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Evans L, Greenberger S, Freeze-Ramsey R, Young A, Sparks C, Seupaul R, Eastin T, Eastin C. Improvement in Resident Scholarly Output with Implementation of a Scholarly Activity Guideline and Point System. West J Emerg Med 2023; 24:861-867. [PMID: 37788026 PMCID: PMC10527827 DOI: 10.5811/westjem.60346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/27/2023] [Accepted: 07/19/2023] [Indexed: 10/04/2023] Open
Abstract
Introduction: Ensuring high-quality scholarly output by graduate medical trainees can be a challenge. Within many specialties, including emergency medicine (EM), it is unclear what constitutes appropriate resident scholarly activity. We hypothesized that the quantity and quality of scholarly activity would improve with a clearer guideline, including a point system for eligible scholarly activities. Methods: A resident Scholarly Activity Guideline was implemented for EM residents in a university setting. The guideline consists of a point system in which point values, ranging from 1-10, are assigned to various types of scholarly activities. Residents must earn at least 10 points and present their work to meet their scholarly graduation requirement. We tracked scholarly activities for graduates from the classes of 2014-2020, with the guideline being implemented for the class of 2016. In a blind analysis, we compared median total points per resident, mean counts of the Boyer model of scholarship components per resident, and mean counts of significant scholarly output per resident before vs after the guideline was implemented. Significant scholarly output was defined as an implemented protocol, a research project with data collection and analysis, a research abstract presentation, or an oral abstract presentation. Results: Among 64 residents analyzed, 48 residents used the guideline. We found that median points per resident increased after the guideline was implemented (median, interquartile range: before 7 [7], after 11 [10, 13], P = 0.002). Post-guideline scholarly activities were found to represent more of Boyer's components of scholarship [mean before 0.81 [SD 0.40], mean after 1.52 [SD 0.71], mean difference 0.71, 95% confidence interval [CI] 0.332 ± 1.09, P < 0.001. There was no difference in the mean significant scholarly output per resident (mean before 1.38 [SD 1.02], mean after 1.02 [SD 1.00], mean difference 0.35, 95% CI 0.93 ± 0.23, P = 0.23). Conclusion: Implementation of a Scholarly Activity Guideline point system significantly increased the quantity and, by one of two measures, increased the quality of scholarly output in our program. Our point-based guideline successfully incorporated traditional and modern forms of scholarship that can be tailored to resident interests.
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Affiliation(s)
- Lauren Evans
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Sarah Greenberger
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Rachael Freeze-Ramsey
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Amanda Young
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Crystal Sparks
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Rawle Seupaul
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Travis Eastin
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
| | - Carly Eastin
- University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas
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Pillow MT, Gottlieb M, Messman A, Hartman ND, Tsyrulnik A, Barnes D, Lall MD, Sule H. Reconceptualizing the emergency medicine resident scholarly requirement: Proposed framework and rubric. AEM EDUCATION AND TRAINING 2023; 7:S33-S40. [PMID: 37383837 PMCID: PMC10294215 DOI: 10.1002/aet2.10878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/30/2023]
Abstract
Background The completion of a scholarly project is a common program requirement by the Accreditation Council for Graduate Medical Education (ACGME) for all residency training programs. However, the implementation can vary significantly between programs. Lack of generalizable standards for scholarly projects required of all trainees within ACGME-accredited residencies has led to a large range of quality and effort put forth to complete these projects. Our goal is to introduce a framework and propose a corresponding rubric for application to resident scholarship to quantify and qualify the components of scholarship to better measure resident scholarly output across the graduate medical education (GME) continuum. Methods Eight experienced educators and members of the Society for Academic Emergency Medicine Education Committee were selected to explore the current scholarly project guidelines and propose a definition that can be universally applied to diverse training programs. Following a review of the current literature, the authors engaged in iterative, divergent, and convergent discussions via meetings and asynchronous dialogue to develop a framework and associated rubric. Results The group proposes that emergency medicine (EM) resident scholarship should (1) involve a structured process, (2) generate outcomes, (3) be disseminated, and (4) be peer reviewed. These components of resident scholarly activity are achieved whether this is a single project encompassing all four domains, or multiple smaller projects that sum to the whole. To assist residency programs in assessing a given individual resident's achievement of the standards set forth, a rubric is proposed. Conclusion Based on current literature and consensus, we propose a framework and rubric for tracking of resident scholarly project achievement in an effort to elevate and advance EM scholarship. Future work should explore the optimal application of this framework and define minimal scholarship goals for EM resident scholarship.
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Affiliation(s)
| | | | - Anne Messman
- Wayne State University School of MedicineDetroitMichiganUSA
| | | | | | - David Barnes
- University of CaliforniaDavis School of MedicineSacramentoCaliforniaUSA
| | | | - Harsh Sule
- Rutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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Fallon TS, Germann CA, Anderson RS, Strout TD. The research escape hunt: An escape room-scavenger hunt for resident education. AEM EDUCATION AND TRAINING 2022; 6:e10833. [PMID: 36562029 PMCID: PMC9764032 DOI: 10.1002/aet2.10833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
Objectives Research and evidence-based medicine (EBM) education are important elements of emergency medicine (EM) residency training; however, curricular time is limited and integrating novel strategies to engage learners and improve understanding of complex concepts is challenging. We sought to develop a unique research escape hunt educational experience to teach EM residents basic research and EBM skills using an active-learning, team-based strategy. Methods A nine-station escape room-scavenger hunt was designed around educational content including (1) predictive statistics and diagnostic test characteristics, (2) interpretation of data and statistical analysis, (3) study design, (4) informed consent for research, and (5) the ethical principles guiding research. Stations required participants to use a variety of strategies to solve puzzles, with a correct response required to progress through the escape hunt. Teams worked together to solve each station's puzzles, with opportunities to reinforce the content in real time. Subsequent sessions were presented in a virtual format using Zoom breakout rooms over the past 2 years. Results Postactivity assessments were grounded in Kirkpatrick's model and focused on participants' reactions, learning, and behavior. Participants reported high levels of satisfaction (100% [21/21] "satisfied" or "extremely satisfied") and engagement (95% [20/21] "engaged" or "very engaged") with the activity, as well as increased comfort with the research and EBM concepts covered (91% [19/21] "agree" or "strongly agree" increased comfort), and demonstrated improvements in knowledge across each content area presented (91% [19/21]). Reflective Discussion This practical, team-based curriculum was found to be a successful way to engage residents with research methodology and EBM content. This curriculum is feasible for both in-person and virtual formats and we will continue to use this as a component of our EM residency program moving forward.
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Affiliation(s)
- Timothy S. Fallon
- Department of Emergency MedicineMaine Medical Center, Tufts University School of MedicinePortlandMaineUSA
| | - Carl A. Germann
- Department of Emergency MedicineMaine Medical Center, Tufts University School of MedicinePortlandMaineUSA
| | - Robert S. Anderson
- Department of Emergency MedicineMaine Medical Center, Tufts University School of MedicinePortlandMaineUSA
| | - Tania D. Strout
- Department of Emergency MedicineMaine Medical Center, Tufts University School of MedicinePortlandMaineUSA
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Jordan J, Berger M, Curato M, Ilgen JS, Hopson LR, Clarke SO, Chipman AK, Janicki A, Gottlieb M. "Not just a checkbox": A qualitative study of the resident scholarly experience. AEM EDUCATION AND TRAINING 2022; 6:e10824. [PMID: 36562030 PMCID: PMC9763974 DOI: 10.1002/aet2.10824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/07/2022] [Accepted: 10/20/2022] [Indexed: 06/17/2023]
Abstract
Objectives Scholarship is a requirement of residency training; however, the scholarly productivity of trainees is highly variable. The purpose of this study was to explore the perspectives of residents who have been highly productive in scholarship. Methods We performed a qualitative study using a constructivist-interpretivist paradigm and conducted semistructured interviews at seven Accreditation Council for Graduate Medical Education-accredited emergency medicine residency programs in the United States. We included sites of diverse locations and training formats (PGY-1 to -4 vs. PGY-1 to -3). Program leadership identified residents with high levels of scholarly productivity at their institutions. We used purposive sampling to seek out residents with diversity in gender and PGY level. Two researchers independently performed a thematic analysis of interview transcripts. Discrepancies were resolved through in-depth discussion and negotiated consensus. Results We invited 14 residents and all consented to be interviewed. Residents felt scholarship enhanced their knowledge and skills, grew collaborative networks, and provided personal fulfillment and external rewards. Scholarship positively impacted their careers by focusing their professional interests and informing career decisions. Participants identified individual and institutional facilitators of success including personal prior knowledge and skills, project management skills, mindset, protected time, mentorship, and leadership support. Challenges to conducting scholarship included lack of time, expertise, and resources. Participants acknowledged that participating in scholarly activities was hard work and recommended that residents seek out quality mentorship, work on projects that they are passionate, start early, and be persistent in their efforts. Participants' advice to faculty supporting resident scholarship included recommendations to allow resident autonomy of projects, provide scholarly opportunities, and be responsive to trainee needs. Conclusions Participants in this study highlighted benefits of participating in scholarly activity as well as challenges and strategies for success. These results can inform residencies seeking to enhance the scholarly experience of trainees.
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Affiliation(s)
- Jaime Jordan
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Max Berger
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Mark Curato
- Department of Emergency MedicineNew YorkNew YorkUSA
| | - Jonathan S. Ilgen
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Laura R. Hopson
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Samuel O. Clarke
- Department of Emergency MedicineUC Davis HealthSacramentoCaliforniaUSA
| | - Anne K. Chipman
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Adam Janicki
- Department of Emergency MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Michael Gottlieb
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
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Schreyer KE, del Portal DA, Blome A, DeAngelis M, Ufberg JW. The content expert program: A structured approach to increase emergency medicine resident scholarly activity. AEM EDUCATION AND TRAINING 2022; 6:e10758. [PMID: 35656535 PMCID: PMC9125506 DOI: 10.1002/aet2.10758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 06/03/2023]
Abstract
Objectives The Accreditation Council for Graduate Medical Education requires residents to participate in scholarship and requires residency programs to provide an environment within which residents can acquire skills related to scholarly activities. However, consensus on the definition of scholarship and structure of program environments does not yet exist. We designed and implemented a content expert program (CEP) in 2015, in which each resident worked with a faculty advisor to develop a longitudinal scholarly activity linked to a core area of practice and, in doing so, became the department's "content expert." We hypothesized that the CEP would significantly increase the number of scholarly outputs per resident. Methods The CEP was structured around an oversight committee composed of key faculty members, which guided development of CEP projects through regular meetings and formative feedback. Each resident generated one or more scholarly outputs from their content area. Outputs were categorized into educational, operational, research, and miscellaneous domains and further identified as intradepartmental, interdepartmental, or interdisciplinary collaborations. The number of outputs was compared to the baseline number of scholarly activities per resident at the study program using a Mann-Whitney U test. Results A total of 187 scholarly outputs were generated by 76 residents, which equated to 31.2 outputs per year, or 2.5 outputs per resident. This was a significant increase compared to the program baseline of one output per resident (p = 0.003). Eighteen distinct types of outputs spanned four major categories. Of the outputs, 37 were interdepartmental, 42 were interdisciplinary, and 32 were intradepartmental. Conclusions The CEP proved to be a sustainable way to significantly increase scholarly activity and additionally improved collaborative efforts. With the appropriate structure and willing faculty in place, such a program can enhance the practical education provided by residency programs.
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Affiliation(s)
- Kraftin E. Schreyer
- Department of Emergency MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Daniel A. del Portal
- Department of Emergency MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Andrea Blome
- Department of Emergency MedicineOchsner Medical CenterNew OrleansLouisianaUSA
| | - Michael DeAngelis
- Department of Emergency MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
| | - Jacob W. Ufberg
- Department of Emergency MedicineTemple University HospitalPhiladelphiaPennsylvaniaUSA
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Wisniewski SJ, Corser WD. Common Problematic Scholarly Activity Project Planning Expectations of Project Novices. Spartan Med Res J 2021; 6:21274. [PMID: 33870001 PMCID: PMC8043909 DOI: 10.51894/001c.21274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Scholarly Activity (SA) projects, whether using methods more traditionally associated with research and or "quality improvement" projects, have been shown to confer value to resident physicians and other project novices in multiple ways. The inclusion of community and university-based residents and faculty in spearheading SA projects has led to improved understanding of medical literature and enhanced clinical practices, arguably producing more "well-rounded" physicians. PURPOSE OF PAPER The primary purpose of this paper is to provide a summary of problematic expectations frequently assumed by project novices when developing and conducting SA projects. RESULTS The authors will discuss a total of 26 problematic project-related novice expectations during five typical project phase categories. CONCLUSIONS Learning to navigate the complexities of training to become a practicing physician, while also planning high quality SA project designs has been and will continue to be a complex challenge. The authors hope that this article can be used by supervising faculty and other graduate medical education mentors to assist the SA project novice (SAPN) plan SA projects. By establishing realistic expectations during project planning phases, the SAPN can avoid potential missteps that typically impede SA project completion.
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Garg N, Kumar P, Gupta S. Concept of virtual research scribes in clinical research in emergency medicine. Am J Emerg Med 2021; 47:30-34. [PMID: 33756130 DOI: 10.1016/j.ajem.2021.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Due to the unique nature of working in the field of emergency medicine (EM), physicians often find it difficult to engage in research and scholarly activity while also working clinical shifts. Barriers to engaging in both academic and clinical work include lack of time, resources, and incentives. EM physicians are familiar with the concept of scribes working alongside them in the emergency department, and there are multiple papers published that examine and advocate for their benefits. OBJECTIVES This paper aims to introduce the concept of virtual research scribes in clinical research in EM to offer physicians an opportunity to alleviate the burdens of balancing clinical work and academia simultaneously. METHODS A research scribe is a student who is interested in healthcare and research and aids the PI in literature reviews and manuscript writing and editing, completely remotely. Six research scribes were hired in a pilot program to test their efficacy in a clinical research setting. The scribes were assigned tasks including manuscript writing and editing, performing literature reviews, and writing newsletters. RESULTS The six research scribes in the pilot program proved to be beneficial for time management, collaboration, and editing in the research and scholarly process. The remote nature of the program allowed for flexibility in scheduling on both the PI and scribe's behalf. CONCLUSION By utilizing a research scribe in their academic career, EM physicians can increase efficiency and productivity in scholarly work.
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Affiliation(s)
- Nidhi Garg
- Southside Hospital, Northwell Health, 301 E Main St, Bayshore, NY 11706, United States of America.
| | - Pridha Kumar
- Long Island Jewish Medical Center, Northwell Health, 270-05 76(th) Ave, New Hyde Park, NY 11040, United States of America.
| | - Sanjey Gupta
- Southside Hospital, Northwell Health, 301 E Main St, Bayshore, NY 11706, United States of America.
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Scholarly Activity Training During Pediatric Residency: How Well Aligned Are Program Directors and Residents? Acad Pediatr 2020; 20:998-1006. [PMID: 32087378 DOI: 10.1016/j.acap.2020.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Training residents to be scholars is endorsed by leading medical education organizations. Our previous research suggests that the scholarly activity (SA) training experience is highly variable across pediatric residency programs, and residents and program directors (PDs) are generally dissatisfied. Understanding how PD and resident views align can help programs better guide resource allocation and improvement efforts. METHODS We conducted cross-sectional surveys of second and third year pediatric residents and PDs at 22 diverse US categorical programs. We compared resident and PD responses to SA training beliefs, barriers, and satisfaction by 2-proportion z tests. We used descriptive statistics to describe resident responses in relation to same-institution PD responses. RESULTS About 464 of 771 residents (60.2%) and 22 PDs (100%) responded. Across programs, PDs more strongly agreed that all residents should participate in SA (59% of PDs [n = 13] versus 27% of residents [n = 127], P = .002). Residents more strongly believed all residents should have protected SA time (91% of residents [n = 424] versus 68% of PDs [n = 15], P = .001). PDs more strongly perceived gaps in other resources as barriers, including lack of funding to conduct or present SA (P < .001, P = .02), lack of statistical support (P = .03), and lack of faculty mentorship (P < .001). Within program concordance was low. CONCLUSIONS Discordance exists between PDs and residents with respect to SA participation and necessary resources, particularly, protected time. Programs must help residents identify when SA can be accomplished. Clearer national guidelines around SA training may also be necessary to reduce discordance and improve perceptions.
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Paxton JH, Messman AM, Harrison NE, Malik AN, Burke RJ, Levy PD. Resident Research in Emergency Medicine: An Introduction and Primer. West J Emerg Med 2020; 21:1118-1122. [PMID: 32970564 PMCID: PMC7514385 DOI: 10.5811/westjem.2020.6.46520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/30/2020] [Indexed: 11/29/2022] Open
Abstract
Training in research methodology represents an important aspect of emergency medicine (EM) resident education, but best methods for design, implementation, and dissemination of resident research remain elusive. Here we describe recommendations and best practices from the existing literature on EM resident research, including helpful tips on how to best implement a resident research program.
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Affiliation(s)
- James H Paxton
- Wayne State University, Department of Emergency Medicine, Detroit, Michigan
| | - Anne M Messman
- Wayne State University, Department of Emergency Medicine, Detroit, Michigan
| | | | - Adrienne N Malik
- Kansas University Medical Center, Department of Emergency Medicine, Kansas City, Kansas
| | - Raina J Burke
- Wheeling Hospital, Department of Emergency Medicine, Wheeling, West Virginia
| | - Phillip D Levy
- Wayne State University, Department of Emergency Medicine, Detroit, Michigan
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Abramson EL, Naifeh MM, Stevenson MD, Clifton S, Li STT. Scholarly Activity Training During Residency: A Progress Report. Acad Pediatr 2020; 20:438-439. [PMID: 31857251 DOI: 10.1016/j.acap.2019.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/14/2019] [Accepted: 12/13/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Erika L Abramson
- Departments of Pediatrics and Healthcare Policy & Research, Weill Cornell Medicine (EL Abramson), New York, NY.
| | - Monique M Naifeh
- Department of Pediatrics, University of Oklahoma Health Sciences Center (MM Naifeh), Oklahoma City, Okla
| | - Michelle D Stevenson
- Department of Pediatrics, University of Louisville (MD Stevenson), Louisville, Ky
| | - Shari Clifton
- Health Sciences Library and Information Management, University of Oklahoma Health Sciences Center (S Clifton), Oklahoma City, Okla
| | - Su-Ting T Li
- Department of Pediatrics, University of California Davis (S-TT Li), Sacramento, Calif
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