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Poster 499 A Nationwide Review of Residency Call in Physical Medicine & Rehabilitation
S322
Abstracts / PM R 8 (2016) S151-S332
Design: Cross-sectional survey. Setting: A major academic-medical and trauma center in West Africa. Participants: Residents and medical students completing training in 7 medical and surgical specialties (N¼253). Interventions: Not applicable. Main Outcome Measures: Responses to a 25-item survey organized into four domains: 1. General attitudes towards persons with disability (PWDs); 2. Perceived adequacy of disability education; 3. Importance of disability training and education to current and future practice; and 4. General perceived value of caring for PWDs. Results: Of all respondents, 51% were female, 94 were residents, 159 were medical students and the mean age was 24.0 3.85 years old. Majority of respondents were in a surgical (41%) or medical specialty (21%). Residents had limited experience with PWDs (12% had some experience and 13% had little experience) whereas medical students had very limited experience (a total of 50% had little to no experience with PWDs) and more negative responses towards PWDs. Overall, residents demonstrated significantly higher mean composite scores than medical students for general perceived value of care for PWD (P ¼ .0001), importance of disability education (P ¼ .0001), and perceived adequacy of disability education score (P ¼ .006). There was no statistically significant difference between the 2 groups for general attitudes composite score (P ¼ .08). The mean composite scores of West-African trainees in each of the survey domains were comparable to the scores of physiatry residents in the United states, with the highest positive attitudes demonstrated for importance of disability education and perceived adequacy of disability education. Conclusions: The study highlights attitudinal health challenges towards disabled persons in a milieu devoid of rehabilitation-trained physicians and identifies areas of opportunity for strategic interventions. Level of Evidence: Level III Poster 498 Geographic Differences in the Characteristics of Cervical Dystonia Patients Richard Trosch, MD (Parkinson’s & Movement Disorders Center, Farmington Hills, Michigan, United States), Vijay P. Misra, MD, FRCP, Savary Om, MD, Pascal Maisonobe, MSc Disclosures: Richard Trosch: Consulting fees or other remuneration (payment) - Ipsen pharmaceuticals, Research Grants - US WorldMeds Objective: To investigate geographic differences (U.S. versus Europe versus rest of world [ROW]) in clinical features of patients with cervical dystonia (CD) presenting for routine treatment with botulinum neurotoxin Type A (BoNT-A). Design: Meta-analyses were conducted on baseline data from 2 observational international studies (INTEREST IN CD1 & 2) and 1 U.S. registry (ANCHOR-CD). Setting: Two international studies (INTEREST IN CD1 & 2, encompassing 9 and 34 countries, respectively) and 1 U.S. registry (ANCHOR-CD). Participants: Baseline descriptive data are presented for 1624 subjects (U.S. n¼297, Europe [18 countries] n¼948, ROW [16 countries] n¼379) with CD. Interventions: Not applicable. Main Outcome Measures: Clinical examination. Results: Meta-analyses revealed differences in the characteristics of U.S. subjects presenting for BoNT-A treatment compared with Europe and ROW. The U.S. population had a higher proportion of females (76% vs 67% & 64%, respectively) and there was a higher proportion of familial CD (12% vs 6% & 8%, respectively). Although U.S. subjects tended to be older than those in Europe or ROW (56% were aged 61 years vs 32% & 40%, respectively), the median [range] time since the first BoNT-A injection was shorter (25.2 [3.0 e281.0] months vs 60.1 [2.3e357.0] & 65.4 [2.0e269.0] months, respectively). There were no
observable geographic differences in the median [range] time between last injection prior to study entry and first study injection (3.3 [0.8e124.5], 3.6 [1.8e192.0] and 3.7 [2.0e84.2] months, respectively). Conclusions: These baseline analyses suggest subtle disparities in the way that CD patients are diagnosed and managed in the U.S. compared with Europe and ROW. Variations in access to care and models of physician reimbursement may account for these differences. Level of Evidence: Level II Poster 499 A Nationwide Review of Residency Call in Physical Medicine & Rehabilitation Jane Hwang, MD (Loyola University Medical Center, Maywood, IL, United States) Disclosures: Jane Hwang: I Have No Relevant Financial Relationships To Disclose Objective: To assess PM&R residency call nationwide. Design: Survey. Setting: ACGME accredited PM&R residency programs. Participants: 221 total PM&R residents including 5 PGY-1, 78 PGY-2, 69 PGY-3, and 69 PGY-4. Interventions: Not applicable. Main Outcome Measures: Participants completed an anonymous online survey made up of 7 questions. The first question listed 20 items which residents were to score on a 5-point scale how comfortable or uncomfortable they felt handling while on call. Other key questions addressed the top 3 issues residents were getting paged about while on call, type of call, and type of PGY-1 training. Results: A total of 221 PM&R residents from at least 48 programs across 25 states/US territories participated in the survey. The top 3 reasons for which residents were getting paged during call were pain, abnormal vital signs, and bowel/bladder issues. The top 3 items residents were least comfortable with handling during call were running a code, arrhythmias, and seizures. The top 3 items residents were most comfortable with were constipation, pain, and insomnia. 50% of unique programs were found to take home call, 19% in-house call, and 31% home and/or in-house call. 46% of residents completed their PGY1 training in a preliminary medicine program, 36% in a transitional year program, 6% in a preliminary surgery program, and 12% in another type of program. Conclusions: There have been limited studies assessing residency call, especially in the field of PM&R. This study gives an overview of the most common reasons why residents are getting paged during call and what residents feel comfortable and uncomfortable handling while on call. This information can better guide residency programs in regards to their educational conferences, especially in the beginning of the year when new PM&R residents are being transitioned into taking call on their own. Level of Evidence: Level V Poster 500 A Five Year Longitudinal Intervention for Improving Medical Student Exposure to Physical Medicine & Rehabilitation (PM&R) Kimberly Ross, MD, MBA (Jackson Memorial Hospital/Jackson Health System, Miami, FL, United States), Alexander Harrington, MBA, Andrew L. Sherman, MD, Seema Khurana, DO Disclosures: Kimberly Ross: I Have No Relevant Financial Relationships To Disclose Objective: To increase medical student exposure to and interest in PM&R.
Abstracts / PM R 8 (2016) S151-S332
Design: Cross-sectional survey. Setting: A major academic-medical and trauma center in West Africa. Participants: Residents and medical students completing training in 7 medical and surgical specialties (N¼253). Interventions: Not applicable. Main Outcome Measures: Responses to a 25-item survey organized into four domains: 1. General attitudes towards persons with disability (PWDs); 2. Perceived adequacy of disability education; 3. Importance of disability training and education to current and future practice; and 4. General perceived value of caring for PWDs. Results: Of all respondents, 51% were female, 94 were residents, 159 were medical students and the mean age was 24.0 3.85 years old. Majority of respondents were in a surgical (41%) or medical specialty (21%). Residents had limited experience with PWDs (12% had some experience and 13% had little experience) whereas medical students had very limited experience (a total of 50% had little to no experience with PWDs) and more negative responses towards PWDs. Overall, residents demonstrated significantly higher mean composite scores than medical students for general perceived value of care for PWD (P ¼ .0001), importance of disability education (P ¼ .0001), and perceived adequacy of disability education score (P ¼ .006). There was no statistically significant difference between the 2 groups for general attitudes composite score (P ¼ .08). The mean composite scores of West-African trainees in each of the survey domains were comparable to the scores of physiatry residents in the United states, with the highest positive attitudes demonstrated for importance of disability education and perceived adequacy of disability education. Conclusions: The study highlights attitudinal health challenges towards disabled persons in a milieu devoid of rehabilitation-trained physicians and identifies areas of opportunity for strategic interventions. Level of Evidence: Level III Poster 498 Geographic Differences in the Characteristics of Cervical Dystonia Patients Richard Trosch, MD (Parkinson’s & Movement Disorders Center, Farmington Hills, Michigan, United States), Vijay P. Misra, MD, FRCP, Savary Om, MD, Pascal Maisonobe, MSc Disclosures: Richard Trosch: Consulting fees or other remuneration (payment) - Ipsen pharmaceuticals, Research Grants - US WorldMeds Objective: To investigate geographic differences (U.S. versus Europe versus rest of world [ROW]) in clinical features of patients with cervical dystonia (CD) presenting for routine treatment with botulinum neurotoxin Type A (BoNT-A). Design: Meta-analyses were conducted on baseline data from 2 observational international studies (INTEREST IN CD1 & 2) and 1 U.S. registry (ANCHOR-CD). Setting: Two international studies (INTEREST IN CD1 & 2, encompassing 9 and 34 countries, respectively) and 1 U.S. registry (ANCHOR-CD). Participants: Baseline descriptive data are presented for 1624 subjects (U.S. n¼297, Europe [18 countries] n¼948, ROW [16 countries] n¼379) with CD. Interventions: Not applicable. Main Outcome Measures: Clinical examination. Results: Meta-analyses revealed differences in the characteristics of U.S. subjects presenting for BoNT-A treatment compared with Europe and ROW. The U.S. population had a higher proportion of females (76% vs 67% & 64%, respectively) and there was a higher proportion of familial CD (12% vs 6% & 8%, respectively). Although U.S. subjects tended to be older than those in Europe or ROW (56% were aged 61 years vs 32% & 40%, respectively), the median [range] time since the first BoNT-A injection was shorter (25.2 [3.0 e281.0] months vs 60.1 [2.3e357.0] & 65.4 [2.0e269.0] months, respectively). There were no
observable geographic differences in the median [range] time between last injection prior to study entry and first study injection (3.3 [0.8e124.5], 3.6 [1.8e192.0] and 3.7 [2.0e84.2] months, respectively). Conclusions: These baseline analyses suggest subtle disparities in the way that CD patients are diagnosed and managed in the U.S. compared with Europe and ROW. Variations in access to care and models of physician reimbursement may account for these differences. Level of Evidence: Level II Poster 499 A Nationwide Review of Residency Call in Physical Medicine & Rehabilitation Jane Hwang, MD (Loyola University Medical Center, Maywood, IL, United States) Disclosures: Jane Hwang: I Have No Relevant Financial Relationships To Disclose Objective: To assess PM&R residency call nationwide. Design: Survey. Setting: ACGME accredited PM&R residency programs. Participants: 221 total PM&R residents including 5 PGY-1, 78 PGY-2, 69 PGY-3, and 69 PGY-4. Interventions: Not applicable. Main Outcome Measures: Participants completed an anonymous online survey made up of 7 questions. The first question listed 20 items which residents were to score on a 5-point scale how comfortable or uncomfortable they felt handling while on call. Other key questions addressed the top 3 issues residents were getting paged about while on call, type of call, and type of PGY-1 training. Results: A total of 221 PM&R residents from at least 48 programs across 25 states/US territories participated in the survey. The top 3 reasons for which residents were getting paged during call were pain, abnormal vital signs, and bowel/bladder issues. The top 3 items residents were least comfortable with handling during call were running a code, arrhythmias, and seizures. The top 3 items residents were most comfortable with were constipation, pain, and insomnia. 50% of unique programs were found to take home call, 19% in-house call, and 31% home and/or in-house call. 46% of residents completed their PGY1 training in a preliminary medicine program, 36% in a transitional year program, 6% in a preliminary surgery program, and 12% in another type of program. Conclusions: There have been limited studies assessing residency call, especially in the field of PM&R. This study gives an overview of the most common reasons why residents are getting paged during call and what residents feel comfortable and uncomfortable handling while on call. This information can better guide residency programs in regards to their educational conferences, especially in the beginning of the year when new PM&R residents are being transitioned into taking call on their own. Level of Evidence: Level V Poster 500 A Five Year Longitudinal Intervention for Improving Medical Student Exposure to Physical Medicine & Rehabilitation (PM&R) Kimberly Ross, MD, MBA (Jackson Memorial Hospital/Jackson Health System, Miami, FL, United States), Alexander Harrington, MBA, Andrew L. Sherman, MD, Seema Khurana, DO Disclosures: Kimberly Ross: I Have No Relevant Financial Relationships To Disclose Objective: To increase medical student exposure to and interest in PM&R.