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Darko K, Kenfack YJ, Venkatesh P, Bah MG, Tissot MIJ, Barrie U, Detchou D, Jabang JN, Totimeh T. Emanuel Olatunde Alaba Olanrewaju Odeku (1927-1974): First African Neurosurgeon Trained in the United States and Establisher of the National and West African Postgraduate Medical Colleges. World Neurosurg 2023; 176:98-105. [PMID: 37120143 DOI: 10.1016/j.wneu.2023.04.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 04/20/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND In this comprehensive historical account, the authors delve into the remarkable trajectory of Dr. Latunde E. Odeku, a pioneering figure in neurosurgery. METHODS The inspiration for this project was ignited by the discovery of the original scientific and bibliographic materials of Latunde Odeku, a renowned Nigerian neurosurgeon and the first African neurosurgeon in history. Following a thorough review of the literature and information available on Dr. Odeku, we have compiled a comprehensive and detailed analysis of his life, work, and legacy. RESULTS This paper begins by introducing his childhood and early education in Nigeria, highlights his journey through medical school and residency in the United States, and follows his career and role in establishing the first neurosurgical unit in West Africa. We celebrate the life and legacy of Latunde Odeku, a trailblazing neurosurgeon whose contribution has inspired generations of medical professionals in Africa and around the world. CONCLUSIONS This article sheds light on the remarkable life and achievements of Dr. Odeku and his trailblazing work for generations of doctors and researchers.
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Affiliation(s)
- Kwadwo Darko
- University of Ghana Medical School, Accra, Ghana
| | - Yves J Kenfack
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Pooja Venkatesh
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Momodou G Bah
- Department of Neurosurgery, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Marianne I J Tissot
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Umaru Barrie
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
| | - Donald Detchou
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John N Jabang
- Department of Surgery - Neurosurgery unit, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Teddy Totimeh
- Department of Neurosurgery, University of Ghana Medical Centre, Accra, Ghana
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Rhee DW, Chun JW, Stern DT, Sartori DJ. Experience and Education in Residency Training: Capturing the Resident Experience by Mapping Clinical Data. Acad Med 2022; 97:228-232. [PMID: 33983144 DOI: 10.1097/acm.0000000000004162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PROBLEM Internal medicine training programs operate under the assumption that the 3-year residency training period is sufficient for trainees to achieve the depth and breadth of clinical experience necessary for independent practice; however, the medical conditions to which residents are exposed in clinical practice are not easily measured. As a result, residents' clinical educational experiences are poorly understood. APPROACH A crosswalk tool (a repository of International Classification of Diseases [ICD]-10 codes linked to medical content areas) was developed to query routinely collected inpatient principal diagnosis codes and translate them into an educationally meaningful taxonomy. This tool provides a robust characterization of residents' inpatient clinical experiences. OUTCOMES This pilot study has provided proof of principle that the crosswalk tool can effectively map 1 year of resident-attributed diagnosis codes to both the broad content category level (e.g., "cardiovascular disease") and to the more specific condition category level (e.g., "myocardial disease"). The authors uncovered content areas in their training program that are overrepresented and some that are underrepresented relative to material on the American Board of Internal Medicine (ABIM) Certification Exam. NEXT STEPS The crosswalk tool introduced here translated residents' patient care activities into discrete, measurable educational content and enabled 1 internal medicine residency program to characterize residents' inpatient educational experience with a high degree of resolution. Leaders of other programs seeking to profile the clinical exposure of their trainees may adopt this strategy. Such clinical content mapping drives innovation in the experiential curriculum, enables comparison across practice sites, and lays the groundwork to test associations between individual clinical exposure and competency-based outcomes, which, in turn, will allow medical educators to draw conclusions regarding how clinical experience reflects clinical competency.
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Affiliation(s)
- David W Rhee
- D.W. Rhee is a fellow, the Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Jonathan W Chun
- J.W. Chun is clinical assistant professor, Department of Medicine, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, and an affiliate, Stanford University School of Medicine, Stanford, California
| | - David T Stern
- D.T. Stern is chief of medicine, Veterans Affairs NY Harbor Healthcare System, and professor of medicine and vice chair, Education and Faculty Affairs, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Daniel J Sartori
- D.J. Sartori is assistant professor and associate program director, Internal Medicine Residency Program, Department of Medicine, NYU Grossman School of Medicine, New York, New York ORCID: https://orcid.org/0000-0003-3138-7183
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Affiliation(s)
- Debra F Weinstein
- From the University of Michigan Medical School and Michigan Medicine - both in Ann Arbor
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Frishman GN, Raker CA, Frankfurter D. Well-being in trainee and faculty physicians. Med Educ Online 2021; 26:1950107. [PMID: 34252014 PMCID: PMC8276666 DOI: 10.1080/10872981.2021.1950107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/16/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Background: Physician well-being remains a critical topic with limited information concerning the impact of the progression of training and duty hours. To date, our knowledge and interventions have not adequately addressed these issues. We assessed differences in well-being across the USA: (1) between all post-graduate trainees and their academic core faculty; (2) between all obstetrics and gynecology trainees and their academic core faculty and (3) during the progression of training within obstetrics and gynecology (OB/GYN).Methods: A cross-sectional study analyzing responses to well-being questions included in the 2017-2018 Accreditation Council for Graduate Medical Education (ACGME) surveys given to all U.S. trainees and core faculty. Results: More than 85% of all U.S. physician-trainees and faculty surveyed responded. Respondents included 128,443 trainees from all specialties combined, 5,206 OB/GYN residents and 799 OB/GYN subspecialty fellows. A total of 94,557 faculty from all specialties combined, 4,082 general OB/GYN faculty and 1,432 sub-specialty OB/GYN faculty responded. Trainees were more negative than faculty for the majority of questions for both all trainees combined and within OB/GYN when progressing from resident to subspecialty fellow to subspecialty faculty (p ≤ 0.05). Questions focusing on work satisfaction (e.g., pride in work) were more negative for residents compared to fellows and for fellows compared to faculty. In contrast to work satisfaction, responses to the question 'Felt the amount of work you were expected to complete in a day was reasonable' showed either no difference or higher scores for trainees compared to their faculty. Conclusions: Although an issue for all physicians, well-being impacts trainees more, and differently, than faculty and well-being improves during training from resident to fellow to faculty. Survey responses suggest that interventions should focus on workplace satisfaction over workplace environment areas and further limitations in duty hours are unlikely to improve physician well-being.
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Affiliation(s)
- Gary N. Frishman
- Professor of Obstetrics and Gynecology, Division of Reproductive Endocrinlogy and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Christina A. Raker
- Division of Research, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - David Frankfurter
- Professor of Obstetrics and Gynecology, Division of Reproductive Endocrinlogy and Infertility, Department of Obstetrics and Gynecology. George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Wolff M, Ross P, Jackson J, Skye E, Gay T, Dobson M, Hughes DT, Morgan HK. Facilitated transitions: coaching to improve the medical school to residency continuum. Med Educ Online 2021; 26:1856464. [PMID: 33978568 PMCID: PMC7717875 DOI: 10.1080/10872981.2020.1856464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/07/2020] [Accepted: 11/23/2020] [Indexed: 05/23/2023]
Abstract
Background: Current efforts incompletely address the educational, social, and developmental aspects of a learner's transition from medical school to residency.Objective: To determine the feasibility and acceptability of a transition to residency (TTR) coaching program.Designs: In March 2019, we designed, implemented, and evaluated a TTR coaching program for students who matched into residency programs at our institution. Goals were to stimulate reflection on successes and challenges encountered during medical school, develop strategies to problem-solve barriers and address concerns, identify professional and personal resources, improve confidence, and make an action plan.Results: Of eligible learners, 42% (10/24) enrolled in TTR coaching. Learners were most interested in coaching in the following areas: wellbeing (70%, 7/10), interpersonal/communication skills (60%, 6/10), and learning plan development (50%, 5/10). The majority (90%; 9/10) expressed satisfaction with the program and would recommend participation. One month after starting internship, 90% (9/10) of learners stated the program helped facilitate their transition. Learners who did not enroll in TTR cited concerns around the coach selection process (72%, 8/11), upcoming travel (45%, 5/11), insufficient time/competing demands (27%, 3/11), and lack of perceived benefit (18%, 2/11).Conclusion: This pilot study demonstrated preliminary feasibility and acceptability for TTR coaching.
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Affiliation(s)
- Margaret Wolff
- Emergency Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Paula Ross
- RISE, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jasmyne Jackson
- Pediatrics, Boston Combined Residency Program, Boston, MA, USA
| | - Eric Skye
- Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tamara Gay
- Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Margaret Dobson
- Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - David T. Hughes
- Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Helen Kang Morgan
- Department of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA
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Brown DR, Moeller JJ, Grbic D, Andriole DA, Cutrer WB, Obeso VT, Hormann MD, Amiel JM. The First 2 Years of Entrustment Decisions in the Core Entrustable Professional Activities (Core EPAs) Pilot. Acad Med 2021; 96:S201-S202. [PMID: 34705702 DOI: 10.1097/acm.0000000000004275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- David R Brown
- Author affiliations: D.R. Brown, V.T. Obeso, Florida International University Herbert Wertheim College of Medicine
| | | | - Douglas Grbic
- D. Grbic, D.A. Andriole, Association of American Medical Colleges
| | | | | | - Vivian T Obeso
- Author affiliations: D.R. Brown, V.T. Obeso, Florida International University Herbert Wertheim College of Medicine
| | | | - Jonathan M Amiel
- J.M. Amiel, Columbia University College of Physicians and Surgeons
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Ridinger HA, Bonnet K, Schlundt DG, Tekian A, Riddle J, Lomis KD. Defining Successful Practice Within Health Systems Science Among Entering Residents: A Single-Institution Qualitative Study of Graduate Medical Education Faculty Observations. Acad Med 2021; 96:S126-S135. [PMID: 34380937 DOI: 10.1097/acm.0000000000004357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The American Medical Association's Accelerating Change in Medical Education consortium defined health systems science (HSS) as the study of how health care is delivered, how health care professionals work together to deliver that care, and how the health system can improve patient care and health care delivery. This framework is increasingly being incorporated into medical school curricula. Graduate medical education (GME) had previously elevated systems-based practice (SBP) as a core competency, but expectations are defined by specialty-specific milestones. The lack of a shared competency framework between undergraduate medical education (UME) and GME makes it challenging to ensure that entering residents are prepared to implement HSS/SBP concepts in the workplace. The authors explored GME faculty observations of residents exemplifying successful practice across HSS domains to inform targets for UME training and assessment. METHOD Authors performed a single-institution qualitative study using transcribed phone interviews with eligible Vanderbilt residency program directors, associate program directors, and core faculty. Participants described observations of successful residents within each HSS domain. Two researchers independently coded, discussed, and reconciled deidentified transcripts using inductive-deductive approaches to identify themes. RESULTS Seventeen faculty participated across specialties (17/39, 45%). Faculty responses emphasize precurricular experiences including professional degrees, work experience, extracurriculars, and medical school exposure. Importantly, successful residents exhibit foundational core workforce characteristics including growth mindset, curiosity, and a desire to learn about systems. GME faculty identified HSS domain-specific skills, noting distinctions among learning environments. Outcomes resulting from residents' application of HSS concepts include delivering high-quality, person-centered care and systems improvements. CONCLUSIONS Descriptions of successful practice within HSS domains highlight preparatory experiences and core workforce characteristics and outline entry-level HSS behaviors. Conceptualized in a logic model framework, these findings describe key inputs, learning activities, outputs, and outcomes for systems-prepared entering residents bridging the UME-GME transition.
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Affiliation(s)
- Heather A Ridinger
- H.A. Ridinger is assistant professor, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Kemberlee Bonnet
- K. Bonnet is coordinator, Qualitative Research Core, Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - David G Schlundt
- D.G. Schlundt is associate professor, Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Ara Tekian
- A. Tekian is professor, Department of Medical Education, University of Illinois Chicago, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-9252-1588
| | - Janet Riddle
- J. Riddle is research assistant professor and director, faculty development, Department of Medical Education, University of Illinois Chicago, Chicago, Illinois
| | - Kimberly D Lomis
- K.D. Lomis is vice president for undergraduate medical education innovations, American Medical Association, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-3504-6776
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Martin S, Khatib M, Reissis D, Srinivasan JR. Bridging the gap for aesthetic training amidst the Covid-19 pandemic. J Plast Reconstr Aesthet Surg 2021; 75:439-488. [PMID: 34774445 PMCID: PMC8801923 DOI: 10.1016/j.bjps.2021.09.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 04/26/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Serena Martin
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom.
| | - Manaf Khatib
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
| | - Dimitris Reissis
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
| | - Jeyaram R Srinivasan
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
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Kotta PA, Elango M. A guide for final year medical students: transitioning to foundation training during the covid-19 pandemic. BMJ 2021; 375:n2287. [PMID: 34663569 DOI: 10.1136/bmj.n2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Madhivanan Elango
- Department of Medicine, Imperial College Healthcare NHS Trust, London, UK
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Bartosch P. Navigating the maze of DHB locality authorisation. N Z Med J 2021; 134:147-149. [PMID: 34695088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Patrick Bartosch
- M.A., PhD Candidate, University of Otago, Department of General Practice and Rural Health
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Coe CL, Baker HM, Byerley JS, Page CP. Fully Integrated Readiness for Service Training (FIRST): An Accelerated Medical Training Program for Rural and Underserved North Carolina. Acad Med 2021; 96:1436-1440. [PMID: 33538484 DOI: 10.1097/acm.0000000000003946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PROBLEM The U.S. primary care workforce remains inadequate to meet the health needs of the U.S. population. Effective programs are needed to provide workforce development for rural and other underserved areas. APPROACH At the University of North Carolina (UNC) School of Medicine (SOM), between November 2014 and July 2015, the authors developed and implemented the Fully Integrated Readiness for Service Training (FIRST) Program, an accelerated curriculum focused on rural and underserved care that links 3 years of medical school with a conditional acceptance into UNC's 3-year family medicine residency, followed by 3 years of practice support post-graduation. Students are recruited to the FIRST Program during the fall of their first year of medical school. The FIRST Program promotes close faculty mentorship and familiarity with the health care system, includes a longitudinal quality improvement project with an assigned patient panel, includes early integration into the clinic, and fosters a close cohort of fellow students. OUTCOMES As of March 2020, the FIRST Program had successfully recruited 5 classes of medical students, and 3 of those classes had matched into residency. In total, as of March 2020, 18 students had participated in the FIRST Program. NEXT STEPS The FIRST Program will be expanded to additional clinical sites across North Carolina and to specialties beyond family medicine, including pediatrics, general surgery, and psychiatry.
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MESH Headings
- Curriculum
- Education, Medical, Graduate/organization & administration
- Education, Medical, Graduate/standards
- Education, Medical, Undergraduate/organization & administration
- Education, Medical, Undergraduate/standards
- Health Workforce
- Humans
- Internship and Residency/organization & administration
- Internship and Residency/standards
- Medically Underserved Area
- Mentoring
- North Carolina
- Physicians, Primary Care/education
- Physicians, Primary Care/supply & distribution
- Program Development
- Quality Improvement
- Rural Population
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Affiliation(s)
- Catherine L Coe
- C.L. Coe is assistant professor of family medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0003-3851-0295
| | - Hannah M Baker
- H.M. Baker is program manager, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Julie S Byerley
- J.S. Byerley is vice dean for academic affairs, chief education officer, and professor of pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Cristen P Page
- C.P. Page is executive dean and William B. Aycock Distinguished Professor of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Quiros PA, Gordon LK. Neuro-Ophthalmology: Creating a Diverse, Equitable, and Inclusive Subspecialty Is the Responsibility of Everyone. J Neuroophthalmol 2021; 41:279-284. [PMID: 34415264 DOI: 10.1097/wno.0000000000001378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Peter A Quiros
- Doheny Eye Institute (PAQ), and Stein Eye Institute (PAQ, LKG), Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California
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Siedhoff MT, Truong MD, Wright KN. Innovating patient care and gynecologic surgery instruction through tele-education. Curr Opin Obstet Gynecol 2021; 33:317-323. [PMID: 34054102 DOI: 10.1097/gco.0000000000000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Effects of the coronavirus disease 2019 pandemic prompted the need for rapid, flexible change in the delivery of care, education, and commitment to the well-being of obstetrics and gynecology (OB/GYN) residents. RECENT FINDINGS Published literature shows multiple models for surge scheduling for residency programs in other specialties. We describe our experience creating a surge schedule for OB/GYN residents that allowed for sufficient coverage of inpatient care while minimizing resident exposure and limited hospital resources, respecting work hour requirements, and plans for coverage due to illness or need for home quarantine. We also report innovative approaches to trainee education through the use of remote-learning technology and gynecologic surgery skills training in absence of normal clinical exposure. SUMMARY Our approach serves as a model for adapting to unprecedented challenges and offers suggestions for creative transformations of traditional teaching that can be continued beyond the immediate crisis.
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Affiliation(s)
- Matthew T Siedhoff
- Cedars-Sinai Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Los Angeles, California, USA
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Motilal S, Paul-Charles J, Asnani M, Khan R, Ricketts-Roomes T, Pinder-Butler S, Herbert J, Farquharson C, Conliffe C, Standard-Goldson A, Smith K, Morris E, Maharaj RG. 2020 family medicine postgraduate examinations at The University of the West Indies: successes and challenges in the time of COVID-19 pandemic. Postgrad Med J 2021; 97:423-426. [PMID: 34039692 PMCID: PMC8159667 DOI: 10.1136/postgradmedj-2021-140242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
Little has been published regarding postgraduate assessments during the COVID-19 pandemic. There is an urgent need to graduate well-trained specialists including family physicians who play a key role in patient care. The successes and challenges encountered in mounting qualifying 2020 Family Medicine examinations during the COVID-19 pandemic at the University of the West Indies are described in this paper. Human resource, planning, use of technology and virtual environments are discussed, which enabled successful examinations at this multicampus regional site.
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Affiliation(s)
- Shastri Motilal
- Paraclinical Sciences, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, St Augustine, Trinidad and Tobago
| | - Joanne Paul-Charles
- The University of the West Indies, Cave Hill Campus, Faculty of Medical Sciences, St Michael, Barbados
| | - Monika Asnani
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies at Mona Faculty of Medical Sciences, Mona, Saint Andrew, Jamaica
| | - Raveed Khan
- Paraclinical Sciences, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, St Augustine, Trinidad and Tobago
| | - Tana Ricketts-Roomes
- Department of Community Health and Psychiatry, The University of the West Indies at Mona Faculty of Medical Sciences, Mona, Saint Andrew, Jamaica
| | | | - Joseph Herbert
- The University of the West Indies, Cave Hill Campus, Faculty of Medical Sciences, Bridgetown, Saint Michael, Barbados
| | - Carnille Farquharson
- University of the West Indies School of Clinical Medicine and Research, Nassau, Bahamas
| | - Catherine Conliffe
- University of the West Indies School of Clinical Medicine and Research, Nassau, Bahamas
| | - Aileen Standard-Goldson
- Department of Community Health and Psychiatry, The University of the West Indies at Mona Faculty of Medical Sciences, Mona, Saint Andrew, Jamaica
| | - Kristen Smith
- Department of Community Health and Psychiatry, The University of the West Indies at Mona Faculty of Medical Sciences, Mona, Saint Andrew, Jamaica
| | - Euclid Morris
- The University of the West Indies, Cave Hill Campus, Faculty of Medical Sciences, Bridgetown, Saint Michael, Barbados
| | - Rohan G Maharaj
- Paraclinical Sciences, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, St Augustine, Trinidad and Tobago
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Affiliation(s)
- Ali Zakaria
- Gastroenterology chief fellow, Internal Medicine, Division of Gastroenterology, Ascension Providence Hospital, Michigan State University/College of Human Medicine, Southfield, Michigan;
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VetGDP 3: advising for the future. Vet Rec 2021; 188:379-81. [PMID: 34018592 DOI: 10.1002/vetr.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Veterinary Graduate Development Programme (VetGDP) advisers will be central to supporting new graduates as they set, and reach, their professional development goals and settle into life as a veterinary professional. In this article, the third in our series from the RCVS, we hear from three senior vets about their reasons for becoming VetGDP advisers and their experience of the online training they are undertaking.
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VetGDP 2: building new vet confidence. Vet Rec 2021; 188:338-40. [PMID: 33960493 DOI: 10.1002/vetr.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this article, the second in our series from the RCVS, Linda Prescott-Clements explains how the Veterinary Graduate Development Programme (VetGDP) will offer new vets the support of VetGDP advisers. Also, on page 340, established new graduate mentor Charlotte Moody gives her perspective on the importance of the adviser's role.
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VetGDP 1: the origins of the programme. Vet Rec 2021; 188:297-9. [PMID: 33891726 DOI: 10.1002/vetr.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Over the next few months, the RCVS will be giving us more details of its new Veterinary Graduate Development Programme (VetGDP). In this first article, chair of the education committee Sue Paterson explains the origins of the scheme and how the construction of the VetGDP was framed by an evidence base provided by students, new graduates and veterinary practices.
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Bush B, Cheema N, Frost A, Ahn J. Identifying the Gaps: Needs Assessment to Guide Development of a Dedicated Toxicology Curriculum for Emergency Medicine Residents. J Med Toxicol 2021; 17:271-277. [PMID: 33844171 DOI: 10.1007/s13181-021-00834-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The American Board of Emergency Medicine identifies medical toxicology as an essential curricular element for emergency medicine (EM) residencies; however, access to medical toxicology education varies widely by institution. We hypothesized that EM residents are uncomfortable with core toxicology content and would be interested in a dedicated toxicology curriculum. METHODS An electronic needs assessment survey developed by experts in EM and medical toxicology was sent to residents and program leadership at nine EM programs participating in the Emergency Medicine Education Research Alliance (EMERA), a geographically diverse sampling of academic EM residency programs. We queried the presence of a current toxicology curriculum, interest in a dedicated toxicology curriculum, and comfort with core toxicology concepts for board examinations and in clinical practice. RESULTS: A total of 148 residents and 8 faculty leadership completed the survey. Only 29% of resident respondents felt comfortable with toxicology concepts, and only 66% of respondents reported access to a toxicology curriculum. Of those without a known toxicology curriculum, most were interested in a formal curriculum. Faculty respondents reported 6/8 programs offered a toxicology curriculum. Faculty at the two programs without a formal curriculum expressed interest in a dedicated curriculum. CONCLUSIONS Emergency medicine residents remain uncomfortable with the core toxicology content in clinical practice. The majority of residents without a known toxicology curriculum would be interested in a dedicated toxicology curriculum.
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Affiliation(s)
- Brian Bush
- Department of Emergency Medicine, University of Illinois Hospital, 808 S Wood St, Chicago, IL, 60612, USA
| | - Navneet Cheema
- Department of Medicine, Section of Emergency Medicine, University of Chicago, 837 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Arian Frost
- Department of Medicine, Section of Emergency Medicine, University of Chicago, 837 S. Maryland Avenue, Chicago, IL, 60637, USA.
| | - James Ahn
- Department of Medicine, Section of Emergency Medicine, University of Chicago, 837 S. Maryland Avenue, Chicago, IL, 60637, USA
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Kaur S, Bir M, Chandran DS, Deepak KK. Adaptive strategies to conduct participant-centric structured virtual group discussions for postgraduate students in the wake of the COVID-19 pandemic. Adv Physiol Educ 2021; 45:37-43. [PMID: 33464190 PMCID: PMC8083176 DOI: 10.1152/advan.00136.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/19/2020] [Accepted: 12/06/2020] [Indexed: 05/29/2023]
Abstract
In the wake of COVID-19, the postgraduate activities in physiology were shifted from live (face-to-face teaching) to virtual mode. This transition posed a challenge to postgraduate students and faculty moderators, especially for participant-centric group discussion, wherein face-to-face interaction contributes significantly to active learner engagement. To bridge the gap between live group discussion (GD) and virtual GD in the conventional format (VGD), we implemented an innovative yet feasible multistep approach of conducting structured virtual group discussion (sVGD). It involved priming of students during the preparatory phase and incorporation of the Tuckman model of group dynamics, which consists of sequential substages of forming, storming, norming, and performing into the virtual format. Unsupervised synchronous and asynchronous, as well as supervised synchronous interactions within and in between the minigroups in a structured way, led to active engagement of students with one another and the moderator, despite the constraints imposed by the virtual format. After establishing the feasibility of the approach during the first GD (sVGD-1), sVGD-2 was conducted, further refining the approach, and feedback was obtained from the postgraduate students. Pre-GD feedback revealed that the live session was preferred over virtual for the conduct of GD, whereas both live GD and sVGD were perceived to be more effective than VGD in the post-GD feedback. Such pedagogical innovations may also help to address the challenges posed in traditional teaching across the undergraduate and postgraduate courses in medical education and beyond during such unforeseeable circumstances.
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MESH Headings
- COVID-19
- Education, Distance/methods
- Education, Distance/organization & administration
- Education, Graduate/methods
- Education, Graduate/organization & administration
- Education, Medical, Graduate/methods
- Education, Medical, Graduate/organization & administration
- Feasibility Studies
- Feedback, Psychological
- Group Processes
- Humans
- India
- Internet
- Pandemics
- Physiology/education
- SARS-CoV-2
- Students/psychology
- Students, Medical/psychology
- Virtual Reality
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Affiliation(s)
- Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Megha Bir
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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21
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Griffith CH, de Beer F, Edwards RL, Smith C, Colvin G, Karpf M. Addressing Kentucky's Physician Shortage While Securing a Network for a Research-Intensive, Referral Academic Medical Center: Where Public Policy Meets Effective Clinical Strategic Planning. Acad Med 2021; 96:375-380. [PMID: 33661849 DOI: 10.1097/acm.0000000000003582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of "training Kentuckians in Kentucky to practice in Kentucky."
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Affiliation(s)
- Charles H Griffith
- C.H. Griffith III is vice dean for education and professor of internal medicine and pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Fred de Beer
- F. de Beer is dean emeritus and professor of internal medicine, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Robert L Edwards
- R.L. Edwards is associate vice president, Health System Administration, and chief external affairs officer, UK HealthCare, Lexington, Kentucky
| | - Connie Smith
- C. Smith is president and chief executive officer, Med Center Health, Bowling Green, Kentucky
| | - Garren Colvin
- G. Colvin is president and chief executive officer, St. Elizabeth Healthcare, Edgewood, Kentucky
| | - Michael Karpf
- M. Karpf is advisor to the president and professor of internal medicine, University of Kentucky, Lexington, Kentucky
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22
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Davis RW, Sherif YA, Vu MT, Shilstone H, Scott B, Olutoye OO, Hollier L, Nuchtern J, Rosengart TK. Personalized Graduate Medical Education and the Global Surgeon: Training for Resource-Limited Settings. Acad Med 2021; 96:384-389. [PMID: 33332906 DOI: 10.1097/acm.0000000000003898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PROBLEM The World Health Organization and the World Bank have identified improvement in access to surgical care as an urgent global health challenge and a cost-effective investment in public health. However, trainees in standard U.S. general surgery programs do not have adequate exposure to the procedures, technical skills, and foundational knowledge essential for providing surgical care in resource-limited settings. APPROACH The Michael E. DeBakey Department of Surgery at Baylor College of Medicine (BCM) created a 7-year global surgery track within its general surgery residency in 2014. Individualized rotations equip residents with the necessary skills, knowledge, and experience to operate in regions with low surgeon density and develop sustainable surgical infrastructures. BCM provides a formal, integrated global surgery curriculum-including 2 years dedicated to global surgery-with surgical specialty rotations in domestic and international settings. Residents tailor their individual experience to the needs of their future clinical practice, region of interest, and surgical specialty. OUTCOMES There have been 4 major outcomes of the BCM global surgery track: (1) increased exposure for trainees to a broad range of surgeries critical in resource-limited settings, (2) meaningful international partnerships, (3) contributions to global surgery scholarship, and (4) establishment of sustainable global surgery activities. NEXT STEPS To better facilitate access to safe, timely, and affordable surgical care worldwide, global surgeons should pursue expertise in topics not currently included in U.S. general surgical curricula, such as setting-specific technical skills, capacity building, and organizational collaboration. Future evaluations of the BCM global surgery track will assess the effect of individualized education on trainees' professional identities, clinical practices, academic pursuits, global surgery leadership preparedness, and comfort with technical skills not encompassed in general surgery programs. Increasing availability of quality global surgery training programs would provide a critical next step toward contributing to the delivery of safe surgical care worldwide.
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Affiliation(s)
- Rachel W Davis
- R.W. Davis is a seventh-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Youmna A Sherif
- Y.A. Sherif is a fourth-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Megan Thuy Vu
- M.T. Vu is a fifth-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Holly Shilstone
- H. Shilstone is director of education and alumni affairs, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Bradford Scott
- B. Scott is professor and vice chair for education, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Oluyinka O Olutoye
- O.O. Olutoye is professor of pediatric surgery, Department of Surgery, The Ohio State University College of Medicine, and surgeon-in-chief, Nationwide Children's Hospital, Columbus, Ohio
| | - Larry Hollier
- L. Hollier Jr is professor of surgery and chief, Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and surgeon-in-chief, Texas Children's Hospital, Houston, Texas
| | - Jed Nuchtern
- J. Nuchtern is professor of pediatric surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Chief of Global Surgery, Texas Children's Hospital, Houston, Texas
| | - Todd K Rosengart
- T.K. Rosengart is professor and chair, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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23
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Tjia J, Pugnaire M, Calista J, Esparza N, Valdman O, Garcia M, Yazdani M, Hale J, Terrien J, Eisdorfer E, Zolezzi-Wyndham V, Chiriboga G, Rappaport L, Puerto G, Dykhouse E, Potts S, Sifuentes AF, Stanhope S, Allison J, Duodo V, Sabin J. COmmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT-BP): A study protocol. Medicine (Baltimore) 2021; 100:e23680. [PMID: 33592827 PMCID: PMC7870252 DOI: 10.1097/md.0000000000023680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Healthcare professionals have negative implicit biases toward minority and poor patients. Few communication skills interventions target implicit bias as a factor contributing to disparities in health outcomes. We report the protocol from the COmmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT-BP), a trial evaluating a novel educational and training intervention targeting graduate medical and nursing trainees that is designed to mitigate the effects of implicit bias in clinical encounters. The CONSULT-BP intervention combines knowledge acquisition, bias awareness, and practice of bias mitigating skills in simulation-based communication encounters with racially/ethnically diverse standardized patients. The trial evaluates the effect of this 3-part program on patient BP outcomes, self-reported patient medication adherence, patient-reported quality of provider communication, and trainee bias awareness. METHODS We are conducting a cluster randomized trial of the intervention among cohorts of internal medicine (IM), family medicine (FM), and nurse practitioner (NP) trainees at a single academic medical center. We are enrolling entire specialty cohorts of IM, FM, and NP trainees over a 3-year period, with each academic year constituting an intervention cycle. There are 3 cycles of implementation corresponding to 3 sequential academic years. Within each academic year, we randomize training times to 1 of 5 start dates using a stepped wedge design. The stepped wedge design compares outcomes within training clusters before and after the intervention, as well as across exposed and unexposed clusters. Primary outcome of blood pressure control is measured at the patient-level for patients clustered within trainees. Eligible patients for outcomes analysis are: English-speaking; non-White racial/ethnic minority; Medicaid recipient (regardless of race/ethnicity); hypertension; not have pregnancy, dementia, schizophrenia, bipolar illness, or other serious comorbidities that would interfere with hypertension self-control; not enrolled in hospice. Secondary outcomes include trainee bias awareness. A unique feature of this trial is the engagement of academic and community stakeholders to design, pilot test and implement a training program addressing healthcare. DISCUSSION Equipping clinicians with skills to mitigate implicit bias in clinical encounters is crucial to addressing persistent disparities in healthcare outcomes. Our novel, integrated approach may improve patient outcomes. TRIAL REGISTRATION NCT03375918. PROTOCOL VERSION 1.0 (November 10, 2020).
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Affiliation(s)
| | | | | | | | | | | | | | - Janet Hale
- University of Massachusetts Medical School
| | | | | | | | | | | | | | | | | | | | | | | | | | - Janice Sabin
- University of Washington, Seattle, Washington, USA
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24
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Francisco GE. The COVID-19 Pandemic Is an Accelerator of the Evolution of Physiatry. Am J Phys Med Rehabil 2021; 100:S1-S2. [PMID: 33181530 DOI: 10.1097/phm.0000000000001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gerard E Francisco
- From the Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center McGovern Medical School, Houston, Texas; and NeuroRecovery Research Center, TIRR Memorial Hermann, Houston, Texas
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25
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Affiliation(s)
- J Bryan Carmody
- Associate professor of pediatrics, Eastern Virginia Medical School, Norfolk, Virginia; ; ORCID: https://orcid.org/0000-0001-9079-1835
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26
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Abstract
ABSTRACT Medical trainees are expected to achieve leadership competencies by the end of their training. However, there is a lack of standardized postgraduate leadership education. The aims of this study were to evaluate a pilot program consistent with leadership aims of the medical education body and to assess learners' perceived responses to the curriculum. A pilot workshop was developed using Kern's six-step approach to curriculum development for medical education. Topics included leading teams, managing conflict, feedback, goal setting, and time management, as these gaps were identified during a targeted needs assessment. Learning was assessed by preworkshop and postworkshop self-assessments, and the curriculum was evaluated with a postworkshop survey. The workshop was attended by 14 physical medicine and rehabilitation residents and 1 medical student. There was a statistically significant increase in participants' Likert scale confidence scores for the summative areas of leading teams, managing conflict, feedback, goal setting, and time management (P < 0.001). All participants rated the session as 4 or 5/5 on all evaluation domains. In conclusion, a single session targeting stated needs of trainees was successful in increasing perceived competence in areas relevant to clinical leadership. Expansion to include a longitudinal component, with assessment for behavior change for ongoing improvement would be beneficial.
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Affiliation(s)
- McKyla McIntyre
- From the Toronto Rehabilitation Institute-University Centre, Toronto, Ontario, Canada (MM, SMA); Toronto Rehabilitation Institute-Lyndhurst Centre, Toronto, Ontario, Canada (SMA); and Post MD Program, University of Toronto, Toronto, Ontario, Canada (AM)
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27
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Gintrowicz R, Pawloy K, Degel A. Social distancing in advanced emergency medicine courses - can it work? GMS J Med Educ 2021; 38:Doc22. [PMID: 33659627 PMCID: PMC7899119 DOI: 10.3205/zma001418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/15/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Introduction: The corona virus pandemic rendered most live education this spring term impossible. Many classes were converted into e-learning formats. But not all learning content and outcomes can readily be transferred into digital space. Project outline: Emergency medicine teaching relies on hands-on simulation training. Therefore, we had to devise a catalogue of measures, that would enable us to offer simulation training for Advanced Life Support. Summary of work: Strict hygienic rules including disinfection of hands, wearing personal protective gear at all times and disinfection of equipment were implemented. Group size and number of staff was reduced, introducing fixed student teams accompanied by the same teacher. Only large rooms with good ventilation were used. Under these conditions, we were allowed to carry out core Advanced Life Support simulations. Other content had to be transferred to online platforms. Discussion: Heeding general hygiene advise and using personal protective gear, a central cluster of simulations was carried out. Students and staff adhered to rules without complaint. No infections within faculty or student body were reported. Conclusion: It seems feasible to conduct core simulations under strict hygienic protocol.
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Affiliation(s)
- Robert Gintrowicz
- Charité Universitätsmedizin Berlin, Prodekanat für Studium und Lehre, Berlin, Germany
| | - Klemens Pawloy
- Charité Universitätsmedizin Berlin, Prodekanat für Studium und Lehre, Berlin, Germany
| | - Antje Degel
- Charité Universitätsmedizin Berlin, Prodekanat für Studium und Lehre, Berlin, Germany
- Charité Universitätsmedizin Berlin, Med. Klinik für Kardiologie, Campus Benjamin Franklin, Berlin, Germany
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Bell SG, Smith R, Inman ER. It Is Time to Have More After-Hours Gynecological Care for Medical Trainees. Acad Med 2021; 96:16-17. [PMID: 33394658 DOI: 10.1097/acm.0000000000003795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Sarah G Bell
- Fourth-year resident physician, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan;
| | - Roger Smith
- Fourth-year resident physician, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan;
| | - Erin R Inman
- Fourth-year resident physician, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan;
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29
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Baghus A, Giroldi E, Muris J, Stiggelbout A, van de Pol M, Timmerman A, van der Weijden T. Identifying Entrustable Professional Activities for Shared Decision Making in Postgraduate Medical Education: A National Delphi Study. Acad Med 2021; 96:126-133. [PMID: 32739926 PMCID: PMC7769188 DOI: 10.1097/acm.0000000000003618] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE Although shared decision making (SDM) is considered the preferred approach in medical decision making, it is currently not routinely used in clinical practice. To bridge the transfer gap between SDM training and application, the authors aimed to reach consensus on entrustable professional activities (EPAs) for SDM and associated behavioral indicators as a framework to support self-directed learning during postgraduate medical education. METHOD Using existing literature on SDM frameworks and competencies; input from an interview study with 17 Dutch experts in SDM, doctor-patient communication, and medical education; and a national SDM expert meeting as a starting point, in 2017, the authors conducted a modified online Delphi study with a multidisciplinary Dutch panel of 32 experts in SDM and medical education. RESULTS After 3 Delphi rounds, consensus was reached on 4 EPAs-(1) the resident discusses the desirability of SDM with the patient, (2) the resident discusses the options for management with the patient, (3) the resident explores the patient's preferences and deliberations, and (4) the resident takes a well-argued decision together with the patient. Consensus was also reached on 18 associated behavioral indicators. Of the 32 experts, 30 (94%) agreed on this list of SDM EPAs and behavioral indicators. CONCLUSIONS The authors succeeded in developing EPAs and associated behavioral indicators for SDM for postgraduate medical education to improve the quality of SDM training and the application of SDM in clinical practice. These EPAs are characterized as process EPAs for SDM in contrast with content EPAs related to diverse medical complaints. A next step is the implementation of the SDM EPAs in existing competency-based workplace curricula.
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Affiliation(s)
- Anouk Baghus
- A. Baghus is a PhD student and resident, Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0002-6481-9256
| | - Esther Giroldi
- E. Giroldi is assistant professor, Department of Family Medicine, Care and Public Health Research Institute and Department of Educational Development and Research, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0003-3254-4849
| | - Jean Muris
- J. Muris is professor, Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0002-8780-476X
| | - Anne Stiggelbout
- A. Stiggelbout is professor, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; ORCID: http://orcid.org/0000-0002-6293-4509
| | - Marjolein van de Pol
- M. van de Pol is associate professor, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands; ORCID: http://orcid.org/0000-0002-0977-7954
| | - Angelique Timmerman
- A. Timmerman is assistant professor, Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0002-8114-8802
| | - Trudy van der Weijden
- T. van der Weijden is professor, Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; ORCID: http://orcid.org/0000-0002-7469-3781
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30
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Ikeda N, Asamura H, Chida M. Training program of general thoracic surgery in Japan: Present status and future tasks. J Thorac Cardiovasc Surg 2020; 163:353-358. [PMID: 33468327 DOI: 10.1016/j.jtcvs.2020.11.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Hisao Asamura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan
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Förster C, Eismann-Schweimler J, Stengel S, Bischoff M, Fuchs M, Graf von Luckner A, Ledig T, Barzel A, Maun A, Joos S, Szecsenyi J, Schwill S. Opportunities and challenges of e-learning in vocational training in General Practice - a project report about implementing digital formats in the KWBW-Verbundweiterbildung plus. GMS J Med Educ 2020; 37:Doc97. [PMID: 33364376 PMCID: PMC7740008 DOI: 10.3205/zma001390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/30/2020] [Accepted: 10/15/2020] [Indexed: 06/12/2023]
Abstract
Background: The task of the Competence Centers for vocational training (KW) is to increase the attractiveness and quality of vocational (=post-graduate) training in general practice. For this purpose, they offer, among other things, a structured seminar program for post-graduate trainees in general practice (GP-trainees). During the Covid-19 pandemic the seminar program of the KWBW-Verbundweiterbildungplus® in Baden-Württemberg was converted to digital formats. The goal of the paper is to evaluate the acceptance by the GP-trainees and lecturers, to describe experiences with the conversion to e-learning and to derive recommendations with regard to the future orientation of seminar programs in post-graduate as well as continuing medical education. The implementation was based on a modified Kern-cycle and aimed at offering eight teaching units of 45 minutes each to a large number of GP-trainees. It tried to maintain the high quality of content and education as well as the interactive character of the previous seminars. For this purpose, the events were designed as synchronous webinars (six units) with asynchronous preparation and post-processing (two units) according to the flipped classroom method. The evaluation by the participating GP-trainees and lecturers was performed online using a multi-center developed and pre-piloted questionnaire. Results and discussion: N=101 GP-trainees participated in the evaluation of five individual seminar days in the second quarter of 2020 (response rate 97%). 58% (N=59) of the trainees were satisfied or very satisfied with the implementation. 82% (n=83) rated pre-tasks as helpful. 99% (n=100) would participate in an online seminar again. For 52% (n=53) of the trainees, the attitude towards e-learning had changed positively. The main advantages mentioned were no travel, save in time and costs as well as increased flexibility. The main disadvantages mentioned were less personal interaction and technical obstacles. The high acceptance of the new digital format showed the fundamental potential of e-learning in continuing medical education. The experiences can be a source of inspiration for other departments and KW. However, it also shows that important goals of KW, such as the personal interaction of the peer group, could not be achieved. In the future, it is important to develop a suitable mix of presence and digital formats with the aim to improve the attractiveness as well as sustainability of continuing medical education.
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Affiliation(s)
- Christian Förster
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Germany
| | | | - Sandra Stengel
- Universitätsklinikum Heidelberg, Abteilung für Allgemeinmedizin und Versorgungsforschung, Heidelberg, Germany
| | - Martina Bischoff
- Universitätsklinikum Freiburg, Lehrbereich Allgemeinmedizin, Freiburg, Germany
| | - Monika Fuchs
- Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Germany
| | | | - Thomas Ledig
- Universitätsklinikum Heidelberg, Abteilung für Allgemeinmedizin und Versorgungsforschung, Heidelberg, Germany
| | - Anne Barzel
- Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Germany
| | - Andy Maun
- Universitätsklinikum Freiburg, Lehrbereich Allgemeinmedizin, Freiburg, Germany
| | - Stefanie Joos
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Germany
| | - Joachim Szecsenyi
- Universitätsklinikum Heidelberg, Abteilung für Allgemeinmedizin und Versorgungsforschung, Heidelberg, Germany
| | - Simon Schwill
- Universitätsklinikum Heidelberg, Abteilung für Allgemeinmedizin und Versorgungsforschung, Heidelberg, Germany
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Ellison EC, Spanknebel K, Stain SC, Shabahang MM, Matthews JB, Debas HT, Nagler A, Blair PG, Eberlein TJ, Farmer DL, Sloane R, Britt LD, Sachdeva AK. Impact of the COVID-19 Pandemic on Surgical Training and Learner Well-Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators. J Am Coll Surg 2020; 231:613-626. [PMID: 32931914 PMCID: PMC7486868 DOI: 10.1016/j.jamcollsurg.2020.08.766] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/27/2022]
Abstract
BACKGROUND The COVID-19 pandemic disrupted the delivery of surgical services. The purpose of this communication was to report the impact of the pandemic on surgical training and learner well-being and to document adaptations made by surgery departments. STUDY DESIGN A 37-item survey was distributed to educational leaders in general surgery and other surgical specialty training programs. It included both closed- and open-ended questions and the self-reported stages of GME during the COVID-19 pandemic, as defined by the ACGME. Statistical associations for items with stage were assessed using categorical analysis. RESULTS The response rate was 21% (472 of 2,196). US stage distribution (n = 447) was as follows: stage 1, 22%; stage 2, 48%; and stage 3, 30%. Impact on clinical education significantly increased by stage, with severe reductions in nonemergency operations (73% and 86% vs 98%) and emergency operations (8% and 16% vs 34%). Variable effects were reported on minimal expected case numbers across all stages. Reductions were reported in outpatient experience (83%), in-hospital experience (70%), and outside rotations (57%). Increases in ICU rotations were reported with advancing stage (7% and 13% vs 37%). Severity of impact on didactic education increased with stage (14% and 30% vs 46%). Virtual conferences were adopted by 97% across all stages. Severity of impact on learner well-being increased by stage-physical safety (6% and 9% vs 31%), physical health (0% and 7% vs 17%), and emotional health (11% and 24% vs 42%). Regardless of stage, most but not all made adaptations to support trainees' well-being. CONCLUSIONS The pandemic adversely impacted surgical training and the well-being of learners across all surgical specialties proportional to increasing ACGME stage. There is a need to develop education disaster plans to support technical competency and learner well-being. Careful assessment for program advancement will also be necessary. The experience during this pandemic shows that virtual learning and telemedicine will have a considerable impact on the future of surgical education.
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Affiliation(s)
| | | | - Steven C Stain
- Department of Surgery, Albany Medical College, Albany, NY
| | | | | | - Haile T Debas
- Department of Surgery, University of California-San Francisco, San Francisco, CA
| | - Alisa Nagler
- Division of Education, American College of Surgeons, Chicago, IL
| | | | - Timothy J Eberlein
- Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Diana L Farmer
- Department of Surgery, University of California-Davis, Sacramento, CA
| | - Richard Sloane
- Duke Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | - L D Britt
- Department of Surgery, Eastern Virginia University, Norfolk, VA
| | - Ajit K Sachdeva
- Division of Education, American College of Surgeons, Chicago, IL
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Affiliation(s)
- Yinghao Lim
- Associate consultant, Department of Cardiology, National University Heart Centre, Singapore;
| | - Shaun Chook
- Senior resident, Department of Cardiology, National University Heart Centre, Singapore
| | - Ting-Ting Low
- Consultant, Department of Cardiology, program director, Women's Heart Health Programme, and program director, Cardiology Undergraduates Programme, Department of Cardiology, National University Heart Centre, Singapore
| | - Wee Tiong Yeo
- Senior consultant, Department of Cardiology, program director, Cardiology Postgraduate Programme, Department of Cardiology, assistant professor, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, and member, Residency Advisory Committee, Specialists Accreditation Board, Singapore
| | - Edgar Tay
- Associate consultant, Department of Cardiology, National University Heart Centre, Singapore;
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Al-Balas M, Al-Balas HI, Jaber HM, Obeidat K, Al-Balas H, Aborajooh EA, Al-Taher R, Al-Balas B. Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives. BMC Med Educ 2020; 20:341. [PMID: 33008392 PMCID: PMC7530879 DOI: 10.1186/s12909-020-02257-4] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/24/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. METHODS This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. RESULTS A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. CONCLUSION With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.
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Affiliation(s)
- Mahmoud Al-Balas
- General and Breast Surgery, Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Irbid-Amman Street, Al Husn, P.O. Box 3, Irbid, 21510 Jordan
| | | | - Hatim M. Jaber
- Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
| | - Khaled Obeidat
- Transplant and Hepatopancreaticobiliary Surgery, Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamzeh Al-Balas
- General and Gastrointestinal Surgery, Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Emad A. Aborajooh
- General and Gastrointestinal Surgery, Department of General Surgery, Faculty of Medicine, Mutah University, Mu’tah, Jordan
| | - Raed Al-Taher
- Pediatric surgery, Department of general surgery, Faculty of Medicine, Jordan University, Irbid, Jordan
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Meneses E, McKenney M, Elkbuli A. Reforming our general surgery residency program at an urban level 1 Trauma Center during the COVID-19 pandemic: Towards maintaining resident safety and wellbeing. Am J Surg 2020; 220:847-849. [PMID: 32586630 PMCID: PMC7282736 DOI: 10.1016/j.amjsurg.2020.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Evander Meneses
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
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Hallen S. Redesigning the Clinical Learning Environment to Improve Interprofessional Care and Education: Multi-Method Program Evaluation of the iPACE Pilot Unit. J Grad Med Educ 2020; 12:598-610. [PMID: 33149830 PMCID: PMC7594784 DOI: 10.4300/jgme-d-19-00675.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/17/2020] [Accepted: 07/23/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In 2016, Maine Medical Center received an Accreditation Council for Graduate Medical Education Pursuing Excellence in Innovation grant to redesign the clinical learning environment to promote interprofessional care and education. The Interprofessional Partnership to Advance Care and Education (iPACE) model was developed and piloted on an adult inpatient medicine unit as an attempt achieve these aims. OBJECTIVE We describe the iPACE model and associated outcomes. METHODS Surveys and focus groups were employed as part of a multimethod pragmatic observational strategy. Team surveys included relational coordination (RC): a validated proprietary measure of interpersonal communication and relationships within teams. Pre-iPACE respondents were a representative historical sample from comparable inpatient medical units surveyed from March to April 2017. iPACE respondents were model participants surveyed March to August 2018 to allow for adequate sample size. RESULTS Surveys were administered to pre-iPACE (N = 113, response rate 74%) and iPACE (N = 32, 54%) teams. Summary RC scores were significantly higher for iPACE respondents (iPACE 4.26 [SD 0.37] vs 3.72 [SD 0.44], P < .0001), and these respondents were also more likely to report a professionally rewarding experience (iPACE 4.4 [SD 0.6] vs 3.5 [SD 1.0], P < .0001). Learners felt the model was successful in teaching interprofessional best practices but were concerned it may hinder physician role development. Patient experience was positive. CONCLUSIONS This pilot may have a positive effect on team functioning and team member professional experience and patient experience. Learner acceptance may be improved by increasing autonomy and preserving traditional learning venues.
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Ko SS, Guck A, Williamson M, Buck K, Young R. Family Medicine Faculty Time Allocation and Burnout: A Residency Research Network of Texas Study. J Grad Med Educ 2020; 12:620-623. [PMID: 33149833 PMCID: PMC7594782 DOI: 10.4300/jgme-d-19-00930.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/15/2020] [Accepted: 06/30/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Burnout among graduate medical education (GME) faculty is a well-documented phenomenon, but few studies have explored the relationship between faculty time allocation and burnout. OBJECTIVE Our objectives were to (1) characterize time allocation of academic family physicians, (2) measure the difference between actual versus preferred time spent on various tasks, and (3) examine this difference in relation to burnout. METHODS From January to March 2017, family medicine GME faculty across Texas completed anonymous online surveys for burnout (Maslach Burnout Inventory) and occupational stress (Primary Care Provider Stress Checklist). They also reported the percentage of time they actually versus prefer to allocate across 5 categories of tasks: direct patient care, nondirect clinical duties, teaching, administration, and research. Difference scores between actual and preferred time allocation were calculated and correlated with burnout and stress scores. RESULTS Of the faculty physicians surveyed, 53% provided complete responses (103 of 195). On average they engaged in their preferred amount of time on direct patient care (30% of their time) and administrative duties (15%). Meanwhile, faculty preferred to increase time spent teaching (37% to 41%, P = .002) and conducting research (4% to 7%, P ≤ .001), while reducing time spent on nondirect clinical duties (14% to 7%, P < .001). Those with higher misalignment in their weekly schedules reported higher levels of professional burnout and occupational stress. CONCLUSIONS Many family medicine GME faculty spent 20% or more of their time in a manner incongruent with their preferences, which may place them at higher risk for burnout and occupational stress.
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Sabharwal S, Ficke JR, LaPorte DM. How We Do It: Modified Residency Programming and Adoption of Remote Didactic Curriculum During the COVID-19 Pandemic. J Surg Educ 2020; 77:1033-1036. [PMID: 32546387 PMCID: PMC7253931 DOI: 10.1016/j.jsurg.2020.05.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/21/2020] [Accepted: 05/25/2020] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To describe the modified operational plan we implemented for residents and faculty in our orthopedic surgery department to allow continuation of resident education and other core activities during the novel coronavirus (COVID-19) pandemic. DESIGN Description of educational augmentation and programming modifications. SETTING The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, Baltimore, MD. PARTICIPANTS Residents and faculty, Department of Orthopaedic Surgery. METHODS In response to the COVID-19 pandemic, we developed and implemented a modified operational schedule and remote curriculum in the orthopedic surgery department of our health system. Our plan was guided by the following principles: protecting the workforce while providing essential clinical care; maintaining continuity of education and research; and promoting social distancing while minimizing the impact on team psychosocial well-being. RESULTS The operational schedule and remote curriculum have been implemented successfully and allow resident education and other core departmental functions to continue as our health care system responds to the pandemic. CONCLUSIONS We have been proactive and deliberate in implementing these operational changes, without compromise of our workforce. This experience provides residents exposure to real-life systems-based practice. We hope that our early experience will provide a framework for other surgical residency programs facing this crisis.
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Affiliation(s)
- Samir Sabharwal
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - James R Ficke
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dawn M LaPorte
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Juprasert JM, Gray KD, Moore MD, Obeid L, Peters AW, Fehling D, Fahey TJ, Yeo HL. Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic: Lessons From New York City. JAMA Surg 2020; 155:870-875. [PMID: 32936281 DOI: 10.1001/jamasurg.2020.3107] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
On March 1, 2020, the first case of coronavirus disease 2019 (COVID-19) was confirmed in New York, New York. Since then, the city has emerged as an epicenter for the ongoing pandemic in the US. To meet the anticipated demand caused by the predicted surge of patients with COVID-19, the Department of Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medicine developed and executed an emergent restructuring of general surgery resident teams and educational infrastructure. The restructuring of surgical services described in this Special Communication details the methodology used to safely deploy the necessary amount of the resident workforce to support pandemic efforts while maintaining staffing for emergency surgical care, limiting unnecessary exposure of residents to infection risk, effectively placing residents in critical care units, and maintaining surgical education and board eligibility for the training program as a whole.
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Affiliation(s)
- Jackly M Juprasert
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Katherine D Gray
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Maureen D Moore
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Lama Obeid
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Alexander W Peters
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - David Fehling
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Thomas J Fahey
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Heather L Yeo
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
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Shaw KS, Karagounis TK, Yin L, Svigos K, Gibbon GT, Betensky RA, Lo Sicco KI. Exchanging Dermatoscopes for Stethoscopes: Has the COVID-19 Pandemic Highlighted Gaps in US Dermatology Residency Training? J Drugs Dermatol 2020; 19:905-906. [PMID: 33026742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Price S. A Perfect Match? COVID-19 Forces GME Programs, Med Students to Adjust Resident Selection Process. Tex Med 2020; 116:34-36. [PMID: 33023279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
COVID-19 has forced GME programs and medical students to make last-minute adjustments in the resident selection process.
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Affiliation(s)
- Colm McCarthy
- Departments of Surgery (McCarthy, Walton) and Medicine (Carayannopoulos), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Orthopedics (McCarthy) Brigham and Women's Hospital, Boston, Mass.; Department of Pediatric Surgery (Walton) McMaster Children's Hospital, Hamilton, Ont
| | - Kallirroi Carayannopoulos
- Departments of Surgery (McCarthy, Walton) and Medicine (Carayannopoulos), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Orthopedics (McCarthy) Brigham and Women's Hospital, Boston, Mass.; Department of Pediatric Surgery (Walton) McMaster Children's Hospital, Hamilton, Ont
| | - J Mark Walton
- Departments of Surgery (McCarthy, Walton) and Medicine (Carayannopoulos), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Department of Orthopedics (McCarthy) Brigham and Women's Hospital, Boston, Mass.; Department of Pediatric Surgery (Walton) McMaster Children's Hospital, Hamilton, Ont.
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Chick RC, Clifton GT, Peace KM, Propper BW, Hale DF, Alseidi AA, Vreeland TJ. Using Technology to Maintain the Education of Residents During the COVID-19 Pandemic. J Surg Educ 2020; 77:729-732. [PMID: 32253133 PMCID: PMC7270491 DOI: 10.1016/j.jsurg.2020.03.018] [Citation(s) in RCA: 410] [Impact Index Per Article: 102.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic presents a unique challenge to surgical residency programs. Due to the restrictions recommended by the Centers for Disease Control and Prevention and other organizations, the educational landscape for surgical residents is rapidly changing. In addition, the time course of these changes is undefined. METHODS We attempt to define the scope of the problem of maintaining surgical resident education while maintaining the safety of residents, educators, and patients. Within the basic framework of limiting in-person gatherings, postponing or canceling elective operations in hospitals, and limiting rotations between sites, we propose innovative solutions to maintain rigorous education. RESULTS We propose several innovative solutions including the flipped classroom model, online practice questions, teleconferencing in place of in-person lectures, involving residents in telemedicine clinics, procedural simulation, and the facilitated use of surgical videos. Although there is no substitute for hands-on learning through operative experience and direct patient care, these may be ways to mitigate the loss of learning exposure during this time. CONCLUSIONS These innovative solutions utilizing technology may help to bridge the educational gap for surgical residents during this unprecedented circumstance. The support of national organizations may be beneficial in maintaining rigorous surgical education.
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Affiliation(s)
| | | | | | | | | | - Adnan A Alseidi
- University of California at San Francisco, San Francisco, California
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He K, Stolarski A, Whang E, Kristo G. Addressing General Surgery Residents' Concerns in the Early Phase of the COVID-19 Pandemic. J Surg Educ 2020; 77:735-738. [PMID: 32354684 PMCID: PMC7164873 DOI: 10.1016/j.jsurg.2020.04.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the concerns of General Surgery residents as they prepare to be in the frontlines of the response against coronavirus disease 2019 (COVID-19_). DESIGN, SETTING, AND PARTICIPANTS A qualitative study with voluntary dyadic and focus group interviews with a total of 30 General Surgery residents enrolled at 2 academic medical centers in Boston, Massachusetts was conducted between March 12 to 16, 2020. RESULTS The most commonly reported personal concern related to the COVID-19 outbreak was the health of their family (30 of 30 [100%]), followed by the risk of their transmitting COVID-19 infection to their family members (24 of 30 [80%]); risk of their transmitting COVID-19 infection their patients (19 of 30 [63%]); anticipated overwork for taking care of a high number of patients (15 of 30 [50%]); and risk of their acquiring COVID-19 infection from their patients (8 of 30 [27%]) . The responses were comparable when stratified by sex, resident training level, and residency program. All residents self-expressed their readiness to take care of COVID-19 patients despite the risk of personal or familial harm . To improve their preparedness, they recommend increasing testing capacity, ensuring personal protective equipment availability, and transitioning to a shift schedule in order to minimize exposure risk and prevent burnout. CONCLUSIONS General Surgery residents are fully dedicated to taking care of patients with COVID-19 infection despite the risk of personal or familial harm. Surgery departments should protect the physical and psychosocial wellbeing of General Surgery residents in order to increase their ability to provide care in the frontlines of the COVID-19 pandemic.
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Affiliation(s)
- Katherine He
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Allan Stolarski
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston University, Boston, Massachusetts
| | - Edward Whang
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gentian Kristo
- Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Jones RE, Abdelfattah KR. Virtual Interviews in the Era of COVID-19: A Primer for Applicants. J Surg Educ 2020; 77:733-734. [PMID: 32278546 PMCID: PMC7142702 DOI: 10.1016/j.jsurg.2020.03.020] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 05/13/2023]
Abstract
PROBLEM The COVID-19 pandemic is an evolving crisis with widespread impact upon our medical system, including senior trainee travel for fellowship interviews. Numerous institutions have conscientiously deferred in-person interviews or virtual formats. Given the competitive nature of fellowship interviews, candidates may express concern that they are at a disadvantage in engaging in online meetings versus live, on-site interviews, and similarly may feel ill prepared to perform optimally during online interviews. APPROACH We draw upon our experience with online interview platforms in this guide for fellowship candidates who are rapidly adapting to new technology and styles associated with videoconference interviews so that they can best promote themselves for competitive positions.
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Affiliation(s)
- Ruth Ellen Jones
- University of Texas Southwestern Medical Center, Department of Surgery, Dallas, Texas.
| | - Kareem R Abdelfattah
- University of Texas Southwestern Medical Center, Department of Surgery, Dallas, Texas
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Affiliation(s)
- Chen Seong Wong
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
- National Centre for Infectious Diseases, Singapore
| | - Woo Chiao Tay
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Xing Fu Hap
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
| | - Faith Li-Ann Chia
- National Healthcare Group Residency, Singapore
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
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Shah P, Gutierrez D, Zampella JG. Teaching Lessons from the Coronavirus Disease 2019 (COVID-19) Pandemic in Telemedicine. J Drugs Dermatol 2020; 19:677. [PMID: 32574008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.
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Dennis B, Highet A, Kendrick D, Mazer L, Loiselle S, Bandeh-Ahmadi H, Gupta T, Abbott K, Lea J, Dang T, Ramey M, George B, Terhune K. Knowing Your Team: Rapid Assessment of Residents and Fellows for Effective Horizontal Care Delivery in Emergency Events. J Grad Med Educ 2020; 12:272-279. [PMID: 32595843 PMCID: PMC7301919 DOI: 10.4300/jgme-d-20-00290.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Horizontal care, in which clinicians assume roles outside of their usual responsibilities, is an important health care systems response to emergency situations. Allocating residents and fellows into skill-concordant clinical roles, however, is challenging. The most efficient method to accomplish graduate medical education (GME) assessment and deployment for horizontal care is not known. OBJECTIVE We designed a categorization schema that can efficiently facilitate clinical and educational horizontal care delivery for trainees within a given institution. METHODS In September 2019, as part of a general emergency response preparation, a 4-tiered system of trainee categorization was developed at one academic medical center. All residents and fellows were mapped to this system. This single institution model was disseminated to other institutions in 2020 as the COVID-19 pandemic began to affect hospitals nationally. In March 2020, a multi-institution collaborative launched the Trainee Pandemic Role Allocation Tool (TPRAT), which allows institutions to map institutional programs to COVID-19 roles within minutes. This was disseminated to other GME programs for use and refinement. RESULTS The emergency response preparation plan was disseminated and selectively implemented with a positive response from the emergency preparedness team, program directors, and trainees. The TPRAT website was visited more than 100 times in the 2 weeks after its launch. Institutions suggested rapid refinements via webinars and e-mails, and we developed an online user's manual. CONCLUSIONS This tool to assess and deploy trainees horizontally during emergency situations appears feasible and scalable to other GME institutions.
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