Tyler Johnson

All Publications

• Phase II trial of organ preservation program using short-course radiation and FOLFOXIRI for rectal cancer (SHORT-FOX). Pollom, E. L., Fisher, G. A., Shelton, A., Johnson, T., Chen, C., Jackson, S., Shaheen, S., Holden, T., Bien, J., King, D., Morris, A. M., Kin, C., Dawes, A., Kirilcuk, N., Gahagan, J., Vitzthum, L., Sheth, V., Brown, E., Pratapneni, A., Chang, D. LIPPINCOTT WILLIAMS & WILKINS. 2024

  View details for Web of Science ID 001275557400852

• Optimizing hematology/oncology (H/O) curricula for internal medicine (IM) residents: A two-institution Delphi survey. Silverstein, J., Huppert, L., Schwede, M., Goglin, S., Johnson, T., Babik, J., Brondfield, S. LIPPINCOTT WILLIAMS & WILKINS. 2024

  View details for Web of Science ID 001275557402174

• Web-Based Scaffolds: The Feasibility of a Constructivist Approach to Oncology Fellow Learning. JMIR cancer Brondfield, S., Schwede, M., Johnson, T. P., Arora, S. 2024; 10: e52501

  Abstract

  In this 2-institution feasibility pilot, oncology fellows used and updated freely available web-based learning tools (scaffolds) in a constructivist fashion.

  View details for DOI 10.2196/52501

  View details for PubMedID 38393780

• Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios. Pediatrics Khan, A., Patel, S. J., Anderson, M., Baird, J. D., Johnson, T. M., Liss, I., Graham, D. A., Calaman, S., Fegley, A. E., Goldstein, J., O'Toole, J. K., Rosenbluth, G., Alminde, C., Bass, E. J., Bismilla, Z., Caruth, M., Coghlan-McDonald, S., Cray, S., Destino, L. A., Dreyer, B. P., Everhart, J. L., Good, B. P., Guiot, A. B., Haskell, H., Hepps, J. H., Knighton, A. J., Kocolas, I., Kuzma, N. C., Lewis, K., Litterer, K. P., Kruvand, E., Markle, P., Micalizzi, D. A., Patel, A., Rogers, J. E., Subramony, A., Vara, T., Yin, H. S., Sectish, T. C., Srivastava, R., Starmer, A. J., West, D. C., Spector, N. D., Landrigan, C. P., Patient and Family Centered I-PASS SCORE Study Group 2024

  Abstract

  BACKGROUND AND OBJECTIVES: Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel "Mentor-Trio" implementation approach with multidisciplinary parent-nurse-physician teams coaching sites.METHODS: Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with ≥3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents.RESULTS: We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%-60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, "excellent"/"very good" safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged.CONCLUSIONS: Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected.

  View details for DOI 10.1542/peds.2023-062666

  View details for PubMedID 38164122

• Developing an Inpatient Relationship Centered Communication Curriculum (I-RCCC) rounding framework for surgical teams. BMC medical education Nassar, A. K., Weimer-Elder, B., Yang, R., Kline, M., Dang, B. K., Spain, D. A., Knowlton, L. M., Valdez, A. B., Korndorffer, J. R., Johnson, T. 2023; 23 (1): 137

  Abstract

  Morning rounds by an acute care surgery (ACS) service at a level one trauma center are uniquely demanding, given the fast pace, high acuity, and increased patient volume. These demands notwithstanding, communication remains integral to the success of surgical teams. Yet there are limited published curricula that address trauma inpatient communication needs. Observations at our institution confirmed that the surgical team lacked a shared mental model for communication. We hypothesized that creating a relationship-centered rounding conceptual framework model would enhance the provider-patient experience.A mixed-methods approach was used for this study. A multi-pronged needs assessment was conducted. Provider communion items for Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys were used to measure patients' expressed needs. Faculty with experience in relationship-centered communication observed morning rounds and documented demonstrated behaviors. A five-hour workshop was designed based on the identified needs. A pre-and post-course Assessment and course evaluation were conducted. Provider-related patient satisfaction items were measured six months before the course and six months after the workshop.Needs assessment revealed a lack of a shared communication framework and a lack of leadership skills for senior trauma residents. Barriers included: time constraints, patient load, and interruptions during rounds. The curriculum was very well received. The self-reflected behaviors that demonstrated the most dramatic change between the pre and post-workshop surveys were: I listened without interrupting; I spoke clearly and at a moderate pace; I repeated key points; and I checked that the patient understood. All these changed from being performed by 50% of respondents "about half of the time" to 100% of them "always". Press Ganey top box likelihood to recommend (LTR) and provider-related top box items showed a trend towards improvement after implementing the training with a percentage difference of up to 20%.The Inpatient Relationship Centered Communication Curriculum (I-RCCC) targeting senior residents and Nurse Practitioners (NP) was feasible, practical, and well-received by participants. There was a trend of an increase in LTRs and provider-specific patient satisfaction items. This curriculum will be refined based on the study results and potentially scalable to other surgical specialties.

  View details for DOI 10.1186/s12909-023-04105-7

  View details for PubMedID 36859253

• Utilizing co-production to improve patient-centeredness and engagement in healthcare delivery: Lessons from the Patient and Family-Centered I-PASSstudies. Journal of hospital medicine O'Toole, J. K., Calaman, S., Anderson, M., Baird, J., Fegley, A., Goldstein, J., Johnson, T., Khan, A., Patel, S. J., Rosenbluth, G., Sectish, T. C., West, D. C., Landrigan, C. P., Spector, N. D., Patient and Family-Centered I-PASS Education Executive and SCORE Program Education and Training Committees 2023

  View details for DOI 10.1002/jhm.13055

  View details for PubMedID 36717094

• Mismatch Repair and Microsatellite Instability Testing for Immune Checkpoint Inhibitor Therapy: ASCO Endorsement of College of American Pathologists Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology Vikas, P., Messersmith, H., Compton, C., Sholl, L., Broaddus, R. R., Davis, A., Estevez-Diz, M., Garje, R., Konstantinopoulos, P. A., Leiser, A., Mills, A. M., Norquist, B., Overman, M. J., Sohal, D., Turkington, R. C., Johnson, T. 2023: JCO2202462

  Abstract

  The College of American Pathologists (CAP) has developed a guideline on testing for mismatch repair (MMR) and microsatellite instability (MSI) for patients considered for immune checkpoint inhibitor therapy. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.The CAP guideline was reviewed for developmental rigor by methodologists. An ASCO Endorsement Panel subsequently reviewed the content and the recommendations.The ASCO Endorsement Panel determined that the recommendations from the CAP guideline, published on August 3, 2022, are clear, thorough, and based on the most relevant scientific evidence. ASCO endorses Mismatch Repair and Microsatellite Instability Testing for Immune Checkpoint Inhibitor Therapy: Guideline From the College of American Pathologists in Collaboration With the Association for Molecular Pathology and Fight Colorectal Cancer.Within the guideline, MMR immunohistochemistry (IHC), MSI polymerase chain reaction, and MSI next-generation sequencing are all recommended testing options for colorectal cancer, MMR-IHC and MSI-polymerase chain reaction for gastroesophageal and small bowel cancer, and only MMR-IHC for endometrial cancer. No recommendation in favor of any testing method over another could be made for any other cancer. Tumor mutational burden was not recommended as a surrogate for DNA MMR deficiency. If MMR deficiency consistent with Lynch syndrome is detected, it should be communicated to the treating physician.Additional information is available at www.asco.org/molecular-testing-and-biomarkers-guidelines.

  View details for DOI 10.1200/JCO.22.02462

  View details for PubMedID 36603179

• Embracing Our Highest Worship Some Thoughts on Our Approach to the Temple BYU STUDIES QUARTERLY Johnson, T. 2023; 62 (2): 73-97

  View details for Web of Science ID 001127077200001

• Family, nurse, and physician beliefs on family-centered rounds: A 21-site study JOURNAL OF HOSPITAL MEDICINE Patel, S. J., Khan, A., Bass, E. J., Graham, D., Baird, J., Anderson, M., Calaman, S., Cray, S., Destino, L., Fegley, A., Goldstein, J., Johnson, T., Kocolas, I., Lewis, K. D., Liss, I., Markle, P., O'Toole, J. K., Rosenbluth, G., Srivastava, R., Vara, T., Landrigan, C. P., Spector, N. D., Knighton, A. J. 2022

  Abstract

  Variation exists in family-centered rounds (FCR).We sought to understand patient/family and clinician FCR beliefs/attitudes and practices to support implementation efforts.Patients/families and clinicians at 21 geographically diverse US community/academic pediatric teaching hospitals participated in a prospective cohort dissemination and implementation study.We inquired about rounding beliefs/attitudes, practices, and demographics using a 26-question survey coproduced with family/nurse/attending-physician collaborators, informed by prior research and the Consolidated Framework for Implementation Research.Out of 2578 individuals, 1647 (64%) responded to the survey; of these, 1313 respondents participated in FCR and were included in analyses (616 patients/families, 243 nurses, 285 resident physicians, and 169 attending physicians). Beliefs/attitudes regarding the importance of FCR elements varied by role, with resident physicians rating the importance of several FCR elements lower than others. For example, on adjusted multivariable analysis, attending physicians (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.8) and nurses (OR 3.1, 95% CI 1.3-7.4) were much more likely than resident physicians to report family participation on rounds as very/extremely important. Clinician support for key FCR elements was higher than self-reported practice (e.g., 88% believed family participation was important on rounds; 68% reported it often/always occurred). In practice, key elements of FCR were reported to often/always occur only 23%-70% of the time.Support for nurse and family participation in FCR is high among clinicians but varies by role. Physicians, particularly resident physicians, endorse several FCR elements as less important than nurses and patients/families. The gap between attitudes and practice and between clinician types suggests that attitudinal, structural, and cultural barriers impede FCR.

  View details for DOI 10.1002/jhm.12962

  View details for Web of Science ID 000855975200001

  View details for PubMedID 36131598

• Implementation and efficacy of a fellow-led, case-based noon lecture series. Dickerson, J., Myall, N., Roy, M., Johnson, T. LIPPINCOTT WILLIAMS & WILKINS. 2022

  View details for Web of Science ID 000863680300287

• Online scaffolds: A constructivist approach to oncology fellow learning. Brondfield, S., Schwede, M., Johnson, T., Arora, S. LIPPINCOTT WILLIAMS & WILKINS. 2022

  View details for Web of Science ID 000863680300286

• Phase II trial of organ preservation program using short-course radiation and folfoxiri for rectal cancer (SHORT-FOX) Pollom, E. L., Shelton, A., Fisher, G. A., Bien, J., King, D., Johnson, T., Chen, C., Shaheen, S., Chong, C., Vitzthum, L., Kirilcuk, N., Morris, A. M., Kin, C., Dawes, A., Sheth, V., Sundaram, V., Brown, E., Chang, D. LIPPINCOTT WILLIAMS & WILKINS. 2022

  View details for DOI 10.1200/JCO.2022.40.4_suppl.TPS218

  View details for Web of Science ID 000770995900213

• Education research - Understanding the factors involved in inpatient communication for orthopedic trainees. Annals of medicine and surgery (2012) Daniel, D., Avedian, R., Johnson, T., Michaud, J. B., Weimer-Elder, B., Kline, M., Nassar, A. K. 2021; 72: 103079

  Abstract

  Background: "Interpersonal and Communication Skills" (ICS) is a core competency set forth by the ACGME. No structured curriculum exists to train orthopedics residents in ICS.Methods: Twenty-four out of thirty-five orthopedics residents completed the survey (69%). The survey had the following domains: [1] Demographics, [2] Communication Needs/Goals, and [3] Communication Barriers.Results: Eighty-three percent of respondents wanted to improve their communication skills and their patient's experience. Interns-PGY4s wanted to improve on similar specific communication skills. All residents desired training in conflict management.Conclusion: There is a need among orthopedics residents for a communication skills curriculum early in residency training, specifically in conflict management.

  View details for DOI 10.1016/j.amsu.2021.103079

  View details for PubMedID 34876980

• When it's needed most: a blueprint for resident creative writing workshops during inpatient rotations. BMC medical education Edwards, L. M., Kim, Y., Stevenson, M., Johnson, T., Sharp, N., Reisman, A., Srinivasan, M. 2021; 21 (1): 535

  Abstract

  BACKGROUND: Narrative Medicine may mitigate physician burnout by increasing empathy and self-compassion, and by encouraging physicians to deeply connect with patient stories/experiences. However, Narrative Medicine has been difficult to implement on hectic inpatient teaching services that are often the most emotionally taxing for residents.OBJECTIVE: To evaluate programmatic and learner outcomes of a novel narrative medicine curriculum implementation during inpatient medicine rotations for medical residents. Programmatic outcomes included implementation lessons. Learner outcomes included preliminary understanding of impact on feelings ofburnout. Additionally, we developed a generalizable narrative medicine framework for program implementation across institutions.METHODS: We developed and implemented a monthly 45-min Narrative Medicine workshop on Stanford's busiest and emotionally-demanding inpatient rotation (medical oncology). Using the Physician Wellbeing Inventory (PWBI, range 1-7; 3-4=high burnout risk; ≥4, high burnout), we anonymously assessed resident burnout during pre-implementation control year (2017-2018, weeks 1and 4), and implementation year (2018-2019, weeks 1 and 4). We interviewed program directors and facilitators regarding curriculum implementation challenges/facilitators.RESULTS: Residents highly rated the narrative medicine curriculum, and the residency program renewed the course for 3 additional years. We identified success factors for programmatic success including time neutrality, control of session, learning climate, building trust, staff partnership, and facilitators training. During control year, resident burnout was initially high (n=16; mean PBWI=3.0, SD: 1.1) and increased by the final week (n=15; PBWI=3.4, SD: 1.6). During implementation year, resident burnout was initially similar (n=13; PBWI=3.1, SD: 1.9) but did not rise as much by rotation end (n=24; PBWI=3.3, SD: 1.6). Implementation was underpowered to detect small effect sizes. Based on our our experience and literature review, we propose an educational competency framework potentially helpful to facilitate inpatient narrative medicine workshops, as a blueprint for other institutions.CONCLUSIONS: Inpatient Narrative Medicine is feasible to implement during a challenging inpatient rotation and may have important short-term effects in mitigating burnout rise, with more study needed. We share teaching tools and propose a competency framework which may be useful to support development of inpatient narrative medicine curricula across institutions.

  View details for DOI 10.1186/s12909-021-02935-x

  View details for PubMedID 34670565

• Implementation of a cloud-based electronic patient-reported outcome (ePRO) platform in patients with advanced cancer. Journal of patient-reported outcomes Generalova, O., Roy, M., Hall, E., Shah, S. A., Cunanan, K., Fardeen, T., Velazquez, B., Chu, G., Bruzzone, B., Cabot, A., Fisher, G. A., Srinivas, S., Fan, A. C., Haraldsdottir, S., Wakelee, H. A., Neal, J. W., Padda, S. K., Johnson, T., Heestand, G. M., Hsieh, R. W., Ramchandran, K. 2021; 5 (1): 91

  Abstract

  BACKGROUND: Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here we report on the execution, feasibility and healthcare utilization outcomes of an electronic PRO (ePRO) application for cancer patients at an academic medical center.METHODS: We conducted a randomized trial comparing an experimental ePRO arm to standard of care in patients with advanced cancer in the thoracic, gastrointestinal, and genitourinary oncology groups at Stanford Cancer Center from March 2018 to November 2019. We describe the pre-implementation, implementation, and post-implementation phases of the ePRO arm, technological barriers, electronic health record (EHR) integration, clinician burden, and patient data privacy and security. Feasibility was pre-specified to be at least 70% completion of all questionnaires. Acceptability was based on patient and clinician feedback. Ambulatory healthcare utilization was assessed by reviewing numbers of phone messages, electronic portal messages, and referrals for supportive care.RESULTS: Of 617 ePRO questionnaires sent to 72 patients, 445 (72%) were completed. Most clinicians (87.5%) and patients (93%) felt neutral or positive about the ePRO tool's ease of use. Exposure to ePRO did not cause a measurable change in ambulatory healthcare utilization, with a median of less than two phone messages and supportive care referrals, and 5-6 portal messages.CONCLUSIONS: Web-based ePRO tools for patients with advanced cancer are feasible and acceptable without increasing clinical burden. Key lessons include the importance of pilot testing, engagement of stakeholders at all levels, and the need for customization by disease group. Future directions for this work include completion of EHR integration, expansion to other centers, and development of integrated workflows for routine clinical practice.

  View details for DOI 10.1186/s41687-021-00358-2

  View details for PubMedID 34524558

• Teacher's Plea BYU STUDIES QUARTERLY Johnson, T. 2021; 60 (2): 81-118

  View details for Web of Science ID 000670428900004

• Metastatic Pancreatic Cancer: ASCO Guideline Update. Journal of clinical oncology : official journal of the American Society of Clinical Oncology Sohal, D. P., Kennedy, E. B., Cinar, P., Conroy, T., Copur, M. S., Crane, C. H., Garrido-Laguna, I., Lau, M. W., Johnson, T., Krishnamurthi, S., Moravek, C., O'Reilly, E. M., Philip, P. A., Pant, S., Shah, M. A., Sahai, V., Uronis, H. E., Zaidi, N., Laheru, D. 2020: JCO2001364

  Abstract

  PURPOSE: The aim of this work was to provide an update to the ASCO guideline on metastatic pancreatic cancer pertaining to recommendations for therapy options after first-line treatment.METHODS: ASCO convened an Expert Panel and conducted a systematic review to update guideline recommendations for second-line therapy for metastatic pancreatic cancer.RESULTS: One randomized controlled trial of olaparib versus placebo, one report on phase I and II studies of larotrectinib, and one report on phase I and II studies of entrectinib met the inclusion criteria and inform the guideline update.RECOMMENDATIONS: New or updated recommendations for germline and somatic testing for microsatellite instability high/mismatch repair deficiency, BRCA mutations, and TRK alterations are provided for all treatment-eligible patients to select patients for recommended therapies, including pembrolizumab, olaparib, larotrectinib, or entrectinib, or potential clinical trials. The Expert Panel continues to endorse the remaining recommendations for second-line chemotherapy, as well as other recommendations related to treatment, follow-up, and palliative care from the 2018 version of this guideline. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines.

  View details for DOI 10.1200/JCO.20.01364

  View details for PubMedID 32755482

• NARRATIVE ONCOLOGY: AN INTERVENTION TO PROMOTE RESIDENT WELLBEING AND PATIENT-CENTERED CARE ON AN EMOTIONALLY EXHAUSTING INPATIENT ROTATION Stevenson, M., Edwards, L., Kim, Y., Kim, C., Johnson, T., Garvert, D. SPRINGER. 2020: S754

  View details for Web of Science ID 000567143602345

• Developing an Inpatient Relationship-Centered Communication Curriculum for Surgical Teams: Pilot Study Nassar, A., Weimer-Elder, B., Kline, M., Minthorn, C., Staudenmayer, K. L., Yang, R., Spain, D. A., Maggio, P., Korndorffer, J. R., Johnson, T. ELSEVIER SCIENCE INC. 2019: E48

  View details for Web of Science ID 000492749600102

• Feasibility and design of a cloud-based digital platform in patients with advanced cancer. Roy, M., Hall, E., Velazquez, B., Shah, S., Fardeen, T., Cunanan, K., San Pedro-Salcedo, M., Wakelee, H. A., Neal, J. W., Padda, S., Das, M., Fan, A. C., Srinivas, S., Fisher, G. A., Haraldsdottir, S., Johnson, T., Chu, G., McMillan, A., Ramchandran, K. AMER SOC CLINICAL ONCOLOGY. 2019

  View details for DOI 10.1200/JCO.2019.37.27_suppl.211

  View details for Web of Science ID 000518223100208

• In Support of a Complex IDEA-A New Meta-analysis Supporting the Findings of the International Duration Evaluation of Adjuvant Therapy Collaboration. JAMA network open Johnson, T. 2019; 2 (5): e194161

  View details for DOI 10.1001/jamanetworkopen.2019.4161

  View details for PubMedID 31099858

• Thrombophilia testing in the inpatient setting: impact of an educational intervention. BMC medical informatics and decision making Kwang, H. n., Mou, E. n., Richman, I. n., Kumar, A. n., Berube, C. n., Kaimal, R. n., Ahuja, N. n., Harman, S. n., Johnson, T. n., Shah, N. n., Witteles, R. n., Harrington, R. n., Shieh, L. n., Hom, J. n. 2019; 19 (1): 167

  Abstract

  Thrombophilia testing is frequently ordered in the inpatient setting despite its limited impact on clinical decision-making and unreliable results in the setting of acute thrombosis or ongoing anticoagulation. We sought to determine the effect of an educational intervention in reducing inappropriate thrombophilia testing for hospitalized patients.During the 2014 academic year, we implemented an educational intervention with a phase implementation design for Internal Medicine interns at Stanford University Hospital. The educational session covering epidemiology, appropriate thrombophilia evaluation and clinical rationale behind these recommendations. Their ordering behavior was compared with a contemporaneous control (non-medicine and private services) and a historical control (interns from prior academic year). From the analyzed data, we determined the proportion of inappropriate thrombophilia testing of each group. Logistic generalized estimating equations were used to estimate odds ratios for inappropriate thrombophilia testing associated with the intervention.Of 2151 orders included, 934 were deemed inappropriate (43.4%). The two intervention groups placed 147 orders. A pooled analysis of ordering practices by intervention groups revealed a trend toward reduction of inappropriate ordering (p = 0.053). By the end of the study, the intervention groups had significantly lower rates of inappropriate testing compared to historical or contemporaneous controls.A brief educational intervention was associated with a trend toward reduction in inappropriate thrombophilia testing. These findings suggest that focused education on thrombophilia testing can positively impact inpatient ordering practices.

  View details for DOI 10.1186/s12911-019-0889-6

  View details for PubMedID 31429747

• Reclaiming Reality Doctoring and Discipleship in a Hyperconnected Age BYU STUDIES QUARTERLY Johnson, T. 2018; 57 (3): 7–38

  View details for Web of Science ID 000447681100002

• A high value care curriculum for interns: a description of curricular design, implementation and housestaff feedback POSTGRADUATE MEDICAL JOURNAL Hom, J., Kumar, A., Evans, K. H., Svec, D., Richman, I., Fang, D., Smeraglio, A., Holubar, M., Johnson, T., Shah, N., Renault, C., Ahuja, N., Witteles, R., Harman, S., Shieh, L. 2017; 93 (1106): 725–29

  View details for DOI 10.1136/postgradmedj-2016-134617

  View details for Web of Science ID 000416160200005

• A high value care curriculum for interns: a description of curricular design, implementation and housestaff feedback. Postgraduate medical journal Hom, J. n., Kumar, A. n., Evans, K. H., Svec, D. n., Richman, I. n., Fang, D. n., Smeraglio, A. n., Holubar, M. n., Johnson, T. n., Shah, N. n., Renault, C. n., Ahuja, N. n., Witteles, R. n., Harman, S. n., Shieh, L. n. 2017

  Abstract

  Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns.Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine. Our topics were as follows: introduction to value-based care; telemetry utilisation; lab ordering; optimal approach to thrombophilia work-ups and fresh frozen plasma use; optimal approach to palliative care referrals; antibiotic stewardship; and optimal approach to imaging for low back pain. Our curriculum was implemented at the Stanford Internal Medicine residency programme over the course of two academic years (2014 and 2015), during which 100 interns participated in our high value care curriculum. After each high value care session, interns were offered the opportunity to complete surveys regarding feedback on the curriculum, self-reported improvements in knowledge, skills and attitudinal module objectives, and quiz-based knowledge assessments.The overall survey response rate was 67.1%. Overall, the material was rated as highly useful on a 5-point Likert scale (mean 4.4, SD 0.6). On average, interns reported a significant improvement in their self-rated knowledge, skills and attitudes after the six seminars (mean improvement 1.6 points, SD 0.4 (95% CI 1.5 to 1.7), p<0.001).We successfully implemented a novel high value care curriculum that specifically targets intern physicians.

  View details for PubMedID 28663352

• Prevalence and Financial Impact of Inappropriate Thrombophilia Testing in the Inpatient Hospital Setting: A Retrospective Analysis Mou, E., Kwang, H., Hom, J., Shieh, L., Ahuja, N., Harman, S., Johnson, T., Kumar, A., Shah, N., Witteles, R., Berube, C. AMER SOC HEMATOLOGY. 2016

  View details for Web of Science ID 000394452508066

• Bruton's tyrosine kinase inhibitors in chronic lymphocytic leukemia and lymphoma. Clinical advances in hematology & oncology : H&O Varma, G., Johnson, T. P., Advani, R. H. 2016; 14 (7): 543-554

  Abstract

  The development of Bruton's tyrosine kinase (BTK) inhibitors and their introduction into clinical practice represent a major advance in the treatment of chronic lymphocytic leukemia (CLL) and other B-cell lymphomas. Although ibrutinib is the only BTK inhibitor that has been approved by the US Food and Drug Administration, several others are under investigation. Ibrutinib is currently approved for use in relapsed/refractory CLL, CLL with 17p deletion (del[17p]), relapsed or refractory mantle cell lymphoma, and Waldenström macroglobulinemia. Although it is clear that ibrutinib has altered treatment paradigms and outcomes in these diseases, several questions remain regarding (1) its role in frontline vs salvage therapy; (2) its use as a single agent vs in combination with biologic agents, other small molecules, or traditional chemoimmunotherapy; (3) the optimal duration of treatment; and (4) the treatment of patients who cannot tolerate or have disease resistant to ibrutinib. Because sparse clinical data are available on other BTK inhibitors, it is unclear at present whether their clinical efficacy and toxicity will differ from those of ibrutinib.

  View details for PubMedID 27379948

• Empathy and the Atonement BYU STUDIES QUARTERLY Johnson, T. 2016; 55 (4): 105-122

  View details for Web of Science ID 000390830400009

• Throughput. Annals of internal medicine Johnson, T. 2011; 155 (2): 133-?

  View details for DOI 10.1059/0003-4819-155-2-201107190-00012

  View details for PubMedID 21768589