Irene Kocolas, Lara Kothari, Elizabeth Kruvand, Nicholas Kuzma, Mary Lacy, Michele Lane, Kate Langrish, Christy J.W. Ledford, Laura LeRoux, Kheyandra Lewis, Stuart Lipsitz, Katherine P. Litterer, Joseph O. Lopreiato, Aimee Lyons, Avram Mack, Meghan Mallouk, Christopher G. Maloney, Amanda Mangan, Keith Mann, Peggy Markle, Christine Marrese, David Marseille, Greg Maynard, Bijal Mehta, Fernando Mendoza, Alexandra N. Mercer, Dale Micalizzi, Lisa Mims, Vineeta Mittal, Stephanie Mueller, Thuy L. Ngo, Ann Nolan, Christopher Nyenpan, Maria Obermeyer, Katherine O'Donnell, Jennifer K. O'Toole, Mary Ottolini, Mobola Owolabi, Aarti Patel, Rajesh Patel, Shilpa J. Patel, Catherine Perron, Rita Pickler, Alina Popa, Patrick Reppert, Robert Riss, Justin Roesch, Jayne E. Rogers, Glenn Rosenbluth, Jeffrey M. Rothschild, Lee Sanders, Kimberly Sauder, Jeff Schnipper, Kumiko O Schnock, Amy Scholtz, Barry Seltz, Theresa Serra, Janet Serwint, Samir Shah, Meesha Sharma, Kathleen Sheppard, Arabella Simpkin, Karin A Sloan, Lauren G. Solan, Michael W Southgate, Jaime Blank Spackman, Scott M. Stevens, Adam Stevenson, Windy Stevenson, Anupama Subramony, William Surkis, Sudhagar Thangarasu, E. Douglas Thompson, Cheryl Toole, Laura Trueman, Tanner Trujillo, Lisa Tse, Michael P. Turmelle, Vishwas Vaniawala, Tamara Wagner, Cindy Warnick, John Webster, Mary Webster, Adina Weinerman, Chelsea Welch, Andrew J. White, Matthew F. Wien, Ariel S. Winn, Stephanie Wintch, H. Shonna Yin, Catherine S. Yoon, Clifton E. Yu, Dominick Zampino, and Katherine R. Zigmont

Subjects
Quality management, Leadership and Management, Information Dissemination, Severity of Illness Index, Workflow, 03 medical and health sciences, Patient safety, 0302 clinical medicine, 030225 pediatrics, Medicine, Humans, 030212 general & internal medicine, Staff Development, Patient Care Team, Medical education, business.industry, Communication, Professional development, Health services research, Patient Handoff, Awareness, Work Engagement, Quality Improvement, United States, Group Processes, Observational study, Patient Safety, business
Abstract

Background In 2009 the I-PASS Study Group was formed by patient safety, medical education, health services research, and clinical experts from multiple institutions in the United States and Canada. When the I-PASS Handoff Program, which was developed by the I-PASS Study Group, was implemented in nine hospitals, it was associated with a 30% reduction in injuries due to medical errors and significant improvements in handoff processes, without any adverse effects on provider work flow. Methods To effectively disseminate and adapt I-PASS for use across specialties and disciplines, a series of federally and privately funded dissemination and implementation projects were carried out following the publication of the initial study. The results of these efforts have informed ongoing initiatives intended to continue adapting and scaling the program. Results As of this writing, I-PASS Study Group members have directly worked with more than 50 hospitals to facilitate implementation of I-PASS. To further disseminate I-PASS, Study Group members delivered hundreds of academic presentations, including plenaries at scientific meetings, workshops, and institutional Grand Rounds. Some 3,563 individuals, representing more than 500 institutions in the 50 states in the United States, the District of Columbia, Puerto Rico, and 57 other countries, have requested access to I-PASS materials. Most recently, the I-PASSSM Patient Safety Institute has developed a virtual immersion training platform, mobile handoff observational tools, and processes to facilitate further spread of I-PASS. Conclusion Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond.

Published
2017

4. Families as Partners in Hospital Error and Adverse Event Surveillance

Author

F. Sessions Cole, Wilma Alvarado-Little, Carolyn E Beck, Mary C. Ottolini, Stephannie L. Furtak, Lauren Destino, Irene Kocolas, Jayne Elizabeth Rogers, Amy Guiot, Chelsea Welch, James F. Bale, Jennifer K. O'Toole, Marisa Atsatt, Jennifer L. Everhart, Anuj K. Dalal, Helen Haskell, Elizabeth Kruvand, Christopher G. Maloney, Sally Coghlan-McDonald, Amy J. Starmer, Samir S. Shah, Sharon Calaman, Jennifer Hepps, Roxi Da Silva, Brian Good, Alisa Khan, Dorene F. Balmer, Michael Turmelle, Briana M. Garcia, Michele Marie Lane, Brenda K. Allair, Ariel S. Winn, Katherine R. Zigmont, Devesh Dahale, Meesha Sharma, Lee M. Sanders, Stuart R. Lipsitz, Zia Bismilla, Kheyandra Lewis, Maria Obermeyer, Clifton E. Yu, Aarti Patel, Katherine P. Litterer, Kevin T. Barton, Dale Ann Micalizzi, Elizabeth Corless, Daniel C. West, Claire Alminde, Shilpa J. Patel, Maitreya Coffey, Amanda S. Growdon, Kimberly Sauder, Vineeta Mittal, Peggy Markle, Christopher P. Landrigan, Michael D. Wolf, Roben Harris, Debra Chandler, Katherine O'Donnell, Rebecca Blankenburg, Eileen Christensen, E. Douglas Thompson, Cindy Warnick, Megan Aylor, Jennifer Baird, Amanda Mangan, Christy J.W. Ledford, Catherine Yoon, Theodore C. Sectish, Nancy D. Spector, Anupama Subramony, Nicholas Kuzma, Matthew F. Wien, Arabella L Simpkin, Laura Trueman, LeAnn Gubler, Joseph O. Lopreiato, Glenn Rosenbluth, Tanner Trujillo, Kathleen Langrish, Stephanie Wintch, Amanda Choudhary, Benard P. Dreyer, Michele Ashland, Rita Pickler, Andrew J. White, Rajendu Srivastava, Sharon Cray, H. Shonna Yin, and Fernando S. Mendoza

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, government.form_of_government, Article, Cohort Studies, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Interquartile range, 030225 pediatrics, Humans, Medicine, Family, Prospective Studies, 030212 general & internal medicine, Poisson regression, Child, Prospective cohort study, Generalized estimating equation, Medical Errors, business.industry, Medical record, Repeated measures design, Hospitals, Pediatric, United States, Pediatrics, Perinatology and Child Health, government, symbols, Female, business, Child, Hospitalized, Incident report, Cohort study
Abstract

Importance Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. Objective To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports. Design, Setting, and Participants We conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%-90%; κ, 0.50-0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient. Main Outcomes and Measures Error and AE rates. Results Overall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26-40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95% CI, 1.1-1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95% CI, 1.0-1.2; P = .006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95% CI, .5-1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95% CI, 0.8-2.2). Family-reported error rates were 5.0-fold (95% CI, 1.9-13.0) higher and AE rates 2.9-fold (95% CI, 1.2-6.7) higher than hospital incident report rates. Conclusions and Relevance Families provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety.

Published
2017
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6. The Pediatric Hospital Medicine Core Competencies Supplement

Author

Erin R, Stucky, Jennifer, Maniscalco, Mary C, Ottolini, Rishi, Agrawal, Brian, Alverson, Allison, Ballantine, Julia, Beauchamp-Walters, Glenn F, Billman, April O, Buchanan, Douglas W, Carlson, Vincent W, Chiang, Michael R, Clemmens, Jamie L, Clute, Shannon Connor, Phillips, Tanya, Dansky, Jennifer, Daru, Yasmeen N, Daud, Craig, DeWolfe, Joseph M, Geskey, Paul D, Hain, Keith, Herzog, Margaret, Hood, Kevin B, Johnson, Rick, Johnson, Brian, Kelly, Herbert C, Kimmons, Su-Ting T, Li, Patricia S, Lye, David E, Marcello, Sanford M, Melzer, Margaret I, Mikula, Laura J, Mirkinson, Christopher D, Miller, Christopher, O'Hara, Brian M, Pate, Dana, Patrick, Jack M, Percelay, David, Pressel, Kris P, Rehm, Kyung E, Rhee, Mark F, Riederer, Michael, Ruhlen, Henry M, Seidel, Anand, Sekaran, Kristin A, Shadman, Vipul, Singla, Karen, Smith, Jeffrey L, Sperring, Glenn, Stryjewski, E Douglas, Thompson, Michael, Turmelle, Macdara G, Tynan, Ronald J, Williams, Heidi, Wolf, Susan, Wu, Lisa B, Zaoutis, and William T, Zempsky

Subjects
medicine.medical_specialty, Adolescent, Leadership and Management, Acknowledgement, MEDLINE, Assessment and Diagnosis, Pediatrics, Pediatric hospital, medicine, Curriculum development, Humans, Child, Care Planning, business.industry, Health Policy, Infant, Newborn, Core competency, Infant, General Medicine, Hospitals, Pediatric, Competency-Based Education, Hospital medicine, Hospitalists, Child, Preschool, Family medicine, Workforce, Fundamentals and skills, Clinical Competence, Curriculum, business
Published
2010
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7. The use of evidence-based medicine in pediatrics: past, present and future

Author

John G. Frohna, E Douglas Thompson, and Hans B. Kersten

Subjects
medicine.medical_specialty, Medical education, Evidence-based practice, Evidence-Based Medicine, business.industry, MEDLINE, Alternative medicine, Evidence-based medicine, Pediatrics, Clinical expertise, Family medicine, Pediatrics, Perinatology and Child Health, Medicine, Humans, business, Research evidence
Abstract

Evidence-based medicine is a process that seeks to integrate the best research evidence with clinical expertise and patient values in order to optimize clinical outcomes for our patients. This article will review the benefits of and barriers to the use of evidence-based medicine in pediatrics in the twenty-first century, discuss various implementation strategies and outline the resources that pediatricians could use to increase their knowledge and skills and apply them to their clinical practice.Although physicians have generally welcomed evidence-based medicine, the benefits and limitations are often debated, and studies reveal that physicians feel that practicing evidence-based medicine could be difficult in a busy clinical practice because they lack the time, knowledge and resources. There have been many recent developments to help pediatricians overcome these barriers and to use best evidence in their practice.Pediatricians must be able to use the evidence-based medicine process to identify, access, apply and integrate new knowledge into their practice to provide high-quality care for their patients. The resources discussed in this review will help pediatricians make clinical decisions about patient care that are based on the best, most current, valid, and relevant evidence available.

Published
2008

8. Fever and Rash

Author

Keith D. Herzog and E. Douglas Thompson

Subjects
medicine.medical_specialty, business.industry, Medicine, medicine.symptom, business, Dermatology, Rash
Published
2007
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9. Contributors

Author

David Adams, Sherri L. Adams, Chhavi Agarwal, Elizabeth R. Alpern, Armand H. Matheny Antommaria, Megan H. Bair-Merritt, Lourival Baptista-Neto, Jill Baren, Carl R. Baum, Eric D. Baum, Pamela J. Beasley, Suzanne Beno, Laurie A. Bernard, Stacey E. Bernstein, Chad K. Brands, Laura K. Brennan, Marisa B. Brett-Fleegler, Manish J. Butte, Julie Story Byerley, Diane P. Calello, Deirdre Caplin, Rebecca G. Carlisle, Douglas W. Carlson, Jean Marie Carroll, Mary Wu Chang, Grace M. Cheng, Aaron S. Chidekel, Denesh K. Chitkara, Bill Chiu, Christine S. Cho, Jeanne S. Chow, Bartley G. Cilento, Susan E. Coffin, Bernard A. Cohen, Kristina A. Cole, Patrick H. Conway, Maura Cooper, Timothy Cornell, Kate M. Cronan, Catherine Cross, Bari B. Cunningham, Melody J. Cunningham, Jennifer A. Daru, Ian J. Davis, Matthew A. Deardorff, Barbara Degar, Michael DelVecchio, David Ray DeMaso, Marissa de Ungria, Stephanie B. Dewar, Craig C. DeWolfe, Martha Dimmers, James G.H. Dinulos, Ed Donovan, Kenneth J. Dooley, Emmanuel Doyne, Christine N. Duncan, Marie Egan, Lawrence F. Eichenfield, Moussa El-hallak, Scott A. Elisofon, Stephen C. Eppes, Michele Burns Ewald, Mirna M. Farah, Chris Feudtner, Andrew M. Fine, Susan Hetzel Frangiskakis, Gary Frank, Eric Frehm, Nicole R. Frei, Ilona J. Frieden, Eron Y. Friedlaender, Jeremy Friedman, Robert Hugh Fryer, David R. Fulton, Paul J. Galardy, Mirabai Galashan, Mary Pat Gallagher, Beth D. Gamulka, Rupali Gandhi, Mary B. Garza, Maria C. Garzon, Robert L. Geggel, Michael H. Gewitz, Timothy Gibson, Amy E. Gilliam, Katherine B. Ginnis, Amy Goldberg, Anna M. Golja, Melissa J. Gregory, April A. Harper, Mary Catherine Harris, Natalie Hayes, Matthew M. Heeney, Diana M. Heinzman, Meredith Lee Heltzer, Keith D. Herzog, Malinda Ann Hill, Jessica L. Hills, Alejandro Hoberman, K. Sarah Hoehn, Amber M. Hoffman, Robert J. Hoffman, Amy P. Holst, Charles J. Homer, Paul J. Honig, Patricia M. Hopkins, Mark D. Hormann, B. David Horn, Michael S. Isakoff, Katherine A. Janeway, Katherine Ahn Jin, Maureen M. Jonas, Tammy Kang, Krista Keilty, Ron Keren, Anupam Kharbanda, Marin Kiesau, Caroline C. Kim, Jason Y. Kim, Juliann Lipps Kim, Nicola Klein, Paul K. Kleinman, Joel B. Korin, Uma Kotagal, Lisa K. Kresnicka, Rana N. Kronfol, Cynthia L. Kuelbs, Subra Kugathasan, Amethyst C. Kurbegov, Christopher P. Landrigan, Miriam Laufer, Christine Lauren, Daniel J. Lebovitz, Natasha Leibel, Lucinda P. Leung, Leonard J. Levine, Jason A. Levy, Phyllis A. Lewis, Marilyn G. Liang, Daniel J. Licht, Carolyn M. Long, Jeffrey P. Louie, Barry A. Love, Patricia V. Lowery, Ian B. MacLusky, Katarzyna Madejczyk, Mary Beth Madonna, Sanjay Mahant, Paul E. Manicone, Jennifer Maniscalco, Keith Mann, Rebekah Mannix, Jonathan M. Mansbach, Peter Mattei, Oscar H. Mayer, Sarah C. McBride, Kevin D. McBryde, Michele R. McKee, William McNett, Sanford M. Melzer, Talene A. Metjian, Denise W. Metry, Stephen E. Muething, Emily E. Milliken, Laura J. Mirkinson, Manoj K. Mittal, Angela C. Mix, Debra Monzack, Kimberly D. Morel, Douglas E. Moses, Eugene M. Mowad, Elizabeth A. Mullen, John B. Mulliken, Sharon Muret-Wagstaff, Nancy Murphy, Frances M. Nadel, Joshua Nagler, James A. Nard, Mark I. Neuman, Jason G. Newland, Alice W. Newton, Peter F. Nichol, Lise E. Nigrovic, Richard J. Noel, Sharon E. Oberfield, Maureen M. O'Brien, Karen J. O'Connell, Kevin C. Osterhoudt, Mary Ottolini, Raj Padman, Horacio M. Padua, Alka Patel, Susmita Pati, Jack M. Percelay, Jeannette M. Perez-Rossello, Kieran J. Phelan, Annapurna Poduri, J. Rainer Poley, Jill C. Posner, Sampath Prahalad, Howard B. Pride, Daniel Rauch, David J. Rawat, Scott Reeves, Daniel H. Reirden, Brandie J. Roberts, Jack Rodgers, José R. Romero, Paul Rosen, David M. Rubin, Esther Maria Sampayo, Lisa Samson-Fang, Gina Santucci, Julie V. Schaffer, Karen E. Schetzina, Sandra Schwab, Donald F. Schwarz, Jordan Scott, Steven M. Selbst, Kara N. Shah, Samir S. Shah, Nader Shaikh, Michael W. Shannon, Adhi N. Sharma, George K. Siberry, Karen Smith, Michael J. Smith, Michael J.G. Somers, Neal Sondheimer, Steven J. Spalding, Philip R. Spandorfer, Jonathan M. Spergel, Jeffrey L. Sperring, David A. Spiegel, Rajendu Srivastava, Keith H. St. John, Michael C. Stephens, Christopher C. Stewart, Bryan L. Stone, Erin R. Stucky, Eric R. Sundel, Robert Sundel, Suzanne Swanson, Lesli Taylor, E. Douglas Thompson, Avram Z. Traum, Harsh K. Trivedi, Bryan D. Upham, Andrea M. Vandeven, Brigid L. Vaughan, Charles P. Venditti, Venus M. Villalva, Robert N. Vincent, Samuel Volchenboum, Michael T. Vossmeyer, Robert M. Wachter, Daniel J. Weiner, Michael Weinstein, Elizabeth A. Wharff, Stephen D. Wilson, Jerry A. Winkelstein, Heidi Wolf, George A. Woodward, Albert C. Yan, Elaine H. Zackai, Andrea L. Zaenglein, Theoklis E. Zaoutis, and David Zipes

Published
2007
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10. A Milestones Friendly Clinical Reasoning Assessment Tool

Author

Elizabeth Maxwell, Sarah S. Long, Stacy A. McDonald, Robert S. McGregor, E. Douglas Thompson, Blair Dickinson, Matthew B. McDonald, Darshita Bhatia, and Nicholas Dawlabani

Subjects
Cognitive science, Pediatrics, Perinatology and Child Health, Clinical reasoning, Psychology, Developmental psychology
Published
2013
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