Impact of Communication Method and Timeliness on Student and Faculty Perception of Professionalism and Value

Objective. This study sought to evaluate the impact of faculty, preceptor, and student preferences for type of communication received and timeliness of communication on their perceptions of professionalism and personal value.Methods. An anonymous questionnaire was designed to assess pharmacy faculty, preceptor, and students’ preferred method of communication, response time expectations, impact on their perception of the sender’s professionalism, and personal perception of being valued. The questionnaire was sent to 924 faculty, preceptors, and students.Results. Of the 253 responses received, 27 (11%) were from full-time faculty, 94 (37%) from part-time faculty preceptors, and 132 (52%) from students. Overall, email was the preferred communication method for receiving information that was not time sensitive (98%), with a majority of faculty, preceptors, and students indicating that 48 hours was a reasonable response time. Most participants felt that less than 24 hours was a reasonable response time for texts or phone calls. Most students indicated that response time was somewhat or not impactful (58%) on their view of the faculty or preceptor’s professionalism, while faculty and preceptors indicated that response time was neutral or somewhat impactful on their view of the student’s professionalism (60%). Most students (77%) indicated that a faculty or preceptor’s response time to their text or phone call impacted their perceptions of feeling valued and important.Conclusion. Communication preferences among faculty, preceptors, and students differ. Professionalism related to communication was important to all groups, and timeliness of communication between faculty, preceptors, and students impacted their perception of their value and self-worth.     

Flap Monitoring Using Transcutaneous Oxygen or Carbon Dioxide Measurements

Free tissue transfer is a cornerstone of complex reconstruction. In many cases, it represents the last option available for a patient and their reconstruction. At high-volume centers, the risk of free flap failure is low but its occurrence can be devastating. Currently, the mainstay for flap monitoring is the clinical examination. Though reliable when performed by experienced clinicians, the flap exam is largely subjective, is performed discontinuously, and often results in significant time delay between detection of flap compromise and intervention. Among emerging flap monitoring technologies, the most promising appear to be those that rely on noninvasive transcutaneous oxygen and carbon dioxide measurements, which provide information regarding flap perfusion. In this article, we review and summarize the literature on various techniques but primarily emphasizing those technologies that rely on transcutaneous gas measurements. We also define characteristics for the ideal flap monitoring tool and discuss critical barriers, predominantly cost, preventing more widespread utilization of adjunct monitoring technologies, and their implications.     

Acoustic radiation force imaging (ARFI) in the non-distended bladder does not predict abnormal urodynamic parameters in children

IntroductionAcoustic radiation force imaging (ARFI) is a recently developed form of ultrasound imaging that allows in vivo measurement of tissue stiffness. This technology could be useful at predicting bladder compliance in children. We hypothesize that tissue stiffness, as measured by ARFI, correlates with abnormal bladder compliance and capacity in patients with bladder dysfunction.MethodsPatients who presented for cystometrography (CMG) underwent ARFI of the bladder wall. Nine bladder wall shear wave speed (SWS) measurements were acquired using point and 2D ultrasound shear wave elastography. The mean for each ARFI technique was correlated to bladder compliance, calculated using Wahl’s dimensionless number. ARFI parameters also were correlated with bladder capacity.ResultsA total of 25 patients were enrolled. Mean age at time of enrollment was 4.2±3.9 years (range two months to 15 years). There was no significant correlation between bladder compliance and point shear wave speed measurements (r=−0.22, p=0.31) or 2D shear wave speed measurements (r=−0.35, p=0.1). A total of 19 patients had bladder capacity below expected bladder capacity (EBC). There was no significant correlation between bladder capacity and point shear wave speed measurements (r =−0.08, p=0.7) or 2D shear wave speed measurements (r=−0.36, p=0.09).ConclusionsOur results did not demonstrate a significant correlation between bladder wall ARFI shear wave measurements and bladder compliance or bladder capacity. Further studies are warranted to determine whether ARFI may be used to predict abnormal urodynamic parameters in children.