Creating a web of support: an important leadership strategy for advancing campus diversity

Research demonstrates that leadership, particularly among presidents, is important for moving a diversity agenda forward and make appreciable progress on it. The research questions pursued here are: What is the role of the college president in advancing a diversity agenda? What strategies do presidents identify as important to facilitating a diversity agenda? There were three main findings: (1) strategies are deployed in a non-linear way best represented through a web metaphor, (2) six sets of actors that serve as key nodes on the web and specific strategies were crucial to enhancing and deepening the web-developing an internal network, hiring, mentoring, partnering with faculty on the curriculum, supporting student affairs staff, working directly with and learning from students, and establishing external networks; and, (3) strategies within the human resource frame are noted by presidents as particularly important to moving a diversity agenda forward.     

Mandatory criteria for the application of variability-based parameters of fluid responsiveness: a prospective study in different groups of ICU patients

Background and objective

Stroke volume variation (SVV) has high sensitivity and specificity in predicting fluid responsiveness. However, sinus rhythm (SR) and controlled mechanical ventilation (CV) are mandatory for their application. Several studies suggest a limited applicability of SVV in intensive care unit (ICU) patients. We hypothesized that the applicability of SVV might be different over time and within certain subgroups of ICU patients. Therefore, we analysed the prevalence of SR and CV in ICU patients during the first 24 h of PiCCO-monitoring (primary endpoint) and during the total ICU stay. We also investigated the applicability of SVV in the subgroups of patients with sepsis, cirrhosis, and acute pancreatitis.

Methods

The prevalence of SR and CV was documented immediately before 1241 thermodilution measurements in 88 patients.Results: In all measurements, SVV was applicable in about 24%. However, the applicability of SVV was time-dependent: the prevalence of both SR and CV was higher during the first 24 h compared to measurements thereafter (36.1% vs. 21.9%; P<0.001). Within different subgroups, the applicability during the first 24 h of monitoring ranged between 0% in acute pancreatitis, 25.5% in liver failure, and 48.9% in patients without pancreatitis, liver failure, pneumonia or sepsis.

Conclusions

The applicability of SVV in a predominantly medical ICU is only about 25%–35%. The prevalence of both mandatory criteria decreases over time during the ICU stay. Furthermore, the applicability is particularly low in patients with acute pancreatitis and liver failure.

     

Examining the Institutional Transformation Process: The Importance of Sensemaking,Interrelated Strategies,and Balance

This study develops elements of a transformational change framework that is theoretically and empirically grounded and is context based through case studies of 6 institutions over a 4-year period. The 3 key findings include: (a) 5 core strategies for transformational change; (b) the characteristic that makes them the essential, sensemaking; and (c) the interrelationship among core and secondary strategies, the nonlinear process of change, and the need for balance among strategies. Two major conclusions are developed from the study findings: (a) the efficacy for researchers of combining multiple conceptual models for understanding change processes; and (b) the importance of social cognition models for future studies of transformational change based on the significance of sensemaking.     

Orthopedic resident anatomy review course: a collaboration between anatomists and orthopedic surgeons

A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months for all of its residents. The primary purpose of the course is to renew competencies in basic science disciplines so that incoming residents more quickly reach a level of functional proficiency and to afford senior residents a platform to teach their junior colleagues. Before 2005, this course was conducted with minimal participation from anyone outside of the Department of Orthopaedics. Many of the residents voiced concerns that the educational benefits were not proportionate to the time invested. To improve the teaching of orthopedic-related anatomy, an educational collaboration between the Departments of Neurobiology and Anatomy and Orthopaedics was established in 2004 and continues to the present time. The major objectives of refining the course pedagogy, developing a Course Manual and Dissection Guide, and evaluating the results by administering a course survey questionnaire are described in this article. Implementation of all facets of the revised course has resulted in better participation by orthopedic faculty and more favorable reviews by the participating residents. Based on current levels of interest and positive comments from course participants, the Anatomy and Orthopedic faculty course directors plan to continue to develop course materials and pedagogy.