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Frantz AM, Fahy BG. The pulse of professionalism: Administering feedback in anesthesiology residency. J Clin Anesth 2024; 96:111494. [PMID: 38740534 DOI: 10.1016/j.jclinane.2024.111494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Amanda M Frantz
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Brenda G Fahy
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
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Chang MW, Kung CT, Yu SF, Wang HT, Lin CL. Exploring the Critical Driving Forces and Strategy Adoption Paths of Professional Competency Development for Various Emergency Physicians Based on the Hybrid MCDM Approach. Healthcare (Basel) 2023; 11:healthcare11040471. [PMID: 36833005 PMCID: PMC9957007 DOI: 10.3390/healthcare11040471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
The implementation of competency-based medical education (CBME) focuses on learners' competency outcomes and performance during their training. Competencies should meet the local demands of the healthcare system and achieve the desired patient-centered outcomes. Continuous professional education for all physicians also emphasizes competency-based training to provide high-quality patient care. In the CBME assessment, trainees are evaluated on applying their knowledge and skills to unpredictable clinical situations. A priority of the training program is essential in building competency development. However, no research has focused on exploring strategies for physician competency development. In this study, we investigate the professional competency state, determine the driving force, and provide emergency physicians' competency development strategies. We use the Decision Making Trial and Evaluation Laboratory (DEMATEL) method to identify the professional competency state and investigate the relationship among the aspects and criteria. Furthermore, the study uses the PCA (principal component analysis) method to reduce the number of components and then identify the weights of the aspects and components using the ANP (analytic network process) approach. Therefore, we can establish the prioritization of competency development of emergency physicians (EPs) with the VIKOR (Vlse kriterijumska Optimizacija I Kompromisno Resenje) approach. Our research demonstrates the priority of competency development of EPs is PL (professional literacy), CS (care services), PK (personal knowledge), and PS (professional skills). The dominant aspect is PL, and the aspect being dominated is PS. The PL affects CS, PK, and PS. Then, the CS affects PK and PS. Ultimately, the PK affects the PS. In conclusion, the strategies to improve the professional competency development of EPs should begin with the improvement from the aspect of PL. After PL, the following aspects that should be improved are CS, PK, and PS. Therefore, this study can help establish competency development strategies for different stakeholders and redefine emergency physicians' competency to reach the desired CBME outcomes by improving advantages and disadvantages.
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Affiliation(s)
- Meng-Wei Chang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Chang Gung Medical Education Research Centre (CG-MERC), Taoyuan 333, Taiwan
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung 802, Taiwan
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Shan-Fu Yu
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung 802, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hui-Ting Wang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Chang Gung Medical Education Research Centre (CG-MERC), Taoyuan 333, Taiwan
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung 802, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chia-Li Lin
- Department of International Business, Ming Chuan University, Taipei 111, Taiwan
- Correspondence:
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Waheed S, Maursetter L. Evaluation Evolution: Designing Optimal Evaluations to Enhance Learning in Nephrology Fellowship. Adv Chronic Kidney Dis 2022; 29:526-533. [PMID: 36371117 DOI: 10.1053/j.ackd.2022.06.006] [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: 01/18/2022] [Revised: 04/26/2022] [Accepted: 06/28/2022] [Indexed: 11/10/2022]
Abstract
Evaluations serve as the backbone of any educational program and can be broadly divided into formative and summative evaluations. Formative evaluations are "just in time" evaluations focused on informing the learning process, whereas summative evaluations compare fellows to a preset standard to determine their readiness for unsupervised practice. In the nephrology fellowship programs, evaluations assess competence in the framework of ACGME Milestones 2.0. A variety of learning venues, evaluators, and tools should be incorporated into the measurement process. It is important to determine which milestones can be best assessed in each education venue to decrease the burden of assessment fatigue. Additionally, programs can diversify the evaluators to include nurses, medical students, peers, and program coordinators in addition to faculty to provide a well-rounded assessment of the fellows and share the assessment burden. Lastly, the evaluation data should be presented to fellows in a format where it can inform goal setting. The evaluation system needs to evolve along with the changes being made in curriculum design. This will help to make fellowship learning effective and efficient.
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Affiliation(s)
- Sana Waheed
- Piedmont Nephrology and Internal Medicine, Atlanta, GA
| | - Laura Maursetter
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
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Y Cantwell C, B Lee J, Saadat S, Bove N, Sakaria S, Wiechmann W, Wray A, Toohey S. Accreditation Council for Graduate Medical Education Milestones for Emergency Medicine Residency Training Incorporated into First- and Second-Year Medical Student Elective. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2021; 9:136-143. [PMID: 34277844 PMCID: PMC8273531 DOI: 10.30476/jamp.2021.88982.1360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/10/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION As part of its Next Accreditation System, the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine describe 6 competencies containing 23 sub-competencies graded by milestones ranging from level 1 (expected of an incoming intern) to level 5 (demonstrates abilities of an attending) that are used to track resident training progression. To the best of our knowledge, there have been no studies introducing a milestones-based curriculum to medical students prior to their introduction to the wards, so we sought to determine the effects that a pre-clinical Emergency Medicine Interest Group (EMIG) Milestones Elective would have on preparing the students interested in Emergency Medicine (EM) as a specialty to meet the level 1 milestones prior to their intern year. METHODS The elective hosted 15 events throughout the academic year, and pre- and post-curriculum surveys were administered. Thirteen first- and second-year medical students at our institution who completed the elective self-reported their perception of preparedness for each level 1 milestone in the 19 sub-competencies. A repeated measures design was used through identical pre- and post-curriculum surveys to determine any changes in self-reported preparedness for meeting level 1 milestones after completing the elective using Wilcoxon Signed Ranks Test. RESULTS There was a significant increase in the median scoring from 1 to 2 (p=0.027) in overall self-reported preparedness for meeting the level 1 milestones included in the elective, as well as significant increases in subcategories across competencies 1-4 outlined by the ACGME. There was no significant increase in preparedness for professionalism or interpersonal communication competencies. There was no significant increase in interest in EM as a result of the elective. CONCLUSION Implementing a milestones-based curriculum during the pre-clinical years shows improved self-reported preparedness of students interested in pursuing EM for meeting level 1 milestones prior to residency. Additionally, a specialty-based elective such as this one offered through EMIG may further increase interest in the field during pre-clinical years.
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Affiliation(s)
- Christina Y Cantwell
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Jonathan B Lee
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Soheil Saadat
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Nicholas Bove
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Sangeeta Sakaria
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Warren Wiechmann
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Alisa Wray
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
| | - Shannon Toohey
- University of California Irvine Medical Center, Department of Emergency Medicine, 101 The City Drive South, Orange, CA 92868, USA
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Burkhardt JC, Parekh KP, Gallahue FE, London KS, Edens MA, Humbert AJ, Pillow MT, Santen SA, Hopson LR. A Critical Disconnect: Residency Selection Factors Lack Correlation With Intern Performance. J Grad Med Educ 2020; 12:696-704. [PMID: 33391593 PMCID: PMC7771600 DOI: 10.4300/jgme-d-20-00013.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/30/2020] [Accepted: 08/01/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty. OBJECTIVE We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes. METHODS Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results. RESULTS For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance. CONCLUSIONS Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.
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Affiliation(s)
- John C Burkhardt
- Assistant Professor, Departments of Emergency Medicine and Learning Health Sciences, University of Michigan Medical School
| | - Kendra P Parekh
- Associate Professor, Department of Emergency Medicine, Vanderbilt University School of Medicine
| | - Fiona E Gallahue
- Residency Program Director and Associate Professor, Department of Emergency Medicine, University of Washington
| | - Kory S London
- Associate Residency Program Director, Director of Clinical Operations, Jefferson Methodist ED, Associate Director of Quality Assurance and Practice Improvement, and Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University
| | - Mary A Edens
- Residency Program Director and Associate Professor, Department of Emergency Medicine, Louisiana State University Health Sciences Center Shreveport
| | - A J Humbert
- Residency Program Director and Associate Professor of Clinical Emergency Medicine, Indiana University School of Medicine
| | - M Tyson Pillow
- Vice Chair of Education, and Associate Professor, Department of Emergency Medicine, Baylor College of Medicine
| | - Sally A Santen
- Senior Associate Dean for Assessment, Evaluation and Scholarship, and Professor, Department of Emergency Medicine, Virginia Commonwealth University School of Medicine
| | - Laura R Hopson
- Associate Chair of Education, Emergency Medicine Residency Program, and Associate Professor of Emergency Medicine, University of Michigan Medical School
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