Clinical Focus

  • Pediatric Hospital Medicine

Academic Appointments

  • Clinical Assistant Professor, Pediatrics

Administrative Appointments

  • Clinical Faculty, Co-Director of Inpatient Pediatrics, John Muir Family Practice Residency (2018 - Present)
  • Subject Matter Expert, Pediatrics, John Muir Hospital Physician IT Leadership (2018 - Present)
  • Epic Physician Builder, John Muir Hospital (2020 - Present)

Professional Education

  • Board Certification: American Osteopathic Board of Preventive Medicine, Clinical Informatics (2024)
  • Board Certification: American Board of Pediatrics, Pediatric Hospital Medicine (2022)
  • Medical Education: Touro University California (2013) CA
  • Internship: Children's Hospital and Research Center Oakland Pediatric Residency (2014) CA
  • Board Certification: American Board of Pediatrics, Pediatrics (2016)
  • Chief Residency, UCSF Benioff Children's Hospital - Oakland (2016)
  • Residency, UCSF Benioff Children's Hospital - Oakland, Pediatrics (2014)
  • Medical Education, Touro University California, Osteopathic Medicine (2013)

Contact

  • Academic
    nicholst@stanford.edu
    University - Academic staff Department: Peds/Hospital Medicine Position: Clinical Assistant Professor
  • Clinical (Primary)  Stanford Healthcare Tri-Valley Hospital 5555 W Las Positas Blvd Pleasanton, CA 94588 (925) 416-3539 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 5776

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