Objective
To describe experiences and activities of Clinical Informatics (CI) fellows since the first fellowships were accredited in 2014.
Materials and Methods
We performed a voluntary and anonymous survey of 394 alumni and current clinical informatics fellows from the graduating classes of 2016–2024 in the summer of 2022.
Results
We received 198 responses; 2% declined to participate. Most were male (62%), White (39%), 31–40 years old (72%), from primary care specialties (54%) and nonprocedural specialties (95%), and without prior informatics experience or any careers before medicine. Most fellows (87–94%) participated significantly in operations, research, coursework, quality improvement, and clinical care activities during fellowship.
Discussion
Women, underrepresented racial and ethnic minorities, and procedural physicians were underrepresented. Many incoming CI fellows did not have an informatics background. During CI fellowship, trainees earned Master’s degrees and certificates, were exposed to many different types of CI activities, and were able to spend most of their time pursuing projects that supported their personal career goals.
Conclusion
These findings represent the most comprehensive report to date of CI fellows and alumni. Physicians without prior informatics experience who are interested in CI should be encouraged to apply because CI fellowship provides a strong foundation of informatics knowledge while supporting fellows’ personal career goals. There remains a lack of women and underrepresented minorities in CI fellowship programs; efforts to expand the pipeline are needed.
including 17,000 pediatric patients) and busy tertiary care pediatric hospital (80, 000 ED visits annually) from January 2015 to December 2020. Patients were included if they had an age less than or equal to 18 years, had an ultrasound done as part of their initial ED work up, and had appendicitis confirmed on surgical pathology. Patients were excluded if an alternate diagnosis was found on pathology or if their appendix was not removed during the same hospitalization. A multivariate analysis was used to compare the rates of inconclusive ultrasounds, computed tomography, magnetic resonance imaging, and ruptured appendicitis. All tests were two-sided and performed using SAS EG 7.13 (Cary, NC). P values of less than 0.05 were considered statistically significant.Results: There were 256 patients at the community hospital and 2,925 patients at the pediatric hospital that met all criteria. Both hospitals had similar baseline demographics (age, sex, body mass index, weight, and weight-for-age percentile). The community ED had a higher inconclusive rate of ultrasound (41% vs. 34.7%, p ¼0.04) and a higher rate of subsequent computed tomography imaging (43% vs 20.8%, p<0.0001) than the pediatric ED. The pediatric hospital has a higher rate of ruptured appendicitis compared to the community hospital (33.3% vs 12.9%, p<0.0001).Conclusion: Pediatric emergency departments more accurately diagnosed appendicitis using ultrasound. Pediatric patients with appendicitis presenting to a community hospital are more likely to have an inconclusive ultrasound leading to subsequent utilization of computed tomography.
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