A5007331651- Innovations in Medical Education
- Child and Adolescent Health
- Health Sciences Research and Education
- COVID-19 and Mental Health
- Respiratory viral infections research
- Clinical Reasoning and Diagnostic Skills
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Medical Education and Admissions
- Diversity and Career in Medicine
- Health and Medical Research Impacts
- HIV-related health complications and treatments
- COVID-19 epidemiological studies
- Respiratory and Cough-Related Research
- Pneumocystis jirovecii pneumonia detection and treatment
- Immunodeficiency and Autoimmune Disorders
- Cytomegalovirus and herpesvirus research
- Parvovirus B19 Infection Studies
- HIV/AIDS drug development and treatment
- Empathy and Medical Education
- SARS-CoV-2 detection and testing
- Microbial metabolism and enzyme function
- Hospital Admissions and Outcomes
- Infection Control and Ventilation
- Infections and bacterial resistance
Duke Medical Center
2013-2025
Pediatrics and Genetics
2015-2023
Duke University Hospital
2016-2023
Duke University
2015-2021
Office of Infectious Diseases
2019
Duke University Health System
2017
Washington University in St. Louis
2002-2006
Abbott (Germany)
2004
St. Louis Children's Hospital
1997
Children's Hospital of Philadelphia
1990-1994
BACKGROUND: In an effort to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), North Carolina closed prekindergarten through grade 12 public schools in-person instruction on March 14, 2020. On July 15, 2020, Carolina’s governor announced could open via remote learning or a hybrid model that combined and instruction. August 56 115 school districts joined The ABC Science Collaborative (ABCs) implement health measures prevent SARS-CoV-2 transmission share...
Macrophages and lymphocytes are the two main targets for productive HIV-1 infection in vivo. To compare effects of "nonessential" accessory genes vpr, vpu, nef on viral replication these primary cell types, we generated a panel mutant viruses derived from molecularly cloned macrophage-tropic isolate. Mutant had markedly different patterns macrophages, contrast to which differences were modest. Loss vpr or vpu reduced antigen production macrophages by up 1000-fold, while was only marginally...
Throughout the COVID-19 pandemic, masking has been a widely used mitigation practice in kindergarten through 12th grade (K-12) school districts to limit within-school transmission. Prior studies attempting quantify impact of have assessed total cases within schools; however, metric that more optimally defines effectiveness practices is transmission, or secondary cases. We estimated various on transmission cohort K-12 schools.
BACKGROUND. HIV/AIDS mortality rates in the United States are declining; pediatric HIV has become a chronic disease, with quality of life (QoL) outcomes assuming greater importance. OBJECTIVES. To compare QoL among HIV-infected and uninfected children to assess impact different antiretroviral regimens on children. METHODS. Perinatally exposed, (N = 1847) 712) adolescents were studied. Among infected children, 1283 available for regimen analysis. domain scores assessed subjects 6 months 4...
Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions the minimum required a trainee successfully graduate. In 2017, SPIN surveyed FPDs accredited...
OBJECTIVES We evaluated the impact of distancing practices on secondary transmission severe acute respiratory syndrome coronavirus 2 and degree sports-associated across a large diverse cohort schools during spring 2021. METHODS Participating districts in North Carolina Wisconsin charter offering in-person instruction between March 15, 2021 June 25, reported policies, community- school-acquired infections, quarantines, infections associated with school-sponsored sports. calculated ratio to...
BACKGROUND AND OBJECTIVES The American Board of Pediatrics requires that proposed changes to the duration pediatric subspecialty training must include a framework for competency assessment with measurement component. We analyzed clinical Entrustable Professional Activity (EPA) level supervision ratings across 3-year fellowships determine if trainees met minimum thresholds graduation after 2 years fellowship training. METHODS From spring 2019 through 2022, Clinical Competency Committees...
To characterize the role of placenta in vertical transmission human immunodeficiency virus type 1 (HIV-1), susceptibility primary placental cultures and transformed trophoblast cell lines to infection by several HIV-1 isolates was examined. Placental supported replication all strains tested, including lymphocyte-, macrophage-, amphotropic isolates. All viruses replicated modest levels, with production both viral antigen infectious culture supernatants. cells demonstrated a pattern...
The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required submit milestone reports their trainees semiannually. Likert-type scale assessment tools not designed inform reporting, creating a challenge Clinical Competency Committees.To determine if milestone-based assessments better...
When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in setting of high levels community transmission. We describe secondary transmission SARS-CoV-2 within North Carolina kindergarten through 12th-grade school districts during a winter surge to determine if mitigation strategies can hinder within-school
The volume of information that physicians must learn is increasing; yet, trainee educational time limited. Many experts propose using trainees' learning preferences to guide teaching. However, data regarding predominant within pediatrics are limited.Identify among pediatric residents in a Residency Training Program.The Visual-Aural-Read/Write-Kinesthetic (VARK) questionnaire and Kolb Learning Style Inventory (LSI) were administered anonymously 50 residents.Learning style assessments...
Physician-scientists represent a critical component of the biomedical and health research workforce. However, proportion physicians who spend significant amount effort on scientific has declined over past 40 years. This trend been particularly noticeable in pediatrics despite recent work revealing that early life influences, exposures, status play role lifelong disease. To address this problem, Duke University Department Pediatrics developed Pediatric Research Scholars Program for...
Neurological dysfunction in AIDS occurs the absence of productive infection neurons, and may involve modulation neuronal cell function by viral or cellular products released from surrounding infected cells. The human immunodeficiency virus type 1 (HIV-1) transactivator protein Tat be one such factor, as it can act a neurotoxin, induces marked morphological changes neurons astrocytes primary embryonic rodent brain cultures, is certain HIV-1-infected In addition, alter expression genes several...
BACKGROUND AND OBJECTIVES Entrustable professional activities (EPAs) will be used for initial certification by the American Board of Pediatrics 2028. Less than half pediatric fellowships currently use EPAs assessment, yet all need to adopt them. Our objectives were identify facilitators and barriers implementation assess fellows determine fellowship program directors’ (FPD) perceptions Milestones. METHODS We conducted a survey FPDs from 15 subspecialties. EPA users asked about their EPAs,...
Nadel, Simon M.R.C.P.(U.K.); McGann, Kathleen M.D.; Hodinka, Richard L. Ph.D.; Rutstein, Chatten, Jane M.D. Author Information
Entrustable Professional Activities (EPAs) were developed to assess pediatric fellows. We previously showed that fellowship program directors (FPDs) may graduate fellows who still require supervision. How this compares with their expectations for entrustment of practicing subspecialists is unknown. surveyed US FPDs in 14 subspecialties through the Subspecialty Pediatrics Investigator Network between April and August 2017. For each 7 common subspecialty EPAs, we compared minimum level...
Entrustable Professional Activities (EPA) and competencies represent components of a competency-based education framework. EPAs are assessed based on the level supervision (LOS) necessary to perform activity safely effectively. The broad competencies, broken down into narrower subcompetencies, using milestones, observable behaviors one's abilities along developmental spectrum. Integration two methods, accomplished by mapping most relevant subcompetencies each EPA, may provide cross check...
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted in-person education for kindergarten through 12th grade (K-12) students. In recent recommendations, shortened durations of quarantine allowed if a negative SARS-CoV-2 test result is obtained at 5 to 7 days postexposure, but access testing remains limited. We hypothesized that providing in-school postexposure would...
Objectives: Fellowship program directors (FPD) and Clinical Competency Committees (CCCs) both assess fellow performance. We examined the association of entrustment levels determined by FPD with those CCC for 6 common pediatric subspecialty entrustable professional activities (EPAs), hypothesizing there would be strong correlation minimal bias between these raters. Methods: The FPDs CCCs separately assigned a level supervision to each their fellows EPAs. For EPA, we assessments calculated as...
Objective: Teaching and evaluation of handovers are important requirements graduate medical education (GME), but well-defined effective methods have not been clearly established. Case-based computer simulations provide potential to teach, evaluate, practice handovers. Methods: simulation modules were developed. In these modules, trainees care for a virtual patient in time-lapsed session, followed by real-time synthesis handover the clinical information partner who uses this continue caring...