by Lindy Hall on 2020-11-13T11:49:00-05:00 | 0 Comments
From the Director of Medical Education
This quarter has seen rapid changes in the Department of Medical Education. In late August, the Director of the Defense Health Agency approved Womack to begin its Internal Medicine and General Surgery Residency Programs in Summer 2021. The departments have had a successful recruiting season, and medical student interest in Womack has been robust! We are working on the Orthopedic Surgery application, in anticipation of a combined program with Cape Fear Valley Medical Center, to start in Summer 2022.
While GME has been growing, we also opened the Womack Simulation Center on 5-North. This represents a tremendous upgrade for our simulation team, and has rapidly facilitated an increase in in-situ simulation opportunities, partnerships with Patient Safety for PPE training and greater partnerships with HESD.
Finally, we are thrilled to reinstate Womack Grand Rounds. The inaugural Grand Rounds speaker in November was LTC John Berry, discussing updates in treatment for Rectal Cancer. Grand Rounds will be held the 1st Wednesday of every month, at 1300 in the Weaver Auditorium. December's Grand Rounds will be a panel discussion with several Womack providers who deployed in support of the COVID Mission. We are open to suggestions for speakers - please reach out to COL Foglia if you have a suggested speaker, or would like to present Grand Rounds, and look forward to earning CME and having a virtual platform in the next calendar year.
The Department of Clinical Investigation has been busy supporting COVID related research over the past several months, while still maintaining support for non-COVID research projects.
IPAP Graduation
The IPAP class 18-2 graduated October 2nd, 2020 in the Weaver Auditorium. The Army Surgeon General, LTG R. Scott Dingle, served as the virtual guest speaker and recited the Oath of Office for 1LT Esther Spradling. WAMC Troop Battalion Commander, LTC Anastasia McKay, recited the Oath of Office for 1LT Miriam C. Reyna. Hospital Commander COL Jarvis and CSM Stanley were also in attendance.
Graduates included 1LT Mathew Simmons, 1LT Miriam Reyna, 1LT Nicole Rosso and 1LT Esther Spradling.
Scholarly Activity Highlights
The American College of Obstetricians and Gynecologists held their Virtual Annual Meeting from 2-4 October 2020.
The Keynote speaker was LTG Ronald Place, DHA Director: "Taking Command of Your Specialty, the Essential Role of the OB/Gyn Community in in Today's Military".
Womack had several presentations at this meeting. Congratulations to CPT Marion Ward, PGY2, who received one of the 'Outstanding Resident Research' Awards!
VIRTUAL POSTERS
CPT Alexandra Carney PGY4, MAJ Emily Penick: "Endometriosis Masquerading as a Neuroendocrine Tumor in the Rectosigmoid Colon"
CPT Alexandra Carney PGY4: "The Effect of Anti-Coagulation on SSI Following Cesarean Section"
CPT Alexandra Carney PGY4, :The Effect of Aspirin on the Risk for Postpartum Endometritis
CPT Christopher Heurer PGY4, MAJ Emily Penick: "Retained Peritoneal Gallstone Remnants During Laparoscopic Hysterectomy"
CPT Katherine Joseph PGY4, MAJ Emily Penick: "To Gyn or not to Gyn"
CPT Leighann Black PGY3: "Iatrogenic Bladder and Urethral Dysfunction Following Surgery for Endometriosis:
MAJ Emily Penick: Human Epididymis Protein 4 (HE4) Among Women in the United States"
VIRTUAL PODIUM PRESENTATIONS
CPT Marion Ward, PGY2: "Pilot Study Assessing Soldier's Knowledge and Attitudes Regarding HPV Infection and Vaccination among Active Duty Military at Fort Bragg, NC"
CPT Robert Lawrence, PGY3: "Cervical Length Screening in Multi-Fetal Gestations for Prevention of Preterm Birth"
CPT Robert Lawrence, PGY3: "Screening for Early GDM in a High Risk Pregnant Population"
COL Lisa Foglia: "Hysterectomy Volume in Military Residency Graduates - Can Military Training Save the Vaginal Hysterectomy?"
Several Womack Faculty Members were speakers at this event:
LTC Torie Plowden (Armed Forces District Young Physician) - Panel Member for "Reconciling Our Past to Achieve Equity Today" along with Dr. Wanda Nicholson (head of ACOGs Diversity/Equity/Inclusion Task Force) and Dr. Maureen Phipps, CEO of ACOG
LTC Alison Batig (Army Section Chair) - Army Section Breakout
COL Lisa Foglia (Armed Forces District Chair-Elect) - Program Director Academic Breakout Session; Moderator for "Reconciling Our Past to Achieve Equity Today"
Accolades
CPT Christine Spiker, Family Medicine PGY1, had an article published in Clinical Biochemistry. It is truly impressive to achieve a publication as an intern! The novelty of this work is that it is the first paper to establish normative levels of formaldehyde (FA) in humans. Previously, FA was difficult to measure as it is highly volatile. This new assay developed by CDC provides the ability to measure FA and an FA-hemoglobin adduct as it retains the original FA molecule in its entirety. FA has been deemed a carcinogen, so establishing the first ever normative levels can provide a tool to assist in research in this area. Additionally, one of our conclusions was that “humans have a very consistent level of endogenous FA production, and that the consistent measurement of FA-Hb adducts across all demographics is typical of other markers of human physiology/metabolism.” Congratulations to CPT Spiker!
Congratulations to LTC Karen Wilson on her selection for A Designator status!
Congratulations to the class of 2020 USUHS DNP FNP students. They were selected as the AACN 2020-2021 Excellence in Advanced Nursing Practice Award recipients for their project regarding the use of Battlefield Acupuncture (BFA) for the reduction of Low Back Pain (LBP) in Active Duty Soldiers. This is a highly prestigious and competitive recognition, reflecting great credit on USUHS, WAMC, and CRDAMC.
This evidence based practice project was a multi-site intervention at clinics at Ft Bragg and Ft Hood. The project began with BFA educational in-services to clinic providers with the goal of increasing patient education and encouraging providers to incorporate BFA treatment into care plan, ultimately establishing BFA walk-in clinics at both locations. Over 200 charts were audited and a BFA for LBP toolkit was created for clinic and provider reference. Over 230 patients were treated during the intervention period with the results below. The project mirrored the literature in effectiveness for pain relief, but also found significant decreases in new activity limiting profiles and somnolent medication prescriptions, translating to an increase in soldier readiness. Their project was accepted for podium presentation at the 2020 American Academy of Nurse Practitioners National (AANP) and poster at the 2020 Military Health System Research Symposium (both cancelled due to COVID).
Overall Impact:
• 231 Individual patient encounters
o Ft Bragg: 82% (130) reported immediate pain relief (avg 2.1 on 10 point pain scale where 0=no pain)
o Ft Bragg: 46% less likely to be prescribed a somnolent medication
o Ft Hood: 43% (31) reported immediate pain relief (avg 1.9 on 10 point pain scale where 0= no pain)
o After BFA therapy, service members were less likely (Bragg 93%, Hood 52%) to have a new, activity limiting profile
Specifically at Ft Bragg
• 121% Increase in soldiers offered BFA
• 203% increase in BFA rates
The DNP students/new grads who received this award and responsible for this project are: (current duty station)
MAJ Angelyn Brown (Ft Bragg, NC)
MAJ Diana Costa (Ft Bragg, NC)
MAJ Amber Birkle (PCS Bragg to JBLM, WA)
MAJ Vonya Gibbons (PCS Bragg to Ft Meade, MD)
MAJ Marita Prince (Ft Hood, TX)
Simulation Center Highlights
On 14SEPT2020 the Simulation Center on 5N was opened in conjunction with the beginning of Healthcare Simulation Week 2020.
Healthcare Simulation Week celebrates global professionals who use simulation to improve the safety, effectiveness, and efficiency of healthcare delivery. This week also raises awareness in communities nationwide about how healthcare simulation is leading us to safer, more knowledgeable patient care.
The Simulation Center has quickly become a system wide resource for training in the facility and since its opening has hosted Patient Safety PPE training, the Fundamentals of Critical Care Support course, Advanced Trauma Life Support course and the Trauma Nursing Core Course and the Nursing Skills Fair.
Nearly $250K of equipment has arrived or will arrive soon for the Simulation Center, funded by the Army for support for Individual Critical Task List (ICTL) training.
Department of Research
Since the beginning of the year, DCI has been supporting the Ft. Bragg/WAMC response to the COVID-19 pandemic. This included several early clinical trials using remdesivir and convalescent COVID-19 plasma therapy, which are now available at Womack under FDA EUA use. Ongoing studies include: A Multicenter, Adaptive, Randomized Blinded Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for the Treatment of COVID-19 in Hospitalized Adults (ACTT-3) and Epidemiology, Immunology and Clinical Characteristics of Emerging Infectious Diseases (EPICC-EID) with Pandemic Potential. These are two collaborative multi-site national studies being led by the Uniformed Services University of the Health Sciences (USUSHS). Additionally, DCI will be part of Operation Warp Speed as Ft. Bragg has been selected as an Operation Tier 2 DoD site for one of the vaccine candidates.
DCI and the North Carolina Department of Public Health have agreed to collaborate in the genetic epidemiology of respiratory illnesses within the state’s Flu Region 3 which includes Ft. Bragg and the surrounding 11 counties. Briefly, genomic sequence data from respiratory disease pathogens will inform NC DPH and Ft. Bragg leadership on the specific type and strain of pathogen that is present or ‘in transit’ within this geographic area. DCI continues to lead the OSPREY Team, which, composed of WAMC health care providers, informs the senior leadership at Ft. Bragg on the current state of ongoing health care delivery efforts and the upcoming mitigation strategies during the pandemic. Our collective efforts include the Force Health Protection and Surveillance for the XVIII Airborne Corps, the 82nd ABN DIV, and JSOC among others.
The process improvement project titled “Safe Post: Mobile App Intervention Project for Sexual Assault and Intimate Partner Violence within the Military Community” was recently funded by the Advanced Medical Technology Initiative (AMTI). This 18 month project involves the usability of ‘myPlan’, a decision aide and safety planning mobile application. The study will also explore its impact on intimate partner violence (IPV) prevention among Fort Bragg Service Members and spouses through the use of interviews and surveys.
On 24 August, DCI received a fully executed data sharing agreement with Defense Manpower Data Center to incorporate information from all services into the Medical Assessment and Readiness System (MARS). MARS is a massive longitudinal database of US Army active duty Soldiers from 2014-2017 that will eventually include all data from 2018 and will be continually updated. It provides information such as demographic, anthropometric, diagnostic (all ICD-10 codes), radiographic (all free text radiology interpretations for total Army Soldiers' radiology reports done at MTFs), medical profile data, admin data (e.g. weapons qualifications, MOS, unit assignment such as 82nd ABD), and standard testing such as ANAM or GAD. Moreover, DCI is coordinating the access to and use of medical records from the Dept. of Veterans Affairs. This will further expand the enterprise level capabilities of the MARS in support of a WAMC-based Center of Excellence for observational research.
For more information about these and other research, areas please contact the DCI at 910-907-6522.
Welcome to our New Personnel
Mrs. Joanna Rodriguez: Professional Education Residency Program Coordinator
Ms. Joanna Rodriguez was born and raised in Southern California. Her first position as a federal employee was held with DoDEA while in Germany. Upon her relocation to Fort Bragg, she has held positions within USASOC. She enjoys the outdoors; eating delicious food; and basketball. Go Lakers!!! She is happy and excited to be part of the WAMC team.
Ms. Rodriguez is the administrative point of contact for the Clinical Psychology Internship Program, Clinical Psychology Residency Program, Social Work Internship Program, Podiatry and Nutrition Care programs at Womack.
Ms. Andrea Miller: DME Student Coordinator
Ms. Andrea Miller has been with Womack with the Department of Medical Education for just over a year and a half previously serving in the capacity of COL Lisa Foglia’s Executive Assistant. She has spent her time here learning the ropes and jumping through hoops for the Department of Medical Education. She has transitioned to the role of GME Student Coordinator. We are excited to watch her progress in this new role! This is a great fit for her for her welcoming welcoming personality and we know she will take great care of our students!
Ms. Miller will be responsible for all non-USUHS students who conduct rotations at Womack.
Mrs. Tracy Bryant: DME Executive Assistant
Mrs. Bryant was born and raised in Savannah, GA, and is a military veteran. She has two children, a daughter who is a retired military veteran, and a son who is an AG 1LT stationed at Fort Bliss. She has previously held various Social Service Assistant positions at the SRU and FAP, and is a graduate of Pembroke University obtaining her MSW. In her free time, it’s all about her grandson! She truly enjoys reading a good suspense novel, or completing find-a-word puzzles. We are thrilled to welcome her to the team as COL Foglia's Executive Assistant!
Mrs. Carla Heilman: DME Program Support Specialist
Mrs. Heilman is well known to Womack, having served as the student coordinator. We are thrilled to announce that she has been promoted to the DME Program Support Specialist! She serves as the go-to person for all training agreements, and plays a critical role in preparation for Intern Orientation, Graduation and financial management of the Department of Medical Education. We are so proud of her and thrilled to continue to have her on our team!
LTC Lindsey Graham: Internal Medicine Program Director
In November, LTC Lindsey Graham was selected as the Internal Medicine Program Director. We are thrilled to welcome her to the GME team! She currently serves as the Chief of Hematology/Oncology, and is well known for her outstanding teaching skills. She is an Assistant Professor of Internal Medicine at the Uniformed Services University, and has several peer-reviewed publications.
Medical Student Clerkship Changes
Effective August 3rd, MAJ Julie Baunchalk took over as the USUHS Pediatric Clerkship Coordinator replacing CPT Cierrea Roach. Thank you to CPT Roach for your hard work and a warm welcome to MAJ Baunchalk!
We are working with the Uniformed Services University to expand medical student core clerkship rotations in Internal Medicine and General Surgery, as well as electives in Pathology and Orthopedic Surgery. We already have core rotations in Family Medicine, Obstetrics & Gynecology and Pediatrics. If your department is interested in making rotations available for USUHS students, please contact COL Foglia or Ms. Angela Johansen, USUHS Student Coordinator.
Call for Speakers
The US Army Recruiting Station in Raleigh, NC is looking for individuals who are interested in speaking at local residency programs and medical schools in nearly every medical specialty. If you are interested, please reach out to CPT Abner Michel AN, Station OIC of the Physician Acquisition Team, at abner.michel.mil@mail.mil.
Mrs. Joanna Rodriguez: Professional Education Residency Program Coordinator
Ms. Andrea Miller: DME Student Coordinator
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