1
|
Bohler F, Garden A, Santiago CJ, Bohler L, Taranikanti V. Characterizing the initial effects of the single accreditation system merge on the ophthalmology residency match. Med Educ Online 2024; 29:2307124. [PMID: 38262001 PMCID: PMC10810612 DOI: 10.1080/10872981.2024.2307124] [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] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs. MATERIALS AND METHODS Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates. RESULTS Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study's inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low. DISCUSSION The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.
Collapse
Affiliation(s)
- Forrest Bohler
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Allison Garden
- Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, SC
| | - Christian J. Santiago
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | | | - Varna Taranikanti
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| |
Collapse
|
2
|
Davison JM, Taylor MB, Bumsted TN. Medical student non-modifiable risk factors and USMLE Step 1 exam score. Med Educ Online 2024; 29:2327818. [PMID: 38481113 PMCID: PMC10946258 DOI: 10.1080/10872981.2024.2327818] [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] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
For diversity to exist in the medical graduate workforce, students from all backgrounds should have equitable opportunities of employment. Specialties have utilized a minimal threshold for USMLE Step 1 score when screening applicants for residency interviews. The OHSU SOM class of 2021 completed a 14-question voluntary survey on their Step 1 score and the following non-modifiable risk factors: Adverse Childhood Experience score (ACEs), sex, gender, Underrepresented in Medicine status (URiM), family income during adolescence, highest degree held by a guardian, discrimination experience during medical school, federal/state assistance use, and rural versus urban primary home. Descriptive statistics and unadjusted risk ratios were applied to study the relation between Step 1 score and non-modifiable risk factors as well as certain non-modifiable risk factors and ACEs ≥ 3. The mean Step 1 score was 230 (213, 247). Of the students, 28.2% identified ACEs ≥ 3, 13.6% were considered URiM, and 65.4% were female. URiM were 2.34 (1.30, 4.23),females were 2.77 (1.06-7.29), and those who experienced discrimination in medical school were 4.25 (1.85, 9.77) times more likely to have ACEs ≥ 3. Students who had ACEs ≥ 3 were 3.58 (1.75, 7.29) times less likely to meet a minimal threshold for residency interviews of 220. These are the first results to demonstrate a relationship between Step 1 score and ACEs. Those who identified as URiM, females, and those who experienced discrimination in medical school were at a higher risk of ACEs of ≥ 3. Step 1 transitioned to pass/fail in January 2022. However, the first application cycle that residencies will see pass/fail scoring is 2023-2024, and fellowships will continue to see scored Step 1 until, at the earliest, the 2026-2027 application cycle. These data contribute to a foundation of research that could apply to Step 2CK testing scores, and help to inform decisions about the diversity and equity of the residency interview process.
Collapse
Affiliation(s)
| | - Margot B. Taylor
- Portland State University School of Public Health, Portland, OR, USA
| | - Tracy N. Bumsted
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
3
|
Blaszczak J, Wiener S, Plegue M, Shumer D, Shatzer J, Hernandez A. Evaluating the effectiveness of an online curriculum on caring for transgender and nonbinary patients. Med Educ Online 2024; 29:2311481. [PMID: 38320110 PMCID: PMC10848997 DOI: 10.1080/10872981.2024.2311481] [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] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND AND OBJECTIVES It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care. METHODS Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination. RESULTS Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)). CONCLUSIONS An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.
Collapse
Affiliation(s)
- Julie Blaszczak
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Sara Wiener
- Department of Organizational Learning University of Michigan, Ann Arbor, MI, USA
| | - Melissa Plegue
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Dan Shumer
- Department of Pediatric Endocrinology University of Michigan, Ann Arbor, MI, USA
| | - John Shatzer
- School of Education Johns Hopkins, Baltimore, MD, USA
| | - Anita Hernandez
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Cahill A, Martin M, Beachy B, Bauman D, Howard-Young J. The contextual interview: a cross-cutting patient-interviewing approach for social context. Med Educ Online 2024; 29:2295049. [PMID: 38320114 PMCID: PMC10848999 DOI: 10.1080/10872981.2023.2295049] [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] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024]
Abstract
Patient interviewing pedagogy in medical education has not evolved to comprehensively capture the biopsychosocial model of healthcare delivery. While gathering a patient's social history targets important aspects of social context it does not adequately capture and account for the real-time reassessment required to understand evolving factors that influence exposure to drivers of health inequities, social determinants of health, and access to supports that promote health. The authors offer a patient interviewing approach called the Contextual Interview (CI) that specifically targets dynamic and ever-changing social context information. To substantiate the use of the CI in medical education, the authors conducted a qualitative review of the Accreditation Council for Graduate Medical Education Milestones for primary care specialties (Family Medicine, Internal Medicine, and Pediatrics). Milestones were coded to the extent to which they reflected the learner's need to acknowledge, assess, synthesize and/or apply patient contextual data in real-time patient encounters. Approximately 1 in 5 milestones met the context-related and patient-facing criteria. This milestone review further highlights the need for more intentional training in eliciting meaningful social context data during patient interviewing. The CI as a cross-cutting, practical, time-conscious, and semi-structured patient interviewing approach that deliberately elicits information to improve the clinician's sense and understanding of a patient's social context. The authors reviewed future directions in researching adapted versions of the CI for undergraduate and graduate medical education.
Collapse
Affiliation(s)
- Amber Cahill
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Matthew Martin
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Bridget Beachy
- Central Washington Family Medicine Residency, Community Health of Central Washington, Yakima, WA, USA
| | - David Bauman
- Central Washington Family Medicine Residency, Community Health of Central Washington, Yakima, WA, USA
| | - Jordan Howard-Young
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, USA
| |
Collapse
|
5
|
Wang X, Song Z, Chen X, Zhou Y, Lou Y, Liu T, Zhang D. Rapid cycle deliberate practice: application in forceps simulation training for gynecology and obstetrics residents. Ann Med 2024; 56:2301596. [PMID: 38478750 PMCID: PMC10939101 DOI: 10.1080/07853890.2023.2301596] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 12/17/2023] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Rapid Cycle Deliberate Practice (RCDP) has gained prominence in recent years as an innovative teaching method in simulation-based training for adult and pediatric emergency medical skills. However, its application in the training of forceps delivery skills among obstetrics and gynecology residents remains unexplored. This study aimed to assess the impact of RCDP in this domain. METHODS Conducted in March 2021, this randomized controlled study involved 60 second-year obstetrics and gynecology residents undergoing standardized training. Participants were randomly assigned to the RCDP group or the traditional teaching method (TTM) group, each comprising 30 residents. The RCDP group followed the RCDP practice mode, while the TTM group adhered to conventional simulation teaching. Post-training assessment of operational proficiency was conducted immediately and after one year. Independent operational confidence and training satisfaction were evaluated through questionnaire surveys and the Satisfaction with Simulation Experience (SSE) scale. Data analysis utilized SPSS 23.0. RESULTS The RCDP group displayed significantly higher immediate post-training forceps operation scores compared to the TTM group (92.00 [range: 90.00-94.00] vs. 88.00 [range: 86.75-92.00]; z = 3.79; p < .001). However, no significant difference emerged in forceps operation scores after one year (86.00 [range: 85.00-88.00] vs. 85.50 [range: 84.00-88.25]; z = 0.54; p = .59). The RCDP group exhibited notable performance improvement over the TTM group (z = 3.49; p < .001). Independent operation confidence showed no significant discrepancy (p > .05). Importantly, the RCDP group reported higher satisfaction scores, particularly in the Debriefing and Reflection subscale (44.00 [range: 43.00-45.00] vs. 41.00 [range: 41.50-43.00]; z = 5.24; p < .001), contributing to an overall superior SSE score (z = 4.74; p < .001). CONCLUSIONS RCDP exhibits immediate efficacy in elevating forceps delivery skills among residents. However, sustained skill enhancement necessitates innovative approaches, while RCDP's value lies in tailored feedback and reflection for enriched medical education.
Collapse
Affiliation(s)
- Xiaoxue Wang
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zixuan Song
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xueting Chen
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yangzi Zhou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yingze Lou
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tong Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dandan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
6
|
Kresse ME, Morris RW, Weaver JS, Chang CY. Current state of musculoskeletal fellowship program directors and future directions. Skeletal Radiol 2024; 53:1165-1172. [PMID: 38133671 DOI: 10.1007/s00256-023-04553-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To better understand the current state of musculoskeletal fellowship program directors and identify opportunities for formal training that could increase job satisfaction, provide a broader knowledge base for mentoring/advising trainees and increase diversity in musculoskeletal radiology. MATERIALS AND METHODS Eighty-one fellowship program directors who signed the Fellowship Match Memorandum of Understanding with the Society of Skeletal Radiology were sent a survey with questions about demographics, career, background, and training both for musculoskeletal radiology and for the fellowship director role. RESULTS A 57/81 (70%) of program directors responded, representing 27 different states with a range of 1-9 fellowship positions. Nearly half are in their forties (48%) with most identifying as White (67%) followed by Asian (30%). The majority are male (72%) with over half (60%) remaining at the institution where they completed prior training. Over half plan to change roles within 5 years and do not feel adequately compensated. Top qualities/skills identified as important for the role include effective communication, being approachable, and clinical excellence. Other than clinical excellence, most do not report formal training in skills identified as important for the role. CONCLUSIONS Given the high amount of interaction with trainees, program directors play a key role in the future of our subspecialty. The low diversity among this group, the lack of formal training, and the fact that most do not feel adequately compensated could limit mentorship and recruitment. Program directors identified effective communication, organizational/planning skills, and conflict resolution as the top skills they would benefit from formal training.
Collapse
Affiliation(s)
- Maxine E Kresse
- Department of Radiology and Medical Imaging, University of Virginia, PO Box 800170, Charlottesville, VA, 22908, USA.
| | - Robert W Morris
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Jennifer S Weaver
- University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Connie Y Chang
- Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA
| |
Collapse
|
7
|
Rubin JE, Pandian B, Jotwani R, Pryor KO, Rubin LA, Mack PF. Leveraging spatial computing to improve crisis management training in anesthesiology. J Clin Anesth 2024; 93:111358. [PMID: 38104400 DOI: 10.1016/j.jclinane.2023.111358] [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] [Received: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Affiliation(s)
- John E Rubin
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America.
| | - Balaji Pandian
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America
| | - Rohan Jotwani
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America
| | - Kane O Pryor
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America
| | - Lori A Rubin
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America
| | - Patricia F Mack
- Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States of America
| |
Collapse
|
8
|
Gibbon LM, Buck L, Schmidt L, Bogetz JF, Trowbridge A. "It's a Heavy Thing to Carry:" Internal Medicine and Pediatric Resident Experiences Caring for Dying Patients. Am J Hosp Palliat Care 2024; 41:492-500. [PMID: 37288486 DOI: 10.1177/10499091231181567] [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] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Residents often feel unprepared to care for dying patients and may benefit from more training. Little is known about factors in the clinical setting that promote resident learning about end of life (EOL) care. OBJECTIVES This qualitative study aimed to characterize the experiences of residents caring for dying patients and elucidate the impact of emotional, cultural, and logistical factors on learning. METHODS 6 US internal medicine and 8 pediatric residents who had cared for at least 1 dying patient completed a semi-structured one-on-one interview between 2019 and 2020. Residents described an experience caring for a dying patient including their confidence in clinical skills, emotional experience, role within the interdisciplinary team, and perspective on how to improve their education. Interviews were transcribed verbatim and investigators conducted content analysis to generate themes. RESULTS 3 themes (with subthemes) emerged: (1) experiencing strong emotion or tension (loss of patient personhood, emerging professional identity, emotional dissonance); (2) processing the experience (innate resilience, team support); and (3) recognition of a new perspective or skill (bearing witness, meaning making, recognizing biases, emotional work of doctoring). CONCLUSIONS Our data suggests a model for the process by which residents learn affective skills critical to EOL care: residents (1) notice strong emotion, (2) reflect on the meaning of the emotion, and (3) crystallize this reflection into a new perspective or skill. Educators can use this model to develop educational methods that emphasize normalization of physician emotions and space for processing and professional identity formation.
Collapse
Affiliation(s)
- Lindsay M Gibbon
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Harborview Medical Center, Seattle, WA, USA
| | - Laura Buck
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Lauren Schmidt
- Department of Social Work, University of Washington Medical Center, Seattle, WA, USA
| | - Jori F Bogetz
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Amy Trowbridge
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| |
Collapse
|
9
|
Woodworth GE, Goldstein ZT, Ambardekar AP, Arthur ME, Bailey CF, Booth GJ, Carney PA, Chen F, Duncan MJ, Fromer IR, Hallman MR, Hoang T, Isaak R, Klesius LL, Ladlie BL, Mitchell SA, Miller Juve AK, Mitchell JD, McGrath BJ, Shepler JA, Sims CR, Spofford CM, Tanaka PP, Maniker RB. Development and Pilot Testing of a Programmatic System for Competency Assessment in US Anesthesiology Residency Training. Anesth Analg 2024; 138:1081-1093. [PMID: 37801598 DOI: 10.1213/ane.0000000000006667] [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: 10/08/2023]
Abstract
BACKGROUND In 2018, a set of entrustable professional activities (EPAs) and procedural skills assessments were developed for anesthesiology training, but they did not assess all the Accreditation Council for Graduate Medical Education (ACGME) milestones. The aims of this study were to (1) remap the 2018 EPA and procedural skills assessments to the revised ACGME Anesthesiology Milestones 2.0, (2) develop new assessments that combined with the original assessments to create a system of assessment that addresses all level 1 to 4 milestones, and (3) provide evidence for the validity of the assessments. METHODS Using a modified Delphi process, a panel of anesthesiology education experts remapped the original assessments developed in 2018 to the Anesthesiology Milestones 2.0 and developed new assessments to create a system that assessed all level 1 through 4 milestones. Following a 24-month pilot at 7 institutions, the number of EPA and procedural skill assessments and mean scores were computed at the end of the academic year. Milestone achievement and subcompetency data for assessments from a single institution were compared to scores assigned by the institution's clinical competency committee (CCC). RESULTS New assessment development, 2 months of testing and feedback, and revisions resulted in 5 new EPAs, 11 nontechnical skills assessments (NTSAs), and 6 objective structured clinical examinations (OSCEs). Combined with the original 20 EPAs and procedural skills assessments, the new system of assessment addresses 99% of level 1 to 4 Anesthesiology Milestones 2.0. During the 24-month pilot, aggregate mean EPA and procedural skill scores significantly increased with year in training. System subcompetency scores correlated significantly with 15 of 23 (65.2%) corresponding CCC scores at a single institution, but 8 correlations (36.4%) were <30.0, illustrating poor correlation. CONCLUSIONS A panel of experts developed a set of EPAs, procedural skill assessment, NTSAs, and OSCEs to form a programmatic system of assessment for anesthesiology residency training in the United States. The method used to develop and pilot test the assessments, the progression of assessment scores with time in training, and the correlation of assessment scores with CCC scoring of milestone achievement provide evidence for the validity of the assessments.
Collapse
Affiliation(s)
- Glenn E Woodworth
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
| | - Zachary T Goldstein
- Department of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, California
| | - Aditee P Ambardekar
- Department of Anesthesiology and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Mary E Arthur
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Caryl F Bailey
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Gregory J Booth
- Uniformed Services University of the Health Sciences, Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia
| | - Patricia A Carney
- Division of Hospital Medicine, Department of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, Oregon
| | - Fei Chen
- Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Michael J Duncan
- Department of Anesthesiology, University of Missouri-Kansas City, Kansas City, Missouri
| | - Ilana R Fromer
- Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota
| | - Matthew R Hallman
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | - Thomas Hoang
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
| | - Robert Isaak
- Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina
| | - Lisa L Klesius
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Beth L Ladlie
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | | | - Amy K Miller Juve
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon
| | - John D Mitchell
- Department of Anesthesiology, Critical Care, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan
| | - Brian J McGrath
- Department of Anesthesiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
| | - John A Shepler
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Charles R Sims
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Christina M Spofford
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pedro P Tanaka
- Department of Anesthesiology, Stanford University, Stanford, California
| | - Robert B Maniker
- Department of Anesthesiology, Columbia University, New York, New York
| |
Collapse
|
10
|
Update on Educational Resources and Evaluation Tools for Orthopaedic Surgery Residents: Erratum. J Am Acad Orthop Surg 2024; 32:381. [PMID: 38639650 DOI: 10.5435/JAAOS-D-23-00627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
|
11
|
Tsui GO, Kunac A, Oliver JB, Mehra S, Anjaria DJ. Did Residents Stop Operating During COVID? Impact of COVID-19 Across VA Teaching Hospitals on Surgical Resident Education. Am Surg 2024; 90:1015-1022. [PMID: 38059816 DOI: 10.1177/00031348231220598] [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] [Indexed: 12/08/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, elective cases across the nation were suspended, leading to major decreases in operative volume for surgical trainees. Surgical resident operative autonomy has been declining over time, so we sought to explore the effect COVID-19 had on resident autonomy within VA teaching hospitals. METHODS A retrospective analysis of surgical cases across specialties was performed using the VA Surgical Quality Improvement Program database from September 2019 to September 2021 at VA teaching hospitals. Supervision codes are recorded prospectively: attending surgeon performs the operation (AP), resident completes majority of the case with the attending scrubbed (AR), and resident is primary surgeon without attending scrubbed (RP). RESULTS 20,457 cases pre-COVID decreased to 11,035 during peak-COVID (P < .001). Overall, RP cases increased from 6.5% to 7.6% during the peak (P < .001) and trended back downwards during the recovery periods. AP decreased initially (29.9%-27.7%, P < .001), but regressed back to pre-pandemic numbers. In general surgery RP cases, urgent cases such as laparoscopic cholecystectomies increased from 18.8% to 27.5%, while elective repairs decreased during the peak. Similar changes were noted across specialties. DISCUSSION Operative cases dropped by half from pre- to peak- COVID and remained 20% below pre-pandemic volume the following year. Interestingly, RP rates increased for several specialties during the peak of the pandemic, which may have resulted from a relative higher ratio of resident personnel:case volume and shift in case distribution from elective to urgent. The increase in RP rate has begun to regress to pre-COVID levels which need to be readdressed.
Collapse
Affiliation(s)
- Grace O Tsui
- Department of Surgery, VA New Jersey Healthcare System, East Orange, NJ, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Anastasia Kunac
- Department of Surgery, VA New Jersey Healthcare System, East Orange, NJ, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Joseph B Oliver
- Department of Surgery, VA New Jersey Healthcare System, East Orange, NJ, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Shyamin Mehra
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Devashish J Anjaria
- Department of Surgery, VA New Jersey Healthcare System, East Orange, NJ, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
12
|
Hilton E, Song C, Park SE. Perspectives on virtual interviews for dental school admissions. Eur J Dent Educ 2024; 28:438-446. [PMID: 37927159 DOI: 10.1111/eje.12966] [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] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Admissions interviews are an integral part of the dental school application process. In light of the COVID-19 pandemic, interviews had to adapt and become a part of the virtual realm. The purpose of the study was to evaluate the perspectives of interviewees and interviewers in this process. METHODS Admission data for all prospective students were compiled for the classes of 2016 through 2025 to compare in-person to virtual interview scores. Additionally, surveys were sent to members of the admissions committee as well as interviewees asking questions regarding the virtual interview experience. A Likert scale was used for the majority of questions and free responses were also an option. RESULTS The comparison data showed that the virtual candidates may have had higher overall undergraduate and application scores, in addition to better interview scores compared to in-person candidates. Interviewees and interviewers both agreed in their top three rankings of what was enjoyable about the virtual interviews, specifically the lower cost for applicants, the convenience, and the safety during the pandemic. There was also agreement with their top three aspects that were least desirable in the interview process, specifically the absence of visual cues/lack of body language, lack of personal contact, and connectivity issues. Around 74% of committee members would recommend virtual interviews in the future whereas only 49% of interviewees would recommend virtual interviews in the future. CONCLUSION The pandemic brought about many changes, including the way admissions interviews were conducted. While this was a change made of necessity, it was valuable to explore the appropriateness of implementing virtual interviews in the future as a part of dental school admissions processes.
Collapse
Affiliation(s)
| | - Crystal Song
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Sang E Park
- Office of Dental Education, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
13
|
Schulze M, Streith L, Wiseman SM. Intraoperative teaching methods, models, and frameworks: A scoping review for surgical resident education. Am J Surg 2024; 231:24-40. [PMID: 38342713 DOI: 10.1016/j.amjsurg.2024.01.024] [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: 11/20/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND This review aimed to consolidate the existing literature on intraoperative teaching strategies and highlight areas for future research. OBJECTIVE The objective is to review the research conducted regarding the implementation of various teaching frameworks for surgical learners and to present their feasibility, benefits, and limitations within surgical residencies, as well as areas for future research. METHODS Two independent investigators searched MEDLINE, EMBASE, and ERIC and reviewed articles on intraoperative teaching strategies for surgical resident education. RESULTS 3050 abstracts were reviewed, and 66 studies (2.2%) were included. The most common study type was single cohort studies (33%), followed by survey studies (17%). The majority of articles were carried out in General Surgery (50%), or a combination of surgical specialties (17%). CONCLUSIONS The BID model encompasses perioperative teaching time points and suggests a universal organizational approach to intraoperative teaching that would likely be compatible with documented competency assessments for residents.
Collapse
Affiliation(s)
- Marie Schulze
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, Canada
| | - Lucas Streith
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, Canada.
| |
Collapse
|
14
|
Lafont C, Decante C, Samarut E, Salaud C. A circulating cadaveric simulation model for neurosurgery residents. Med Educ 2024; 58:594-595. [PMID: 38356352 DOI: 10.1111/medu.15338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024]
|
15
|
Pino B, Song J, Orlando A, Wang DS. Fostering Diversity in Urology: Addressing Ethnic Disparities in Applicant and Resident Recruitment. Urol Pract 2024; 11:559-566. [PMID: 38560948 DOI: 10.1097/upj.0000000000000521] [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: 10/09/2023] [Accepted: 12/26/2023] [Indexed: 04/04/2024]
Abstract
INTRODUCTION In this retrospective database review, the objective was to investigate the ethnic composition of urology applicants and residents in recent years and assess whether any advancements have been made in enhancing the recruitment of candidates from historically underrepresented groups in medicine. METHODS A retrospective database review was conducted on self-reported data on the ethnicity of urology applicants from academic year 2016 to 2017 (AY2016) to AY2021 and urology residents from AY2011 to AY2021. Applicant data were collected from the Association of American Medical Colleges, and resident data were collected from the Accreditation Council for Graduate Medical Education. The ethnic proportions of applicants and residents within cohorts were analyzed using χ2 tests, and differences between cohorts were analyzed using Z tests. RESULTS There was a statistically significant decrease in the proportion of White applicants from 61.4% to 50.5% from AY2016 to AY2021 and a statistically significant increase in the proportion of applicants of multiple race/ethnicity from 4.7% to 12.0% from AY2016 to AY2021. There were disproportionately more Hispanic/Latino residents than applicants and disproportionately fewer residents of multiple race/ethnicity than applicants in the 2 cycles analyzed. There were disproportionately fewer Black residents than applicants only in the comparison of AY2016 to AY2020 applicants to AY2020 residents. CONCLUSIONS There continues to be a lack of ethnic representation among applicants and residents in urology from underrepresented groups in medicine, despite some measurable improvement over the years. This deficit highlights the important need for new and ongoing efforts to diversify the field.
Collapse
Affiliation(s)
- Bruna Pino
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Jonathan Song
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Andrew Orlando
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Department of Urology, Boston Medical Center, Boston, Massachusetts
| | - David S Wang
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Department of Urology, Boston Medical Center, Boston, Massachusetts
| |
Collapse
|
16
|
Mehta PM, Prajapati P, Kumar S, Jain N, Vilanilam GK, Purushothaman R, Jensen HK, Kaukis N, Ram R. Review of the demographic and educational profiles of abdominal imaging fellowship program directors in the United States. Curr Probl Diagn Radiol 2024; 53:384-388. [PMID: 38281843 DOI: 10.1067/j.cpradiol.2024.01.014] [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: 10/20/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To evaluate demographics, academic backgrounds, and scholarly activities of Program Directors (PDs) in Abdominal Imaging Fellowships in the United States (US), emphasizing gender representation, international origins, and academic milestones. METHODS A list of Fellowships in Abdominal Imaging programs in the US was obtained from the Society of Abdominal Radiology. The search was expanded using the Fellowship and Residency Electronic Interactive Database. Data for PDs were sourced from program websites, Healthgrades, Doximity, and Elsevier's Scopus. Metrics such as age, gender, education, academic rank, additional qualifications, prior leadership roles, publications, and h-indices were analyzed using R software. A two-tailed unpaired t-test was used to calculate the difference in means of scholarly activity between male and female PDs. RESULTS 113 programs were identified: South (36.28%), Northeast (25.66%), Mid-West (20.35%), West (17.69%). Of 107 PDs, 54% male, 41% female, and average age 48 ± 9.4 years. 66.6% were US graduates, 29.2% were international graduates. Most were Assistant Professors (36.28%). 19.46% had degrees like M.P.H. or M.B.A. 45% had prior leadership roles. Average year of residency graduation was 2007. Mean publication count was 54.16, and mean h-index was 14.663. Male PDs had higher publication counts and h-indices than female PDs (p= 0.009 and p= 0.0019 respectively). CONCLUSION In Abdominal Imaging Fellowship programs in the US, there is an increasing representation of females in Program Director roles. However, research led by female PDs remains less prevalent. The field of Abdominal Imaging values contributions from international graduates and insights from Assistant Professors.
Collapse
Affiliation(s)
- Parv M Mehta
- Department of Radiology, Mayo Clinic, 611 3rd Avenue SW, Rochester, Minnesota 55902, United States
| | - Priyanka Prajapati
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Shruti Kumar
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States.
| | - Navita Jain
- Department of Medicine, Lady Hardinge Medical College, Delhi 110001, India
| | - George K Vilanilam
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Rangarajan Purushothaman
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Hanna K Jensen
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Nicholas Kaukis
- Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, United States
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| |
Collapse
|
17
|
Charnell AM, Davies NE, Tate J, Dennis CA. Patient collaborators in post-graduate teaching development sessions on bedside teaching. Med Educ 2024; 58:615-616. [PMID: 38356290 DOI: 10.1111/medu.15337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024]
|
18
|
Wasserman MS, Rozenshtein A, Bedi HS. Implementation of training level-specific self-study guides for diagnostic radiology residents. Curr Probl Diagn Radiol 2024; 53:395-398. [PMID: 38272752 DOI: 10.1067/j.cpradiol.2024.01.023] [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: 12/22/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Currently, there is no universally accepted diagnostic radiology curriculum for self-studying, so diagnostic radiology residents often have a challenging time knowing where to begin their independent studying away from work. In an effort to meet the needs of today's residents, we attempted to provide structured, comprehensive self-studying suggestions in a digestible and personalized format. MATERIALS AND METHODS Each radiology division attempted to create an optimal learning resource form for the residents to use for self-studying while on each rotation. Each self-study guide included hyperlinks to easily accessible online resources. RESULTS Training level-specific week-by-week recommendations were provided based on the expected types of cases a resident would typically encounter during that timeframe. All of the neuroradiology rotation forms and several of the other subspecialty forms were originally made available to the residents and faculty electronically on July 1, 2022. The forms are now distributed to newly rotating residents on a monthly basis. DISCUSSION There is a fine balance between providing residents with comprehensive review material and promoting realistic expectations. In addition, educators must keep in mind financial limitations of their residents and institutions. Learning resources must be affordable to be accessible to all residents. As radiology and technology continuously advance, there will undoubtedly be more and more excellent resources for trainees to learn from. To optimize self-studying, retention of information, and wellness, it is imperative to provide our residents with a structured, personalized, manageable curriculum including easily accessible high-yield resources.
Collapse
Affiliation(s)
- Michael S Wasserman
- Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Department of Radiology, 820 Harrison Avenue, FGH Building, 4th Floor, Boston, MA 02118, USA.
| | - Anna Rozenshtein
- New York Medical College, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USA
| | - Harprit S Bedi
- Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Department of Radiology, 820 Harrison Avenue, FGH Building, 4th Floor, Boston, MA 02118, USA
| |
Collapse
|
19
|
Tovilla-Zárate CA, Fresán A, Guízar-Sánchez D, Yoldi-Negrete M, Robles-García R, Martínez-López JN. What lies behind suicide ideation during medical residency? A comparison between medical specialties in Mexican physicians in training. Gen Hosp Psychiatry 2024; 88:79-80. [PMID: 38360430 DOI: 10.1016/j.genhosppsych.2024.02.004] [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] [Received: 01/22/2024] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Carlos-Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico.
| | - Diana Guízar-Sánchez
- Departamento de Fisiología de la Facultad de Medicina, Universidad Nacional Autónoma de México, UNAM, Mexico City, Mexico
| | - María Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Rebeca Robles-García
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - J Nicolás Martínez-López
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| |
Collapse
|
20
|
Hodge E. Addressing low clinical examination pass rates among international medical graduates (IMGs). Med Educ 2024; 58:650-651. [PMID: 38380712 DOI: 10.1111/medu.15343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
|
21
|
Haider A, Sullivan J, Lawrence E, Russell JC, Paul J, Greenbaum A. General Surgery Resident Participation in a Mandatory Wellness Program: Six Years Later. J Surg Res 2024; 297:83-87. [PMID: 38460453 DOI: 10.1016/j.jss.2024.02.005] [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: 03/02/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Following the approval of a resident-created physician wellness program in 2016, an initial survey demonstrated majority support for the implementation of a mandatory curriculum. The purpose of this study is to survey surgical residents about the wellness curriculum six years after implementation and re-evaluate preference for mandatory participation. METHODS In 2016, the CORE7 Wellness Program didactic sessions were integrated into the general surgery resident education curriculum. A comparison between 2016 and 2022 resident survey results was done to examine overall approval and resident experience. RESULTS A total of 25 general surgery residents responded to the 2022 survey which equaled to a response rate of 67.5% compared to a response rate of 87.1% in 2016. Similar to the results in 2016, there was unanimous support (100%, n = 25) in favor of the ongoing development of a general surgery wellness program. The majority of residents (88% versus 85.2% in 2016) preferred quarterly "wellness half-days" remain a mandatory component of the program. In 2016, most of the residents (50%) stated that the reason for mandatory preference for wellness half-days was ease of explanation to faculty. In 2022, the reason changed to a combination of reasons with most residents (59%) selecting ease of explanation to attendings, feeling too guilty otherwise to leave the shift, and forcing the resident to think about self-care. Complaints about taking a wellness half-day from other team members increased from 29% in 2016 to 48% in 2022. CONCLUSIONS Six years after implementation, there is unanimous support for the mandatory components of a general surgery residency wellness curriculum. Increased perceived complaints from faculty and staff about resident wellness present an opportunity for improvement.
Collapse
Affiliation(s)
- Aleezay Haider
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jessica Sullivan
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Elizabeth Lawrence
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - John C Russell
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jasmeet Paul
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Alissa Greenbaum
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
| |
Collapse
|
22
|
Papillon-Ferland L, Sadowski CA. Case mapping of geriatrics: Looking beyond age in skills laboratories. Curr Pharm Teach Learn 2024; 16:377-385. [PMID: 38609769 DOI: 10.1016/j.cptl.2024.03.003] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/31/2023] [Accepted: 03/11/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND PURPOSE Development of competencies related to care of older adults is necessary in pharmacy education. Skills laboratories as an essential part of the curriculum represent an important setting to teach geriatrics. The purpose of this research was to describe geriatrics cases in skills/simulation activities of an undergraduate pharmacy program. EDUCATIONAL ACTIVITY AND SETTING A retrospective review of one academic year of skills laboratories from the pharmacy program at the Faculty of Pharmacy of University of Montreal was performed. Sessions including cases aged ≥65 years were selected. Content was extracted for characteristics relating to the patient, health, medications, and care context. A framework including geriatric considerations such as geriatric syndromes, frailty status, and potentially inappropriate medications was developed for data collection. FINDINGS In total, 210 patient cases were extracted. Older adults (≥ 65 years) were represented in 51 cases (24%), with 8 cases (4%) aged ≥80 years. Geriatric syndromes were documented in 8%, functional status in 10%, and mobility in 12% of the cases. The median number of comorbidities and medications were 4 and 7, respectively. Regarding polypharmacy, only 10 cases had >10 medications, and none had >15 medications. Potentially inappropriate medications were found in 47% (n = 24) of the cases but were addressed in only 14% (n = 7) cases. SUMMARY This mapping of skills laboratories highlights gaps in geriatrics content. Inclusion of the oldest patients and geriatrics issues were incorporated in a minority of cases and lacked many characteristics essential for geriatrics care.
Collapse
Affiliation(s)
- Louise Papillon-Ferland
- Faculty of pharmacy, University of Montreal, 2940, chemin de Polytechnique, Montréal, QC H3T 1J4, Canada.
| | - Cheryl A Sadowski
- Faculty of Pharmacy & Pharmaceutical Sciences, College of Health Sciences, University of Alberta, 11405 - 87 Ave NW, Edmonton, Alberta T6G 1C9, Canada.
| |
Collapse
|
23
|
Roizenblatt M, Gehlbach PL, Marin VDG, Roizenblatt A, Saraiva VDS, Nakanami MH, Noia LDC, Watanabe SES, Yasaki ES, Passos RM, Magalhães O, Fernandes RAB, Stefanini FR, Caiado R, Jiramongkolchai K, Farah ME, Belfort R, Maia M. ASSESSMENT OF SIMULATED SURGICAL DEXTERITY AFTER MODIFIABLE EXTERNAL EXPOSURES AMONG NOVICE VERSUS EXPERIENCED VITREORETINAL SURGEONS. Retina 2024; 44:820-830. [PMID: 38194677 DOI: 10.1097/iae.0000000000004045] [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: 01/11/2024]
Abstract
PURPOSE To evaluate novice and senior vitreoretinal surgeons after various exposures. Multiple comparisons ranked the importance of these exposures for surgical dexterity based on experience. METHODS This prospective cohort study included 15 novice and 11 senior vitreoretinal surgeons (<2 and >10 years' practice, respectively). Eyesi-simulator tasks were performed after each exposure. Day 1, placebo, 2.5 mg/kg caffeine, and 5.0 mg/kg caffeine; day 2, placebo, 0.2 mg/kg propranolol, and 0.6 mg/kg propranolol; day 3, baseline simulation, breathalyzer readings of 0.06% to 0.10% and 0.11% to 0.15% blood alcohol concentrations; day 4, baseline simulation, push-up sets with 50% and 85% repetitions maximum; and day 5, 3-hour sleep deprivation. Eyesi-generated score (0-700, worst-best), out-of-tolerance tremor (0-100, best-worst), task completion time (minutes), and intraocular pathway (in millimeters) were measured. RESULTS Novice surgeons performed worse after caffeine (-29.53, 95% confidence interval [CI]: -57.80 to -1.27, P = 0.041) and alcohol (-51.33, 95% CI: -80.49 to -22.16, P = 0.001) consumption. Alcohol caused longer intraocular instrument movement pathways (212.84 mm, 95% CI: 34.03-391.65 mm, P = 0.02) and greater tremor (7.72, 95% CI: 0.74-14.70, P = 0.003) among novices. Sleep deprivation negatively affected novice performance time (2.57 minutes, 95% CI: 1.09-4.05 minutes, P = 0.001) and tremor (8.62, 95% CI: 0.80-16.45, P = 0.03); however, their speed increased after propranolol (-1.43 minutes, 95% CI: -2.71 to -0.15 minutes, P = 0.029). Senior surgeons' scores deteriorated only following alcohol consumption (-47.36, 95% CI: -80.37 to -14.36, P = 0.005). CONCLUSION Alcohol compromised all participants despite their expertise level. Experience negated the effects of caffeine, propranolol, exercise, and sleep deprivation on surgical skills.
Collapse
Affiliation(s)
- Marina Roizenblatt
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peter L Gehlbach
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vitor D G Marin
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Arnaldo Roizenblatt
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Vinicius da S Saraiva
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mauricio H Nakanami
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luciana da C Noia
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sung E S Watanabe
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Erika S Yasaki
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Renato M Passos
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Octaviano Magalhães
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo A B Fernandes
- Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | | | - Rafael Caiado
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Michel E Farah
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rubens Belfort
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mauricio Maia
- Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil
- Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
24
|
Buchanan CJ, Young E, Mastalerz KA. Engaging resident physicians in the design, implementation, and assessment of bedside interdisciplinary rounds. J Interprof Care 2024; 38:469-475. [PMID: 36814080 DOI: 10.1080/13561820.2023.2176471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/21/2021] [Revised: 10/28/2022] [Accepted: 01/07/2023] [Indexed: 02/24/2023]
Abstract
Bedside interdisciplinary rounds (IDR) improve teamwork, communication, and collaborative culture in inpatient settings. Implementation of bedside IDR in academic settings depends on engagement from resident physicians; however, little is known about their knowledge and preferences related to bedside IDR. The goal of this program was to identify medical resident perceptions about bedside IDR and to engage resident physicians in the design, implementation, and assessment of bedside IDR in an academic setting. This is a pre-post mixed methods survey assessing resident physicians' perceptions surrounding a stakeholder-informed bedside IDR quality improvement project. Resident physicians in the University of Colorado Internal Medicine Residency Program (n = 77 pre-implementation survey responses from 179 eligible participants - response rate 43%) were recruited via e-mail to participate in surveys assessing perceptions surrounding the inclusion of interprofessional team members, timing, and preferred structure of bedside IDR. A bedside IDR structure was created based on input from resident and attending physicians, patients, nurses, care coordinators, pharmacists, social workers, and rehabilitation specialists. This rounding structure was implemented on acute care wards in June 2019 at a large academic regional VA hospital in Aurora, CO. Resident physicians were surveyed post implementation (n = 58 post-implementation responses from 141 eligible participants - response rate 41%) about interprofessional input, timing, and satisfaction with bedside IDR. The pre-implementation survey revealed several important resident needs during bedside IDR. Post-implementation survey results revealed high overall satisfaction with bedside IDR among residents, improved perceived efficiency of rounds, preserved quality of education, and value added by interprofessional input. Results also suggested areas for future improvement including timeliness of rounds and enhanced systems-based teaching. This project successfully engaged residents as stakeholders in system-level interprofessional change by incorporating their values and preferences into a bedside IDR framework.
Collapse
Affiliation(s)
- Cole J Buchanan
- Department of Internal Medicine, University of Colorado Internal Medicine Residency Program, Denver, CO, USA
| | - Eric Young
- Department of Hospital Medicine, Eastern Colorado VA Healthcare System, Aurora, CO, USA
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Katarzyna A Mastalerz
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
25
|
Johny A, Shenot PJ, Green C, Chisholm L, Riggs S, Jackman SV, Khan AA, Kolettis PN, McNeil BK, Mayer WA. Program Directors' Perspectives on Residency Applications in the Post‒United States Medical Licensing Examination Step 1 Era: A Case for Standardized Letters of Recommendation? Urol Pract 2024; 11:577-584. [PMID: 38526424 DOI: 10.1097/upj.0000000000000556] [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: 10/22/2023] [Accepted: 02/22/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The United States Medical Licensing Examination (USMLE) Step 1 test evolved into a key metric utilized by program directors (PDs) in assessing candidates for residency. The transition to a USMLE Step 1 binary pass/fail scoring system has resulted in a loss of an important objective assessment. With national movements toward pass/fail systems for clerkship grading and trends toward abandonment of class ranking, assessing residency applications has become increasingly challenging. METHODS The Society of Academic Urologists convened a task force to, in part, assess the perspectives of urology PDs regarding the importance of various aspects of a residency application for predicting clinical performance. An anonymous survey was disseminated to all urology PDs in the US. Perspectives on 11 potential application predictors of clinical performance and demographics were recorded. Descriptive statistics characterized PD responses. Friedman test and pairwise Wilcoxon tests were used to evaluate the relative ranks assigned to application elements by PDs. RESULTS There was a 60.5% response rate (89/147). Letters of recommendation (LORs) were ranked as the most important predictor, with a mean rank of 2.39, median of 2 (IQR 1-3). Clerkship grades and USMLE Step 1 were comparable and ranked second. Medical school reputation ranked the lowest. There was significant subjective heterogeneity among categories; however, this was less so for LORs, which predominated as the most important factor among application elements (P < .001). CONCLUSIONS To our knowledge, this is the largest sample size assessing PD perspectives on application factors that predict clinical performance. The second (clerkship grades) and third (USLME Step 1) most important factors moving toward binary pass/fail systems create an opportunity for actionable change to improve assessment objectivity. Our data demonstrate LORs to be the most important factor of residency applications, making a compelling argument for moving toward a standardized LOR to maximize this tool, mitigate bias, and improve interreviewer reliability.
Collapse
Affiliation(s)
| | - Patrick J Shenot
- Thomas Jefferson College of Medicine, Philadelphia, Pennsylvania
| | | | | | | | - Stephen V Jackman
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | | | - Brian K McNeil
- University of Alabama School of Medicine, Birmingham, Alabama
| | | |
Collapse
|
26
|
Nasef H, Awan MU, Hernandez N, Cruz F, Havron W, Elkbuli A. The National Resident Matching Program: An Outdated Business Model Due for Reform. Am Surg 2024; 90:959-962. [PMID: 38048418 DOI: 10.1177/00031348231220591] [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] [Indexed: 12/06/2023]
Abstract
INTRODUCTION This study aims to examine the trends across the entire NRMP application cycles from 2007-2008 to 2022-2023, specifically exploring trends across competitive surgical specialties to assess the efficacy of the existing NRMP business model and provide evidence-based recommendations to better address the current needs of both applicants and programs. METHODS A cross-sectional study exploring the trends in the mean number of applicants and mean number of total ranked positions per applicant across surgical, the top 5 most competitive surgical specialties, and non-surgical specialties from 2007-2008 to the 2022-2023 match cycles utilizing data from the NRMP database. RESULTS Over the studied 16 match cycles, the mean number of applicants to surgical specialties has increased by 47.99% and the mean number of total ranked positions per applicant has increased by 88.07%. For the top 5 most competitive specialties, the mean number of applicants has increased by 57.66% and the mean number of total ranked positions per applicant has increased by 83.33%. CONCLUSION Trends across the 16 most recent NRMP cycles show evidence of increased congestion in the match system, the burden of which is primarily placed on applicants. Our findings support the need for drastic reform in the NRMP to relieve this burden, and we discuss practical solutions to allow the NRMP to better meet the needs of applicants and residency programs alike.
Collapse
Affiliation(s)
- Hazem Nasef
- Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA
| | - Muhammad Usman Awan
- Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA
| | - Nickolas Hernandez
- William Carey University College of Osteopathic Medicine, Hattiesburg, MS, USA
| | - Francis Cruz
- University of Alabama School of Medicine, Birmingham, AL, USA
| | - Will Havron
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA
- Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA
- Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA
| |
Collapse
|
27
|
Kao LS, Diller ML. Embedding Mindfulness-Based Resiliency Curricula Into Surgical Training to Combat Resident Burnout and Improve Wellbeing. Am Surg 2024; 90:954-958. [PMID: 37129239 DOI: 10.1177/00031348221117046] [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] [Indexed: 05/03/2023]
Abstract
Surgery residents are at a higher-than-average risk of burnout syndrome, which is characterized by emotional exhaustion, depersonalization, and a sense of ineffectiveness. This risk of burnout can translate to increased stress and distress in trainees, poor performance, as well as worse patient outcomes. Therefore, developing and implementing burnout reduction strategies that are feasible, acceptable, and effective among surgical residents is paramount. Studies demonstrate that inherent mindfulness is associated with improved resiliency, reduced stress and burnout, as well as improved cognitive and motor skill performance. Fortunately, mindfulness is a skill that can be developed and maintained through targeted mindfulness-based interventions embedded within surgical education curriculum. Here, we present the data supporting the use of mindfulness as an integral part of burnout reduction efforts in surgical trainees as well as highlight evidence-based strategies for implementation in diverse surgical training environments.
Collapse
|
28
|
Lawson McLean AC, Maurer S, Nistor-Gallo D, Moritz I, Tourbier M. Survey on Training Satisfaction among German Neurosurgical Trainees. J Neurol Surg A Cent Eur Neurosurg 2024; 85:269-273. [PMID: 36914157 DOI: 10.1055/a-2053-3108] [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: 03/14/2023]
Abstract
BACKGROUND There has been a fivefold increase of neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1,000 neurosurgical residents employed at training hospitals. Little is known about the overall training experience and career opportunities for these trainees. METHODS In our role as resident representatives, we implemented a mailing list for interested German neurosurgical trainees. Thereafter, we created a survey including 25 items to assess the trainees' satisfaction with their training and their perceived career prospects, which we then distributed through the mailing list. The survey was open from April 1 until May 31 2021. RESULTS Ninety trainees were enrolled in the mailing list and we received 81 completed responses to our survey. Overall, 47% of the trainees were very dissatisfied or dissatisfied with their training. Sixty-two percent of the trainees reported a lack of surgical training. Fifty-eight percent of trainees found it difficult to attend courses or classes and only 16% had consistent mentoring. There was an expressed desire for a more structured training program and mentoring projects. In addition, 88% of trainees were willing to relocate for fellowships outside their current hospitals. CONCLUSIONS Half of the responders were dissatisfied with their neurosurgical training. There are various aspects that require improvement, such as the training curriculum, structured mentoring, and reduction of the amount of administrative work. We propose the implementation of a modernized structured curriculum, which addresses the mentioned aspects, in order to improve neurosurgical training and, consecutively, patient care.
Collapse
Affiliation(s)
| | - Stefanie Maurer
- Department of Neurosurgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Ina Moritz
- Department of Neurosurgery, Vivantes Hospital Berlin Neukölln, Berlin, Germany
| | - Meriem Tourbier
- Department of Neurosurgery, University Hospital Carl Gustav Carus, Dresden, Germany
| |
Collapse
|
29
|
De Luca P, Di Stadio A, Scarpa A, Ricciardiello F, Viola P, Radici M, Camaioni A. 3-D virtual reality surgery training to improve muscle memory and surgical skills in head and neck residents/young surgeons. Eur Arch Otorhinolaryngol 2024; 281:2767-2770. [PMID: 38436755 DOI: 10.1007/s00405-024-08573-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Affiliation(s)
| | | | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Pasquale Viola
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Marco Radici
- Otolaryngology Department, Gemelli Isola, Rome, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| |
Collapse
|
30
|
Li RD, Pillado E, DiLosa K, Chia MC, Visenio M, Zhan T, Eng JS, Amortegui D, Johnson JK, Sheahan MG, Bilimoria KY, Hu YY, Coleman DM. Perception of shared learning environment differs between vascular surgery and general surgery residents. J Vasc Surg 2024; 79:1224-1232. [PMID: 38070784 DOI: 10.1016/j.jvs.2023.12.003] [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: 11/13/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND An enriching learning environment is integral to resident wellness and education. Integrated vascular (VS) and general surgery (GS) residents share 18 months of core GS rotations during the postgraduate years 1-3 (PGY1-3); differences in their experiences may help identify practical levers for change. METHODS We used a convergent mixed-methods design. Cross-sectional surveys were administered after the 2020 American Board of Surgery In-Training Examination and Vascular Surgery In-Training Examination, assessing eight domains of the learning environment and resident wellness. Multivariable logistic regression models identified factors associated with thoughts of attrition between categorical PGY1-3 residents at 57 institutions with both GS and VS programs. Resident focus groups were conducted during the 2022 Vascular Annual Meeting to elicit more granular details about the experience of the learning environment. Transcripts were analyzed using inductive and deductive logics until thematic saturation was achieved. RESULTS Surveys were completed by 205 VS and 1198 GS PGY1-3 residents (response rates 76.8% for VS and 82.5% for GS). After adjusting for resident demographics, PGY level, and program type, GS residents were more likely than their VS peers to consider leaving their programs (odds ratio [OR]: 2.61, 95% confidence interval [CI]: 1.37-4.99). This finding did not persist after adjusting for differences in perceptions of the learning environment, specifically: GS residents had higher odds of mistreatment (OR: 1.99, 95% CI: 1.36-2.90), poorer work-life integration (OR: 2.88, 95% CI: 1.41-5.87), less resident camaraderie (OR: 3.51, 95% CI: 2.26-5.45), and decreased meaning in work (OR: 2.94, 95% CI: 1.80-4.83). Qualitative data provided insight into how the shared learning environment was perceived differently: (1) vascular trainees expressed that early specialization and a smaller, more invested faculty allow for an apprenticeship model with early operative exposure, hands-on guidance, frequent feedback, and thus early skill acquisition (meaning in work); (2) a smaller program is conducive to closer relationships with co-residents and faculty, increasing familiarity (camaraderie and work-life integration); and (3) due to increased familiarity with program leadership, vascular trainees feel more comfortable reporting mistreatment, allowing for prompt responses (mistreatment). CONCLUSIONS Despite sharing a learning environment, VS and GS residents experience training differently, contributing to differential thoughts of attrition. These differences may be attributable to intrinsic features of the integrated training paradigm that are not easily replicated by GS programs, such as smaller program size and higher faculty investment due to early specialization. Alternative strategies to compensate for these inherent differences should be considered (eg, structured operative entrustment programs and faculty incentivization).
Collapse
Affiliation(s)
- Ruojia Debbie Li
- Division of Vascular and Endovascular Surgery, Department of Surgery, Loyola University Medical Center, Maywood, IL; Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Eric Pillado
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kathryn DiLosa
- Department of Surgery, University of California Davis, Sacramento, CA
| | - Matthew C Chia
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michael Visenio
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Tiannan Zhan
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Joshua S Eng
- Surgical Outcomes and Quality Improvement Center, Indiana University, Indianapolis, IN
| | - Daniela Amortegui
- Surgical Outcomes and Quality Improvement Center, Indiana University, Indianapolis, IN
| | - Julie K Johnson
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Malachi G Sheahan
- Division of Vascular and Endovascular Surgery, Louisiana State University, New Orleans, LA
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center, Indiana University, Indianapolis, IN
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center, Indiana University, Indianapolis, IN; Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Dawn M Coleman
- Division of Vascular and Endovascular Surgery, Duke University, Durham, NC.
| |
Collapse
|
31
|
Rajagopalan A, Sim K. Reclaiming the 'person' and advocacy for good clinical care in psychiatric residency training through medical humanities. Med Educ 2024; 58:623-624. [PMID: 38362618 DOI: 10.1111/medu.15327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
|
32
|
Richards SM, Valenti J, Nadeau N, Posner KM, Bakus C. The use of virtual interviews in orthopaedic residency programs and how it affects applicants. J Orthop Res 2024; 42:1122. [PMID: 38015197 DOI: 10.1002/jor.25748] [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] [Received: 10/26/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Sean M Richards
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Jasmin Valenti
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Nicolas Nadeau
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Kevin M Posner
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Cassandra Bakus
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| |
Collapse
|
33
|
Pillado E, Li RD, Chia MC, Eng JS, DiLosa K, Grafmuller L, Conway A, Escobar GA, Shaw P, Sheahan MG, Bilimoria KY, Hu YY, Coleman DM. Reported pain at work is a risk factor for vascular surgery trainee burnout. J Vasc Surg 2024; 79:1217-1223. [PMID: 38215953 DOI: 10.1016/j.jvs.2024.01.003] [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: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being. METHODS A confidential, voluntary survey was administered after the 2022 Vascular Surgery In-Service Examination to trainees in all Accreditation Council for Graduate Medical Education-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (eg, burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study. RESULTS We included 527 trainees who completed the survey (82.2% response rate); 38% reported moderate to severe pain after a full day of work, of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%; P < .01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (odds ratio, 2.52; 95% confidence interval, 1.48-4.26) and using physiotherapy as pain management (odds ratio, 3.06; 95% confidence interval, 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change after adjustment. CONCLUSIONS Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should consider mitigating this occupational hazard by offering ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.
Collapse
Affiliation(s)
- Eric Pillado
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Ruojia Debbie Li
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Matthew C Chia
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Joshua S Eng
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Kathryn DiLosa
- Division of Vascular Surgery, Department of Surgery, University of California, Davis, Sacramento, CA
| | - Leanne Grafmuller
- Division of Vascular Surgery, Department of Surgery, University of Rochester, Rochester, NY
| | - Allan Conway
- Division of Vascular Surgery Lenox Hill Hospital, Department of Surgery, Northwell Health, New York, NY
| | - Guillermo A Escobar
- Division of Vascular Surgery, Department of Surgery, Emory University, Atlanta, GA
| | - Palma Shaw
- Division of Vascular Surgery, Upstate Medical University, Syracuse, NY
| | - Malachi G Sheahan
- Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Dawn M Coleman
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC.
| |
Collapse
|
34
|
Shahriari M, Hesami M, Bar-Or YD, Davoudmanesh Z, Franck B, Yousem DM. Radiology trainee retirement programs: Options and participation. Curr Probl Diagn Radiol 2024; 53:389-394. [PMID: 38272751 DOI: 10.1067/j.cpradiol.2024.01.020] [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] [Received: 01/01/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Financial security and retirement planning are essential for all medical professionals including radiology residents. Given the available discretionary income during residency it is crucial to have insights into investment. We aimed to assess the prevalence of retirement plans offered to radiology residents, the available choices, and their degree of participation. METHODS Two surveys were created using Qualtrics platform, one targeting program directors and another one oriented to radiology residents with items focused on demographic, financial status, offered plans, and participation. Analysis was performed using chi square whenever appropriate using Qualtrics platform. P values less than 0.05 were considered statistically significant. RESULTS 199 radiology residents (72.6% attending university-based programs) responded to the survey. 83.7% participated in retirement plans; university-based programs had the highest rate of offering plans; 82.8% vs 70% and 53.8% for university, community and hybrid programs respectively. The most frequently offered retirement plan was a 403(b). Most of the residents (94.3%) started investment in the retirement program as early as PGY1 and PGY2. A considerable proportion of programs lacked formal training on retirement plans; however, residents emphasized the significance of financial education during their residency. CONCLUSION Radiology residents are more likely to participate in a retirement plan if it is offered by their program. Providing proper guidance by incorporating financial education into radiology residency curricula can optimize residents' decision making and economical planning, leading to a more secure financial future.
Collapse
Affiliation(s)
- Mona Shahriari
- Neuroradiology Division, Department of Radiology, Johns Hopkins University School of Medicine, Phipps B100, 600 N. Wolfe Street, Baltimore, MD 21287, United States.
| | - Mina Hesami
- Section of Emergency Ultrasound, Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | | | | | | | - David M Yousem
- Neuroradiology Division, Department of Radiology, Johns Hopkins University School of Medicine, Phipps B100, 600 N. Wolfe Street, Baltimore, MD 21287, United States
| |
Collapse
|
35
|
Grauer R, Stock JA. Editorial Commentary. Urol Pract 2024; 11:585. [PMID: 38526434 DOI: 10.1097/upj.0000000000000562] [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] [Received: 02/21/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Ralph Grauer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jeffrey A Stock
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
- Editorial Committee, Urology Practice®
| |
Collapse
|
36
|
Stanek K, Yao CA, Livingston KA, Weinstock PH, Rogers-Vizena CR. Teaching Unilateral Cleft lip Repair: Lessons from Simulation-Based Mining of Trainee Strengths and Performance Gaps. Cleft Palate Craniofac J 2024; 61:834-843. [PMID: 36529578 DOI: 10.1177/10556656221146736] [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] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE To identify specific areas for improvement in cleft lip repair teaching. DESIGN Secondary analysis of prospectively-collected, blinded data. SETTING Three residency programs rotating at a single academic children's hospital. PARTICIPANTS Plastic surgery residents, and craniofacial/pediatric plastic surgery fellows. MAIN OUTCOME MEASURES Mean scores for each skill in an 18-item Unilateral Cleft Lip Repair competency assessment tool (UCLR) (1-3 scale for each item) were rank ordered. Correlation between level of training (PGY) and performance on steps of the procedure was examined using Pearson R. RESULTS Simulation participants (n = 26) scored highest on skills in the "Marking" subscale (2.38-2.63 mean score). Procedural steps that scored lowest were: closing the nasal floor (2.00), repairing oral mucosa (2.15) and avoiding over/under-dissection (2.19). Interestingly, none of these skills correlated with PGY, suggesting they do not improve with training. CONCLUSIONS These results suggest that marking cleft lip repair is taught well in our current teaching environment, while steps like closing the nasal floor and repairing the oral mucosa are taught less well. Improved teaching of these steps could be achieved with deliberate instruction, video, digital simulation, and high fidelity simulation.
Collapse
Affiliation(s)
- Krystof Stanek
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline A Yao
- Department of Plastic Surgery, Shriner's Hospital for Children, Los Angeles, CA, USA
- Operation Smile, Virginia Beach, Virginia, USA
| | | | - Peter H Weinstock
- Boston Children's Hospital Simulator Program (SIMPeds), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Anesthesia and Critical Care, Boston Children's Hospital, Boston, MA, USA
| | - Carolyn R Rogers-Vizena
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
37
|
Toale C, Morris M, Konge L, Nayahangan LJ, Roche A, Heskin L, Kavanagh DO. Generating a Prioritized List of Operative Procedures for Simulation-based Assessment of General Surgery Trainees Through Consensus. Ann Surg 2024; 279:900-905. [PMID: 37811854 DOI: 10.1097/sla.0000000000006118] [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: 10/10/2023]
Abstract
OBJECTIVE To develop appropriate content for high-stakes simulation-based assessments of operative competence in general surgery training through consensus. BACKGROUND Valid methods of summative operative competence assessment are required by competency-based training programs in surgery. METHOD An online Delphi consensus study was conducted. Procedures were derived from the competency expectations outlined by the Joint Committee on Surgical Training Curriculum 2021, and subsequent brainstorming. Procedures were rated according to their perceived importance, perceived procedural risk, how frequently they are performed, and simualtion feasibility by a purposive sample of 30 surgical trainers and a 5-person steering group. A modified Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula was applied to the generated data to produce ranked procedural lists, which were returned to participants for re-prioritization. RESULTS Prioritized lists were generated for simulation-based operative competence assessments at 2 key stages of training; the end of 'phase 2' prior to the development of a sub-specialty interest, and the end of 'phase 3', that is, end-of-training certification. A total of 21 and 16 procedures were deemed suitable for assessments at each of these stages, respectively. CONCLUSIONS This study describes a national needs assessment approach to content generation for simulation-based assessments of operative competence in general surgery using Delphi consensus methodology. The prioritized procedural lists generated by this study can be used to further develop operative skill assessments for use in high-stakes scenarios, such as trainee progression, entrustment, and end-of-training certification, before subsequent validity testing.
Collapse
Affiliation(s)
- Conor Toale
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marie Morris
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Copenhagen, Denmark
| | - Leizl Joy Nayahangan
- Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Copenhagen, Denmark
| | - Adam Roche
- Department of Simulation, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Leonie Heskin
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Simulation, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dara O Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
38
|
Sohail AH, Ye IB, Martinez KA, Campos MA, Sohail S, Williams CE, Khan MS, Bhatti U, Hakmi H, Akhtar A, Quazi MA, Sheikh AB, Goyal A, Khan A. Colon and Rectal Surgery Fellowship Applicant and Matching Trends in the United States: An Analysis of National Resident Matching Program Data. Am Surg 2024; 90:985-990. [PMID: 38054447 DOI: 10.1177/00031348231220574] [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] [Indexed: 12/07/2023]
Abstract
BACKGROUND Colon and Rectal Surgery fellowships are training programs that aim to train surgeons in the management of small bowel, colon, rectal, and anal pathologies. OBJECTIVE We investigated trends in Colon and Rectal Surgery fellowship match to help applicants anticipate future fellowship application cycles. DESIGN This was a retrospective cohort study of applicants in the Colon and Rectal Surgery match from 2009 to 2023. Proportion of positions filled, match rates, and rank-order lists were collected. The impact of US-MD, non-US-MD, and DO status on match rate was assessed. We used the Mann Kendall trend test to obtain tau statistic and P-value for temporal trends over time, while associations between categorical variables were investigated by a chi-square test. RESULTS Fellowship programs increased from 43 to 67, positions increased from 78 to 110, and number of applicants rose from 113 to 135. Nearly all positions were filled from 2009 to 2023 (range: 96.3%-100%). The overall match rate fluctuated between 67.3% and 80.7%. The match rate over the past 5 years was 72.0%. The match rate for US-MDs was 80.0%, while non-US-MDs had a 56.2% match rate. The percentage matching at each rank were first choice 28.0%, second choice 10.4%, third choice 6.9%, and fourth choice or lower 23.5%. CONCLUSION Despite an increase in Colon and Rectal Surgery fellowship positions, the overall match rate has not changed significantly over the years, mainly as a result of increased applicants.
Collapse
Affiliation(s)
- Amir H Sohail
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Ivan B Ye
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Kevin A Martinez
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Marco A Campos
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | | | | | - Muhammad Salman Khan
- Department of Diagnostic and Interventioanl Imaging, The University of Texas Health Sciences Center, Houston, TX, USA
| | - Umar Bhatti
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Hazim Hakmi
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Aisha Akhtar
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mohammed A Quazi
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Arizona Advanced Surgery, Scottsdale, AZ, USA
| | | | - Aman Goyal
- Vanderbilt University Medical Center, Nashville,TN, USA
| | - Aimal Khan
- Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India
| |
Collapse
|
39
|
Çalım-Gürbüz B, Güvendir İ, Söylemez-Akkurt T, Gürbüz G, Erdoğan-Durmuş Ş. The Journey of Material From Clinic to Pathology Laboratory: How Much Do Clinical Residents Know About This Process? Int J Surg Pathol 2024; 32:462-469. [PMID: 37437129 DOI: 10.1177/10668969231185090] [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] [Indexed: 07/14/2023]
Abstract
Introduction. Pathology plays a major role in the management of patients. Specimen delivery to a pathology laboratory is the first step in the process. Sending materials to the pathology laboratory should be included as part of residency training. The aim of this study was to determine the level of knowledge and daily practice of residents who send materials to pathology laboratory. Methods. A 34-item questionnaire asking questions about biopsy/resection and cytology material handling and transportation was answered by 154 residents. Likert scaling and multiple-choice questions with a single answer were used to evaluate the responses. Their daily routines and levels of knowledge were statistically analyzed. Results. The mean age of the respondents was 29.1 ± 3.04 (range: 24-42 years), and 63% of the residents were male. The residents of the university hospital claimed that the clinical information they had learned about transferring material to the pathology laboratory was "sufficient" or "very sufficient" (statistically significant, P = .04). Correct answers about the process of sending biopsy/resection materials of experienced residents were statistically higher, while there was no statistical significance for questions about cytology materials (P = .005, P = .24, respectively). Conclusion. The pathway to correct diagnosis builds on an understanding of the significance of pathology material. In residency training, knowledge about delivering biopsy/resection material to pathology laboratory is mostly acquired through experience. Experienced residents seem to be less familiar with cytology materials. Clinicopathological meetings may solve the main problems, but both clinics and pathology departments need to emphasize this process.
Collapse
Affiliation(s)
- Begüm Çalım-Gürbüz
- Basaksehir Cam and Sakura City Hospital, Pathology Department, Istanbul, Turkey
| | - İrem Güvendir
- Umraniye Training and Research Hospital, Pathology Department, Istanbul, Turkey
| | | | - Gökhan Gürbüz
- Istanbul Bahcelievler State Hospital, Otorhinolaryngology Department, Istanbul, Turkey
| | | |
Collapse
|
40
|
Abbitt D, Cotton J, Choy K, Jones TS, Wikiel KJ, Robinson TN, Jones EL. Residents and Fellows Forum: Impact on general surgery clinic after telehealth conversion at a Veteran Affairs medical center. Surgery 2024; 175:1458-1459. [PMID: 38103987 DOI: 10.1016/j.surg.2023.11.017] [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] [Received: 07/25/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Danielle Abbitt
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO.
| | - Jake Cotton
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO
| | - Kevin Choy
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO
| | - Teresa S Jones
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Krzysztof J Wikiel
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Thomas N Robinson
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Edward L Jones
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
| |
Collapse
|
41
|
Brooks NE, Feng X, French JC, Simon R, Lipman JM, Prabhu AS. Film Club: A group surgical video review program. Med Educ 2024; 58:629-630. [PMID: 38400771 DOI: 10.1111/medu.15357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/23/2024] [Indexed: 02/26/2024]
|
42
|
Schlessel M, Nakamura M, Wang F. Positive perceptions of virtual didactics during the COVID-19 pandemic: a survey of dermatology residents' satisfaction, perception of efficacy and preferences. Clin Exp Dermatol 2024; 49:491-496. [PMID: 38060687 DOI: 10.1093/ced/llad435] [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] [Received: 08/08/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 04/24/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, resident didactics at many institutions, including ours, were transitioned from in-person to virtual. OBJECTIVES We aimed to examine dermatology residents' attitudes towards virtual didactics, assessing their satisfaction, impression of effectiveness and preference, along with factors correlating with these responses. METHODS An online questionnaire was administered to dermatology residents at our institution 3-6 months following the transition to virtual didactics. RESULTS The response rate was 26 of 31 residents (84%). Of the 26 respondents, 20 (77%) expressed satisfaction, 15 (58%) effectiveness and 12 (46%) a preference towards virtual didactics. Factors associated with satisfaction included feeling that virtual didactics positively impacted learning retention, represented time well spent and utilized high-quality images. Perception of effectiveness correlated with using high-quality images, baseline preference for online instruction and feeling engaged. Factors associated with preference for virtual didactics included having opportunities for critical thinking, using high-quality images and utilizing images applicable to teledermatology care. Advantages of virtual didactics included convenience, decreased commuting and easily hosting guest lecturers. Disadvantages included distractions/decreased focus, reduced social interaction and difficulty with communication. CONCLUSIONS Residents expressed satisfaction with, effectiveness of and some preference towards virtual didactics, which correlated with numerous factors relating to the learning environment, prior educational experiences and technology. Our findings suggest that it is reasonable to maintain a virtual didactic component as part of dermatology resident education. Furthermore, our data provide insights into strategies that residency programme directors and educators may consider when/if integrating virtual didactics into future educational curricula.
Collapse
Affiliation(s)
- Marc Schlessel
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Mio Nakamura
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Frank Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
43
|
Katz NT, Oratz R, Steinert Y, Wald R, Carmi R. When medical duty and advocacy are one-sided, both sides suffer. Lancet 2024; 403:1540-1541. [PMID: 38608684 DOI: 10.1016/s0140-6736(24)00239-3] [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] [Received: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Naomi T Katz
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Ruth Oratz
- School of Medicine, New York University, New York, NY, USA
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Ron Wald
- University of Toronto, Toronto, ON, Canada
| | - Rivka Carmi
- Ben Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
44
|
Alidjinou EK, Pomorski Q, Bauvais M, Dupont A, Grenouillet F, Labalette M, Sendid B, Brousseau T, Hober D, Nicolas O. [Motivational factors for early option choice by laboratory medicine residents in France]. Ann Biol Clin (Paris) 2024; 82:43-57. [PMID: 38638018 DOI: 10.1684/abc.2024.1864] [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] [Indexed: 04/20/2024]
Abstract
In France, both students from medicine and pharmacy background can have access to the residency in laboratory medicine (LM). The current curriculum of LM residency includes an early choice of option after the first two years of residency, which subsequently guides the rest of the training. This study aimed to analyze these choice and motivational factors, since its implementation in 2017. A national survey was conducted among LM residents and former residents who underwent the early option choice process. A questionnaire was developed and sent to residents via Google Forms. Several groups of items corresponding to potential motivational factors were included and rated on a 5-point Likert scale. A psychometric analysis allowed to identify the main motivational factors. A total of 178 responses from 24 residency regions were recorded. The median age was 28 years, with a slight female predominance (52%), and three-quarters of the participants had a pharmacy training background. The "hematology and immunology" option was the most chosen (35%). The psychometric analysis enabled to identify 7 motivational factors, and the most important is the training during the residency, which weights approximately 21 % in the choice. Several associations have been observed between the motivational factors and the background training, origin, the chosen option and the planned career. Several factors influence the choice of early option among LM residents, and some of these factors are associated with the background training, origin, chosen option and planned career.
Collapse
Affiliation(s)
| | - Quentin Pomorski
- Fédération Nationale des Internes de Pharmacie et de Biologie Médicale (FNSIP-BM), France
| | - Maxence Bauvais
- Fédération Nationale des Internes de Pharmacie et de Biologie Médicale (FNSIP-BM), France
| | - Annabelle Dupont
- Univ. Lille, CHU de Lille, Institut d'hématologie, Lille, France
| | - Frédéric Grenouillet
- Univ. Franche-Comté, CHU de Besançon, Pôle de Biologie Médicale, Besançon, France
| | - Myriam Labalette
- Univ. Lille, CHU de Lille, Institut d'immunologie, Lille, France
| | - Boualem Sendid
- Univ. Lille, CHU de Lille, Institut de microbiologie, Lille, France
| | - Thierry Brousseau
- Univ. Lille, CHU de Lille, Pôle de Biologie Pathologie, Lille, France
| | - Didier Hober
- Univ. Lille, CHU de Lille, Laboratoire de Virologie ULR 3610, Lille, France
| | - Olivier Nicolas
- Univ. Lille, IAE, Laboratoire LUMEN - ULR 4999, Lille, France
| |
Collapse
|
45
|
Shafian S, Ilaghi M, Shahsavani Y, Okhovati M, Soltanizadeh A, Aflatoonian S, Karamoozian A. The feedback dilemma in medical education: insights from medical residents' perspectives. BMC Med Educ 2024; 24:424. [PMID: 38641609 PMCID: PMC11031893 DOI: 10.1186/s12909-024-05398-y] [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] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/05/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. METHODS This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. RESULTS The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. CONCLUSIONS Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.
Collapse
Affiliation(s)
- Sara Shafian
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Ilaghi
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Yasamin Shahsavani
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Okhovati
- Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Adel Soltanizadeh
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sarah Aflatoonian
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Karamoozian
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
46
|
|
47
|
Sehgal RR, Sarva H, Safdieh JE, Robbins MS. Pearls and pitfalls in letters of recommendation for neurology residency applications. J Neurol Sci 2024; 459:122951. [PMID: 38461761 DOI: 10.1016/j.jns.2024.122951] [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: 12/24/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
Letters of recommendation are a cornerstone of residency applications. Variability and bias in letters exists across specialties, neurology being no exception. Studies done in other specialty fields assessing nuanced language uncovered key attention points for improvement and mitigation of bias, lessons from which should be applied in the field of neurology. We review common pearls and pitfalls in the letter solicitation, writing and reading process, with suggested best-practices for residency applicants, letter writers, and program faculty reviewers. We advocate for the thoughtful selection of writers, emphasis on highlighting professional skills, and attention to implicit bias. This discussion focuses on recommendations for US advanced or categorical neurology programs, but elements of this guidance may apply more broadly to fellowship and faculty promotion letters as well.
Collapse
Affiliation(s)
- Ryka R Sehgal
- Department of Neurology, University of California - San Francisco, 505 Parnassus Avenue, M798, Box 0114, San Francisco, CA, USA 94143.
| | - Harini Sarva
- Department of Neurology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, 520 E 70(th) St, Suite 607, New York City, NY, USA 10021.
| | - Joseph E Safdieh
- Department of Neurology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, 520 E 70(th) St, Suite 607, New York City, NY, USA 10021.
| | - Matthew S Robbins
- Department of Neurology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, 520 E 70(th) St, Suite 607, New York City, NY, USA 10021.
| |
Collapse
|
48
|
Shirley ED, Renfro SH, Rocchi VJ. Mental Skills for Orthopaedic Surgery. J Am Acad Orthop Surg 2024; 32:323-330. [PMID: 38373405 DOI: 10.5435/jaaos-d-23-00775] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/21/2024] Open
Abstract
Orthopaedic surgery training focuses primarily on the knowledge base and surgical techniques that comprise the fundamental and physical pillars of performance. It also pays much less attention to the mental pillar of performance than does the training of other specialists such as aviators, elite athletes, musicians, and Special Forces operators. However, mental skills optimize the ability to achieve the ideal state during surgery that includes absolute focus with the right amount of confidence and stress. The path to this state begins before surgery with visualization of the surgical steps and potential complications. On the day of surgery, the use of compartmentalization, performance aspirations, performance breathing, and keeping the team focused facilitates achieving and maintaining the proper mental state. Considering the similarities between surgery and other fields of expertise that do emphasize the mental pillar, including this training in orthopaedic residencies, is likely beneficial.
Collapse
Affiliation(s)
- Eric D Shirley
- From the Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia
| | | | | |
Collapse
|
49
|
Cornelius AP, Rodrigues-Rosa A. A faculty-led resident strike team as a force expander during disaster. Am J Disaster Med 2024; 19:5-13. [PMID: 38597642 DOI: 10.5055/ajdm.0467] [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: 04/11/2024]
Abstract
The emergence of the coronavirus disease 2019 (COVID-19) pandemic produced an unprecedented strain on the United States medical system. Prior to the pandemic, there was an estimated 20,000 physician shortage. This has been further stressed by physicians falling ill and the increased acuity of the COVID-19 patients. Federal medical team availability was stretched to its capabilities with the large numbers of deployments. With such severe staffing shortages, creative ways of force expansion were undertaken. New Orleans, Louisiana, was one of the hardest hit areas early in the pandemic. As the case counts built, a call was put out for help. The Louisiana State University (LSU) system responded with a faculty-led resident strike team out of the LSU Health Shreveport Academic Medical Center. Residents and faculty alike volunteered, forming a multispecialty, attending-led medical strike team of approximately 10 physicians. Administrative aspects such as institution-specific credentialing, malpractice coverage, resident distribution, attending physician oversight, among other aspects were addressed, managed, and agreed upon between the LSU Health Shreveport and the New Orleans hospital institutions and leadership prior to deployment in April 2020. In New Orleans, the residents managed patients within the departments of emergency medicine, medical floor, and intensive care unit (ICU). The residents assigned to the medical floor became a new hospitalist service team. The diversity of specialties allowed the team to address patient care in a multidisciplinary manner, leading to comprehensive patient care plans and unhindered team dynamic and workflow. During the first week alone, the team admitted and cared for over 100 patients combined from the medical floor and ICU. In a disaster situation compounded by staff shortages, a resident strike team is a beneficial solution for force expansion. This article qualitatively reviews the first published incidence of a faculty-led multispecialty resident strike team being used as a force expander in a disaster.
Collapse
Affiliation(s)
- Angela P Cornelius
- John Peter Smith Hospital, Fort Worth Emergency Medicine Residency; Associate Professor, Clinical Emergency Medicine TCU/UNT, Fort Worth, Texas; Associate Professor, Louisiana State University-Shreveport Academic Medical Center, Shreveport, Louisiana. ORCID: https://orcid.org/0000-0002-0405-1433
| | | |
Collapse
|
50
|
Han ER, Chung EK. A qualitative study on the adoption of the new duty hour regulations among medical residents and faculty in Korea. PLoS One 2024; 19:e0301502. [PMID: 38603669 PMCID: PMC11008864 DOI: 10.1371/journal.pone.0301502] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
Duty hour regulations (DHRs) were enforced in 2017 in Korea to prevent the detrimental effects of excessively prolonged working hours among medical residents. We investigated the adoption of and implications of the new DHRs among medical residents and faculty members. Semi-structured interviews were conducted with 15 medical residents and 9 faculty members across general surgery, internal medicine, obstetrics-gynecology, and pediatrics departments at Chonnam National University Hospital. Based on the constructivist grounded theory, we developed themes from the data by concurrent coding and analysis with theoretical sampling until data saturation. In addition, respondent validation was used to ensure accuracy, and all authors remained reflexive throughout the study to improve validity. The methods of DHRs adoption among residents and faculty members included the following 4 themes: DHRs improved work schedule, residents have more time to learn on their own, clinical departments have come to distribute work, organization members have strived to improve patient safety. Residents have undertaken initial steps towards creating a balance between personal life and work. Teamwork and shift within the same team are the transitions that minimize discontinuity of patient care considering patient safety. Teaching hospitals, including faculty members, should ensure that residents' work and education are balanced with appropriate clinical experience and competency-based training.
Collapse
Affiliation(s)
- Eui-Ryoung Han
- Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea
| | - Eun-Kyung Chung
- Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea
| |
Collapse
|