Spring 2014

 
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VOS 67th Annual Meeting
May 2-4, 2014
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Med School News

What’s New at
UVA Orthopaedics?

Quanjun "Trey" Cui, MD
Program Director
Department of Orthopaedics

Honoring Outgoing Chair,
Dr. Mark Abel

Dr. A. Bobby Chhabra, new Chair of the Department of Surgery, together with the Faculty and department guests, gathered at Glenmore Country Club for a special dinner to honor Dr. Mark Abel for his unselfish service, innovative leadership and outstanding teaching contributions during his very successful tenure as Chair of the Department of Orthopaedic Surgery. Dr. Abel served as Chair from August 2008 to August 2013. During this time, the Department saw unprecedented growth. Dr. Abel has been with the UVA Health System since 1993. He has served in numerous leadership roles including as Chair of the Department of Orthopaedic Surgery between 2002 and 2003 and from August 2008 through August 2013. With the SOM, he has served on numerous committees including several Chair reviews and the Promotion and Tenure Committee with one year as chairperson of that committee. Under his leadership, the department has been recognized for improving patient access and quality of care as well as for markedly reducing costs by conforming to limit implant variety. For the Health System, he has been involved in Committees overseeing Quality, Contracting and Health System Strategy. He is nationally recognized as an expert in Pediatric Orthopaedic and Scoliosis Surgery and leads the Division of Pediatric Orthopaedics. His clinical expertise of Pediatric Orthopaedic Surgery, covers a broad range of musculoskeletal conditions affecting children. Approximately 50% of his practice deals with the management of Scoliosis and other spinal deformities of the children’s spine. He has published well over 70 peer reviewed articles and numerous book chapters on Pediatric Orthopaedic topics. He has been listed among Connelly’s Best Doctors in America for eight consecutive years. We are extremely grateful for Dr. Abel’s leadership as Chair and look forward to his continued contributions in the guidance of the Department and the Health System.

Certification of Distinction of
the Total Joint Replacement Program at UVA Medical Center

The hip and knee total joint replacement program at University of Virginia Health System has earned certification by the Joint Commission, the national group that accredits hospitals and healthcare organizations. According to the Joint Commission, programs earn certification for their total joint replacement program by demonstrating compliance with national standards and “effective and consistent use of appropriate, evidence-based clinical practice guidelines” for patients undergoing hip or knee replacements. Programs receive certification following a site visit by a Joint Commission surveyor.

UVA’s three board-certified joint replacement surgeons – Thomas E. Brown, MD, James A. Browne, MD, and Quanjun Cui, MD – perform more than 1200 joint replacements each year, drawing patients from Virginia and the mid-Atlantic region. UVA’s surgeons use all of the latest techniques for joint replacement surgery, including minimally invasive and computer-assisted procedures. Following surgery, patients begin their recovery in a dedicated orthopaedic inpatient unit staffed by a treatment team that specializes in caring for orthopaedic and joint replacement patients.

Dr. Miller Named to Notable List
Dr. Mark Miller, S. Ward Casscells Professor and Division Head of Orthopaedic Sports Medicine, was recently named to a list of the “Top 19 US Sports Medicine Specialists.”  Orthopaedics Weekly interviewed thought leaders in the field and “according to those in-the-know, these are 19 high echelon sports medicine specialists in the U.S. who are extraordinarily equipped to meet the needs of athletes.”  Dr. Miller is specifically noted for his prolific work on review courses and is called an “excellent teacher and clinician.”  Also included on the list was UVA alumnus and renowned orthopaedist, Dr. James Andrews.

Dr. David Weiss selected as a Distinguished Visiting Scholar
to Germany

Dr. David Weiss, Associate Professor, Trauma Division Head, University of Virginia was selected for the Distinguished Visiting Scholars Program at Landstuhl Regional Army Medical Center in Germany. The program was established as a joint program between the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association and the United States Military to provide the military Orthopaedic surgeons stationed at Landstuhl Regional Army Medical Center with additional manpower to assist them in their care of wounded warriors in the Iraq and Afghanistan theatre. 

Dr. Brockmeier Selected
as AOSSM Traveling Fellow
to Europe

Dr. Stephen F. Brockmeier, Assistant Professor, Associate Residency Program Director, Sports Medicine and Shoulder Surgery, University of Virginia received this competitive traveling fellowship program which is an annual scientific and cultural exchange among orthopaedic sports medicine physicians in North America, Europe, Asia-Pacific, and Latin America.  This program is a unique opportunity for individuals to witness orthopaedic sports medicine techniques and surgeries from around the world. Three fellows are selected to visit foreign sports medicine centers for four weeks, and are accompanied by a "Godparent", a well-known senior orthopaedic sports medicine specialist selected by the President of the national sports medicine organization sending the fellows.

Dr. James Browne, Assistant Professor of Orthopaedic Surgery
Dr. Brown won the Knee Society John Insall Award for the best work on a Clinical Subject or Outcomes Report.

Cutting Edge Orthopaedic Research at UVA
Dr. Xudong Joshua Li, Assistant Professor of Orthopaedic Surgery, recently received a prestigious NIH R01 (AR064792-01) research grant entitled: “Systemic Application for Injury Site Specific Delivery via Neutrophils to Treat Acute Back Pain.” Low back pain is an endemic health problem and is the second most common reason Americans see their doctor, second only to colds and flu. Current treatments for low back pain, such as surgery or treatment with epidural injections of steroids, has many risks, thus there is an immense need for new treatment approaches. This study aims to specifically targeting at active neutrophil to the site of disc damage in order to treat acute back pain.

Dr. Xudong Joshua Li's research work was also recognized recently at the Eastern Orthopaedic Association meeting by receiving resident/fellow award, with his presentation entitled: "An In-Vitro and In-Vivo Investigation Of Annulus Fibrosus Cell 'Stemness': A Potential Pathogenesis Of Disc Degeneration." Congratulations to Dr. Li!

Outgoing Chief Residents

Anjan Kaushik Anjan Kaushik, MD
Hand & Upper Extremity

University of Rochester
Rochester, NY
Tom Keller Tom Keller, MD
Sports
Santa Monica
Orthopaedic Group
Santa Monica, CA
Boyd Rawles Boyd Rawles, MD
Hand & Upper Extremity
University of Virginia
Charlottesville, VA
Jesse Seamon Jesse Seamon, MD
Trauma
St. Louis University
Medical Center
St. Louis, MO
Jeff Tuman Jeff Tuman, MD
Sports
Stanford University
School of Medicine
Palo Alto, CA

First Year Residents

Ahmad Fashandi Ahmad Fashandi, MD
University of Virginia
Charlottesville, VA
Cody Evans Cody Evans, MD
University of Virginia
Charlottesville, VA
Beamer Carr Beamer Carr, MD
Wake Forest University
Winston-Salem, NC
Jourdan Cancienne Jourdan Cancienne, MD
Tulane University
New Orleans, LA
Ian Dempsey Ian Dempsey, MD
Albany Medical College
Albany, NY

UVA Battle Building Opens
This Summer
The Barry and Bill Battle Building at the University of Virginia (UVA) Children’s Hospital is expected to open Summer 2014. This seven-story, 200,000 square-foot facility on Main Street in Charlottesville will provide dedicated space for care of children in all 36 pediatric specialties including UVA Pediatric Orthopaedics.  The goal is interdisciplinary, multifunctional "neighborhoods" for care, placing children and their families at the center of care. UVA Pediatric Orthopaedics will move from its current location at the Kluge Children’s Rehabilitation Center on Ivy Road as will other pediatric subspecialties consolidate their services at the new building.  The Battle Building is an outpatient facility so UVA Pediatric Orthopaedics will continue inpatient care at the Main Hospital. A connector to the UVA inpatient areas will improve care coordination and efficiencies.  UVA Pediatric Orthopaedics is also developing outpatient satellite clinics in Zion Crossroads, which is now open and in Crozet, which is on the horizon.

The UVA Outpatient Surgery Center for pediatric and adult patients will also move from its current location to the lower levels of the Barry and Bill Battle Building. The new surgery center will increase the number of operating rooms to 12 from 6 (and two temporary rooms) and provide well needed increase in operating room space and availability.

Architectural video of the building
can be viewed at
http://www.youtube.com/
watch?v=43e052RIV04

 

What’s New at
Naval Medical Center Portsmouth?

By Luke Balsamo, MD
Program Director
Department of Orthopaedics

The Orthopaedic residency at the Naval Medical Center Portsmouth is halfway through another academic year. Our PGY-2 residents have assumed leading roles in our department. The military selection board allowed all of our current PGY-1 interns to matriculate as residents in the upcoming academic year. LCDR David Glassman (PGY-4) was selected for a spine fellowship for which he is interviewing now for a 2015 start. Our chiefs, Drs. Needham, Pinkos, and Stepanovich are all eagerly looking forward to the challenges the next year will have in store for them.

Research continues to be an important part of our program. Currently, there are over 30 IRB approved projects with over $300,000 of command funding and grants.  In 2012, the department authored over 20 articles and book chapters and we are on pace to do the same in the current academic year.

We are one of the busiest orthopaedic departments in DoD, seeing over 80,000 outpatient visits a year and performing over 5,000 surgeries. We couldn’t do this without our dedicated civilian and military support staff and the hard work of our residents. We look forward to a robust presence at the 2014 VOS Annual Meeting in Roanoke, VA.


What’s New
at VCU?

News Release from the
VCU Public Affairs
Department

Medical Students Learn
Art of Patient Perspective


VCU Schools of the Arts and Medicine Collaborate to Launch Standardized Patient Program

By Sathya Achia Abraham

and Cassie Williams Jones
University Public Affairs
VCU Across the Spectrum

A well-known Native-American proverb says, “Tell me and I’ll forget. Show me, and I may not remember. Involve me, and I’ll understand.” That principle serves as a cornerstone of the new medical school curriculum at Virginia Commonwealth University, where hands-on, active-learning reigns.

In recent years, simulation-based education has become a growing trend in medical schools across the country, and the VCU School of Medicine has been among the frontrunners.

As it launches a new medical school curriculum focused on active-learning, VCU aims to help these future physicians learn to practice medicine efficiently and with empathy and caring through a unique collaboration between the VCU School of Medicine and the VCU School of the Arts.

VCU’s Standardized Patient Program is designed to help medical students learn to effectively conduct the physicians’ traditional interview: the history and physical. They will learn to care for the entire spectrum of the patient population – from pediatric to geriatric patients.

Traditionally, medical students’ first encounters with patients occur when they begin training on the hospital’s different units with faculty physicians. Now, however, students will work with standardized patients from the first day of medical school. These individuals are trained to act as patients and to participate in active role-playing with medical school students.

The standardized patients are taught to give feedback to the students and are familiar with steps involved in taking a patient’s history and performing physical examinations. For example, these specially trained patients can tell the medical student whether he or she has palpated the abdomen hard enough to feel the liver.

“Sometimes learning involves very sick patients, or very invasive procedures. In those cases we use high fidelity manikins and their sophisticated software,” said Ellen L. Brock, MD, medical director of the VCU Center for Human Simulation and Patient Safety, which is home to the Standardized Patient Program.

“Sometimes learning involves developing communication skills, the ability to take an accurate medical history and becoming comfortable with the physician/patient human interaction. This is where our Standardized Patient program makes such a dramatic contribution,” she said.

“What inspires me about this work is that when art is used in health care the impact can be both direct and profound,” said Aaron Anderson, PhD, associate professor and associate chair of the Department of Theatre in the VCU School of the Arts, who has played a key role in launching the program at VCU.

VCU

The VCU Center for Human Simulation and Patient Safety has approximately 25,000-square-feet of simulation space equipped with state-of-the-art simulation technology.

Photo courtesy of VCU Schools
of the Arts and Medicine.

The Power of Simulation-based Education
The VCU Center for Human Simulation and Patient Safety provides simulation-based training for faculty and medical students of the School of Medicine and for trainees and staff of the VCU Health System. The center is located in the new James W. and Frances G. McGlothlin Medical Education Center, and has approximately 25,000-square-feet of simulation space equipped with state-of-the-art simulation technology. Physician groups from outside VCU also are expected to visit to learn new techniques in surgery or treating critical care patients.

“Simulation represents the difference between learning about something and learning to do something,” said Brock.

“It is the place where students apply theoretical and abstract knowledge to a concrete environment. It allows learners to practice the skills necessary for excellent clinical performance before they use those skills on real patients. And it allows reflection on that performance, and identifying and testing opportunities for improvement – with technical, cognitive or teamwork skills.”

The newly-designed space houses a tremendous variety of simulation, a simulated operating room, ICU and more. It also has an entire floor dedicated to 14 patient rooms for the Standardized Patient Program that are equipped with hand-washing sinks, exam tables and patient gowns. There is an area for the student to sit down and take notes at the computer where they can assess a patient case, work through the process of a differential diagnosis to determine what is ailing a patient and develop a treatment plan.

As students go through the first three months of the curriculum, they’ll be working in the simulation rooms. Interactions of the medical students with the standardized patients will be recorded and faculty preceptors will observe from a control room down the hall. Students will receive valuable feedback about their patient examinations from faculty preceptors and learn from watching the playback of their video/audio. As students advance through the curriculum, additional standardized patients will simulate particular illnesses.

Stacie Rearden Hall, an actress and a standardized patient for almost two years, noted that medical students are eager to learn from the perspective of a patient.

“Normally, they don’t get the opportunity to sit down with a patient after an exam to learn how well they communicated,” said Rearden Hall.

“I love this program. It’s a wonderful thing,” she said.

And the medical students are gaining valuable experiences learning to become not only highly skilled doctors but good listeners and communicators.

“It’s been really beneficial to hear what the standardized patients have to say,” said Allison Hastings, a second-year medical student who has worked with standardized patients several times. “It’s a really good opportunity for us to stop and think while it’s fresh in our minds. That opportunity for reflection and feedback is definitely important to improving our performance.”

VCU
Standardized patients, like the one pictured here, are taught to give feedback to medical students and are familiar with steps involved in taking a patient’s history and performing physical examinations. Photos courtesy of VCU Schools of the Arts and Medicine.

Photo courtesy of VCU Schools
of the Arts and Medicine.

Arts and Medicine Collide
Anderson is no stranger to the arts-medicine collaboration. Since 2005, he has been working with colleagues in the VCU Schools of the Arts and Medicine to see how theater training could help physicians develop clinical empathy. In 2007, the VCU team published findings of a pilot study in the Journal of General Internal Medicine suggesting that doctors taught empathy techniques by theater professors show improved bedside manner. In 2010, that training transformed to become the VCU Standardized Patient Program, an in-house program offering services that were formerly outsourced.

“We started this idea by responding to what was then being called a ‘national crisis in healthcare’ – the technical side of medicine had grown so complex that humanism had been all but been pushed out of the curricula of many medical programs,” said Anderson.

In other work, Anderson works closely with David Leong, professor and chairman of the Department of Theatre, as well as Alan Dow, MD, associate professor, and Richard Wenzel, MD, professor, in the Department of Internal Medicine in the School of Medicine, to develop communication workshops that not only strengthen relationships between doctor and patient, but also between health professionals from various backgrounds working to heal a patient. This aspect is highlighted through interprofessional education – another key medical education innovation that has become part of the new curriculum.

“Teams of health care professionals need to communicate and be on the same page,” said Anderson. “We are working on skills and techniques to get them there.”

“Many times I’ve seen arts in medicine change a patient’s life … moments in healthcare are vastly important,” Anderson said. “Even miniscule changes can resonate a lifetime. All patients are vulnerable. This is the nature of healthcare. Arts in medicine can keep a terrible moment from being worse. It can make wonderful moments better. For an artist there is no higher calling.”

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