Gayatri Boddupalli Madduri

All Publications

• Improving Family-Centered Rounds With a Nursing Checklist in the Electronic Health Care Record. Hospital pediatrics Madduri, G. B., Nichols, T., Gunturkun, F., Johnson, D., Lum, A., Shaner, M. A., Weng, Y., Srinivas, N., Dos Santos, L. 2024; 14 (11): 919-927

  Abstract

  Family-centered rounds (FCR) is the standard for pediatric communication, but community pediatric hospital medicine services may face barriers in implementation, including offering FCR to families with a language preference other than English (LOE) versus those with an English preference (EP). The goal of our quality improvement project was to increase FCR from 33% to 80% over 1 year.Interventions included an FCR checklist integrated into the electronic healthcare record (EHR-FCR checklist), staff education, visual prompts, and interpreters. Our primary outcome measure was weekly % FCR. Our main process measure was weekly % nursing documentation. To address language inclusion, we compared FCR encounters for families with LOE versus EP. The use of the checklist without interventions was assessed during the sustain period. Control charts were used to analyze measures. Fisher's exact test was used to compare FCR for families with LOE versus EP.FCR increased to 81% during the intervention period and then decreased to 73% during the sustain period. Nursing documentation increased to 93% with the EHR-FCR checklist implemented as a flowsheet. There was no statistical difference in the proportion of families with LOE versus EP who participated in FCR (84% versus 81%, P = .38) during the intervention period; a statistically higher proportion of families with LOE participated in FCR during the sustain period (87% vs 72%, P <.01).We increased documented FCR on our community pediatric hospital medicine service, including FCR for families with LOE, by implementing a nursing-completed EHR-FCR checklist supported by staff education, visual prompts, and interpreters.

  View details for DOI 10.1542/hpeds.2023-007469

  View details for PubMedID 39449662

• CRISP: An Inpatient Pediatric Curriculum for Family Medicine Residents Using Clinical Reasoning and Illness Scripts. MedEdPORTAL : the journal of teaching and learning resources Madduri, G. B., Torwekar, E. L., Demirel, S., Durham, M., Hauff, K. I., Kaul, R., Nichols, T., Ravid, N. L., Shaner, M. A., Rassbach, C. E. 2024; 20: 11393

  Abstract

  Clinical reasoning enables safe patient care and is an important competency in medical education but can be challenging to teach. Illness scripts facilitate clinical reasoning but have not been used to create pediatric curricula.We created CRISP (Clinical Reasoning with Illness Scripts in Pediatrics), a curriculum comprising four 1-hour learning sessions that deliberately incorporated clinical reasoning concepts and illness scripts to organize how four common chief complaints were taught to family medicine residents on inpatient pediatric rotations. We performed a multisite curriculum evaluation project over 6 months with family medicine residents at four institutions to assess whether the use of clinical reasoning concepts to structure CRISP was feasible and acceptable for learners and instructors and whether the use of illness scripts increased knowledge of four common pediatric chief complaints.For all learning sessions, family medicine residents and pediatric hospitalists agreed that CRISP's format was preferable to traditional didactic lectures. Pre-/posttest scores showed statistically significant increases in family medicine resident knowledge (respiratory distress [n = 42]: pretest, 72%, posttest, 92%; abdominal pain [n = 44]: pretest, 82%, posttest, 96%; acute febrile limp [n = 44]: pretest, 68%, posttest, 81%; well-appearing febrile infant [n = 42]: pretest, 58%, posttest, 73%; ps < .05).By using clinical reasoning concepts and illness script comparison to structure a pediatric curriculum, CRISP represents a novel instructional approach that can be used by pediatric hospitalists to increase family medicine resident knowledge about diagnoses associated with common pediatric chief complaints.

  View details for DOI 10.15766/mep_2374-8265.11393

  View details for PubMedID 38524942

  View details for PubMedCentralID PMC10957791

• A Narrative Review of Key Studies in Medical Education in 2022: Applying the Current Literature to Educational Practice and Scholarship. Academic pediatrics Collins, J. E., Ryan, M. S., Klein, M., Kloster, H. M., Lockspeiser, T. M., Oddiri, U., Madduri, G. B. 2023

  Abstract

  The expectation of every academic pediatrician is to stay updated on current evidence in their field; this is especially true of pediatric clinician educators who are training the next generation of pediatricians. Since 2016, select members of the Academic Pediatric Association Education Committee have curated educational research articles in order to distill the increasing volume of research related to medical education. The purpose of this narrative review is to summarize 14 articles published in 2022 related to medical education that may impact the work of pediatric clinician educators and educational leadership. These articles are organized into 6 overarching domains: selection and recruitment, promoting learner growth and development, learning environment and wellness, curriculum development, assessment, and educator development.

  View details for DOI 10.1016/j.acap.2023.10.002

  View details for PubMedID 37793606

• A Narrative Review of Key Studies in Medical Education in 2021: Applying Current Literature to Educational Practice and Scholarship ACADEMIC PEDIATRICS Madduri, G. B., Ryan, M. S., Collins, J., Huber, J. N., Potisek, N. M., Wolbrink, T. A., Lockspeiser, T. M. 2023; 23 (3): 550-561

  View details for Web of Science ID 000992071000001

• Healthcare utilization in children across the care continuum during the COVID-19 pandemic. PloS one Schroeder, A. R., Dahlen, A., Purington, N., Alvarez, F., Brooks, R., Destino, L., Madduri, G., Wang, M., Coon, E. R. 2022; 17 (10): e0276461

  Abstract

  OBJECTIVES: Healthcare utilization decreased during the COVID-19 pandemic, likely due to reduced transmission of infections and healthcare avoidance. Though various investigations have described these changing patterns in children, most have analyzed specific care settings. We compared healthcare utilization, prescriptions, and diagnosis patterns in children across the care continuum during the first year of the pandemic with preceding years.STUDY DESIGN: Using national claims data, we compared enrollees under 18 years during the pre-pandemic (January 2016 -mid-March 2020) and pandemic (mid-March 2020 through March 2021) periods. The pandemic was further divided into early (mid-March through mid-June 2020) and middle (mid-June 2020 through March 2021) periods. Utilization was compared using interrupted time series.RESULTS: The mean number of pediatric enrollees/month was 2,519,755 in the pre-pandemic and 2,428,912 in the pandemic period. Utilization decreased across all settings in the early pandemic, with the greatest decrease (76.9%, 95% confidence interval [CI] 72.6-80.5%) seen for urgent care visits. Only well visits returned to pre-pandemic rates during the mid-pandemic. Hospitalizations decreased by 43% (95% CI 37.4-48.1) during the early pandemic and were still 26.6% (17.7-34.6) lower mid-pandemic. However, hospitalizations in non-psychiatric facilities for various mental health disorders increased substantially mid-pandemic.CONCLUSION: Healthcare utilization in children dropped substantially during the first year of the pandemic, with a shift away from infectious diseases and a spike in mental health hospitalizations. These findings are important to characterize as we monitor the health of children, can be used to inform healthcare strategies during subsequent COVID-19 surges and/or future pandemics, and may help identify training gaps for pediatric trainees. Subsequent investigations should examine how changes in healthcare utilization impacted the incidence and outcomes of specific diseases.

  View details for DOI 10.1371/journal.pone.0276461

  View details for PubMedID 36301947