Bio


Becky is a fellowship-trained Pediatric Hospitalist, who enjoys working at both a tertiary center and a community hospital, California Pacific Medical Center, within the Stanford network. Her roles include direct clinical care, LPCH resident rotation director for the nighttime rotation and surgical co-management rotations, community hospital medical education director for pediatrics (medical students and fellows), clinical research, and local quality improvement projects.

Clinical Focus


  • Pediatrics
  • Pediatric Hospital Medicine

Academic Appointments


  • Clinical Assistant Professor, Pediatrics

Professional Education


  • Board Certification: American Board of Pediatrics, Pediatric Hospital Medicine (2019)
  • Fellowship: UCSD/Rady Children's Hospital (2016) CA
  • Medical Education: University of Southern California Keck School of Medicine (2009) CA
  • Residency: Children's Hospital and Research Center Oakland Pediatric Residency (2012) CA
  • Board Certification: American Board of Pediatrics, Pediatrics (2012)

Research Interests


  • Professional Development
  • Teachers and Teaching

Current Research and Scholarly Interests


Medical Education Projects

- Nighttime curriculum "Nighttime Nuggets" which re-vamps the previous National Nighttime Curriculum into a quick-hits format to facilitate senior-as-teacher model

- Senior Resident Admission Calls: Pilot to study KSA changes as we shift to a model where the senior resident takes ER calls (where previously was hospitalist only) with scaffolding measures in place to promote autonomy


Quality Improvement
- New sedation service launch -- goal to prevent escalations from moderate sedation to general anesthesia and reduce re-scheduled procedures due to failed sedation


Clinical Research
- Stanford site lead; Using PHIS database to develop algorithm for studying MIS-C; multi-center study led by Auger, Brady, Shah et. al.

All Publications


  • Imperative Instruction for Pressurized Metered-Dose Inhalers: Provider Perspectives RESPIRATORY CARE Schmitz, D. C., Ivancie, R. A., Rhee, K. E., Pierce, H. C., Cantu, A. O., Fisher, E. S. 2019; 64 (3): 292–98

    Abstract

    Reports show that many patients do not use their pressurized metered-dose inhalers (pMDIs) effectively. The National Heart, Lung, and Blood Institute recommends that health-care providers educate and assess patients' pMDI technique at each opportunity. However, limited data exist regarding how often pediatric primary care providers perform assessments and which methods they use. We sought to (1) identify instructional methods used to teach pMDI use, (2) describe how pMDI use is reassessed at follow-up visits, and (3) describe primary care provider attitudes and barriers to in-office pMDI instruction.A 34-item electronic survey was distributed from August to December 2016 via E-mail to local pediatric primary care providers. Descriptive statistics were used for analysis.Sixty two of 223 potential primary care providers (28%) responded. Physicians and nurse practitioners were identified most often as the providers of pMDI education (53%). When first prescribing a pMDI, only 10% reported having the patient practice inhaler use in the office and receive feedback. Only 19% "always" reassessed the technique, even for patients with poorly controlled asthma. Among those who reassessed the technique, most (76%) did so verbally, and only 42% asked the patients to demonstrate pMDI use. Only 32% reported that typical patient education in their setting was adequate to ensure proper pMDI use. Commonly cited barriers included time (84%) and access to demo pMDIs (67%). Provider solutions included video tutorials and access to demo inhalers.Many pediatric primary care providers did not demonstrate or have patients practice pMDI use when teaching or assessing pMDI technique, and the reassessment rate was low even for patients with poorly controlled asthma. Identifying and training a consistent pMDI educator and obtaining demo pMDIs may abate some barriers. Respiratory therapists could appropriately fulfill this educator role. Brief, repeated pMDI practice for motor learning could promote more stable pMDI mastery.

    View details for PubMedID 30254041

  • Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke. Archives of physical medicine and rehabilitation Celnik, P., Hummel, F., Harris-Love, M., Wolk, R., Cohen, L. G. 2007; 88 (11): 1369-76

    Abstract

    To test the hypothesis that somatosensory stimulation would enhance the effects of training functional hand tasks immediately after practice and 1 day later in chronic subcortical stroke patients.Single-blinded and randomized, crossover study.Human research laboratory.Nine chronic subcortical stroke patients.Three separate sessions of motor training preceded by (1) synchronous peripheral nerve stimulation (PNS), (2) no stimulation, or (3) asynchronous PNS.Time to complete the Jebsen-Taylor Hand Function Test (JTHFT time) and corticomotor excitability tested with transcranial magnetic stimulation.After familiarization practice, during which all patients reached a performance plateau, training under the effects of PNS reduced JTHFT time by 10% beyond the post-familiarization plateau. This behavioral gain was accompanied by a specific reduction in GABAergically mediated intracortical inhibition in the motor cortex. These findings were not observed after similar practice under the influence of no stimulation or asynchronous PNS sessions.Somatosensory stimulation may enhance the training of functional hand tasks in patients with chronic stroke, possibly through modulation of intracortical GABAergic pathways.

    View details for DOI 10.1016/j.apmr.2007.08.001

    View details for PubMedID 17964875