Factors involved in applicant interview selection and ranking for chronic pain medicine fellowship

INTRODUCTION

Applicants to chronic pain medicine fellowship programs often express confusion regarding the importance of various selection criteria. This study sought to elucidate program directors' considerations in applicant selection for fellowship interviews and ranking and to correlate these criteria with match statistics to provide a guide for prospective candidates.

METHODS

An electronic survey was sent to all Accreditation Council for Graduate Medical Education-accredited chronic pain fellowship directors. The importance of various applicant characteristics were evaluated and compared with recent match data.

RESULTS

Fifty-seven program directors completed the survey. The most important factors involved in applicant interview selection were perceived commitment to the specialty, letters of recommendation from pain faculty, scholarly activities, and leadership experiences. Although completion of a pain rotation was valued highly, experience with procedures was of relatively low importance. There was no preference if rotations were completed within the responders' department. Variability was noted when considering internal applicants or the applicant's geographic location. When citing main factors in ranking applicants, interpersonal skills, interview impression and applicant's fit within the institution were highly ranked by most responders.

DISCUSSION

Assessment of an applicant's commitment to chronic pain is challenging. Most responders prioritize the applicant's commitment to chronic pain as a specialty, scholarly activity, participation in chronic pain rotations, pain-related conferences and letters of recommendation from pain faculty. Chronic pain medicine fellowship candidates should establish a progressive pattern of genuine interest and involvement within the specialty during residency training to optimize their fellowship match potential.

Barriers to workplace-based learning in the intensive care unit: A qualitative description of internal medicine residents' and intensivists' perspectives

BACKGROUND

Residency programs leverage the acquisition of critical care competencies through off-service rotations in the intensive care unit (ICU). However, recent literature questions the effectiveness of increasing the exposition of residents to critical care units to improve their critical care competencies. We aimed to describe the barriers to learning in the ICU from the perspective of internal medicine (IM) residents and intensivists.

METHODS

A qualitative description methodology was applied to data gathered during an ICU quality improvement initiative in a large tertiary academic hospital. Verbatim transcriptions of 12 focus groups including 22 IM residents and 17 intensivists were assessed through thematic data analysis.

RESULTS

We identified three key themes and 13 subthemes related to barriers to learning. Aspects of the environment such as the slow socialization process of residents to the ICU environment and stakeholders' perceptions influenced the quality of learning interactions. Dedicated teaching was further influenced by factors related to the IM residency curricula (e.g. competing co-curricular demands) and contributed to tensions in delivering a standardized ICU curriculum.

CONCLUSION

This study provides a description of educational barriers that may be present during ICU rotations. Recognizing these barriers may help clinical teachers improve their trainees' educational experience.

Resident Productivity in the Emergency Department After Implementation of an Automated Patient Assignment System; a Brief Report

Introduction

The clinical diversity of patients presenting to the emergency department (ED) allows emergency medicine (EM) and non-EM residents to sharpen their clinical skills. In most EDs, residents self-assign patients at their discretion. Our institution transitioned from a self-assignment-system to an automated-system, after which we sought to determine the productivity of our non-EM residents compared to the previous system.

Methods

In this retrospective cross-sectional study, resident productivity was measured as number of patient visits per hour and per 8.5-hour shift before and after the implementation of an automated patient assignment system in emergency department. The automated-system assigns one patient at the start of the shift, another 30 minutes later, and one patient every hour thereafter, throughout the shift.

Results

28 residents performed 406 total shifts prior to implementation and 14 residents performed 252 total shifts post-implementation. The average number of patient visits per hour significantly increased from 0.52 ± 0.18 (95% CI 0.45-0.59, IQR 0.43-0.60) to 0.82 ± 0.11 (95% CI 0.75-0.88, IQR 0.74-0.89) after implementation of our assignment system (p<0.00001; figure 1). Additionally, the average number of patient visits per 8.5-hour shift significantly increased from 4.46 ± 1.53 (CI 3.86-5.05, IQR 3.66-5.08) to 6.52 ± 0.86 (CI 6.02-7.02, IQR 5.90-7.09) after the implementation of our system (p<0.00001; figure 1).

Conclusion

These findings warrant further evaluation of the impact of patient assignment systems on trainee education.

Medical residents and attending physicians’ perceptions of feedback and teaching in the United States: a qualitative study

PURPOSE

Residents and attendings agree on the importance of feedback to resident education. However, while faculty report providing frequent feedback, residents often do not perceive receiving it, particularly in the context of teaching. Given the nuanced differences between feedback and teaching, we aimed to explore resident and attending perceptions of feedback and teaching in the clinical setting.

METHODS

We conducted a qualitative study of internal medicine residents and attendings from December 2018 through March 2019 at the Massachusetts General Hospital to investigate perceptions of feedback in the inpatient clinical setting. Residents and faculty were recruited to participate in focus groups. Data were analyzed using thematic analysis to explore perspectives and barriers to feedback provision and identification.

RESULTS

Five focus groups included 33 total participants in 3 attending (n=20) and 2 resident (n=13) groups. Thematic analysis of focus group transcripts identified 7 themes which organized into 3 thematic categories: (1) disentangling feedback and teaching, (2) delivering high-quality feedback, and (3) experiencing feedback in the group setting. Residents and attendings highlighted important themes in discriminating feedback from teaching. They indicated that while feedback is reactive in response to an action or behavior, teaching is proactive and oriented toward future endeavors.

CONCLUSION

Confusion between the critical concepts of teaching and feedback may be minimized by allowing them to each have their intended impact, either in response to prior events or aimed toward those yet to take place.

Survey of surgical critical care applicant and program director views on virtual interviews for fellowship training: a Surgical Critical Care Program Directors Society sponsored study

Background

The COVID-19 pandemic forced postgraduate interview processes to move to a virtual platform. There are no studies on the opinions of faculty and applicants regarding this format. The aim of this study was to assess the opinions of surgical critical care (SCC) applicants and program directors regarding the virtual versus in-person interview process.

Methods

An anonymous survey of the SCC Program Director’s Society members and applicants to the 2019 (in-person) and 2020 (virtual) interview cycles was done. Demographic data and Likert scale based responses were collected using Research Electronic Data Capture.

Results

Fellowship and program director responses rates were 25% (137/550) and 58% (83/143), respectively. Applicants in the 2020 application cycle attended more interviews. The majority of applicants (57%) and program faculty (67%) strongly liked/liked the virtual interview format but felt an in-person format allows better assessment of the curriculum and culture of the program. Both groups felt that an in-person format allows applicants and faculty to establish rapport better. Only 9% and 16% of SCC program directors wanted a purely virtual or purely in-person interview process, respectively. Applicants were nearly evenly split between preferring a purely in-person versus virtual interviews in the future.

Discussion

The virtual interview format allows applicants and program directors to screen a larger number of programs and applications. However, the virtual format is less useful than an in-person interview format for describing unique aspects of a training program and for allowing faculty and applicants to establish rapport. Future strategies using both formats may be optimal, but such an approach requires further study.

Level of evidence

Epidemiologic level IV

Impact of the Virtual Interview Format on Urology Residency Interviews: A Survey of Program Directors

INTRODUCTION

Our objective is to assess the impact of the virtual interview (VI) format on urology residency interviews during the COVID-19 pandemic from the perspectives of program directors (PDs).

METHODS

An anonymous survey was sent to PDs of American Council for Graduate Medical Education-accredited urology residency programs. Questions were designed to evaluate how VIs affected programs' assessment of applicants, interview logistics, and overall perspectives regarding in-person and virtual interviews.

RESULTS

A total of 42 PDs (31%) responded to our survey. VIs negatively affected programs' ability to assess applicants' fit with their residency program (71%), commitment to urology along with their ability to function as a resident (67%), and personality and communication skills (71%) when compared to in-person interviews. Fifty percent of PDs reported that they relied more heavily on objective metrics when ranking applicants, compared to prior years. VIs were more economical than in-person interviews for all participating programs, with each program saving an average of $3,135 in interview-related costs. Additionally, 33% of PDs reported that VIs were less time-consuming when compared to in-person interviews, with 26% of PDs reporting that they were able to interview more applicants. Only 19% of PDs reported that VIs were better than in-person interviews. Given the option, 60% of PDs intend on hosting both virtual and in-person interviews moving forward, while 9% and 31% of programs intend to exclusively host virtual and in-person interviews, respectively.

CONCLUSIONS

PDs perceived VIs to be less reliable than in-person interviews for subjective evaluation of applicants; however, many PDs still desire to integrate VIs in future application cycles.

The Northwestern University Novel Urology Residency Curriculum: Updated Outcomes from a 13-Year Experience with Flexible Residency Training and Electives

INTRODUCTION

We evaluated educational outcomes and satisfaction following institution of a novel, flexible and urology-driven resident curriculum.

METHODS

A new urology resident curriculum was instituted at Northwestern University in 2006. Rotation schedules and resident electives were recorded annually. Operative case logs and American Urological Association In-Service Examination scores were collected prospectively. Residents and faculty rated satisfaction with the residency program on a 5-point Likert scale from "poor" to "outstanding." Differences in cases logged, In-Service Examination scores and satisfaction ratings under the new and prior curricula were compared.

RESULTS

Curriculum changes included full 5-year urology oversight of the residency curriculum by the program director, 8 months of urology rotations in the first postgraduate year and 2 months of general surgery during the second postgraduate year. General surgery rotations were modified annually based on educational rationale and feedback. Cases logged per resident and In-Service Examination scores were comparable between old and new curricula groups. All residents matriculating under the new curriculum took and passed their written boards. The percentage of faculty and residents describing the program as "outstanding" increased from 50% in 2004‒2005 to 82% in 2017‒2018. Program satisfaction increased significantly when comparing the first and last 6 years (percent rating "outstanding": 56.1±2.1% vs 71.6±10.0%, p=0.028).

CONCLUSIONS

After 13 years with the novel curriculum, resident case numbers and In-Service Examination scores remained similar while faculty/resident satisfaction increased. Direct control of general surgery rotations enabled adjustments based on educational rationale. These results demonstrate that a urology-directed and flexible residency program can be instituted without compromising learner outcomes.

Design and Implementation of a Global Health and Underserved Care Track in an Otolaryngology Residency

Despite widespread resident interest in global health and underserved care, few otolaryngology residency programs offer a formal global health experience. This article is the first to characterize a formal otolaryngology global health and underserved care track with a focus on how this curriculum integrates with and supplements resident education. Components of the track include longitudinal limited-resource field experiences in domestic and abroad settings, a related quality improvement project, and completion of a formalized global health educational curriculum. In addition to delivering humanitarian aid, residents in this track obtain a unique educational experience in all 6 core competencies of the Accreditation Council for Graduate Medical Education. Early barriers to implementation included identifying mentorship, securing funding, and managing busy resident schedules. In this work, we detail track components, schedule by track year, keys to implementation, and potential educational pitfalls.

Demystifying the Op-Ed. A Novel Group Writing Workshop to Improve Upon Existing Pediatric Advocacy Training

An op-ed writing workshop utilizing a group compilation exercise increases participant self-reported comfort in writing op-eds and has led to published op-eds. An experiential op-ed writing workshop could be incorporated into advocacy curricula in pediatric residency programs.

Inter-relationships between burnout, personality and coping features in residents within an ACGME-I Accredited Psychiatry Residency Program

BACKGROUND

Burnout during residency training is associated with various factors. Within the context of stress/coping transactional model in which one's personality can influence stress appraisal and coping, there is limited evidence examining the relationship between burnout and personality factors amongst psychiatry residents.

OBJECTIVES

We aim to evaluate the prevalence of burnout within a cohort of psychiatry residents and its relationship with personality factors, demographic, work-related factors and coping features.

METHODS

We conducted a cross-sectional study involving 50 out of 77 eligible residents (response rate 64.9%) and administered the Oldenberg Burnout Inventory (OLBI), NEO-Five Factor Inventory (NEO-FFI) and Brief COPE Inventory. Burnout was defined as crossing the thresholds for exhaustion (≥2.25) and disengagement (≥2.1) scores. We compared the burnout vs nonburnout groups and examined the relationship between burnout, personality factors and coping strategies using correlational and mediational analyses.

RESULTS

Overall, 78% of our cohort met criteria for burnout. Burnout was correlated with hours of work per week (rs = .409, P = .008), neuroticism (OR 1.2, 95% CI 1.01-1.43, P = .041) and avoidance coping (OR 1.61, 95% CI 1.06-2.46, P = .025). Neuroticism was significantly correlated (all P < .001) with all coping domains (Seeking Social Support, rs = 0.40; Problem Solving, rs = 0.52; Avoidance, rs = 0.55; Positive thinking, rs = 0.41) and was a partial mediator between avoidance coping and burnout (β of indirect path = 0.168, [SE = 0.066]; P = .011).

CONCLUSIONS

We found a considerable burnout rate amongst psychiatry residents which was associated with neuroticism and avoidance coping, and suggest ways to better tackle occupational burnout during residency training.

The Important Factors Applicants Consider When Choosing a Residency: A Survey Study

Background

While medical school graduates compete to get matched into the best residency programs, programs also compete to attract the best applicants. The applicant's decision to rank their programs of interest is determined by several factors, many of which are not always apparent.

Method

This study aimed to evaluate significant factors involved in an applicant's residency program selection. A 12-question survey was sent between June 2020 and September 2020 to all first-year internal medicine residents in the United States (US) through an online national database of residencies using the Survey Monkey platform. We asked them to rank the most significant factors that enticed or deterred them from choosing a specific program. We also compared domestic with international medical graduate (IMG) average ranked responses wherein differences were evaluated using an independent two mean samples t-test. The association between outcomes and predictors was analyzed using Pearson's correlation and chi-square analysis.

Results

Out of 9,127 residents, 102 responded to the survey, which equaled a 1.11% response rate. The findings showed that the location, culture, and organization of a program are high-value factors for applicants. Salary, the number of cases seen, and friends near the residency location were not.There are statistically significant differences between graduates of US medical schools and IMG applicants, with the former placing higher importance on the quality of life during residency. Male and female residents also have different priorities with the latter emphasizing program culture and work environment improvement.Residents who chose programs based on academic competitiveness also placed significance on the prestige of the program (r = 0.418, P < .001), program organization/structure (r = 0.3, P = .006), fellowship match rate (r = 0.307, P = .006) and word of mouth (r = 0.520, P < .001). Residents who chose programs based on program culture also put an emphasis on the perceived happiness of the residents (r = 0.450, P = 0.001), and work-life balance (r = 0.359, P = .004).

Conclusion

Programs can attract stronger applicants if they emphasize modifiable factors that are important to potential residents.

Effectiveness of a SNAPPS in psychiatric residents assessed using objective structured teaching encounters: a case-control study

BACKGROUND

Residents play the role of teachers in almost one-quarter of their activities in residency programs.

OBJECTIVE

To evaluate whether a 45-minute class using summarize, narrow, analyze, probe, plan, and select (SNAPPS) could improve psychiatry residents' case discussion skills in diverse practical learning settings.

DESIGN AND SETTING

This case-control, randomized, blinded study was conducted in a psychiatry hospital at Fortaleza-Ceará.

METHODS

Using "resident as teacher" (RaT), objective structured teaching encounters (OSTEs), and SNAPPS, we conducted a study with 26 psychiatry residents. We analyzed video footage of psychiatric cases in three settings: outpatient, nursing, and emergency. An intervention was held two months later with the residents, who were then assigned to two groups: group A (lecture on SNAPPS) and group B (lecture on a topics in psychiatry). Shortly after the lectures, they were video recorded while discussing the same cases. Three blinded examiners analyzed the videos using an instrument based on the Stanford Faculty Development Program (SFDP-26).

RESULTS

We found high internal consistency among external examiners and an interaction effect, group effect, and moment effect (P < 0.05). The residents who received the SNAPPS lecture scored significantly higher than their counterparts who received a traditional case presentation.

CONCLUSION

This study indicates the efficacy of SNAPPS over traditional case presentation in all three settings as assessed by OSTEs and supports its implementation to improve the teaching of clinical reasoning.

Longitudinal evaluation of the Ophthalmology residents in Brazil: an observational prospective study

BACKGROUND

The longitudinal evaluation of students seems to be a better way to assess their knowledge compared with that of the traditional methods of evaluation, such as modular and final tests. Currently, progress testing is the most consolidated type of longitudinal testing method. However, despite being well consolidated as an assessment tool in medical education, the use of this type of test in residency programs is scarce.

OBJECTIVES

This study aimed to investigate residents' knowledge growth regarding residency training and to describe the implementation of a longitudinal evaluation test in ophthalmological residency training across several medical schools in Brazil. Finally, the study aimed to check whether performance in the tests can be used as a predictor of the results of the specialist title test.

DESIGN AND SETTING

This was a prospective observational study. This study was conducted using an online platform.

METHODS

Online tests were developed following the same pattern as the Brazilian Ophthalmology Council specialist tests. All the residents performed the test simultaneously. The tests were conducted once a year at the end of the school year.

RESULTS

A progress test was conducted across 13 services with 259 residents. Our results demonstrated that resident scores improved over the years (P < 0.0001) and had a moderate correlation with the Brazilian Opthalmology Council specialist test (P = 0.0156).

CONCLUSION

The progress test can be considered a valuable tool to assess knowledge, meaning their knowledge increased over residency training. In addition, it can be used as a predictor of the result in the specialist title test.

Moonlighting and physician residents' compensation: is it all about money? A cross-sectional Brazilian study

BACKGROUND

Moonlighting is a largely discussed, however under-explored, subject among physician residents.

OBJECTIVES

To analyze the frequency of moonlighting and its related factors.

DESIGN AND SETTING

This cross-sectional study enrolled medical residents from all geographical regions of Brazil.

METHODS

A web-based structured closed-ended survey was applied that explored the frequency and type of moonlighting, residency programs characteristics, and psychological distress. The questionnaire was published on social networks.

RESULTS

The completion rate was 71.4% (n = 1,419) and 37.7% were males aged 28.8 ± 3.2 (mean ± standard deviation) years, and 571 (40.2%) were post-graduate year (PGY) 1. There were residents from 50 medical specialties (the most common training area was clinical, 51.9%). A total of 80.6% practiced moonlighting, with an average weekly workload of 14.1 ± 9.4 h, usually overnight or in weekend shifts. Factors related to it were being PGY-2 or higher (adjusted odds ratio = 3.90 [95% confidence interval = 2.93-5.18], logistic regression), lower weekly residency duty hours (0.98 [0.97-0.99]), and a higher salary (1.23 [1.08-1.40]). In contrast, perception of a "fair/adequate" compensation was influenced by age (1.02 [1.01-1.02]), not being single (1.05 [1.01-1.10]), and residency duty hours (1.51 [1.22-1.88]). Depression, anxiety, diurnal somnolence scores, and work-personal life conflicts were not correlated with moonlighting status.

CONCLUSION

Moonlighting frequency is high, and it is related to higher PGY, briefer residency duty hours, and the perception that remuneration should be higher. This study provides insights into the motivations for moonlighting and effort-reward imbalance.

The Use of Entrustable Professional Activities in Pediatric Postgraduate Medical Education: A Systematic Review

BACKGROUND

Entrustable Professional Activities (EPAs) provide a framework to make judgments of trainees' abilities in several settings including postgraduate medical education. No systematic review of the role of EPAs in pediatrics has yet been performed.

OBJECTIVES

In our systematic review, we sought to determine the use of EPAs in pediatrics to identify research gaps, summarize and discuss evidence relating to the development, implementation, and assessment.

DATA SOURCES

Medline, Scopus, PsycINFO, MedEdPortal, and Web of Science.

STUDY ELIGIBILITY CRITERIA

Two independent reviewers used a structured screening protocol in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Association for Medical Education in Europe's guide for systematic reviews to include all articles reporting on EPAs in postgraduate medical education and pediatrics in particular. There were no restrictions due to language, study design, or participants.

STUDY APPRAISAL AND SYNTHESIS METHODS

Data on development, implementation, feasibility, acceptance, and assessment of EPAs were extracted and analyzed by the 2 independent researchers.

RESULTS

Twenty-eight articles published between 2014 and 2020 were included in the review. We found an increase in publications and a notable shift from descriptions of development processes toward aspects beyond development, ie, implementation, feasibility, acceptance/perception, and assessment.

LIMITATIONS

Studies from non-English-speaking countries are scarce which might lead to an inaccurate representation of actual international practice.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

We provide a comprehensive overview of EPAs in pediatrics to guide future curriculum developers in collaborative development, implementation and assessment of EPAs in pediatric postgraduate medical education.

Physiotherapy Students' Performance in Clinical Education: An Analysis of 1 Year of Canadian Cross-Sectional Data

Purpose: This research examines 1 year of cross-sectional, Canada-wide ratings from clinical instructors using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) and analyzes the performance profiles of physiotherapy students' performance ratings over the course of their entry-to-practice clinical placements. Method: Canadian physiotherapy programmes that use the ACP were invited to submit anonymized, cross-sectional data for placements completed during 2018. Descriptive analyses and summary statistics were completed. Mixed-effects modelling was used to create typical performance profiles for each evaluation criterion in the ACP. Stepwise ordered logistic regression was also completed. Results: Ten programmes contributed data on 3,290 placements. Profiles were generated for each ACP evaluative item by means of mixed-effects modelling; three profiles are presented. In all cases, the predicted typical performance by the end of 24 months of study was approximately the rating corresponding to entry level. Subtle differences among profiles were identified, including the rate at which a student may be predicted to receive a rating of "entry level." Conclusions: This analysis identified that, in 2018, the majority of Canadian physiotherapy students were successful on clinical placements and typically achieved a rating of "entry level" on ACP items at the end of 24 months.

Providing a model for validation of the assessment system of internal medicine residents based on Kane's framework

BACKGROUND

Kane's validity framework examines the validity of the interpretation of a test at the four levels of scoring, generalization, extrapolation, and implications. No model has been yet proposed to use this framework particularly for a system of assessment. This study provided a model for the validation of the internal medicine residents' assessment system, based on the Kane's framework.

MATERIALS AND METHODS

Through a five stages study, first, by reviewing the literature, the methods used, and the study challenges, in using Kane's framework, were extracted. Then, possible assumptions about the design and implementation of residents' tests and the proposed methods for their validation at each of their four inferences of Kane's validity were made in the form of two tables. Subsequently, in a focus group session, the assumptions and proposed validation methods were reviewed. In the fourth stage, the opinions of seven internal medicine professors were asked about the results of the focus group. Finally, the assumptions and the final validation model were prepared.

RESULTS

The proposed tables were modified in the focus group. The validation table was developed consisting of tests, used at each Miller's pyramid level. The results were approved by five professors of the internal medicine. The final table has five rows, respectively, as the levels of Knows and Knows How, Shows How, Shows, Does, and the fifth one for the final scores of residents. The columns of the table demonstrate the necessary measures for validation at the four levels of inferences of Kane's framework.

CONCLUSION

The proposed model ensures the validity of the internal medicine specialty residency assessment system based on Kane's framework, especially at the implication level.

Residency Support During a Natural Disaster: Hurricane Ida

Description Natural disasters can have extraordinary impacts on a community and its infrastructure. Disasters can weaken systems that provide crucial resources, such as shelter, food security, water and health care. Recently, southeast Louisiana sustained devastating damage from Hurricane Ida on the 16th anniversary of Hurricane Katrina. Our medical workforce faced challenges caring for patients in a facility without potable water and powered by a generator. With the support of corporate entities and our academic institution, however, these barriers were quickly overcome and thus highlights the importance of collective resilience in the face of a natural disaster.

Characteristics Contributing to a Pharmacy Services Excellence Model in a Large Health System

Objective

To identify characteristics that contribute to and promote a pharmacy services center of excellence model in a large health system.

Methods

In 2019, a survey was conducted of 161 acute care pharmacy departments of health system-affiliated hospitals. Information captured included pharmacy practice models, pharmacist resource allocation, training of pharmacy residents, postgraduate training and pharmacist certifications. Results were combined with clinical pharmacy metric performance and centralized electronic data to identify features of top performing pharmacy departments.

Results

Survey results were received from 141 of 161 affiliated hospitals (88%). Hospitals with 100 to 299 beds comprised 54% (n = 16 of 30) of the hospitals "at goal" and 66% (n = 26 of 40) of hospitals with "opportunity". Hospitals with top performing pharmacy services had greater participation in interdisciplinary rounds, reporting "always" participating in Adult Critical Care (67% versus 43%) and Medical/Surgical (30% vs. 8%) rounds. Hospitals that trained pharmacy residents had a greater number of clinical pharmacy metrics at goal (5.89 ± 1.59 versus 4.16 ± 1.86, p < 0.001), employed more board-certified pharmacists (2.32 ± 1.49 versus 1.57 ± 1.62, p = 0.019), more postgraduate year 1 (PGY1) trained pharmacists (2.06 ± 1.33 versus 1.19 ± 1.19, p < 0.001) and more PGY2 trained pharmacists (0.58 ± 0.64 versus 0.19 ± 0.44, p = 0.002). When including several key hospital characteristics into a single model, hospitals that trained pharmacy residents were significantly associated with achieving "at goal" status (p = 0.011).

Conclusion

Defining characteristics of a pharmacy services center of excellence model included "at goal" clinical pharmacy metrics performance, clinical pharmacist time dedicated to patient care activities, accredited pharmacy residency training programs, presence of pharmacists with advanced training or board certification and optimal operations and scheduling.

Impact of the first COVID-19 wave on surgical training in Flanders: are we losing competence?

BACKGROUND

The COVID-19 pandemic has tremendously impacted the healthcare system and residency programs worldwide. Surgical residents were redeployed to COVID-19 units, whereas education and scientific didactics were reduced. The aim of this study is to identify the impact of COVID-19 on Flemish surgical residents' education, personal life and volume of performed surgeries.

METHODS

A cross-sectional retrospective survey on educational and personal impact during the first COVID-19 wave was administered anonymously to all surgical residents in Flanders. A quantitative comparison of performed surgeries during this period and the same period a year earlier was conducted.

RESULTS

A total of 193 surgical residents (46%) completed the survey. 63% of residents were no longer admitted to multidisciplinary oncologic meetings and 107 (55%) residents had no longer any scientific theoretical meetings at all. Almost one in two residents (46%) indicated more than 50% reduction in time in the operating theater and one in three (31%) residents were involved in care for COVID-19 positive surgical patients. Seventy-eight percent of the residents experienced a negative impact on their surgical training and 41% experienced a negative influence on their private situation. Performed surgical cases during the COVID-19 period were on average 40% less for second, third- and fourth-year residents.

CONCLUSION

Surgical residents perceived a high negative impact on personal and professional lives during the start of the COVID-19 pandemic in Flanders. Education and training programs were cancelled and volume of performed surgeries decreased tremendously. Policymakers and surgical program coordinators should ensure surgical education during further evolution of this and future pandemics.

Teaching quality in neurosurgery: quantitating outcomes over time

OBJECTIVE

High-quality neurosurgery resident training is essential to developing competent neurosurgeons. Validated formative tools to assess faculty teaching performance exist, but are not used widely among Accreditation Council for Graduate Medical Education (ACGME) residency programs in the United States. Furthermore, their longer-term impact on teaching performance improvement and educational outcomes remains unclear. The goal of this study was to assess the impact of implementing an evaluation system to provide faculty with feedback on teaching performance in a neurosurgery residency training program over a 4-year period.

METHODS

The authors performed a prospective cohort study in which a modified version of the System for Evaluation of Teaching Qualities (SETQ) instrument was administered to neurosurgical trainees in their department regularly every 6 months. The authors analyzed subscale score dynamics to identify the strongest correlates of faculty teaching performance improvement. ACGME program survey results and trainee performance on written board examinations were compared for the 3 years before and after SETQ implementation.

RESULTS

The overall response rate among trainees was 91.8%, with 1044 surveys completed for 41 faculty. Performance scores improved progressively from cycle 1 to cycle 6. The strongest correlate of overall performance was providing positive feedback to trainees. Compared to the 3 years prior, the 3 years following SETQ implementation saw significant increases in written board examination and ACGME resident survey scores compared to the national mean.

CONCLUSIONS

Implementation of SETQ was associated with significant improvements in faculty teaching performance as judged by trainees over a 4-year period, and guided curricular changes in the authors' training program that resulted in improved educational outcomes.

How Much Education and Training Do Residents Across Specialties Receive in Neuropsychology?

Introduction

Neuropsychologists play an important role on multidisciplinary teams with physicians from multiple specialties. The extent of residency training on the use of neuropsychological services is unclear. Medical residents across multiple specialties throughout the United States were surveyed to assess resident education, training, and understanding of neuropsychological services, along with their intent to consult neuropsychologists in the future.

Methods

A survey was sent to residents in accredited psychiatry, neurology, family medicine, and internal medicine programs. After data were collected, chi-square group level analyses with post-hoc pairwise comparisons were used to analyze the data.

Results

A total of 434 residents took the survey. The proportion of residents exposed to neuropsychology during residency varied significantly according to specialty (χ² (3, N = 419) = 51.4, p < 0.001), with more psychiatry and neurology residents reporting exposure than residents in family medicine or internal medicine. Similarly, the proportion of psychiatry and neurology residents who ‘agree’ or ‘strongly agree’ that they understand the nature of neuropsychological services differed significantly from family medicine and internal medicine residents (χ² (3, N = 415) = 40.4, p < 0.001). The majority of residents across all specialties (85.7%) reported they are likely to consult/order neuropsychological services in future practice.

Conclusions

The majority of residents in all specialties reported exposure to neuropsychological services in some manner, but forms of exposure varied. Results indicated a need for increased education and training in neuropsychological services, especially within family medicine and internal medicine programs.