Grand Rounds consists of 2 case presentations from the diversity of pathology seen at the Eye Institute. Each is presented chronologically from presenting symptoms, history of present illness, past medical and ocular history, with photos of clinical findings and diagnostic imaging.Using the Socratic model of teaching, questions are raised throughout the process culminating in the formulation of a differential diagnosis. Further diagnostic testing is recommended and a therapeutic plan proposed. Often presented are diagnostic and therapeutic dilemmas for which additional expertise is requested. 

Professional Practice Gaps:
1. Physicians/faculty lack current medical knowledge and preferred practice patterns outside of their area of current and/or sub-specialty expertise.
2. Provide updated case presentations to faculty, fellows, researchers, and fellow residents in order to improve patient care in ophthalmology.

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The Neurology department is composed of a diverse group of faculty members. Some practice neurology while others are sub-specialists who are experts in their field. We also have Advanced Practice Providers, residents, fellow(s) and students from OU College of Medicine. Our aim is to provide sessions which are of value to this diverse group of attendees, providing a mix of common and uncommon neurological conditions, while also including sessions targeting quality improvement, provider wellness and professional development. Each session is 1 hour long, with a question-answer session included at the end.

Professional Practice Gap:
A 2015 prospective study in patients with adrenal insufficiency found a significant number of adrenal crisis related deaths despite all study patients receiving standard care and being educated on crisis prevention strategies, highlighting that current prevention strategies and medical management remain suboptimal.

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Internal Medicine is a diverse specialty area encompassing all the systems of the body, and includes generalists and subspecialists. Grand rounds is a weekly one-hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of internal medicine and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and subspecialists.

Professional Practice Gap
Physicians understand the clinical aspects of medicine but are often not well versed in healthcare delivery challenges.  Additionally, advocacy for patients and the profession is an area that physicians are not well-trained in.  This presentation will help outline the importance of advocacy and the major issues confronting physicians and other frontline healthcare workers in the US today.

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Pediatrics is a diverse specialty area encompassing all the systems of the body, and includes generalists and sub-specialists. Grand rounds is a weekly one hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of pediatrics and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and sub-specialists.

Professional Practice Gap: 
Patient safety and risk event reporting is critical to understanding the current state of a healthcare institution.  However, at Oklahoma Children’s Hospital, our weekly safety reporting is significantly below where it should be. The etiology of this low reporting is likely multifactorial, including lack of knowledge around how to report and what should be reported, as well as a lack of feedback on reported events.  This Grand Rounds provides an opportunity to share the current state of Patient Safety at our facilities.

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Psychiatry is a diverse specialty area encompassing the vast complexities of mental health, and includes both generalists and specialists. Grand rounds is a monthly one hour presentation given by psychiatry faculty to offer learning opportunities on specific  cases, conditions, regulations, procedures, updates on evidence-based therapies, and more. Because of the diversity of psychiatric conditions and treatments, a wide variety of topics are presented which are relevant to both generalists and sub-specialists. Journal club is a monthly one hour presentation given by psychiatry faculty. Dr. Ashley Walker,  to offer learning opportunities on how to read a journal article critically, to improve clinical appraisal and assimilate evidence skills, and to apply knowledge of study design and statistical methods.

Professional Practice Gap:
Practitioners may be unaware of the 2021 billing and coding changes to Outpatient Psychiatry care.

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This live activity will target an audience of physicians, residents, physician extenders and support staff specializing in the field of dermatology. Subjects and formats will vary as followed:

• Grand Rounds: (Approximately 45% of the time) Utilizing expert leaders in their field and resident speakers this conference each week a lecture will be presented in order to bring the most up-to-date information to the local dermatology community. Moreover, Q&A sessions will offer a unique and personalized interaction with faculty and other leaders.
• Morphology Conf. (Approximately 45% of the time)  This is a conference of live patients or virtual patient presentations. Evaluation of skin findings by attendees is followed up by morphologic description and differential diagnosis given by dermatology residents. Subsequent history is given by the physician presenting the case and departmental dermatopathologists present the path slides via video connection. This is followed by a round table discussion of the patient’s case and proper management.M&M (approx. 4 times/year) This live meeting will target an audience of physicians, residents, physician extenders and support staff involved in the practice of dermatology. The course director will identify cases of patient care for discussion. The care provided will be detailed and options to improve patient care will be identified. Discussion among all participants will be highly encouraged and facilitated by the course director. Practical examples will be utilized whenever possible. 2 to 3 case scenarios will be discussed at each session. Patient and provider confidentiality will be maintained as strictly as possible. Each participant will sign a “Confidentiality Agreement” keeping strict compliance with The University of Oklahoma’s OUHSC COM policy number 736 “Standards for Conducting Morbidity and Mortality Conferences as Peer Review”. 

Professional Practice Gaps:
Practitioners may have difficulties describing and integrating cutaneous findings for rare dermatologic diseases. Cases will be presented to improve evaluation and diagnosis.
Practitioners may have difficulties relating the path report to the patient's condition. Through active review of the pathology with the dermatopathologist this situation will be improved.
Patients may not respond to first-line treatments and practitioners may have difficulty developing additional strategies. Cases selected/presented will provide the opportunity to explore various treatment options.

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Professional Practice Gaps:  
The guidelines for chest pain evaluation were updated in 2021 based on new and up-to-date evidence. These recommendations are very important and practice changing. Many cardiovascular professionals may be unaware of these guidelines.

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Psychiatry Grand Rounds provides continuing education for our faculty, trainees, and the public sector. We strive to enable discussion that is both about and involves the patients, so the physician can better understand the depth of a patient's mental illness. In this series, we explore the history of policies and procedures for handling mentally ill patients and what can be done to improve care and treatment they receive, as well as to better explain various forms of mental illness and how treatment should be approached and practiced by the clinician.

Professional Practice Gaps:
Unexpected morbidity or mortality cases occur in the hospitals annually. These cases often occur due to errors which must be identified, trends explored and interventions for prevention of future errors developed. 

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Professional Practice Gaps: (1) Physicians struggle to cope professionally and personally with the stress created by the COVID-19 crisis. (2) To cope resiliently requires that physicians have an understanding of the biopsychosocial nature of stress. (3) Resilience education and training assists physicians implement coping strategies for themselves, treatment teams and patients.

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Professional Practice Gaps:
Practitioners may struggle with management of intraoperative and perioperative complications. (1) Intraoperative hypoxia when placing a tracheostomy is a complication all surgeons should be prepared to manage. (2) Immunosuppression is associated with risk of opportunistic infections and surgeons must be aware of the management of these conditions. (3) The indications for re-exploration after a surgical procedure must be familiar to all surgeons.

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Congenital heart disease frequently encompasses derangements of all bodily systems. For this reason a wide variety of specialty areas are required in order to care for these complex patients. Each week we hold a multidisciplinary conference where the management of these patients is discussed. The duration of the conference is generally 1.5 - 2 hours, and active participation by all attendees is encouraged via case studies, the audience responding to questions, small group discussion, and question and answer opportunities. The ultimate goals of the conference are:
1) to assure that the needs of the patient are understood.
2) The needs of the the patient are being met
3) A long-term care plan is developed, and 
4) Adequate communication with the patient or their care-provider is being performed.

Overall Professional Practice Gap:
A wide variety of specialty areas are required in order to care for congenital heart disease patients. There is a need to review diagnostic and treatment issues and options.

Session Professional Practice Gap:
The participant may not know what imaging modalities are used in deciding about surgical repair in Borderline LV.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Explain how a combination of echo and MRI are used in surgical decision making of borderline LV. 
2.  Discuss what surgical techniques that are used in these patients with borderline LV.

Session Announcement

The hematology oncology field is very diverse which includes all aspects of management of blood disorders and cancer diagnostics and therapeutics. Grand rounds is a weekly one hour presentation incorporating interactive learning environment. Usually the presenter is an external speaker visiting from another institution or another department. The focus of the grands rounds is to update the audience about the advances in the field and discuss topics relevant to hematology/oncology which can serve as a platform to enhance knowledge and better patient care in addition trigger ideas for research. Sessions are usually followed by discussion toward the end with time for questions. 

Professional Practice Gap: The utilization of radiotherapy in the treatment of lymphoma has declined over the past several decades, likely due to an increased concern for late toxicities caused by radiation. In this lecture, I will inform the audience on novel developments in the field to reduce the risk of these late effects to broaden the therapeutic ratio for radiotherapy in this disease.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:

1.  Describe the indications for radiotherapy in mediastinal lymphoma.
2. Distinguish changes in treatment planning, treatment techniques, and radiation doses for mediastinal lymphoma.
3.  Evaluate the risk of late toxicity incurred by both radiotherapy and chemotherapy in the treatment of mediastinal lymphoma.

Session Announcement

Grand Rounds consists of 2 case presentations from the diversity of pathology seen at the Eye Institute. Each is presented chronologically from presenting symptoms, history of present illness, past medical and ocular history, with photos of clinical findings and diagnostic imaging. Using the Socratic model of teaching, questions are raised throughout the process culminating in the formulation of a differential diagnosis. Further diagnostic testing is recommended and a therapeutic plan proposed. Often presented are diagnostic and therapeutic dilemmas for which additional expertise is requested. 

Professional Practice Gaps:
1.  Physicians/faculty lack current medical knowledge and preferred practice patterns outside of their area of current and/or sub-specialty expertise.
2. Provide updated case presentations to faculty, fellows, researchers, and fellow residents in order to improve patient care in ophthalmology.

Session Announcement

Child and adolescent psychiatry is a sub-specialty with focus on development and mental health of young people. As specialists in this field we encounter a wide variety of needs. Professional Rounds is intended to build and widen the base of exposure to important topics within the field for medical students, residents, fellows, and faculty. Presentations include specialist presentations, journal article discussions, and question and answer opportunities.

Overall Professional Practice Gap:
The overarching goal of our bi-weekly Child Professorial Rounds is to bridge the gap between basic classroom instruction and the clinical practice of efficacious psycho-therapeutic treatments of mental disorders among children, adolescents, and families.

Session Professional Practice Gap: Data support a continued need for improved timeliness and accuracy of autism spectrum disorder (ASD) diagnosis to maximize early intervention access and individualized supports.

Session Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Identify core characteristics and diverse presentations of ASD.
2.  Recognize commonly associated risk factors and comorbid conditions.
3.  State the importance of early ASD identification.
4.  Identify evidence-based practices to support autistic individuals.

*A Note on Terminology: Members of the Autism community have voiced different preferences between the use of identity-first versus person-first language. To be sensitive to these different perspectives, both identity-first and person-first language are used interchangeably in this presentation.

Session Announcement

The Neurology department is composed of a diverse group of faculty members. Some practice neurology while others are sub-specialists who are experts in their field. We also have Advanced Practice Providers, residents, fellow(s) and students from OU College of Medicine. Our aim is to provide sessions which are of value to this diverse group of attendees, providing a mix of common and uncommon neurological conditions, while also including sessions targeting quality improvement, provider wellness and professional development. Each session is 1 hour long, with a question-answer session included at the end.

Session Professional Practice Gap:  Regardless of discipline or level of training, we ALL need feedback to continually improve our knowledge, skills, attitudes, and behaviors.  This is especially true of clinicians expected to foster lifelong “practice-based learning and improvement.”  This session will address ways to optimize the quality of feedback you provide – especially in clinical settings – and to refine how you receive feedback from others.

Session Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Describe essentials of providing effective feedback.
2.  Use growth mindset to refine goal-setting and feedback.
3.  Complete clinical evaluation forms accurately with impactful narrative feedback.
4.  Summarize essentials of receiving feedback and implementing measurable change.

Session Announcement

Internal Medicine is a diverse specialty area encompassing all the systems of the body, and includes generalists and subspecialists. Grand rounds is a weekly one-hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of internal medicine and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and subspecialists.

Professional Practice Gap:
The Science of statins for the elderly is not well understood.

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Pediatric grand rounds will be an active learning opportunity for pediatricians and pediatric specialists to learn contemporary knowledge and skills to support their professional development. Each 1 hour presentation will be structured using a variety of learning techniques to achieve its goals and objectives in topics deemed most important to the learning and actively practicing physician. Presenting faculty and invited presenters will be challenged to create a unique, engaging and memorable learning experience that has a significant impact on the learning in support of the learning goals and objectives.

Professional Practice Gaps:
Providers may not be aware of which infantile hemangiomas may require workup or treatment by a specialist
Some providers are not aware of which patients with melanocytic nevi should be referred to a subspecialist for evaluation and monitoring
Skin conditions are common in children, but many primary care providers have not been adequately trained to recognize and treat life threatening rashes


Session Learning Objectives:
Upon completion of this session, participants will improve their competence and performance by being able to:

1.  Identify which high risk infantile hemangiomas should be referred to a specialist.
2.  Identify worrisome diaper rashes that warrant evaluation by a specialist.
3.  Identify which patients with nevi should be referred to a specialist.

Session Announcement

Pediatric Critical Care offers acute tertiary care services. PICU is designed for patients (birth through 20 years) who are in a condition of real or potential physiological instability. Care is offered to patients whose survival is dependent on life-support equipment. The PICU Journal Club is a live 60 minute discussion of journal articles and employs audience participation and integration of learning objectives. 

Overall Professional Practice Gap:
Not all physicians are current on recent literature and evidence based outcomes. The ACGME now requires evidenced based medicine core curriculum to be in place. It is necessary to maintain educational standards for teaching faculty so that the EBM component may be met in their teaching agenda.

Session Professional Practice Gaps: Practitioners (1) may not know that most preterm infants independently breathe at birth; (2) are often unable to support spontaneous breathing effectively, requiring babies to be intubated soon after birth; (3) may find it interesting to learn that failure to maintain self-ventilating from birth can be predicted by close observation of the baby’s oxygen requirement; (4) might be unaware of the benefits and pitfalls of the wide choice of interventions and devices available to support the newborn patient’s respirations.

Session Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Review pertinent literature and apply relevant concepts to patient care.
2.  Integrate evidence based medicine into therapeutic decisions.
3.  Review and interpret statistical outcomes in current literature.
4.  Recognize inconsistent or unsound research.
5.  Assess research methodology.

Session Announcement

Psychiatry Grand Rounds provides continuing education for our faculty, trainees, and the public sector. We strive to enable discussion that is both about and involves the patients, so the physician can better understand the depth of a patient's mental illness. In this series, we explore the history of policies and procedures for handling mentally ill patients and what can be done to improve care and treatment they receive, as well as to better explain various forms of mental illness and how treatment should be approached and practiced by the clinician.

Professional Practice Gaps: 
1. Practitioners may now know the risk of violence directed at practitioners by patients.
2. Practitioners may not be aware of the safety measures they can put in place to decrease their risk of patient violence.

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Professional Practice Gaps: 
Practitioner may not know the application of anesthetic principles in complex neurosurgical cases.    

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Professional Practice Gaps:
Practitioners may struggle with management of intraoperative and perioperative complications. (1) Appropriately selecting gastric cancer patients for curative resection versus palliative surgery is a surgical challenge. (2) Acute organ rejection after transplant is a feared complication. (3) The indications for re-exploration after a surgical procedure must be familiar to all surgeons.

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Congenital heart disease frequently encompasses derangements of all bodily systems. For this reason a wide variety of specialty areas are required in order to care for these complex patients. Each week we hold a multidisciplinary conference where the management of these patients is discussed. The duration of the conference is generally 1.5 - 2 hours, and active participation by all attendees is encouraged via case studies, the audience responding to questions, small group discussion, and question and answer opportunities. The ultimate goals of the conference are:
1) to assure that the needs of the patient are understood.
2) The needs of the the patient are being met
3) A long-term care plan is developed, and 
4) Adequate communication with the patient or their care-provider is being performed.

Overall Professional Practice Gap:
A wide variety of specialty areas are required in order to care for congenital heart disease patients. There is a need to review diagnostic and treatment issues and options.

Session Professional Practice Gap:
The participant may not know what imaging features suggest a high risk anomalous RCA from left sinus

Session Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Discuss about the incidence of RCA from left sinus.
2.  Discuss what imaging features on echo/CT and MRI with exercise stress test are used to determine need for surgery in these patients.

Session Announcement

Grand Rounds consists of 2 case presentations from the diversity of pathology seen at the Eye Institute. Each is presented chronologically from presenting symptoms, history of present illness, past medical and ocular history, with photos of clinical findings and diagnostic imaging. Using the Socratic model of teaching, questions are raised throughout the process culminating in the formulation of a differential diagnosis. Further diagnostic testing is recommended and a therapeutic plan proposed. Often presented are diagnostic and therapeutic dilemmas for which additional expertise is requested. 

Professional Practice Gaps:
1. Physicians/faculty lack current medical knowledge and preferred practice patterns outside of their area of current and/or sub-specialty expertise.
2. Provide updated case presentations to faculty, fellows, researchers, and fellow residents in order to improve patient care in ophthalmology.

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The Neurology department is composed of a diverse group of faculty members. Some practice neurology while others are sub-specialists who are experts in their field. We also have Advanced Practice Providers, residents, fellow(s) and students from OU College of Medicine. Our aim is to provide sessions which are of value to this diverse group of attendees, providing a mix of common and uncommon neurological conditions, while also including sessions targeting quality improvement, provider wellness and professional development. Each session is 1 hour long, with a question-answer session included at the end.

Professional Practice Gap:  There is incomplete understanding of different mechanisms of action, side effect profile, criteria for initiation and changing disease modifying therapies for management of MS.

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Pediatrics is a diverse specialty area encompassing all the systems of the body, and includes generalists and sub-specialists. Grand rounds is a weekly one hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of pediatrics and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and sub-specialists.

Professional Practice Gap: 
Practitioners may not know how to apply strengths-based approaches to promote resilience in the patients they care for; 
Practitioners may not know how to assess for patient strengths at different social-ecological levels.

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This is a weekly seminar that covers diverse topics presented by various professionals with special interests, training or expertise. These presentations are designed for practicing surgeons, surgical residents, ancillary staff and medical students. Speakers emphasize evidence-based research when covering a variety of topics relevant to the various areas of current surgical practice to reduce audience identified gaps. 

Professional Practice Gaps: 
Simulation-based education has been linked to improved patient outcomes yet the medical community has variable familiarity with simulation in healthcare.  Both learners and faculty lack an understanding of education principles that are important to simulation curriculum effectiveness, as well as the potential applications of simulation given current technological advances.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
1.Describe core educational principles that guide the design of robust simulation activities
2.Review advantages of simulation-based education and mastery learning over traditional education strategies 
3.Describe new innovative approaches to deliver high-quality simulation-based activities

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This live activity will target an audience of physicians, residents, physician extenders and support staff specializing in the field of dermatology. Subjects and formats will vary as followed:

• Grand Rounds: (Approximately 45% of the time) Utilizing expert leaders in their field and resident speakers this conference each week a lecture will be presented in order to bring the most up-to-date information to the local dermatology community. Moreover, Q&A sessions will offer a unique and personalized interaction with faculty and other leaders.
• Morphology Conf. (Approximately 45% of the time)  This is a conference of live patients or virtual patient presentations. Evaluation of skin findings by attendees is followed up by morphologic description and differential diagnosis given by dermatology residents. Subsequent history is given by the physician presenting the case and departmental dermatopathologists present the path slides via video connection. This is followed by a round table discussion of the patient’s case and proper management.M&M (approx. 4 times/year) This live meeting will target an audience of physicians, residents, physician extenders and support staff involved in the practice of dermatology. The course director will identify cases of patient care for discussion. The care provided will be detailed and options to improve patient care will be identified. Discussion among all participants will be highly encouraged and facilitated by the course director. Practical examples will be utilized whenever possible. 2 to 3 case scenarios will be discussed at each session. Patient and provider confidentiality will be maintained as strictly as possible. Each participant will sign a “Confidentiality Agreement” keeping strict compliance with The University of Oklahoma’s OUHSC COM policy number 736 “Standards for Conducting Morbidity and Mortality Conferences as Peer Review”. 

Professional Practice Gaps:
Practitioners may have difficulties describing and integrating cutaneous findings for rare dermatologic diseases. Cases will be presented to improve evaluation and diagnosis.
Practitioners may have difficulties relating the path report to the patient's condition. Through active review of the pathology with the dermatopathologist this situation will be improved.
Patients may not respond to first-line treatments and practitioners may have difficulty developing additional strategies. Cases selected/presented will provide the opportunity to explore various treatment options.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to: 
1.  Describe and integrate cutaneous findings for dermatologic diseases.
2.  Integrate dermatopathology reports and appearance with the clinical findings.
3.  Develop sophisticated treatment strategies for dermatologic diseases.

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Professional Practice Gap: Despite being the most common cardiac arrhythmia, the current model of healthcare delivery in atrial fibrillation consists of siloed outpatient clinics with little coordination between primary care physicians, neurologists, general cardiologists and electrophysiologists. Many healthcare professionals might be unfamiliar with evidence-based practice guidelines which emphasize the need for treating different aspects of atrial fibrillation in a patient-centered, multidisciplinary fashion. An atrial fibrillation center of excellence is a system of multidisciplinary integrated healthcare providers that delivers state of the art high quality care which has been shown to improve outcomes.

Professional Practice Gaps:
1) There is significant under-appreciation of heritable connective tissue disorders as an etiology for thoracic aortic aneurysms. 2) There is wide variation in practice for surveillance and follow-up of individuals with thoracic aortic aneurysms.

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Psychiatry Grand Rounds provides continuing education for our faculty, trainees, and the public sector. We strive to enable discussion that is both about and involves the patients, so the physician can better understand the depth of a patient's mental illness. In this series, we explore the history of policies and procedures for handling mentally ill patients and what can be done to improve care and treatment they receive, as well as to better explain various forms of mental illness and how treatment should be approached and practiced by the clinician.

Professional Practice Gaps: 
1. Gap in knowledge in understanding the need and benefits of bariatric surgery
2. Gap in knowledge regarding the emotional/psychological risks involved
3. Gap in knowledge understanding the assessment process involved prior to the and after bariatric surgery

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to: 
1. Identify factors of obesity and the risks and benefits of bariatric surgery
2. Describe the role and responsibility of psychologists within OU’s Bariatric Surgery program.

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Professional Practice Gaps: 
Practitioners need to review patient scenarios and discuss methods to prevent perioperative complications.       

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:  
1.  Describe events that led up to a complication presented.  
2.  Explain methods that may help prevent perioperative complications.  
3.  Identify risk factors that increase risk of perioperative complications presented. 

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Neurosurgery deals with diseases of the nervous system that are amenable to surgical intervention, as well, traumatic, and congenital neurologic abnormalities. Grand rounds is a twice-monthly one-hour presentation. These are generally a traditional lecture/Q&A format learning with what is currently used versus what is ideal.

Professional Practice Gap:
Practitioners may not be familiar with recent diagnostic and treatment advances in leptomeningeal metastases. 

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Review recommended diagnostic protocols for patients with suspected leptomeningeal metastases
2.  Discuss CSF analysis technologies such as circulating tumor cell and cell-free tumor DNA aimed to improve diagnosis of leptomeningeal metastases
3.  Identify established treatment paradigms and emerging therapies used in patients with leptomeningeal metastases

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Professional Practice Gaps:
Practitioners may struggle with management of intraoperative and perioperative complications. (1) Prevention of hiatal hernia formation after trans-diaphragmatic surgery is a challenge of foregut surgery. (2) Inadvertent injury of pelvic organs during inguinal hernia repair is a feared complication of general surgeons.
??? 
Learning Objectives:? Upon completion of this session, participants will improve their competence and performance by being able to:??? 
1.  Describe the etiology of early hiatal hernia, as well as how to diagnose and treat this condition. 
2.  Outline the steps on how to identify and manage bladder injuries at the time of inguinal hernia repair. 

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Congenital heart disease frequently encompasses derangements of all bodily systems. For this reason a wide variety of specialty areas are required in order to care for these complex patients. Each week we hold a multidisciplinary conference where the management of these patients is discussed. The duration of the conference is generally 1.5 - 2 hours, and active participation by all attendees is encouraged via case studies, the audience responding to questions, small group discussion, and question and answer opportunities. The ultimate goals of the conference are:
1) to assure that the needs of the patient are understood.
2) The needs of the the patient are being met
3) A long-term care plan is developed, and 
4) Adequate communication with the patient or their care-provider is being performed.

Professional Practice Gap
1.  Learners may not know the intervention and surgical options for treatment of Atrial septal defect as well as the appropriate timing for intervention. 

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Discuss treatment options by experienced providers regarding different treatment modalities and criteria for each including catheter based closure, surgical patch closure, surgical primary closure of ASD.
2.  Evaluate appropriate patients for each interventional modality by identifying criteria for repair by catheter based closure versus surgical closure. 

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Professional Practice Gaps:
Helping participants recognize that they may or may not be aware of the implicit bias in healthcare and how that effects the care one receives.  This can be experienced by patients as well as providers. 

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.   Identify the implicit biases that have power over our decision-making.  
2.  Choose to pause, question, and reassess our decisions and strive to be objective
3.  Evaluate why you have a negative or positive reaction to the information presented.  This can be a sign that a strongly ingrained bias is at play. 

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Grand Rounds consists of 2 case presentations from the diversity of pathology seen at the Eye Institute. Each is presented chronologically from presenting symptoms, history of present illness, past medical and ocular history, with photos of clinical findings and diagnostic imaging.Using the Socratic model of teaching, questions are raised throughout the process culminating in the formulation of a differential diagnosis. Further diagnostic testing is recommended and a therapeutic plan proposed. Often presented are diagnostic and therapeutic dilemmas for which additional expertise is requested. 

Professional Practice Gaps:
1. Physicians/faculty lack current medical knowledge and preferred practice patterns outside of their area of current and/or sub-specialty expertise.
2. Provide updated case presentations to faculty, fellows, researchers, and fellow residents in order to improve patient care in ophthalmology.

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Child and adolescent psychiatry is a sub-specialty with focus on development and mental health of young people. As specialists in this field we encounter a wide variety of needs. Professional Rounds is intended to build and widen the base of exposure to important topics within the field for medical students, residents, fellows, and faculty. Presentations include specialist presentations, journal article discussions, and question and answer opportunities.

Professional Practice Gap:
In the medical field, there is a subgroup of patients who have been impacted by disability.  When their condition is not the specific reason for this patient to seek healthcare services, the need to accommodate their disability can be overlooked. Unfortunately, this can lead to situations where parents impacted by disability are not able to effectively participate in their child’s healthcare appointment and may not be adequately prepared to follow after instructions provided by the practitioner.  In order to provide optimal care, providers must be able to efficiently identify families impacted by disability and have knowledge of and access to resources and strategies that will allow them to effectively communicate with and support a parent’s disability while they treat either the parent or a minor family member.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to: 
1. Recognize the need to acknowledge and accommodate parental disability in the areas of physical accessibility and effective communication. 
2. List five general categories of disability that may present themselves within this subgroup of patients. 
3. Describe two tips or resources that they could utilize in their practice for each category of disability.

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Pediatric grand rounds will be an active learning opportunity for pediatricians and pediatric specialists to learn contemporary knowledge and skills to support their professional development. Each 1 hour presentation will be structured using a variety of learning techniques to achieve its goals and objectives in topics deemed most important to the learning and actively practicing physician. Presenting faculty and invited presenters will be challenged to create a unique, engaging and memorable learning experience that has a significant impact on the learning in support of the learning goals and objectives.

Professional Practice Gap
Early identification of pubertal disorders is essential to maximize the full growth and developmental potential of the child.  This lecture is designed to aid the pediatrician in early diagnosis and intervention of pubertal disorders. 

Learning Objectives
Review pubertal milestones and growth patterns
Formulate a differential diagnosis for delayed and precocious puberty
Outline a basic work up for patients with delayed and precocious puberty

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The Neurology department is composed of a diverse group of faculty members. Some practice neurology while others are sub-specialists who are experts in their field. We also have Advanced Practice Providers, residents, fellow(s) and students from OU College of Medicine. Our aim is to provide sessions which are of value to this diverse group of attendees, providing a mix of common and uncommon neurological conditions, while also including sessions targeting quality improvement, provider wellness and professional development. Each session is 1 hour long, with a question-answer session included at the end.

Professional Practice Gap: 
The symptom of double vision, or diplopia, can potentially be caused by a variety of ophthalmologic, orbital, or neurologic diseases, and it is a common reason for patients to seek evaluation from medical providers.  It is therefore important for providers, to have familiarity with features of diplopia which may help localize its source or help guide appropriate testing and/or subspecialty evaluations.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
Discuss a clinical approach to the patient presenting with diplopia.
Describe case examples of diplopia caused by ophthalmologic or neurologic conditions.

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Internal Medicine is a diverse specialty area encompassing all the systems of the body, and includes generalists and subspecialists. Grand rounds is a weekly one-hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of internal medicine and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and subspecialists.

Professional Practice Gap:
Practitioners may not know the connection between real medical disease and the history of medicine.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Discuss the folklore and myth of the vampire. 
2.  Discuss the medical disease that inspired the vampire.

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Pediatrics is a diverse specialty area encompassing all the systems of the body, and includes generalists and sub-specialists. Grand rounds is a weekly one hour presentation incorporating active learning techniques including: case studies, the audience responds to questions with audience response systems, small group discussions, panel discussions, and question and answer opportunities. Because of the diversity of pediatrics and the wide range of diverse clinical cases seen, a wide variety of topics are presented which are relevant to both generalists and sub-specialists.

Professional Practice Gap: 
Practitioners may not be aware of the health disparities present in pediatric medicine and may not know the efforts nationally and within Oklahoma Children’s Hospital to address root causes of disparities.
Practitioners may not be aware of the role they can and need to have to reduce health disparities within Oklahoma Children’s Hospital.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
Describe causes of disparities in health outcomes. 
Identify the Justice, Equity, Diversity, and Inclusion (JEDI) committee at The Children’s Hospital and how to become involved in activities.

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Psychiatry is a diverse specialty area encompassing the vast complexities of mental health, and includes both generalists and specialists. Grand rounds is a monthly one hour presentation given by psychiatry faculty to offer learning opportunities on specific  cases, conditions, regulations, procedures, updates on evidence-based therapies, and more. Because of the diversity of psychiatric conditions and treatments, a wide variety of topics are presented which are relevant to both generalists and sub-specialists. Journal club is a monthly one hour presentation given by psychiatry faculty. Dr. Ashley Walker,  to offer learning opportunities on how to read a journal article critically, to improve clinical appraisal and assimilate evidence skills, and to apply knowledge of study design and statistical methods.

Professional Practice Gaps:
On recent reviews/surveys, psychiatry department journal club participants demonstrated desire to review seminal studies in the field of psychiatry, and that they lacked ability and confidence to critically appraise different types of research.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1. Critically appraise a meta-analysis or systematic review.
2. Describe the results of a recent systematic review of the effectiveness of psychoanalytic/psychodynamic psychotherapies for suicidal attempts and self-harm.
3. Define the following concept: heterogeneity.
4. Define the following sources of bias: publication bias, reporting bias.

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This activity is designed to change the way these providers think and act in their practices so their activities related to patient care reflect safest and best practices. It also serves to encourage physicians and hold them accountable to evidence-based practice.

Professional Practice Gaps:
Practitioners (1) may not know that most preterm infants independently breathe at birth; (2) are often unable to support spontaneous breathing effectively, requiring babies to be intubated soon after birth; (3) may find it interesting to learn that failure to maintain self-ventilating from birth can be predicted by close observation of the baby’s oxygen requirement; (4) might be unaware of the benefits and pitfalls of the wide choice of interventions and devices available to support the newborn patient’s respirations.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to: 
• Evaluate complications and errors
• Identify clinical practice changes
• Distinguish errors that can lead to complications
• Integrate effective communication among our expanding group

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This live activity will target an audience of physicians, residents, physician extenders and support staff specializing in the field of dermatology. Subjects and formats will vary as followed:

• Grand Rounds: (Approximately 45% of the time) Utilizing expert leaders in their field and resident speakers this conference each week a lecture will be presented in order to bring the most up-to-date information to the local dermatology community. Moreover, Q&A sessions will offer a unique and personalized interaction with faculty and other leaders.
• Morphology Conf. (Approximately 45% of the time)  This is a conference of live patients or virtual patient presentations. Evaluation of skin findings by attendees is followed up by morphologic description and differential diagnosis given by dermatology residents. Subsequent history is given by the physician presenting the case and departmental dermatopathologists present the path slides via video connection. This is followed by a round table discussion of the patient’s case and proper management.M&M (approx. 4 times/year) This live meeting will target an audience of physicians, residents, physician extenders and support staff involved in the practice of dermatology. The course director will identify cases of patient care for discussion. The care provided will be detailed and options to improve patient care will be identified. Discussion among all participants will be highly encouraged and facilitated by the course director. Practical examples will be utilized whenever possible. 2 to 3 case scenarios will be discussed at each session. Patient and provider confidentiality will be maintained as strictly as possible. Each participant will sign a “Confidentiality Agreement” keeping strict compliance with The University of Oklahoma’s OUHSC COM policy number 736 “Standards for Conducting Morbidity and Mortality Conferences as Peer Review”. 

Professional Practice Gap:
(1) Practitioners may not know the role of antimalarials on SLE management, including prevention of flare, damage accrual and mortality. (2) Practitioners may not be familiar with the 2016 recommendations on screening for hydroxychloroquine (HCQ) - induced retinopathy. (3) Data emerging during the COVID pandemic have raised concerns on cardiac toxicity of HCQ, which may also be pertinent to individuals with autoimmune diseases.

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to: 
1. Review the role of antimalarials on SLE disease management.
2. Review latest recommendations on antimalarial induced retinopathy screening. 
3. Review latest data on cardiovascular safety of HCQ in the COVID era.

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Professional Practice Gaps: 
1) In the field of cardiovascular medicine, there is a robust and evolving evidence base informing practice; however, many studies have shown this evidence base is slowly, incompletely, and inequitably translated into clinical practice.  2) This activity seeks to educate clinicians on emerging methods for translating evidence to practice from the field of behavioral science which can be utilized in the improving the quality, safety, and equity of cardiovascular care delivery.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:  
1.  Recognize key principles of behavioral science/nudging applicable to patients and healthcare providers
2.  Identify how behavioral science/nudging can accelerate effective digital health adoption
3.  Apply behavioral science/nudge principles to improving the quality, safety, and equity of cardiovascular care

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Psychiatry Grand Rounds provides continuing education for our faculty, trainees, and the public sector. We strive to enable discussion that is both about and involves the patients, so the physician can better understand the depth of a patient's mental illness. In this series, we explore the history of policies and procedures for handling mentally ill patients and what can be done to improve care and treatment they receive, as well as to better explain various forms of mental illness and how treatment should be approached and practiced by the clinician.

Professional Practice Gaps:
Practitioners are frequently challenged in their understanding of pathophysiology, biological markers, and evidence-based treatments of mental disorders. Their awareness of the impact and treatments for suicidal or incarcerated patients with mental disorders may be equally contested. The effectiveness of biological and psychotherapeutic treatments of mental disorders must also be weighed against potentials side effects of these same treatments. Actual teaching methods and ideal teaching methods, based on studies of education and human physiology, may occasionally differ and impact overall the intended outcome.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Review the current landscape of diversity leaders 
2. Illustrate the challenges of limited representation of women and BIPOC faculty in leadership positions 
3. Identify the best practices to effectively support psychiatry diversity equity and inclusion leadership efforts

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Professional Practice Gaps:
Practitioners may be unfamiliar with pediatric Patient Blood Management interventions, current guidelines, and the benefits of the implementation of pediatric Patient Blood Management programs.

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to:  
1. Describe Pediatric Patient Blood Management Interventions and their benefits
2. Summarize Pediatric Patient Blood Management guidelines
3. Identify gaps in Patient Blood Management

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Neurosurgery deals with diseases of the nervous system that are amenable to surgical intervention, as well, traumatic, and congenital neurologic abnormalities. Grand rounds is a twice-monthly one-hour presentation. These are generally a traditional lecture/Q&A format learning with what is currently used versus what is ideal.

Professional Practice Gap: Clinicians may not know about the issues surrounding pediatric spinal deformity management

Learning Objectives: Upon completion of this session, participants will improve their competence and performance by being able to:
1.  Identify the different types of scoliosis and related principles surrounding care
2. Discuss different indications for bracing and surgery
3. Develop an approach to managing patients with pediatric spinal deformity

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The orthopedic surgery grand rounds hour is a great opportunity for orthopedic surgeons, residents and support staff to gain continuing education on a variety of musculoskeletal related topics. This format allows for the interaction between practicing surgeons and those in training that encourages a healthy discourse on the latest information in the field. Case study, article review, and surgical technique lectures by qualified faculty are a few of the reasons this activity and those like it are still important and necessary for the medical community to stay informed of current concepts in our field.

PROFESSIONAL PRACTICE GAP:   
It is important for orthopedic surgeons to stay abreast of current referencing softwares and techniques related to the referencing styles and scientific journal requirements for biographies. 

LEARNING OBJECTIVES: Upon completion of this session, participants will improve their competence and performance by being able to
1. Recognize various methods of referencing and biographies for scientific manuscript writing,
2. Summarize concepts of EndNote referencing software and demonstrate competency in managing references. 

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Congenital heart disease frequently encompasses derangements of all bodily systems. For this reason a wide variety of specialty areas are required in order to care for these complex patients. Each week we hold a multidisciplinary conference where the management of these patients is discussed. The duration of the conference is generally 1.5 - 2 hours, and active participation by all attendees is encouraged via case studies, the audience responding to questions, small group discussion, and question and answer opportunities. The ultimate goals of the conference are:
1) to assure that the needs of the patient are understood.
2) The needs of the the patient are being met
3) A long-term care plan is developed, and 
4) Adequate communication with the patient or their care-provider is being performed.

Professional Practice Gap 
•Providers may not understand the cardiac manifestations of syndromic supravalvar PS

Learning objectives 
•Explain syndromic supravalvar PS as poor response to balloon angioplasty 
•Recognize that a combination of supravalvar PS and AS are associated with Williams syndrome, familial elastin arteriopathy. 

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Grand Rounds consists of 2 case presentations from the diversity of pathology seen at the Eye Institute. Each is presented chronologically from presenting symptoms, history of present illness, past medical and ocular history, with photos of clinical findings and diagnostic imaging.Using the Socratic model of teaching, questions are raised throughout the process culminating in the formulation of a differential diagnosis. Further diagnostic testing is recommended and a therapeutic plan proposed. Often presented are diagnostic and therapeutic dilemmas for which additional expertise is requested. 

Professional Practice Gaps:
Physicians/faculty lack current medical knowledge and preferred practice patterns outside of their area of current and/or subspecialty expertise.   

Learning Objectives:  Upon completion of this session, participants will improve their competence and performance by being able to: 
1. Identify the differential diagnosis and appropriate initial workup for the discussed rare findings.
2. Recognize the differential diagnosis and treatment for discussed ophthalmology cases.
3. Design an appropriate treatment and/or referral plan for the discussed cases.

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