Background: Patient is a previously healthy 7-week old Hispanic female who presented to an emergency department with cough, congestion and decreased PO intake x 7 days. Baby had an unremarkable prenatal course and normal delivery. Mother was strictly breastfeeding the patient had normal growth and development. One week prior to the ED visit, mother had [...]

Case Presentation: A 31-year-old woman with a history of rheumatic heart disease and a murmur presented with two months of intermittent subjective fevers, diffuse malaise and inability to walk. Physical exam revealed a systolic 2/6 murmur heard best at the apex, 3 out of 5 strength with right knee extension and flexion and 3 out [...]

Case Presentation: A previously healthy 13-year-old Korean-American girl presented with acute altered mental status. She had fatigue, leg and abdominal pain, and was initially diagnosed with “the flu.” Two days later she progressed to worsening pain, emesis, and inability to walk. On admission she was afebrile and had nystagmus, delayed responses, slow speech, weakness, myoclonic [...]

Background: Patient-physician communication is essential to medical care. Simple physician behaviors, such as sitting at the bedside, may bolster patient-physician communication.1-3 Yet despite the potential benefit of sitting, prior work suggests that inpatient physicians do not sit frequently.1,4 Methods: Trained staff performed in-person surveys of patients admitted to seven general internal medicine teaching services from [...]

Background: Engagement in scholarly activity (clinical vignette, conference presentations, publications etc.) is a fundamental requirement for trainees in medical education. We studied the impact of point intervention – clinical vignette workshop (CVW) to write a Clinical Vignettes (CV) for fourth year medical students at author’s institution. Methods: All fourth year medical students enrolled in internal medicine [...]

Background: Case-based scholarship and education are important and longstanding sources of knowledge about new diseases, rare presentations of known diseases, and side effects of treatments. Cases are commonly used to teach clinical decision-making and to tie together theoretical topics to real-life patient care. Hospital Medicine provides access to a myriad of clinical cases. However, sharing [...]

Background: Rising inpatient census, limited physical space and unpredictable admission rates introduce communication inefficiencies among doctors, nurses and patients. Purpose: At UC San Diego Health System, we aimed to streamline communication among physicians, patients and other care team members. Description: Two operational changes were made: 1) establishment of team-based geographic cohorting and 2) segregation of [...]

Background: Attending evaluations by medical students have many implications including promotion, teaching opportunities, job satisfaction and reputation both for individuals and for groups. In addition to teaching on traditional ward teams with housestaff and students, hospitalists are more commonly teaching in an apprenticeship model, where an attending, often carrying a full census, directly supervises and [...]

Background: Fewer than one in three patients can correctly name a physician on their inpatient care team. Despite the fact, factors associated with correctly naming a physician have not been adequately explored. This study evaluates whether physician behaviors and patient characteristics are associated with a patient’s ability to correctly name their hospitalist physician. Methods: We [...]

Background: The COVID-19 pandemic has disrupted healthcare and put enormous stress upon front-line healthcare workers. Physician trainees may be more vulnerable to poor mental health outcomes, including burnout and distress. The objective of this study was to compare mental health indices of attending physicians versus trainees during the COVID-19 pandemic. Methods: A voluntary survey was [...]