Pediatric Cardiothoracic Surgery

NPC-QIC
American Academy of Pediatrics
The Society of Thoracic Surgeons
The American Association for Thoracic Surgery
American College of Chest Physicians
American Heart Association
Cardiothoracic Surgery Network
American Medical Association
American College of Surgeons

Pediatric Acute Care Cardiology Collaborative (PAC3)
Pediatric Cardiac Critical Care Consortium (PC4)
Hypoplastic Left Heart Syndrome Workgroup
American Academy of Pediatrics Section on Surgery
Arora Advisory Council

Pediatric Cardiothoracic Surgeon
Single Ventricle Program Surgical Director

Administrative Activities and Leadership Roles

a. Heart Institute

Dr. Greiten was recruited to Arkansas Children’s Hospital to help facilitate the transition of the Heart Center into a nationally renowned Heart Institute. Dr. Greiten’s immediate goals were to establish himself as a clinically proficient and trusted leader, not only within the Heart Institute, but also on a national level. Three years later Arkansas Children’s Hospital is recognized as one of the top programs by U.S. News & World Report, and the surgical outcomes consistently earn the highest possible ratings from the Society of Thoracic Surgeons.

Single Ventricle Program Surgical Director
Dr. Greiten serves as the surgical director for Arkansas Children’s Hospital Single Ventricle Program. Dr. Greiten’s responsibilities include: overseeing the immediate inpatient post-operative management for patients who undergo staged single ventricle palliations, directing and coordinating care(s) across multiple specialties in relation to this vulnerable subset of patients, overseeing shunt anticoagulation care plans, and post-operative single ventricle G-tube/feeding, pain/sedation protocols.

Research Group Director
When Dr. Greiten first arrived at UAMS/Arkansas Children’s Hospital one of his first goals was to re-establish research productivity within the Division of Pediatric Congenital Cardiac Surgery. Dr. Greiten’s philosophy was to promote research collaboration across multidisciplinary care while bringing focus to the quality of work done. To date Dr. Greiten leads a research group which includes: pediatric cardiac surgery, pediatric cardiology, pediatric cardiac anesthesia, pediatric cardiac intensive care, pediatric transplant, and pediatric neurology. Dr. Greiten has also been instrumental in promoting collaboration with the Vascular Anomalies Program at UAMS/Arkansas Children’s Hospital while using the program as a spring board to establish a tissue repository/bio-bank within his own division.

Society of Thoracic Surgery Database
Dr. Greiten serves as the surgical liaison working closely with Arkansas Children’s Hospital STS database manager. His responsibilities include overseeing data entry and validating surgical complications. Dr. Greiten’s efforts serve as the cornerstone for maintaining Arkansas Children’s Hospital’s national STS score and ranking.

Internal Practice Management Guidelines UAMS/ACH
Dr. Greiten has been instrumental in maintaining the highest quality standards of patients undergoing surgical repair/palliation. He serves as project leader for several ongoing internal practice management guidelines and quality improvement projects for UAMS/ACH Cardiac Institute including:

1. Single Ventricle Shunt Anticoagulation Prophylaxis
Shunt thrombosis is common in infants undergoing staged palliative surgeries for single-ventricle congenital heart disease. The reported incidence and timing of thrombosis varies widely, making it difficult to understand the burden and development of thrombosis as it relates to prevention. For this reason Dr. Greiten began a quality improvement project aimed to determine the timing a cumulative incidence of stage I palliated patients at Arkansas Children’s Hospital in hopes to identify clinical characteristics associated with thrombosis and to decrease the incidence of thrombosis in his patient population.

2. Single Ventricle Feeding Protocol
Feeding dysfunction commonly occurs in infants with single ventricle congenital heart disease and impacts both growth and long-term outcomes. Little evidence exists to guide safe feeding in this population and there is considerable variation in feeding practices across single ventricle centers. For this reason Dr. Greiten is working on a quality improvement project aimed to determine the best pre and post-operative feeding plans for interstage patients.

3. Post-Operative Pain and Sedation Protocol
Post-operative pain and sedation continues to be a major problem in cardiac surgical patients. Over sedation leads to increased length of ICU stay in addition to delays in extubation and resumption of normal feeding. For this reason, Dr. Greiten helped create a protocol which aimed to guide the use of narcotic, sedative and non-narcotic medication use after cardiac surgical repairs in efforts to better control post-operative pain while promoting enhanced recovery pathways.

4. Viral Panel Screening, Vaping Guidelines
Facing the COVID-19 pandemic, many hospitals implemented viral screening protocols before aerosol-generating procedures in effort to protect patients and healthcare workers. Given the limited prior evidence of the effectiveness of such protocols, Dr. Greiten began a quality improvement project aimed at evaluating efficacy and feasibility of viral screening all patients undergoing cardiac repair at Arkansas Children’s Hospital.

5. Management of Williams Syndrome Patients Undergoing Invasive Procedures
Williams Syndrome, caused by a microdeletion of chromosome7, is a multisystem disorder present a birth affecting boys and girls equally. A majority of children with this syndrome have cardiovascular anomalies including supravalvar aortic stenosis, which includes coronary ostia stenosis. This progressive condition puts them at high risk for sudden cardiac arrest. Dr. Greiten and his team developed a protocol for all patients with Williams Syndrome to have cardiac anesthesia/surgery backup for all invasive procedures at Arkansas Children’s Hospital.
6. Surgical Site Infections-Solutions for Patient Safety Project
Dr. Greiten is an active member of the Surgical Site Infection-Solution for Patient Safety Project at Arkansas Children’s Hospital. As a member Dr. Greiten is responsible for evaluating surgical outcomes and complications pertaining to surgical site infections, and works to maintain system wide adherence to the highest national standards and current practice guidelines for infection prevention.

b. National Collaborations

Since arriving at UAMS/Arkansas Children’s Hospital Dr. Greiten has sought out and been elected to several national organization collaborative workgroups. Dr. Greiten national committee and workgroup involvement has been productive in advancing national guidelines, changing clinical practice, as well as advocacy initiatives for educational training and patient care.

National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC)
Dr. Greiten first became involved in the NPC-QIC through his work as surgical director for the Single Ventricle Program at Arkansas Children’s Hospital. Joining a network of over 60 pediatric cardiology care centers across the United States, Canada and the United Kingdom, Dr. Greiten’s group helps to work within the collaborative to decrease the mortality and improve the quality of life for infants with single ventricle congenital heart disease.

Unplanned Re-Intervention Improvement Project, NPC-QIC
Dr. Greiten is the site director for Arkansas Children’s Hospital involvement in the learning cohort to improve the survival of infants between stage 1 and stage 2 who undergo single ventricle palliation. The aim of the project is to reduce the incidence of unplanned re-intervention 5-10% by March 2023.

National Collaborative Post-Operative Chylothorax Treatment Protocol
Dr. Greiten is the surgeon advisor/consultant for the nationwide collaboration regarding development of treatment guidelines for the management of chylothorax in pediatric patients who have undergone cardiac surgery. In conjunction with medical and critical care colleagues throughout the United States, this group is focused on developing a concise algorithm for the management of this complex patient population.

Performance Improvement and Patient Safety Program
Dr. Greiten serves as the Cardiac Institute representative for Performance Improvement and Patient Safety (PIPS) program through the American College of Surgeons (ACS). Dr. Greiten helps to facilitate discussion and promote education though his work with the PIPS case review board at Arkansas Children’s Hospital. His insights are beneficial to the improvement of patient safety and surgical outcomes through his collaboration and work with the PIPS program.

c. Committee Assignments and Administrative Service

a. National Committees

Scientific Review Committee, Pediatric Acute Care Cardiology Collaborative (PAC3)
Dr. Greiten serves as a voting member of the Scientific Review Committee whose mission is to improve cardiac acute care outcomes by focusing on quality, value and experiences. Dr. Greiten is a reviewer and invited editor for this committee which helps to establish current guidelines and protocols for pediatric patients.

Surgical Sub-Specialty Committee, Pediatric Acute Care Cardiology Collaborative (PAC3)
Dr. Greiten’s work on the Surgical Sub-Specialty Committee is to support the aims and work of the Executive Committee as it relates specifically to congenital cardiac surgery in children. He works closely with other members to set current guidelines and protocols which are used throughout the nation at hospitals and care centers for pediatric patients.

Surgical Specialties Early Career Physician Workgroup, American Association of Pediatrics (AAP SOCCS ECP)
Dr. Greiten is one of 7 leadership members responsible for the education and support of early career physicians (within the first 10 years of practice). Dr. Greiten is responsible for outline both national and regional meetings to support the needs of this group. This committee develops programs and meetings along with online content and materials to guide and foster clinical and professional development within the AAP.

Industry and Development Committee, Section on Surgery, American Association of Pediatrics (AAP SOSu)
Dr. Greiten is one of 5 leadership committee members who is responsible for the education of SOSu members on how to best interact and collaborate with industry regarding device/product use, development and design. The policies they create help physicians navigate institutional and governmental regulation/agencies regarding the best way to safely and legally use new devices/products while advocating for legislation to improve the availability of pediatric appropriate surgical devices and products.

Pediatric Cardiac Critical Care Consortium (PC4)
Dr. Greiten was elected as surgical site representative for Arkansas Children’s Hospital pertaining to their involvement and data collection for PC4. Dr. Greiten assists the program director with monthly meetings and provides surgical insight for complex cases.

Arora Advisory Council
Dr. Greiten is a member of the Arora (Transplantation Network) Advisory Council where he serves as surgical consultant for pediatric cardiac transplantation patients and families. Dr. Greiten works alongside a team of physicians, nurses, technicians, social workers and administrators to help guide the recovery of organs and tissues for transplantation across the southern region.

Thoracic Surgery Residents Education Committee
Working with Thoracic Surgery Residents Association Dr. Greiten served as a founding member of the Education Committee which was dedicated to resident/fellow education. This work allowed Dr. Greiten to develop an interactive curriculum which combined traditional techniques with advanced simulation abilities to better prepare trainees for rotations, board exams and entry into practice.

b. UAMS/Arkansas Children’s Hospital Committees

Research Administrative and Operations Advisory Committee
Dr. Greiten was selected by his peers to serve on an advisory committee to help craft the initial proposal for core support from the Arkansas Clinical Research Institute as it pertains to surgical and translational research. The capacity which Dr. Greiten serves is both as representative for the Heart Institute, but also for the Department of Surgery, as this collaboration continues to evolve.

Professional Practice Evaluation Committee
Dr. Greiten is an elected member of the Professional Practice Evaluation Committee with full voting rights. This committee meets monthly to review any reported transgressions of medical staff, collecting and evaluating supporting material(s) and judging whether any deviation of care/practice occurred and if so, what further steps of education, evaluation or consequence should be recommended.

Surgical Site Infection-Solutions for Patient Safety Project (SSI HAC Team)
Dr. Greiten was recruited to assist the hospital acquired infection team as a physician advisor. He is responsible for providing recommendations as well as helping guide the work of the group pertaining to data analysis and outcome measurements.

Teaching & Mentoring Overview
Education has always been a major focus in Dr. Greiten’s academic career, specifically related to cardiovascular physiology, pathology and surgical repair. Dr. Greiten’s interests and expertise in teaching extends from general medical education to the instruction of surgical techniques, palliations and repairs. Dr. Greiten’s goal as an educator is to be available, affable and able to learners of all educational levels and in a variety of settings including: one-on-one, small groups, formal lectures, bedside clinical rounds, in the operative theater and from behind the podium at various regional, national and international conferences. Dr. Greiten’s clinical teaching begins on cardiac intensive care rounds, which are conducted twice daily. The lessons to medical students, residents, fellows, and nursing/physician assistant students encompass a wide range of medical topics from post-operative management, interpretation of diagnostic testing/imaging, and the nuances of cardiac critical care. Once within the operative theater the students/trainees are able to engage in “hands on” care including direct instruction by Dr. Greiten and exposure to: cardiopulmonary bypass, extracorporeal membrane oxygenation strategy, hybrid catheter based procedures/interventions, and of course a multitude of congenital cardiac palliation and repair operations. Dr. Greiten feels his teaching style is effective and stimulating by being interactive and engaging. Direct feedback and anonymous evaluations frequently compliment on Dr. Greiten’s teaching style and ability, specifically commenting on an engrossing learning experience. To this point, Dr. Greiten’s leadership in education has been recognized throughout both the Divisions of Pediatric Cardiothoracic Surgery and Cardiology along with the Department of Surgery at UAMS in that he was solicited to implement a new curriculum specifically focused on Congenital Cardiovascular Surgery. Dr. Greiten believes that his passion for educating the “next generation” of medical providers is reflected through and in these educational endeavors.
Educator’s Portfolio
Dr. Greiten’s Educator’s Portfolio documents his teaching experience and trajectory in medical education. It states Dr. Greiten’s teaching philosophy and highlights his teaching activities, mentoring activities, professional development in education, regional and national recognition, and his long-term goals in medical education.
Courses Taught
Dr. Greiten has delivered numerous lectures and moderated multiple sessions to medical students, residents, fellows, nursing/physician assistant students, faculty and staff – in total over 50 lectures/sessions.
Regarding medical student education, Dr. Greiten is an instructor for the first year medical student didactic “Cardiovascular Curriculum Block” (Course Director Rhee Sung Ph.D). His responsibilities include lecturing to the students and helping compose questions for their block exam. Dr. Greiten also engages the medical school class through the Summer in Surgery Program where he sponsors and mentors two students/session, providing both a structured curriculum which includes daily lessons and journal club readings along with operative exposure and research opportunities. On several occasions Dr. Greiten has been asked to assist in cadaveric lab dissections and operative/procedure demonstrations to students in the first year medical class. In the past Dr. Greiten has been an instructor for both the General Surgery and Cardiothoracic Surgery Boot Camps which are conducted to help new graduates integrate into surgical training programs. He has also assisted with several medical school simulation scenarios including: fundamentals of surgical procedures (open and laparoscopic), trauma/shock management, cardiopulmonary resuscitation, advanced airway placement/management, and placement of invasive lines/monitoring. Dr. Greiten serves the third year medical school class through his involvement with the surgical clinical rotation as a mock oral examiner. Every 6 week block Dr. Greiten meets with 2-3 students individually where he administers an oral examination pertaining to surgical diagnosis, advanced imaging/medical workup, pre/post-operative care, and operative technique(s). Furthermore, Dr. Greiten has served as an international student mentor through outreach work with the International Clinical Research Center located in Brno Czech Republic.
Dr. Greiten created and serves as the site director for an Elective Rotation in Congenital Cardiothoracic Surgery. Fourth year medical students are offered a 4 week elective in Pediatric Congenital Cardiac Surgery on Dr. Greiten’s surgical service at Arkansas Children’s Hospital. During this block they develop an understanding of clinical diagnosis and management of complex congenital cardiac lesions. They are instructed on how to formulate a care plan and how to both utilize and interpret diagnostic imaging. They are engaged in operative procedures and interventions. Lastly, they are supervised as they help lead the pre/post-operative critical care of these complex patients. While on this elective rotation block they are encouraged and involved in a multitude of academic developmental activities including research activities, quality improvement projects, and educational videography; all of which are presented for publication and presentation.
Dr. Greiten also provides instruction to the general surgery residents through various activities as well. In terms of hands on teaching Dr. Greiten has assisted in cadaver dissection sessions. Previously Dr. Greiten provided education in: open and laparoscopic operative techniques, fundamentals of endoscopic surgery, endovascular surgical training, trauma/shock, cardiopulmonary resuscitation (Basic Life Support and Advanced Life Support courses), and post-operative critical care management. Specific to Dr. Greiten’s surgical expertise, he gives both didactic lectures regarding thoracic trauma/injury as well as provides operative instruction to the residents in thoracic exposure and surgical techniques.
Although the Division of Pediatric Cardiothoracic Surgery at UAMS/Arkansas Children’s Hospital does not have fellows, Dr. Greiten works closely with his colleagues in: Cardiology (Program Director Josh Daily, M.D.) who train 2 accredited fellows/year, and with Division of Pediatrics who oversee the training of Cardiac Intensive/Critical Care Fellowship (Program Director Rupal Bhakta, M.D.) along with residents in the Neonatal Intensive Care Unit and Pediatric Intensive Care Unit. Collaborating with the ACGME Cardiology Fellowship, Dr. Greiten helped create and is the surgical supervisor for a required phase III external rotation in Congenital Cardiac Surgery and Anesthesiology. Fellows are required to complete a 1 month rotation with Dr. Greiten, where he directly supervises and teaches them proving experience and exposure to various surgical repairs and palliations of congenital cardiac patients. Dr. Greiten also provides a 6-part series of Cardiovascular Curriculum to the Cardiology and Cardiac Critical Care Fellows which includes topics of: Cardiopulmonary Bypass and Deep Hypothermic Arrest, Mechanical Circulatory Support, Surgical Techniques and Biomaterials, Valve Repair and Replacement, Three Stage Palliation of the Single Ventricle Patient, and Double Outlet Right Ventricle a “Surgeon’s Perspective.” To the Neonatal and Pediatric Intensive Care Residents Dr. Greiten gives three dedicated lectures pertaining to: the History of Cardiac Surgery, Cardiopulmonary Bypass and Surgical Repairs, and Mechanical Circulatory Support in Pediatrics.
Dr. Greiten has lectured numerous times to nurses, physician assistants, perfusion and advanced practice staff/students during his time at Arkansas Children’s Hospital. Dr. Greiten works closely with the nurse educator and clinical nursing specialist in the Cardiac Intensive Care and Step-Down units, in addition to the nurse supervisor of the cardiovascular operative room and chief of perfusion at Arkansas Children’s Hospital. Quarterly Dr. Greiten provides both a surgical lecture and a cardiac pathophysiology lecture pertaining to congenital cardiac patient care. Dr. Greiten has also served as sponsor and mentor (approximately 1-2 students per quarter) to several individual care providers who were working towards advanced degrees by providing both clinical and academic support through approved rotations and quality improvement projects.
Dr. Greiten is a frequent invited speaker for various educational groups including: an ongoing multi-institutional webinar series on the Csurgeries video educational platform, The Society of Thoracic Surgeons Looking to the Future Programs (to both the medical student program and the resident program) where he serves both on the scholarship program committee and serves as an invited mentor, along with departmental opportunities where he has presented at Grand Rounds for UAMS and the Mayo Clinic.
On a national level Dr. Greiten has worked with and continues to advance surgical education through working on a National Education Curriculum for the Thoracic Surgery Residents Education Committee. Dr. Greiten developed curriculum based off the book chapters he authored regarding: Combined Valve and Coronary Artery Bypass Grafting, Post-Pneumonectomy Complications, and Post-Operative Chylothorax. Working with a national committee dedicated to resident/fellow education has allowed Dr. Greiten to further define and refine his dedication to changing surgical training. Dr. Greiten has collaborated with some of the best minds within the field of Cardiothoracic Surgery, and together they developed an interactive curriculum which combined traditional techniques with advanced simulation abilities to better prepare trainees for rotations, board exams and entry into practice. Additionally, Dr. Greiten also serves as a Section-In-Chief Editor for Cardiothoracic Surgery for board review course. Dr. Greiten has published/recorded several sessions (Redo Coronary Artery Bypass Graft, Coronary Artery Stents, and Tricuspid Valve Repair) which are available for review with over 4 hours of content and high yield questions to prepare examinees for success on the American Board of Thoracic Surgery written and oral exams.
Curriculum and Program Development
In Dr. Greiten’s short time at UAMS/Arkansas Children’s Hospital, he has created educational programs for multiple level learners. As mentioned above Dr. Greiten collaborates with the medical school to assist in the education and instruction of both junior and senior level medical students. Dr. Greiten lectures within the cardiovascular curriculum block to junior medical students in addition to serving as preceptor and mentor throughout the college. Moreover Dr. Greiten’s education and mentorship efforts also include various shadowing opportunities for students, hosting Summer in Surgery students, and serving as Senior Medical Student Advisor to 4th year students matching into surgery and surgical specialties. Nationally, Dr. Greiten has successfully sponsored several medical students as they competed for scholarships through The Society of Thoracic Surgeons and serves as a committee member for the Looking to the Future Scholarship Program.
Working closely with UAMS Dr. Greiten founded the Cardiothoracic Interest Group. Members of this medical school group include 1st-4th year students who have an interest in a career in cardiac surgery, thoracic surgery, vascular surgery and cardiology. The group has grown to include over 120 members and hosts several forums and activities throughout the academic year. Dr. Greiten provides students with professional contacts, encourages growth and education through several industry sponsored activities/wet labs, in addition to providing guidance and resources to students as they develop their academic portfolios.
Although Dr. Greiten’s sub-specialization career path has moved him out of the realm of General Surgery, he still remains an active member within that community. Dr. Greiten serves as faculty mentor to their current residency class, offering career and academic guidance as well as board prep for his mentees. On a national stage Dr. Greiten mentors and advises several general surgery residents throughout the country as they vie for competitive Accreditation Council for Graduate Medical Education residency spots. Since starting at UAMS Dr. Greiten has collaborated with the UAMS Cardiology Fellowship and the Cardiac Intensive Care Fellowship Program Directors to create a new and novel curriculum specific to his field of expertise. Dr. Greiten was also able to develop a 6-part cardiology curriculum in addition to a more basic 3-part series of intensive care lectures, which he presents throughout the year to residents and fellows.

Throughout his training and early career, Dr. Greiten has demonstrated a dedicated and focused research path which enhances the quality of care he provides to his patients as a congenital pediatric cardiac surgeon. Furthermore, Dr. Greiten has quickly become an active and funded investigator at UAMS/Arkansas Children’s Hospital. Dr. Greiten’s clinical research interests include: clinical outcomes of palliative and definitive repairs of congenital cardiac malformations, neurodevelopmental outcomes after cardiac surgery, single ventricle pathophysiology, and cardiac transplantation. Dr. Greiten has also published several surgical education projects and has an interest in developing simulation platforms pertaining to extracorporeal membrane oxygenation, minimally invasive cardiac and endovascular techniques. Throughout his early career, Dr. Greiten’s research has been supported with nearly one million dollars in funding. Lastly, during his surgical training Dr. Greiten successfully completed a Master’s in Biomedical Sciences, Clinical and Translational Science where he published several papers on thromboprophylaxis and became an internationally renowned expert shifting the paradigm of novel anticoagulation strategies. In his career, Dr. Greiten has been the primary or major contributor of multiple publications, several book chapters, as well as various abstracts and surgical videos. In the process Dr. Greiten has received numerous research awards at various national conferences and institutions.

Teaching & Mentoring Overview

Education has always been a major focus in Dr. Greiten’s academic career, specifically related to cardiovascular physiology, pathology and surgical repair. Dr. Greiten’s interests and expertise in teaching extends from general medical education to the instruction of surgical techniques, palliations and repairs. Dr. Greiten’s goal as an educator is to be available, affable and able to learners of all educational levels and in a variety of settings including: one-on-one, small groups, formal lectures, bedside clinical rounds, in the operative theater and from behind the podium at various regional, national and international conferences. Dr. Greiten’s clinical teaching begins on cardiac intensive care rounds, which are conducted twice daily. The lessons to medical students, residents, fellows, and nursing/physician assistant students encompass a wide range of medical topics from post-operative management, interpretation of diagnostic testing/imaging, and the nuances of cardiac critical care. Once within the operative theater the students/trainees are able to engage in “hands on” care including direct instruction by Dr. Greiten and exposure to: cardiopulmonary bypass, extracorporeal membrane oxygenation strategy, hybrid catheter based procedures/interventions, and of course a multitude of congenital cardiac palliation and repair operations. Dr. Greiten feels his teaching style is effective and stimulating by being interactive and engaging. Direct feedback and anonymous evaluations frequently compliment on Dr. Greiten’s teaching style and ability, specifically commenting on an engrossing learning experience. To this point, Dr. Greiten’s leadership in education has been recognized throughout both the Divisions of Pediatric Cardiothoracic Surgery and Cardiology along with the Department of Surgery at UAMS in that he was solicited to implement a new curriculum specifically focused on Congenital Cardiovascular Surgery. Dr. Greiten believes that his passion for educating the “next generation” of medical providers is reflected through and in these educational endeavors.

Courses Taught
Dr. Greiten has delivered numerous lectures and moderated multiple sessions to medical students, residents, fellows, nursing/physician assistant students, faculty and staff – in total over 50 lectures/sessions.
Regarding medical student education, Dr. Greiten is an instructor for the first year medical student didactic “Cardiovascular Curriculum Block” (Course Director Rhee Sung Ph.D). His responsibilities include lecturing to the students and helping compose questions for their block exam. Dr. Greiten also engages the medical school class through the Summer in Surgery Program where he sponsors and mentors two students/session, providing both a structured curriculum which includes daily lessons and journal club readings along with operative exposure and research opportunities. On several occasions Dr. Greiten has been asked to assist in cadaveric lab dissections and operative/procedure demonstrations to students in the first year medical class. In the past Dr. Greiten has been an instructor for both the General Surgery and Cardiothoracic Surgery Boot Camps which are conducted to help new graduates integrate into surgical training programs. He has also assisted with several medical school simulation scenarios including: fundamentals of surgical procedures (open and laparoscopic), trauma/shock management, cardiopulmonary resuscitation, advanced airway placement/management, and placement of invasive lines/monitoring. Dr. Greiten serves the third year medical school class through his involvement with the surgical clinical rotation as a mock oral examiner. Every 6 week block Dr. Greiten meets with 2-3 students individually where he administers an oral examination pertaining to surgical diagnosis, advanced imaging/medical workup, pre/post-operative care, and operative technique(s). Furthermore, Dr. Greiten has served as an international student mentor through outreach work with the International Clinical Research Center located in Brno Czech Republic.

Dr. Greiten created and serves as the site director for an Elective Rotation in Congenital Cardiothoracic Surgery. Fourth year medical students are offered a 4 week elective in Pediatric Congenital Cardiac Surgery on Dr. Greiten’s surgical service at Arkansas Children’s Hospital. During this block they develop an understanding of clinical diagnosis and management of complex congenital cardiac lesions. They are instructed on how to formulate a care plan and how to both utilize and interpret diagnostic imaging. They are engaged in operative procedures and interventions. Lastly, they are supervised as they help lead the pre/post-operative critical care of these complex patients. While on this elective rotation block they are encouraged and involved in a multitude of academic developmental activities including research activities, quality improvement projects, and educational videography; all of which are presented for publication and presentation.

Dr. Greiten also provides instruction to the general surgery residents through various activities as well. In terms of hands on teaching Dr. Greiten has assisted in cadaver dissection sessions. Previously Dr. Greiten provided education in: open and laparoscopic operative techniques, fundamentals of endoscopic surgery, endovascular surgical training, trauma/shock, cardiopulmonary resuscitation (Basic Life Support and Advanced Life Support courses), and post-operative critical care management. Specific to Dr. Greiten’s surgical expertise, he gives both didactic lectures regarding thoracic trauma/injury as well as provides operative instruction to the residents in thoracic exposure and surgical techniques.

Although the Division of Pediatric Cardiothoracic Surgery at UAMS/Arkansas Children’s Hospital does not have fellows, Dr. Greiten works closely with his colleagues in: Cardiology who train 2 accredited fellows/year, and with Division of Pediatrics who oversee the training of Cardiac Intensive/Critical Care Fellowship along with residents in the Neonatal Intensive Care Unit and Pediatric Intensive Care Unit. Collaborating with the ACGME Cardiology Fellowship, Dr. Greiten helped create and is the surgical supervisor for a required phase III external rotation in Congenital Cardiac Surgery and Anesthesiology. Fellows are required to complete a 1 month rotation with Dr. Greiten, where he directly supervises and teaches them proving experience and exposure to various surgical repairs and palliations of congenital cardiac patients. Dr. Greiten also provides a 6-part series of Cardiovascular Curriculum to the Cardiology and Cardiac Critical Care Fellows which includes topics of: Cardiopulmonary Bypass and Deep Hypothermic Arrest, Mechanical Circulatory Support, Surgical Techniques and Biomaterials, Valve Repair and Replacement, Three Stage Palliation of the Single Ventricle Patient, and Double Outlet Right Ventricle a “Surgeon’s Perspective.” To the Neonatal and Pediatric Intensive Care Residents Dr. Greiten gives three dedicated lectures pertaining to: the History of Cardiac Surgery, Cardiopulmonary Bypass and Surgical Repairs, and Mechanical Circulatory Support in Pediatrics.

Dr. Greiten has lectured numerous times to nurses, physician assistants, perfusion and advanced practice staff/students during his time at Arkansas Children’s Hospital. Dr. Greiten works closely with the nurse educator and clinical nursing specialist in the Cardiac Intensive Care and Step-Down units, in addition to the nurse supervisor of the cardiovascular operative room and chief of perfusion at Arkansas Children’s Hospital. Quarterly Dr. Greiten provides both a surgical lecture and a cardiac pathophysiology lecture pertaining to congenital cardiac patient care. Dr. Greiten has also served as sponsor and mentor (approximately 1-2 students per quarter) to several individual care providers who were working towards advanced degrees by providing both clinical and academic support through approved rotations and quality improvement projects.

Dr. Greiten is a frequent invited speaker for various educational groups including: an ongoing multi-institutional webinar series on the Csurgeries video educational platform, The Society of Thoracic Surgeons Looking to the Future Programs (to both the medical student program and the resident program) where he serves both on the scholarship program committee and serves as an invited mentor, along with departmental opportunities where he has presented at Grand Rounds for UAMS and the Mayo Clinic.

On a national level Dr. Greiten has worked with and continues to advance surgical education through working on a National Education Curriculum for the Thoracic Surgery Residents Education Committee. Dr. Greiten developed curriculum based off the book chapters he authored regarding: Combined Valve and Coronary Artery Bypass Grafting, Post-Pneumonectomy Complications, and Post-Operative Chylothorax. Working with a national committee dedicated to resident/fellow education has allowed Dr. Greiten to further define and refine his dedication to changing surgical training. Dr. Greiten has collaborated with some of the best minds within the field of Cardiothoracic Surgery, and together they developed an interactive curriculum which combined traditional techniques with advanced simulation abilities to better prepare trainees for rotations, board exams and entry into practice. Additionally, Dr. Greiten also serves as a Section-In-Chief Editor for Cardiothoracic Surgery for board review course. Dr. Greiten has published/recorded several sessions (Redo Coronary Artery Bypass Graft, Coronary Artery Stents, and Tricuspid Valve Repair) which are available for review with over 4 hours of content and high yield questions to prepare examinees for success on the American Board of Thoracic Surgery written and oral exams.

Curriculum and Program Development
In Dr. Greiten’s short time at UAMS/Arkansas Children’s Hospital, he has created educational programs for multiple level learners. As mentioned above Dr. Greiten collaborates with the medical school to assist in the education and instruction of both junior and senior level medical students. Dr. Greiten lectures within the cardiovascular curriculum block to junior medical students in addition to serving as preceptor and mentor throughout the college. Moreover Dr. Greiten’s education and mentorship efforts also include various shadowing opportunities for students, hosting Summer in Surgery students, and serving as Senior Medical Student Advisor to 4th year students matching into surgery and surgical specialties. Nationally, Dr. Greiten has successfully sponsored several medical students as they competed for scholarships through The Society of Thoracic Surgeons and serves as a committee member for the Looking to the Future Scholarship Program.

Working closely with UAMS Dr. Greiten founded the Cardiothoracic Interest Group. Members of this medical school group include 1st-4th year students who have an interest in a career in cardiac surgery, thoracic surgery, vascular surgery and cardiology. The group has grown to include over 120 members and hosts several forums and activities throughout the academic year. Dr. Greiten provides students with professional contacts, encourages growth and education through several industry sponsored activities/wet labs, in addition to providing guidance and resources to students as they develop their academic portfolios.

Although Dr. Greiten’s sub-specialization career path has moved him out of the realm of General Surgery, he still remains an active member within that community. Dr. Greiten serves as faculty mentor to their current residency class, offering career and academic guidance as well as board prep for his mentees. On a national stage Dr. Greiten mentors and advises several general surgery residents throughout the country as they vie for competitive Accreditation Council for Graduate Medical Education residency spots. Since starting at UAMS Dr. Greiten has collaborated with the UAMS Cardiology Fellowship and the Cardiac Intensive Care Fellowship Program Directors to create a new and novel curriculum specific to his field of expertise. Dr. Greiten was also able to develop a 6-part cardiology curriculum in addition to a more basic 3-part series of intensive care lectures, which he presents throughout the year to residents and fellows.