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Bhullar PK, Venkateswaran N. Ophthalmology Residency in the United States: The Case for a National Curriculum. Semin Ophthalmol 2023; 38:167-177. [PMID: 36653736 DOI: 10.1080/08820538.2022.2152713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To identify strategies for effective curriculum development and implementation in United States (US) ophthalmology residency training programs. A literature review was conducted for all English-language PubMed/Medline articles relating to ophthalmology residency education or curriculum/curricula. Despite ACGME-defined program requirements outlining curricular goals for US ophthalmology residency training programs, there is no comprehensive, national curriculum with detailed plans for instruction of necessary topics within the 36-month residency training period. Several articles identify a need for detailed curricula on various topics, propose ideas on how residency programs could create curricula, and explore ways of assessing resident competence. There is a paucity of literature evaluating how ophthalmology residents best learn various ophthalmology topics. We need to develop an intentional, comprehensive, and timely national curriculum for ophthalmology residency programs in the US, with detailed plans on how to meet curricular objectives and consideration of the most effective teaching strategies for different ophthalmology concepts.
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Hoyler MM, Pryor KO, Gotian R, Brumberger ED, Chan JM. Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review. Anesth Analg 2023; 136:270-281. [PMID: 36638511 DOI: 10.1213/ane.0000000000006243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.
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Affiliation(s)
- Marguerite M Hoyler
- From the Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York
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Gleason A, Harrington C, Alvi S, Han SM, Sullivan ME, Aziz H. Evaluating General Surgical Residency Education Structure and Incorporation of the Resident as Educator Model. JOURNAL OF SURGICAL EDUCATION 2022; 79:1387-1393. [PMID: 35729057 DOI: 10.1016/j.jsurg.2022.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/16/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND General surgery education has continued to evolve regarding test preparation, simulation, and skill acquisition. The "Resident as Educator" (RAE) model has been proposed and enacted by programs as a viable education model for general surgery education. This study examines the current education structures in general surgery residency programs in the United States and how many programs have adopted the RAE model or aspects of the model. METHODS A 20-question survey regarding education structure was distributed to all program directors in October 2021. Questions focused on the involvement of residents in leading education sessions, creating the weekly education schedule, program feedback to residents on teaching, and recognition for distinguished resident educators. RESULTS A total of 156 programs responded to the survey. The response rate was 60%. 76.4% of the respondents have a combination of resident and faculty-led didactic sessions, 8.5% have an RAE model, and 15% have faculty-led education sessions. In terms of concerns regarding resident-led didactics-24.4% of respondents stated that their main concern would be the quality of education provided, and 20.4% referenced low resident satisfaction levels with resident-led education. There were no differences among the groups regarding the American Board of Surgery board passage rates. CONCLUSIONS Most residency programs have adopted a model in which residents have significant involvement in creating and maintaining the education calendar and leading formal education sessions. However, only 8.5% have a purely resident-led educational curriculum among the responding programs. More studies are needed to assess how to implement a resident as educator model successfully.
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Affiliation(s)
| | | | - Saba Alvi
- Tufts University School of Medicine, Boston, Massachusetts
| | - Sam M Han
- Tufts University School of Medicine, Boston, Massachusetts
| | - Maura E Sullivan
- The University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Hassan Aziz
- Tufts University School of Medicine, Boston, Massachusetts.
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Ramirez-Miranda A, Mangwani-Mordani S, Hernandez-Bogantes E, Abdala-Figuerola A, Olivo-Payne A, Larrea J, Navas A, Graue-Hernandez EO. Visual and Refractive Outcomes Following SMILE to Correct Myopia Performed by Surgeons in Training. J Refract Surg 2022; 38:28-34. [PMID: 35020540 DOI: 10.3928/1081597x-20211209-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess visual outcomes and complications following small incision lenticule extraction (SMILE) performed by cornea fellows under the supervision of experienced surgeons. METHODS This retrospective, noncomparative case series was designed to assess outcomes following SMILE procedures performed at a large surgical center by cornea fellows between May 1, 2012 and March 30, 2015. Preoperative and postoperative uncorrected distance visual acuity (UDVA), preoperative and postoperative corrected distance visual acuity (CDVA), spherical equivalent (SE) up to -10.00 diopters (D), and complications were recorded. RESULTS A total of 114 patients (228 eyes) met the inclusion criteria. The mean preoperative SE was -5.79 ± 1.95 D (range: -1.75 to -10.00 D) and the mean cylinder was -2.21 ± 1.43 D (range: 0.00 to -5.50 D). At the last follow-up visit (average: 6.4 months), 94% of the patients achieved a UDVA of 20/30 or better and 96% of the patients achieved stability in their vision. Adverse events were encountered in 40 eyes (17.5%), with epithelial defect being the most common. Two patients required a second intervention to improve visual outcomes. CONCLUSIONS SMILE performed by cornea fellows under the supervision of an experienced surgeon is an effective and safe refractive procedure with a short learning curve and excellent visual outcomes. [J Refract Surg. 2022;38(1):28-34.].
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Wolcott MD, Kornegay EC, Brame JL. Piloting a first-year resident-as-teacher workshop to foster evidence-based teaching. J Dent Educ 2020; 85:16-22. [PMID: 32915463 DOI: 10.1002/jdd.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/22/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE Residents function as important educators of dental students; however, they often have limited training in educational best-practices. Resident-as-teacher programs have been designed and implemented in other health professions to prepare residents to teach in clinic and classroom settings. In this research, we describe the design, implementation, and evaluation of a 2-day workshop for first-year advanced dental residents. METHODS The program engaged residents in techniques to: (1) foster psychological safety, (2) use the cognitive apprenticeship framework, (3) deliver quality feedback, and (4) conduct effective didactic instruction. Nineteen first-year residents attended 2 four-hour workshops in July 2019. The impact of the program was evaluated using Kirkpatrick's model, which included participant reactions, learning, and self-reported behaviors. RESULTS Most residents (at least 83.3%) reported the value and quality of the workshop was high or very high. With regard to knowledge, residents had statistically significant higher scores after the workshop on knowledge questions about cognitive apprenticeship (P < 0.01), feedback strategies (P < 0.05), and classroom instruction techniques (P < 0.05). Resident reported self-efficacy had a statistically significantly increase (P < 0.05) after the workshop in psychological safety, cognitive apprenticeship, and most items related to providing feedback; there were few changes in self-efficacy on classroom instruction strategies. CONCLUSION Overall, a workshop to prepare residents as teachers can improve knowledge and self-efficacy in evidence-based educational practices.
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Affiliation(s)
- Michael D Wolcott
- Division of Oral and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA.,Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - Elizabeth C Kornegay
- Division of Comprehensive Oral Health, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Jennifer L Brame
- Division of Comprehensive Oral Health, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA
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Ghayda RA, Carrion DM, Gomez Rivas J, Esperto F, Mantica G, Rodriguez-Socarras ME, Mattigk A, Kathrins M, O'Leary M, Niederberger C. Knowledge gap across continents: the andrology and male infertility exposure among urology residents in the United States and Europe. Int J Impot Res 2020; 33:603-610. [PMID: 32826968 DOI: 10.1038/s41443-020-00342-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/19/2020] [Accepted: 08/06/2020] [Indexed: 11/09/2022]
Abstract
It is well established that resident's exposure and training are of primary importance and positively correlated with patient and health quality outcomes. We aimed to compare and contrast urology residents' self-reported perspectives and attitudes toward exposure and education of andrology and male infertility during residency in both the United States and Europe. We performed a cross-sectional design study using a survey that was distributed to a representative sample of American and European urology residents. The survey included questions regarding demographics, and the residents' perception and description of their training in this specific subspecialty. Response data were analyzed using Chi-square tests. Sixty-five percent of European and thirty-five percent American urology residents reported feeling uncomfortable in a new consultation evaluating an infertile patient and interpreting semen analyses. Surprisingly, more than half of responders replied that they would not go to their own training institutions seeking for male fertility care (78% US and 58% Europeans). In the comparative analysis, although no differences were observed in the very low number (18%) of hospitals that offer formal microsurgical training for urology residents between the US and Europe, more US institutions were reported to have an operating microscope for urology (68% vs. 41%), and more US residents replied reported participating in at least one urologic surgery using the microscope (65% vs. 34%). In conclusion, both American and European residents shared the same frustration regarding their education and exposure to andrology and male infertility during residency training. Collaborative efforts between stakeholders are needed to establish a clear and focused curriculum and training objectives to eliminate this educational gap.
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Affiliation(s)
- Ramy Abou Ghayda
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Diego M Carrion
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Francesco Esperto
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Guglielmo Mantica
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Moises E Rodriguez-Socarras
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Instituto de Cirugia Urologica Avanzada (ICUA), Madrid, Spain
| | - Angelika Mattigk
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Ulm University Medical Center, Ulm, Germany
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael O'Leary
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, USA. .,Department of Bioengineering, College of Engineering, University of Illinois at Chicago, Chicago, USA. .,University of Illinois at Chicago Innovation Center, Chicago, USA.
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Majola N. The ophthalmology postgraduate training programme in South Africa: The registrars’ perspective. AFRICAN VISION AND EYE HEALTH 2019. [DOI: 10.4102/aveh.v78i1.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: In South Africa, to become an ophthalmologist, one must successfully complete a 4-year postgraduate training programme as a registrar. This training has been offered at different institutions around the country for many years without ever being scrutinised.Aim: The aim of this study was to evaluate the training methods and platforms, overall satisfaction levels, problems and solutions pertaining to postgraduate ophthalmology training as identified by ophthalmology registrars.Setting: The study was conducted in all the institutions across South Africa offering ophthalmology postgraduate training.Methods: This was an educational evaluation study. The data collection instrument used was a questionnaire created using SurveyMonkey.com and sent via email to all ophthalmology registrars, including supernumerary candidates. Ethical approval was granted by the university’s Biomedical Research Ethics Committee.Results: There was a 48% response rate to the survey. Registrars were satisfied that they had received adequate teaching and support, although there was room for improvement. The common problems that impacted the quality of training, as cited by the registrars, were staff shortages, large patient numbers as well as old and broken-down infrastructure or equipment. Despite 86% of the registrars spending at least 5–10 h a week in theatre, 13.3% indicated that they had no supervision during that time. Access to teaching materials (journals, library and Internet) was not available to 34% of the respondents.Conclusion: Registrars were generally satisfied with their training, but major problems that negatively affect their time as trainees were highlighted. Cooperation between registrars, universities, heads of departments and the department of health will be important to remedy this situation.
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Meinema JG, Buwalda N, van Etten-Jamaludin FS, Visser MR, van Dijk N. Intervention Descriptions in Medical Education: What Can Be Improved? A Systematic Review and Checklist. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:281-290. [PMID: 30157087 PMCID: PMC6365274 DOI: 10.1097/acm.0000000000002428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE Many medical education studies focus on the effectiveness of educational interventions. However, these studies often lack clear, thorough descriptions of interventions that would make the interventions replicable. This systematic review aimed to identify gaps and limitations in the descriptions of educational interventions, using a comprehensive checklist. METHOD Based on the literature, the authors developed a checklist of 17 criteria for thorough descriptions of educational interventions in medical education. They searched the Ovid MEDLINE, Embase, and ERIC databases for eligible English-language studies published January 2014-March 2016 that evaluated the effects of educational interventions during classroom teaching in postgraduate medical education. Subsequently, they used this checklist to systematically review the included studies. Descriptions were scored 0 (no information), 1 (unclear/partial information), or 2 (detailed description) for each of the 16 scorable criteria (possible range 0-32). RESULTS Among the 105 included studies, the criteria most frequently reported in detail were learning needs (78.1%), content/subject (77.1%), and educational strategies (79.0%). The criteria least frequently reported in detail were incentives (9.5%), environment (5.7%), and planned and unplanned changes (12.4%). No article described all criteria. The mean score was 15.9 (SD 4.1), with a range from 8 (5 studies) to 25 (1 study). The majority (76.2%) of articles scored 11-20. CONCLUSIONS Descriptions were frequently missing key information and lacked uniformity. The results suggest a need for a common standard. The authors encourage others to validate, complement, and use their checklist, which could lead to more complete, comparable, and replicable descriptions of educational interventions.
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Affiliation(s)
- Jennita G. Meinema
- J.G. Meinema is a PhD student, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0003-3706-1360
| | - Nienke Buwalda
- N. Buwalda is a PhD student, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0003-2635-2912
| | - Faridi S. van Etten-Jamaludin
- F.S. van Etten-Jamaludin is clinical librarian, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands
| | - Mechteld R.M. Visser
- M.R.M. Visser is senior researcher, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands
| | - Nynke van Dijk
- N. van Dijk is professor of general practice/family medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands
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