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Margolis A, Barile J, Cason G, Milanaik R. Caring for screenagers (part 2): a pediatrician's primer on popular games and educational tools. Curr Opin Pediatr 2024; 36:325-330. [PMID: 38446183 DOI: 10.1097/mop.0000000000001341] [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] [Indexed: 03/07/2024]
Abstract
PURPOSE OF REVIEW The internet has changed the way children can work and play. With the preferences of the youth population constantly evolving, it is important that parents and pediatricians continue to be informed of the ways children spend their time on the internet. Online gaming continues to soar in popularity, as does school usage of educational platforms. RECENT FINDINGS Roblox, Fortnite, and Minecraft are three examples of games that have widespread popularity among youth populations. Though none of the game are designed to display graphic violence, sexual content, or other features that could be considered off-limits for children, there still ways for children to exposed to inappropriate material or engage with strangers. The rise in popularity of eSports also reflects changing attitudes about the value of gaming. On the educational side, school-student platforms and powerful artificial intelligence (AI) tools are becoming more and more prevalent. SUMMARY Parents should not simply know which games or educational tools their children are using, but understand them. This article seeks to provide some insight into popular games and platforms so that parents and pediatricians can make better decisions about what children access.
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Lockhart TJ, Lin EE, Adler AC. Point-of-care ultrasound in pediatric anesthesiology: considerations for training and credentialing. Curr Opin Anaesthesiol 2024; 37:259-265. [PMID: 38573182 DOI: 10.1097/aco.0000000000001371] [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: 04/05/2024]
Abstract
PURPOSE OF REVIEW To discuss considerations surrounding the use of point-of-care ultrasound (POCUS) in pediatric anesthesiology. RECENT FINDINGS POCUS is an indispensable tool in various medical specialties, including pediatric anesthesiology. Credentialing for POCUS should be considered to ensure that practitioners are able to acquire images, interpret them correctly, and use ultrasound to guide procedures safely and effectively. In the absence of formal guidelines for anesthesiology, current practice and oversight varies by institution. In this review, we will explore the significance of POCUS in pediatric anesthesiology, discuss credentialing, and compare the specific requirements and challenges currently associated with using POCUS in pediatric anesthesia. SUMMARY Point-of-care ultrasound is being utilized by the pediatric anesthesiologist and has the potential to improve patient assessment, procedure guidance, and decision-making. Guidelines increase standardization and quality assurance procedures help maintain high-quality data. Credentialing standards for POCUS in pediatric anesthesiology are essential to ensure that practitioners have the necessary skills and knowledge to use this technology effectively and safely. Currently, there are no national pediatric POCUS guidelines to base credentialing processes on for pediatric anesthesia practices. Further work directed at establishing pediatric-specific curriculum goals and competency standards are needed to train current and future pediatric anesthesia providers and increase overall acceptance of POCUS use.
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Affiliation(s)
- Thomas J Lockhart
- Department of Anesthesiology, University of Nebraska College of Medicine, Children's Nebraska, Omaha, Nebraska
| | - Elaina E Lin
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Adam C Adler
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
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Nowicki KD, Balboni IM, Cidon MJ, Dhanrajani AD, Driest KD, Fair DC, Imundo LF, Mehta JJ, Tarvin SE, Walters HM, Woolnough LC, Edgar LC, Curran ML. Assessing Pediatric Rheumatology Fellow Competence in the Milestone Era: Past, Present, and Future. Arthritis Care Res (Hoboken) 2024; 76:600-607. [PMID: 38108087 DOI: 10.1002/acr.25276] [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: 08/25/2023] [Revised: 11/15/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Starting in 2015, pediatric rheumatology fellowship training programs were required by the Accreditation Council for Graduate Medical Education to assess fellows' academic performance within 21 subcompetencies falling under six competency domains. Each subcompetency had four or five milestone levels describing developmental progression of knowledge and skill acquisition. Milestones were standardized across all pediatric subspecialties. As part of the Milestones 2.0 revision project, the Accreditation Council for Graduate Medical Education convened a workgroup in 2022 to write pediatric rheumatology-specific milestones. Using adult rheumatology's Milestones 2.0 as a starting point, the workgroup revised the patient care and medical knowledge subcompetencies and milestones to reflect requirements and nuances of pediatric rheumatology care. Milestones within four remaining competency domains (professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice) were standardized across all pediatric subspecialties, and therefore not revised. The workgroup created a supplemental guide with explanations of the intent of each subcompetency, 25 in total, and examples for each milestone level. The new milestones are an important step forward for competency-based medical education in pediatric rheumatology. However, challenges remain. Milestone level assignment is meant to be informed by results of multiple assessment methods. The lack of pediatric rheumatology-specific assessment tools typically result in clinical competency committees determining trainee milestone levels without such collated results as the foundation of their assessments. Although further advances in pediatric rheumatology fellowship competency-based medical education are needed, Milestones 2.0 importantly establishes the first pediatric-specific rheumatology Milestones to assess fellow performance during training and help measure readiness for independent practice.
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Affiliation(s)
- Katherine D Nowicki
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
| | | | - Michal J Cidon
- Children's Hospital Los Angeles, Los Angeles, California
| | - Anita D Dhanrajani
- The University of Mississippi Medical Center, Jackson, Mississippi, Tulane University School of Medicine, New Orleans, and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Kyla D Driest
- Nationwide Children's Hospital and The Ohio State University, Columbus
| | | | - Lisa F Imundo
- Columbia University Medical Center, New York City, New York
| | - Jay J Mehta
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stacey E Tarvin
- Riley Hospital for Children at Indiana University, Indianapolis
| | - Heather M Walters
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hamptstead, New York, and Cohen Children's Medical Center of New York, New Hyde Park
| | | | - Laura C Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Megan L Curran
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
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Jeppesen E, Schmidt AA, Skjødt CK, Hybschmann J, Gjærde LK, Thestrup J, Hansson H, Sørensen JL. Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review. Eur J Pediatr 2024; 183:2015-2028. [PMID: 38430279 PMCID: PMC11035470 DOI: 10.1007/s00431-024-05455-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
To identify and describe educational programmes in patient- and family-centred care for paediatric healthcare professionals. This scoping review was conducted and reported according to the JBI Manual for Evidence Synthesis and the PRISMA guideline. The databases searched included MEDLINE (PubMed), PsycINFO, CINAHL, Scopus, Cochrane, and Embase. Inclusion criteria were experimental, observational and qualitative studies about educational programmes on patient- and family-centred care for paediatric healthcare professionals. Exclusion criteria were reviews and non-peer-reviewed literature. Two reviewers independently screened and extracted the data using Covidence. Of the 13922 records identified, 49 articles met the inclusion criteria. There was a large variety of educational programmes, half of which were interdisciplinary, that mainly targeted nurses and doctors. The median number of participants was 51 (range 7 to 1411). The predominant target population was children with chronic disabilities and neonatal intensive care units, and only one programme specifically targeted adolescents. The median duration was one day (range 5 min to 3.5 years). Development of competencies was the most common objective. We identified 12 different educational content areas. Content mainly focused on communication and relational competencies, including partnership, which involved shared decision-making, mutual agenda setting, and negotiation of a plan. Many kinds of educational strategies were found but experiential learning through simulation and roleplay was used most. Conclusion: A large variety of educational programmes in paediatric patient- and family-centred care exist. Educational content mainly focused on communication and relational competencies. Experiential learning including roleplay and simulation was the most used educational strategy. What is Known: • Delivery of patient- and family-centred care improves parental satisfaction of care but requires clinicians have a certain attitude towards involving the child and parents in a healthcare partnership as well as advanced triadic communication skills. Little is known about how this attitude, and more broadly, patient- and family-centred care, can be facilitated through education and training. What is New: • This scoping review found a wide array of programmes.. Workshops with simulation or roleplay was the most frequent educational strategy. The programmes, which typically targeted nurses and doctors, chiefly focused on basic and advanced communication and relational competencies, including partnership, which involved shared decision-making and negotiation of plans.
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Affiliation(s)
- Elisabeth Jeppesen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.
- Department of Respiratory Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Anne Aarslev Schmidt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Camilla Kriegbaum Skjødt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Hansson
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Jin ZA. [Reflections on integrating narrative medicine concepts into the development of pediatrics]. Zhongguo Dang Dai Er Ke Za Zhi 2024; 26:325-330. [PMID: 38660894 DOI: 10.7499/j.issn.1008-8830.2310114] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Medicine is a continuously advancing science, characterized by the integration of multiple disciplines, ultimately focusing on the "human" aspect. Over the past half-century, there has been a global surge in efforts to reshape the humanistic spirit of medicine. Narrative medicine, a field that highly integrates medical professionalism with universal humanistic values, has developed rapidly in China from scratch over the past decade or so. This article introduces the development of narrative medicine both domestically and internationally, explains how to correctly understand the connotation of China's narrative medicine system and the significance of practicing narrative medicine. It analyzes current challenges in clinical practice, education and teaching, scientific research, doctor-patient consensus, and social recognition. Furthermore, it proposes directions for effort, namely, in the context of "greater health" and "new medical science", narrative medicine is empowered to help construct a harmonious medical narrative ecosystem, promote high-quality development in pediatrics, contribute to the innovation in medical education and talent training with humanistic strength and wisdom.
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Affiliation(s)
- Zhen-Ai Jin
- Perinatal/Neonatal Clinic and Children's Family Clinic, Yanbian University Affiliated Hospital, Yanji, Jilin 133000, China
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6
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García-Rebollar C, Villaizán Pérez C. Active Training in Primary Care Pediatrics (FAPap) also exists. An Pediatr (Barc) 2024; 100:e34-e35. [PMID: 38580587 DOI: 10.1016/j.anpede.2024.03.040] [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: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 04/07/2024] Open
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Bline KE. Early career investigator biocommentary: Katherine Bline. Pediatr Res 2024; 95:1167. [PMID: 38378753 PMCID: PMC11035127 DOI: 10.1038/s41390-024-03097-4] [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: 01/01/2024] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Katherine E Bline
- Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, OH, USA.
- Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
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Curry B, Buttle S, McMillan HJ, Webster R, Reddy D, Karir A, Spence S, Mineyko A, Writer H, MacLean H, Pohl D. Does E-learning Facilitate Medical Education in Pediatric Neurology? Can J Neurol Sci 2024; 51:196-202. [PMID: 36847175 DOI: 10.1017/cjn.2023.26] [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: 03/01/2023]
Abstract
BACKGROUND E-learning has become commonplace in medical education. Incorporation of multimedia, clinical cases, and interactive elements has increased its attractiveness over textbooks. Although there has been an expansion of e-learning in medicine, the feasibility of e-learning in pediatric neurology is unclear. This study evaluates knowledge acquisition and satisfaction using pediatric neurology e-learning compared to conventional learning. METHODS Residents of Canadian pediatrics, neurology, and pediatric neurology programs and medical students from Queens University, Western University, and the University of Ottawa were invited to participate. Learners were randomly assigned two review papers and two ebrain modules in a four-topic crossover design. Participants completed pre-tests, experience surveys, and post-tests. We calculated the median change in score from pre-test to post-test and constructed a mixed-effects model to determine the effect of variables on post-test scores. RESULTS In total, 119 individuals participated (53 medical students; 66 residents). Ebrain had a larger positive change than review papers in post-test score from pre-test score for the pediatric stroke learning topic but a smaller positive change for Duchenne muscular dystrophy, childhood absence epilepsy, and acute disseminated encephalomyelitis. Learning topics showed statistical relationship to post-test scores (p = 0.04). Depending on topic, 57-92% (N = 59-66) of respondents favored e-learning over review article learning. CONCLUSIONS Ebrain users scored higher on post-tests than review paper users. However, the effect is small and it is unclear if it is educationally meaningful. Although the difference in scores may not be substantially different, most learners preferred e-learning. Future projects should focus on improving the quality and efficacy of e-learning modules.
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Affiliation(s)
- Brittany Curry
- Schulich School of Medicine and Dentistry, Western University, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Sarah Buttle
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Hugh J McMillan
- Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Richard Webster
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Deepti Reddy
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Aneesh Karir
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Manitoba, Winnipeg, Canada
| | | | | | - Hilary Writer
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Heather MacLean
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
- The Ottawa Hospital, Ottawa, ON, Canada
| | - Daniela Pohl
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
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Wang YY, Prendergast E, Butler M. Improving induction to support new junior paediatric staff through an electronic induction guide and buddy scheme. Arch Dis Child Educ Pract Ed 2024; 109:35-37. [PMID: 37907327 DOI: 10.1136/archdischild-2022-324949] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/21/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Yang Yang Wang
- General Paediatrics, Evelina London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Emily Prendergast
- General Paediatrics, Evelina London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mark Butler
- General Paediatrics, Evelina London, Guy's and St Thomas' NHS Foundation Trust, London, UK
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10
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Stephenson N, Forno E, Laguna TA, Lovinsky-Desir S, Moore PE, Sheares BJ, Kazmerski TM, Udoko MN, Lypson ML, Harding LRW, Wilkes DS, Adair DJ, Afolabi F, Balasubramaniam V, Ale GJB, Castner LM, Ghera P, Heras A, Jordan K, Ly NP, Martinez-Fernandez TM, Mishra PE, Narang I, Palla JB, Rivera-Sanchez YM, Tapia IE, Toprak D, Torres-Silva CA, Cohen RT. Diversity, Equity, and Inclusion in the Pediatric Pulmonary Workforce: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2023; 20:1373-1388. [PMID: 37772940 PMCID: PMC10559131 DOI: 10.1513/annalsats.202306-583st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Despite growing recognition of the need for increased diversity among students, trainees, and faculty in health care, the medical workforce still lacks adequate representation from groups historically underrepresented in medicine (URiM). The subspecialty field of pediatric pulmonology is no exception. Although there have been efforts to address issues of diversity, equity, and inclusion (DEI) in our own field, gaps persist. To address these gaps, the members of the Diversity, Equity, and Inclusion Advisory Group (DEI-AG) of the American Thoracic Society Pediatrics Assembly created and distributed a Needs Assessment Survey in the United States and Canada to better understand the racial and ethnic demographics of the pediatric pulmonary workforce and to learn more about successes, gaps, and opportunities to enhance how we recruit, train, and retain a diverse workforce. The DEI-AG leadership cochairs convened a workshop to review the findings of the DEI Needs Assessment Survey and to develop strategies to improve the recruitment and retention of URiM fellows and faculty. This Official ATS Workshop Report aims to identify barriers and opportunities for recruitment, training, and career development within the field of pediatric pulmonology. Additionally, we offer useful strategies and resources to improve the recruitment of URiM residents, the mentorship of trainees and junior faculty, and the career development of URiM faculty in academic centers. This Workshop Report is an important first deliverable by the DEI-AG. We hope that this work, originating from within the Pediatrics Assembly, will serve as a model for other Assemblies, disciplines across the ATS, and other fields in Pediatrics.
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Gborkorquellie TT, Ward MC, Falusi OO, Barber AN, Smith TK. Diversity, Equity, Inclusion, and Justice in Medical Education: A Faculty Development Perspective. Pediatr Ann 2023; 52:e266-e272. [PMID: 37427969 DOI: 10.3928/19382359-20230516-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
As many residency programs expand teaching to address the knowledge, skills, and attitudes that residents need to dismantle structural racism and other systemic inequities, many faculty are not prepared to teach these topics. However, there is limited literature on which to base faculty development in this area. The aim of this article is to review how diversity, equity, inclusion, and justice education is integrated in pediatric faculty development efforts. This review will include published and gray literature on curricula and programs in medical education for faculty learners and will address common barriers and challenges faced by faculty members. [Pediatr Ann. 2023;52(7):e266-e272.].
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12
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Svensson NS, Balslev T. Co-regulation of learning in a department of paediatrics. Dan Med J 2023; 70:A11220667. [PMID: 37381865] [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] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
INTRODUCTION Co-regulated learning (CRL) is a process in which the learner's regulation of learning is guided by social transactions. The change in learning techniques during the transition from university to workplace learning and the rapidly changing learning environment make awareness of CRL extremely relevant. This study examined CRL among medical students and residents and identified the factors affecting CRL. METHODS We applied an explorative approach using direct observation and semi-structured focus group discussions (FGD). The first author made direct observations that produced explorative data about actual behaviour. However, this was not sufficiently sensitive to capture the participants' full perceptions of CRL. Therefore, we conducted semi-structured FGD that involved interactions and reflections among the participants. RESULTS This study suggests that CRL occurred in multiple situations and was affected by many factors. The stimulating factors identified were a supportive learning environment, feedback based on observations and questioning by a supervisor, dyad work and interactive, bimodal presentation of emergency cases at the morning conference. Time pressure, heavy workload and shortage of specialists were inhibiting factors. CONCLUSION We identified several factors affecting CRL. A focus on the augmentation of stimulating factors and reduction of inhibiting factors may help medical students and residents develop CRL. FUNDING None. TRIAL REGISTRATION Not relevant.
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Affiliation(s)
| | - Thomas Balslev
- Centre for Educational Development, Aarhus University, Aarhus
- Department of Paediatrics, Regional Hospital of Central Denmark, Viborg, Denmark
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13
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Ritschl V, Sperl L, Andrews MR, Björk M, Boström C, Cappon J, Davergne T, de la Torre-Aboki J, de Thurah A, Domján A, Dragoi RG, Estévez-López F, Ferreira RJO, Fragoulis GE, Grygielska J, Kõrve K, Kukkurainen ML, Madelaine-Bonjour C, Marques A, Meesters J, Moe RH, Moholt E, Mosor E, Naimer-Stach C, Ndosi M, Pchelnikova P, Primdahl J, Putrik P, Rausch Osthoff AK, Smucrova H, Testa M, van Bodegom-Vos L, Peter WF, Zangi HA, Zimba O, Vliet Vlieland TPM, Stamm TA. Educational readiness among health professionals in rheumatology: low awareness of EULAR offerings and unfamiliarity with the course content as major barriers-results of a EULAR-funded European survey. RMD Open 2023; 9:e003120. [PMID: 37230762 PMCID: PMC10230966 DOI: 10.1136/rmdopen-2023-003120] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/29/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings. METHODS AND PARTICIPANTS We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline. RESULTS The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were 'professional development', 'prevention and lifestyle intervention'. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers. CONCLUSIONS To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.
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Affiliation(s)
- Valentin Ritschl
- Institute for Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Wien, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Lisa Sperl
- Institute for Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Wien, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Margaret Renn Andrews
- Institute for Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Wien, Austria
| | - Mathilda Björk
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Carina Boström
- Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
| | - Jeannette Cappon
- Department of Pediatric Rehabillitation, Reade Centre for Rehabillitation and Rheumatology, Amsterdam, The Netherlands
| | - Thomas Davergne
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | | | - Annette de Thurah
- Rheumatology, Aarhus University Hospital, Århus N, Denmark
- Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andrea Domján
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | - Razvan Gabriel Dragoi
- Department of Balneology, Rehabilitation and Rheumatology, University of Medicine and Pharmacy Victor Babes Timisoara, Timisoara, Romania
| | - Fernando Estévez-López
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ricardo J O Ferreira
- Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Coimbra, Portugal
| | - George E Fragoulis
- Joint Rheumatology Programme, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Katti Kõrve
- Center of Rheumatology, East Tallinn Central Hospital, Tallinn, Estonia
| | | | | | - Andréa Marques
- Health Sciences Research Unit Nursing, Higher School of Nursing of Coimbra, Coimbra, Portugal
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Jorit Meesters
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Rikke Helene Moe
- NKRR, REMEDY, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ellen Moholt
- NKRR, REMEDY, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erika Mosor
- Institute for Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Wien, Austria
| | | | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Jette Primdahl
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Polina Putrik
- Department of Rheumatology, Internal Medicine, MUMC and Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Anne-Kathrin Rausch Osthoff
- Institute of Physiotherapy, Zurich University of Applied Sciences; School of Health Professions, Winterthur, Switzerland
- Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Hana Smucrova
- Center of Medical Rehabilitation, Institute of Rheumatology, Prague, Czech Republic
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Leti van Bodegom-Vos
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilfred F Peter
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
- Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands
| | - Heidi A Zangi
- NKRR, REMEDY, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Rheumatology and Research, VID Specialized University, Oslo, Norway
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Tanja A Stamm
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
- Institute for Outcomes Research, Centre for Medical Data Science, Medical University of Vienna, Wien, Austria
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14
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Gillette C, Garvick SJ, Aldrich RS, Halvorson EE, Flesher SL, Waddell E, Maupin EJ, Daniel S. Attitudes and Beliefs of Pediatric Residents and Physician Assistant Students Toward Screening Adolescents for Suicide in Primary Care. J Physician Assist Educ 2022; 33:179-184. [PMID: 35998048 DOI: 10.1097/jpa.0000000000000441] [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: 06/15/2023]
Abstract
INTRODUCTION The objectives of this study were to: (1) describe attitudes of health professional trainees for conducting routine screening for suicidal ideation with adolescents; (2) identify the relationship between intention to conduct suicide risk assessments and behavioral attitudes, norm referents, and behavioral control; and (3) investigate the relationship between intention to conduct these assessments and self-reported clinic behavior. METHODS Second-year physician assistant (PA) students and pediatric residents (MD) at 3 universities voluntarily completed an anonymous cross-sectional questionnaire. The questionnaire was guided by the Theory of Planned Behavior and included items about previous experience with suicide. Pearson correlation and multivariable linear regression were used to analyze the data. RESULTS There were usable and complete data for 105 respondents (n = 105). The sample included PA students (89.52%, n = 94) and pediatric residents (10.48%, n = 11). Trainees were significantly more likely to have higher intention to conduct suicide risk assessments when they reported greater behavioral control (Std. β = 0.34, p <0.001) and reported suicide being discussed during previous clinic visits as a student/resident (Std. β = 0.21, p = 0.03), controlling for profession, race, behavioral attitudes, and norm referents. Trainees were significantly more likely to report conducting suicide risk assessments when they had greater behavioral control (Std. β = 0.27, p = 0.01) and greater intention to conduct these assessments (Std. β = 0.21, p = 0.03), controlling for profession, race, behavioral attitudes, and norm referents. DISCUSSION Second-year PA students and pediatric residents support screening adolescents for suicide risk. Training on methods to increase behavioral control may increase rates of screenings.
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Affiliation(s)
- Chris Gillette
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Sarah J Garvick
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Rosalie S Aldrich
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Elizabeth E Halvorson
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Susan L Flesher
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Erin Waddell
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Elizabeth J Maupin
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
| | - Stephanie Daniel
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Sarah J. Garvick, MS, MPAS, PA-C, is an assistant professor and associate program director at Wake Forest School of Medicine, Department of PA Studies, in Winston-Salem, North Carolina
- Rosalie S. Aldrich, PhD, is a John and Corinne Graf professor at Indiana University East, Department of Communication Studies, in Indianapolis, Indiana
- Elizabeth E. Halvorson, MD, MS, is an associate professor at Wake Forest School of Medicine, Department of Pediatrics, in Winston-Salem, North Carolina
- Susan L. Flesher, MD, is an associate professor and chair, Department of Pediatrics, and director of Pediatric Hospital Medicine Fellowship at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Erin Waddell, MD, is a resident at Marshall University Joan C. Edwards School of Medicine in Huntington, West Virginia
- Elizabeth J. Maupin, MMS, PA-C, RD, is an assistant professor at Wingate University in Matthews, North Carolina
- Stephanie Daniel, PhD, is a professor and vice chair for research at the Wake Forest School of Medicine, Department of Family and Community Medicine, in Winston-Salem, North Carolina
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15
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Oke I, Heidary G, Mantagos IS, Shah AS, Hunter DG. Comparison of fellowship match opportunities and results across pediatric surgical subspecialities. J AAPOS 2022; 26:145-148. [PMID: 35472597 DOI: 10.1016/j.jaapos.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/22/2022]
Abstract
There is a nationwide shortage of pediatric ophthalmologists, with trends in fellowship applicants foreshadowing a continued reduction in the number of active pediatric ophthalmologists in the years ahead. In this study, we investigated whether similar fellowship applicant shortages exist in other pediatric surgical subspecialties. We compared the match statistics of six pediatric surgical fellowships from 2015 to 2020. During the 6-year interval, a median of 12.2 pediatric ophthalmology fellowship positions (IQR, 12.1-12.4) were offered per 100 graduating residents, 8.7% of ophthalmology residents (IQR, 8.3%-9.3%) pursued pediatric subspecialty training, and 72% of available pediatric fellowship positions (IQR, 69%-74%) were filled. Pediatric general surgery had the highest percentage of available fellowship positions filled, 99% (IQR, 98%-100%), which was significantly higher than for pediatric ophthalmology (P = 0.024). None of the other subspecialties had a significant difference in available positions filled compared to pediatric ophthalmology (P > 0.05).
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Affiliation(s)
- Isdin Oke
- Department of Ophthalmology, Boston Children's Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts
| | - Gena Heidary
- Department of Ophthalmology, Boston Children's Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts
| | - Iason S Mantagos
- Department of Ophthalmology, Boston Children's Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts
| | - David G Hunter
- Department of Ophthalmology, Boston Children's Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts.
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16
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Mallon D, Fei L, Farrell M, Anderson JB, Klein M. Randomized Controlled Trial of Interactive Spaced Education to Support Constipation Management by Pediatric Primary Care Providers. J Pediatr Gastroenterol Nutr 2022; 74:568-574. [PMID: 35149642 DOI: 10.1097/mpg.0000000000003405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Integrating continuing medical education and quality improvement (QI) initiatives is challenging. We aimed to compare one method, Interactive Spaced Education (ISE/QI), with standard (sTD/Qi) education embedded within a constipation management Qi initiative. METHODS We conducted a randomized, controlled study to compare ISE/QI and STD/QI education. Pediatric primary care providers (PCPs) were recruited from a network of local private practices. The QI initiative was implemented with all providers before education interventions. ISE/QI participants received questions by email weekly, provided answers, received feedback, and repeated questions over a 4-month period. The STD/QI group received a Power Point with the same educational content. Pre- and post-surveys evaluated usability, self-assessed confidence, and practice changes while quizzes evaluated knowledge. Process control charts tracked subsequent visits to gastroenterology (GI). RESULTS Of the 212 eligible PCPs, 101 (48%) enrolled, with 49 PCPs in the ISE/QI arm and 52 in STD/QI education arm. Quiz scores improved in the ISE/QI arm with a strong effect size (Cohen d 1.76). Mean increase in confidence managing difficult cases was higher in the ISE/QI group (1.84 vs 1.21, P = 0.030). ISE/QI participants were more likely to rate the activity better than most online education (odds ratio [OR] 18.1, P < 0.0001) and incorporate practice changes (OR 3.35, P = 0.0152). Visits to GI decreased among the entire population, but the effect on GI visits within each education arm was mixed. CONCLUSIONS ISE/QI improved knowledge and confidence managing difficult cases. ISE/QI participants reported higher likelihood to change practice, but no differences were seen in GI referrals.
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Affiliation(s)
- Daniel Mallon
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine
| | - Lin Fei
- Department of Pediatrics, Division of Biostatistics
| | - Michael Farrell
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine
| | - Jeffrey B Anderson
- Department of Pediatrics, University of Cincinnati College of Medicine, Heart Institute, Cincinnati Children's Hospital Medical Center
| | - Melissa Klein
- Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH
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17
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Gong J, Du J, Hao J, Li L. Effects of bedside team-based learning on pediatric clinical practice in Chinese medical students. BMC Med Educ 2022; 22:264. [PMID: 35410211 PMCID: PMC8996540 DOI: 10.1186/s12909-022-03328-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Bedside teaching is a primary educational tool to improve the clinical practice of medical students. As a new medical pedagogical approach, team-based learning (TBL) is gradually being integrated into Chinese medical education programmes to promote clinical reasoning, knowledge application, teamwork and collaboration. The aim of this controlled study is to investigate the effects of TBL on pediatric bedside teaching in medical students. METHODS Thirty medical students in pediatric clinical practice were randomly assigned to an intervention and a control group. Students in the intervention group exposed bedside teaching activity with TBL while students in the control group received traditional bedside teaching. Teaching for the two groups was conducted biweekly, and the same clinical cases were selected for both groups with the same instructors. After six months of clinical practice, the differences of learning outcomes between the two groups were compared through assessments by computer-based case simulations (CCS) and mini-Clinical Evaluation Exercise (mini-CEX). Student feedback following completion of bedside teaching was collected by questionnaire. RESULTS The CCS scores in the intervention group were significantly higher than that in the control group (p < 0.05). The mini-CEX results showed that clinical judgment and counseling skills of the intervention group were higher than those in the control group (p < 0.01). Medical interviewing skills and overall clinical competence in the intervention group were better than those in the control group (p < 0.05). In the questionnaire survey, students in the intervention group believed that bedside teaching activity with TBL could promote active learning ability, improve counseling skills and strengthen teamwork. CONCLUSIONS Application of TBL in bedside teaching not only enhanced clinical practice skills among medical students but also improved their clinical reasoning and counseling skills.
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Affiliation(s)
- Jie Gong
- The Clinical Skills Center, The First Clinical College, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Junfeng Du
- Department of Plastic Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, China
| | - Jinjin Hao
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lei Li
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Department of Pediatrics, Jingshan People's Hospital, Jingshan, 431800, China.
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Blankenburg R, Gonzalez del Rey J, Aylor M, Frohna JG, McPhillips H, Myers RE, Waggoner-Fountain LA, Degnon L, Poitevien P. The Impact of the COVID-19 Pandemic on Pediatric Graduate Medical Education: Lessons Learned and Pathways Forward. Acad Med 2022; 97:S35-S39. [PMID: 34817400 PMCID: PMC8855778 DOI: 10.1097/acm.0000000000004532] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this article, the authors describe the impact of the COVID-19 pandemic on pediatric graduate medical education (GME), including the impact on clinical experiences for trainees, teaching methods used, trainee wellness, GME leader wellness and support, and the traditional interview process. A thorough literature review was done to identify impacts of the COVID-19 pandemic on pediatric GME. In addition, information was collected through Association of Pediatric Program Directors virtual cafes and conferences. Positive changes for GME from the COVID-19 pandemic included: the rapid transition to telehealth; asynchronous learning allowing for increased cross-program collaboration; innovative online teaching modalities; increased flexibility and decreased cost of online recruitment; and shared innovations across pediatric GME. Challenging aspects of the COVID-19 pandemic included: decreased learning about common childhood illnesses, such as bronchiolitis, acute otitis media, and influenza; decreased patient volumes and patient complexity in clinics and inpatient wards, leading to less practice developing efficiency, time management, and triaging skills; and an increased burden on trainees, including moral distress and decreased support from one another and other social supports. The COVID-19 pandemic has highlighted important opportunities in U.S. educational systems. As medical educators move forward, it will be important to learn from these while mitigating the negative impacts.
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Affiliation(s)
- Rebecca Blankenburg
- R. Blankenburg is president, Association of Pediatric Program Directors, and associate chair of education and clinical professor, Stanford University School of Medicine, Palo Alto, California
| | - Javier Gonzalez del Rey
- J. Gonzalez del Rey is past president, Association of Pediatric Program Directors, and associate chair for education and professor, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Megan Aylor
- M. Aylor is secretary-treasurer, Association of Pediatric Program Directors, director, Pediatrics Residency Program, and associate professor, Oregon Health & Science University, Portland, Oregon
| | - John G. Frohna
- J.G. Frohna is a past member-at-large, Association of Pediatric Program Directors Board, vice chair of education and director, Pediatrics Residency Program, and professor, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Heather McPhillips
- H. McPhillips is a member-at-large, Association of Pediatric Program Directors Board, director, Pediatrics Residency Program, and professor, Seattle Children’s Hospital, University of Washington, Seattle, Washington
| | - Ross E. Myers
- R.E. Myers is a member-at-large, Association of Pediatric Program Directors Board, associate director, Pediatrics Residency Program, and associate professor, Rainbow Babies and Children’s Hospital, Cleveland, Ohio
| | - Linda A. Waggoner-Fountain
- L.A. Waggoner-Fountain is a member-at-large, Association of Pediatric Program Directors Board, associate director, Pediatrics Residency Program, and professor, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Laura Degnon
- L. Degnon is executive director, Association of Pediatric Program Directors, McLean, Virginia
| | - Patricia Poitevien
- P. Poitevien is president-elect, Association of Pediatric Program Directors, director, Residency Program, and assistant professor, Hasbro Children’s Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Rideout M, Dawlett M, Plant J, Chitkara M, Trainor JL. Essential yet Ill-defined: leadership roles to support fourth-year medical students in pediatrics. Med Educ Online 2021; 26:1950108. [PMID: 34232843 PMCID: PMC8266242 DOI: 10.1080/10872981.2021.1950108] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Few studies have been published about specialty-specific fourth-year medical student leadership in any discipline. This paper provides insight from pediatric educators about the current status and recommendations for pediatric-specific fourth-year leaders. OBJECTIVE To identify the prevalence of pediatric fourth-year medical student directors across the US and Canada and to compare current and ideal responsibilities for this role. METHODS Five multi-part questions were written and submitted for the 2019 Council on Medical Student Education in Pediatrics (COMSEP) Annual Survey and subsequently disseminated to all COMSEP member physicians. Anonymous responses were collected and results analyzed. The study was IRB exempt. RESULTS The program-level survey response rate was 79%. Of 115 respondent medical schools, 37% reported having a pediatric fourth-year director separate from the clerkship director, with an average of 9.8% full-time equivalent (FTE) protected time for the role. In contrast, individuals indicated 20% FTE would be ideal for fourth-year director responsibilities. The most common role identified for pediatric fourth-year directors was directing sub-internships. Respondents indicated it would be ideal for pediatric fourth-year directors to have an increased level of involvement in all areas queried in the survey, especially directing a pediatric residency preparatory course/boot camp, faculty development for educators of fourth-year students, and remediating fourth-year students. CONCLUSIONS As specialty-specific experiences have grown in the fourth year of medical school, there is an increasing demand for faculty leadership separate from direction of the pediatric clerkship. In this national survey, pediatric educators expressed a need for additional protected time to lead fourth-year specific activities. Similar findings in other disciplines would support advocating for more protected time and expanded roles for specialty-specific fourth-year directors nationally.
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Affiliation(s)
- Molly Rideout
- Department of Pediatrics, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Marie Dawlett
- Department of Pediatrics, University of Texas Medical Branch School of Medicine, Galveston, TX, USA
| | - Jennifer Plant
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Maribeth Chitkara
- Department of Pediatrics, Renaissance School of Medicine at Stony Brook University, NY, USA
| | - Jennifer L. Trainor
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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20
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McDonald C, Henderson A, Barlow P, Keith J. Assessing factors for choosing a primary care specialty in medical students; A longitudinal study. Med Educ Online 2021; 26:1890901. [PMID: 33829968 PMCID: PMC8043606 DOI: 10.1080/10872981.2021.1890901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/07/2020] [Accepted: 02/01/2021] [Indexed: 05/18/2023]
Abstract
A shortage of primary care physicians exists in the US, and medical schools are investigating factors that influence specialty choice. To better understand the factors associated with medical students choosing primary care specialties, a longitudinal annual survey from 2013 to 2019 was administered to students at the University of Iowa Carver College of Medicine, starting pre-matriculation. A logistic regression model examined factors of interest. Matching into a primary care specialty (family medicine, internal medicine, pediatrics) for residency was the primary outcome. Our study compared factors students reported in annual surveys: demographics, mentorship, debt, and lifestyle. Factors significantly associated with primary care specialty included pre-medical and medical school research, a family member in primary care, student age and gender. 28% of men chose primary care, and 47% of women. Although there was no gender difference in rates of medical education debt (N = 286,χ2(1) = 0.28, p = 0.60), men were more likely to report being influenced by debt (N = 278, χ2(1) = 10.88, p = 0.001), and students who reported debt-influenced specialty choice were one-third as likely to enter primary care (N = 189, 95% CI [0.11-1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14-7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men's specialty choice is more negatively influenced by financial concerns.
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Affiliation(s)
- Corry McDonald
- Department of Emergency Medicine, Lincoln Medical & Mental Health Center, Bronx, NY, USA
| | - Austin Henderson
- Washington State University Elson S. Floyd College of Medicine and Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Patrick Barlow
- Department of Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA
| | - Jerrod Keith
- Department of Surgery, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA
- CONTACT Jerrod Keith Department of Surgery, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 1500 John Colloton Pavilion, 200 Hawkins Dr, Iowa City, IA52242, USA
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21
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Ibrahim NI, Bohm L, Roche JS, Stoddard SA, Quintana RM, Vetter J, Bennett J, Costello B, Carter PM, Cunningham R, Hashikawa AN. Creating a 'choose your topic' massive open online course: an innovative and flexible approach to delivering injury prevention education. Med Educ Online 2021; 26:1955646. [PMID: 34282995 PMCID: PMC8293957 DOI: 10.1080/10872981.2021.1955646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/19/2021] [Accepted: 07/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A pediatric injury prevention course has not been available as a massive open online course (MOOC). Creating a comprehensive topic course is particularly challenging because the traditional, week-by-week linear curriculum design is often a barrier to learners interested in only specific topics. We created a novel, flexible course as both a 'choose your topic' MOOC for the public learner and a Small Private Online Course (SPOC) for medical students. METHODS We describe creating 'Injury Prevention for Children and Teens', a course of 59 video learning segments within eight modules taught by a multidisciplinary panel of 25 nationally-recognized experts. Completion tracking and course evaluations were collected. RESULTS In 2.5 years, 4,822 learners from 148 countries have enrolled. Two-thirds of learners were female. Median age of learners was 31 years. For engagement, 19.3% (n = 932) of learners attempted quizzes, and 5.2% (n = 252) participated in online forum discussions. Medical professionals (n = 162) claimed an average of 13 credit hours per learner. Over 200 senior medical students have taken the SPOC. CONCLUSION 'Injury Prevention for Children and Teens' is a novel approach to injury prevention education that is broad, science-based, accessible, and not cost-prohibitive for a diverse group of global learners.
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Affiliation(s)
- Nadine I. Ibrahim
- Department of Otolaryngology, Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI, USA
| | - Lauren Bohm
- Department of Otolaryngology, Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI, USA
| | - Jessica S. Roche
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Sarah A. Stoddard
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | | | - Jennifer Vetter
- Center for Academic Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey Bennett
- Center for Academic Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Beth Costello
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Patrick M. Carter
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca Cunningham
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Office of Research, Ann Arbor, MI, USA
| | - Andrew N. Hashikawa
- University of Michigan Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA
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22
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Costich M, Finkel MA, Friedman S, Catallozzi M, Gordon RJ. Transition-to-residency: pilot innovative, online case-based curriculum for medical students preparing for pediatric internships. Med Educ Online 2021; 26:1892569. [PMID: 33618622 PMCID: PMC7906614 DOI: 10.1080/10872981.2021.1892569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 06/09/2023]
Abstract
Background: There is increasing recognition in medical education that greater emphasis must be placed on preparing graduating medical students for their new roles as interns. Few publications in the literature have described transition-to-residency curricula specifically for students interested in pediatrics or pediatric-related fieldsApproach: We developed novel online pediatric cases, embedded within an innovative, hybrid transition-to-residency course, to address high yield, multi-disciplinary topics within the context of several of the AAMC's identified Entrustable Professional ActivitiesEvaluation: The pilot cases were evaluated over two academic years (2018, 2019) at a single academic medical center as part of routine student course evaluation (N = 18/35) with the 2019 evaluation containing additional retrospective pre-post survey questions (N = 9/18) assessing self-reported changes in knowledge. Almost all students were very satisfied or satisfied with the modules overall (94%), the quality of the resources provided (100%), and the structure and clarity of the presentation of the material (100%). Among the students who completed the retrospective pre-post survey after participation in the online modules, significant self-reported improvements were noted in writing orders to the pediatrics floor (Z = -2.07, p = 0.04), providing anticipatory guidance (Z = -2.0,p = 0.046), formulating a differential diagnosis for common pediatric conditions (Z = -2.24, P = 0.03), and preparedness for managing common pediatric floor emergencies (Z = -2.33, P = 0.02).Reflection: We demonstrated feasibility of implementation of an interactive, online case-based curriculum, medical student satisfaction with content and delivery, and increased self-reported knowledge after completion of the pilot pediatric cases on the online, asynchronous learning platform.
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Affiliation(s)
- Marguerite Costich
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Morgan A. Finkel
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Suzanne Friedman
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Marina Catallozzi
- Departments of Pediatrics and Population and Family Health, Columbia University Medical Center, New York, NY, USA
| | - Rachel J. Gordon
- Departments Medicine and Epidemiology, Columbia University Medical Center, New York, NY, USA
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23
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Affiliation(s)
- Rachel Harwood
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
- Institute of Systems and Molecular Biology, University of Liverpool, Liverpool, UK
| | - Paul D Losty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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24
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Bajwa NM, Nendaz MR, Posfay-Barbe KM, Yudkowsky R, Park YS. A Meaningful and Actionable Professionalism Assessment: Validity Evidence for the Professionalism Mini-Evaluation Exercise (P-MEX) Across 8 Years. Acad Med 2021; 96:S151-S157. [PMID: 34348372 DOI: 10.1097/acm.0000000000004286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE With the growing importance of professionalism in medical education, it is imperative to develop professionalism assessments that demonstrate robust validity evidence. The Professionalism Mini-Evaluation Exercise (P-MEX) is an assessment that has demonstrated validity evidence in the authentic clinical setting. Identifying the factorial structure of professionalism assessments determines professionalism constructs that can be used to provide diagnostic and actionable feedback. This study examines validity evidence for the P-MEX, a focused and standardized assessment of professionalism, in a simulated patient setting. METHOD The P-MEX was administered to 275 pediatric residency applicants as part of a 3-station standardized patient encounter, pooling data over an 8-year period (2012 to 2019 residency admission years). Reliability and construct validity for the P-MEX were evaluated using Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS Cronbach's alpha for the P-MEX was 0.91. The EFA yielded 4 factors: doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. The CFA demonstrated good model fit with a root-mean-square error of approximation of .058 and a comparative fit index of .92, confirming the reproducibility of the 4-factor structure of professionalism. CONCLUSIONS The P-MEX demonstrates construct validity as an assessment of professionalism, with 4 underlying subdomains in doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. These results yield new confidence in providing diagnostic and actionable subscores within the P-MEX assessment. Educators may wish to integrate the P-MEX assessment into their professionalism curricula.
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Affiliation(s)
- Nadia M Bajwa
- N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-1445-4594
| | - Mathieu R Nendaz
- M.R. Nendaz is professor and director, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, and attending physician, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0003-3795-3254
| | - Klara M Posfay-Barbe
- K.M. Posfay-Barbe is professor and chairperson, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland; ORCID: https://orcid.org/0000-0001-9464-5704
| | - Rachel Yudkowsky
- R. Yudkowsky is professor, Department of Medical Education, College of Medicine at the University of Illinois at Chicago, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-2145-7582
| | - Yoon Soo Park
- Y.S. Park is associate professor, Harvard Medical School, and director of health professions education research, Massachusetts General Hospital, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-8583-4335
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25
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Robinson M, Bowen J, Aylor M, M van Schaik S. Finding (and Keeping) a Voice: Pediatric Residents' Perceptions of Autonomy and Patient Care Ownership. Acad Med 2021; 96:S213-S214. [PMID: 34705715 DOI: 10.1097/acm.0000000000004320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Margaret Robinson
- Author affiliations: M. Robinson, S.M. van Schaik, University of California, San Francisco
| | - Judith Bowen
- J. Bowen, Washington State University Elson S. Floyd College of Medicine
| | - Megan Aylor
- M. Aylor, Oregon Health & Science University
| | - Sandrijn M van Schaik
- Author affiliations: M. Robinson, S.M. van Schaik, University of California, San Francisco
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26
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Khakoo Y, Brenton JN, Brumback AC, Desai J, Mytinger JR, Reese JJ, Scantlebury MH. The Pediatric Neurology Trainee Publication Award. Pediatr Neurol 2021; 123:85. [PMID: 34411953 DOI: 10.1016/j.pediatrneurol.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yasmin Khakoo
- Division of Child Neurology, Departments of Pediatrics and Neurology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, New York.
| | - J Nicholas Brenton
- Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - Audrey C Brumback
- Departments of Pediatrics and Neurology, Dell Children's Medical Center and Dell Medical School at The University of Texas at Austin, Austin, Texas
| | - Jay Desai
- Department of Neurology, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - John R Mytinger
- Division of Pediatric Neurology, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
| | - James J Reese
- Pediatric Neurology, Presbyterian Health Services, Albuquerque, New Mexico
| | - Morris H Scantlebury
- Departments of Pediatrics and Clinical Neuroscience, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
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27
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Lee RR, McDonagh JE, Connelly M, Peters S, Cordingley L. Identifying the content and context of pain within paediatric rheumatology healthcare professional curricula in the UK: a summative content analysis. Pediatr Rheumatol Online J 2021; 19:129. [PMID: 34419095 PMCID: PMC8379855 DOI: 10.1186/s12969-021-00614-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The curriculum for professionals working in paediatric rheumatology should include pain but it is unclear to what extent this currently occurs. The aim of this study was to identify pain-related curriculum content and the context in which pain is presented in educational and training documentation for healthcare professionals in this clinical speciality. METHODS Core curricula documents from UK based professional organisations were identified in partnership with healthcare professionals. Documents were analysed using a summative content analysis approach. Key pain terms were quantified and weighted frequencies were used to explore narrative pain themes. Latent content was interpreted qualitatively to explore the context within which pain terms were positioned. RESULTS Nine curriculum documents were identified and analysed from doctors, nurses, physiotherapists and occupational therapists specialising in paediatric rheumatology. Pain themes represented a mean percentage of 1.51% of text across all documents. Pain was rarely presented in the context of both inflammatory and non-inflammatory condition types despite being a common feature of each. Musculoskeletal pain was portrayed simply as a 'somatic' symptom, rather than as a complex phenomenon involving biological and psychosocial processes. Content around the assessment and management of pain was vague and inexplicit. CONCLUSION Current educational and training documentation in paediatric rheumatology do not include core pain topics. Curricula for these healthcare professionals would benefit from updates in contemporary pain theories and examples of in-context, evidence-based pain practices. This should be a priority starting point for optimising patient pain care in paediatric musculoskeletal healthcare.
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Affiliation(s)
- Rebecca Rachael Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
- National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Stopford Building, Oxford Road, Manchester, M13 9PT, UK.
| | - Janet E McDonagh
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Stopford Building, Oxford Road, Manchester, M13 9PT, UK
- Royal Manchester Children's Hospital, Manchester University Foundation Hospitals Trust, Manchester, UK
| | - Mark Connelly
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, USA
| | - Sarah Peters
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Lis Cordingley
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Stopford Building, Oxford Road, Manchester, M13 9PT, UK
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Cully JL, Thikkurissy S, Sahay RD, Harper R, Lehmann C. Integration of a Pilot Oral Health Curriculum into a Medical School Pediatric Rotation. Pediatr Dent 2021; 43:258-261. [PMID: 34467839] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: The purpose of this study was to assess changes in medical student knowledge, skills, and beliefs in oral health after participating in an oral health curriculum that included an online learning module, shadowing pediatric dental residents, and applying fluoride varnish. Methods: Third-year medical students completed a precurriculum questionnaire. After completing the online module and clinical experience, students completed a postcurriculum questionnaire. Data were analyzed via descriptive statistics, and outcomes were assessed. Results: There was an improvement in knowledge and oral health-related skills questions postcurriculum. All questions on beliefs toward oral health showed a more agreeable response following the oral health curriculum. Conclusion: Interprofessional collaboration and oral health curriculum integration lead to positively changing the knowledge, attitudes, and skills of medical students.
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Affiliation(s)
- Jennifer L Cully
- Dr. Cully is assistant professor, Department of Pediatrics, University of Cincinnati, and an assistant professor, Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA;,
| | - S Thikkurissy
- Dr. Thikkurissy is a professor, Department of Pediatrics, University of Cincinnati, and a professor and Robert Creedon Endowed Chair, Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Rashmi D Sahay
- Dr. Sahay is a biostatistian/epidemiologist-II, Division of Biostatistics and Epidemiology, Cincinnati, Ohio, USA
| | - Robert Harper
- Dr. Harper is an assistant professor, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Corinne Lehmann
- Dr. Lehmann is a professor, Department of Pediatrics, Division of Adolescent and Transition Medicine, University of Cincinnati and Cincinnati Children's Hospital Medical Center; Cincinnati, Ohio, USA
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Violato C, Cullen MJ, Englander R, Murray KE, Hobday PM, Borman-Shoap E, Ersan O. Validity Evidence for Assessing Entrustable Professional Activities During Undergraduate Medical Education. Acad Med 2021; 96:S70-S75. [PMID: 34183605 DOI: 10.1097/acm.0000000000004090] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To explore validity evidence for the use of entrustable professional activities (EPAs) as an assessment framework in medical education. METHOD Formative assessments on the 13 Core EPAs for entering residency were collected for 4 cohorts of students over a 9- to 12-month longitudinal integrated clerkship as part of the Education in Pediatrics Across the Continuum pilot at the University of Minnesota Medical School. The students requested assessments from clinical supervisors based on direct observation while engaging in patient care together. Based on each observation, the faculty member rated the student on a 9-point scale corresponding to levels of supervision required. Six EPAs were included in the present analyses. Student ratings were depicted as curves describing their performance over time; regression models were employed to fit the curves. The unit of analyses for the learning curves was observations rather than individual students. RESULTS (1) Frequent assessments on EPAs provided a developmental picture of competence consistent with the negative exponential learning curve theory; (2) This finding was true across a variety of EPAs and across students; and (3) The time to attain the threshold level of performance on the EPA for entrustment varied by student and EPA. CONCLUSIONS The results provide validity evidence for an EPA-based program of assessment. Students assessed using multiple observations performing the Core EPAs for entering residency demonstrate classic developmental progression toward the desired level of competence resulting in entrustment decisions. Future work with larger data samples will allow further psychometric analyses of assessment of EPAs.
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Affiliation(s)
- Claudio Violato
- C. Violato is assistant dean for assessment and evaluation and professor of internal medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Michael J Cullen
- M.J. Cullen is director of evaluation, Graduate Medical Education, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Robert Englander
- R. Englander is associate dean for undergraduate medical education and professor of pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Katherine E Murray
- K.E. Murray is assistant dean for curriculum and assistant professor of pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Patricia M Hobday
- P.M. Hobday is director, Education in Pediatrics Across the Continuum pilot and assistant professor of pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Emily Borman-Shoap
- E. Borman-Shoap is vice chair of education, director, pediatric residency program, and associate professor of pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Ozge Ersan
- O. Ersan is a PhD candidate, Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
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Abstract
BACKGROUND Pediatric orthopaedic fellowship directors (FDs) have a valuable impact on the education of trainees and future leaders in the field. There is currently no research on the characteristics of pediatric orthopaedic FDs. METHODS Programs were identified using the Pediatric Orthopaedic Society of North America fellowship directory. Operative, nonoperative, and specialty programs were included. Data was collected through Qualtrics survey, e-mail, telephone, and online searches. Variables included demographics (age, sex, race/ethnicity), Hirsch index (h-index) as a measure of research productivity, graduate education, residency and fellowship training, years of hire at current institution and as FD, and leadership roles. RESULTS Fifty-five FDs were identified. The majority (49/55, 89%) were male and 77% (27/35) were Caucasian. The mean age at survey was 51.1±8.2 years. The mean h-index was 17.2. Older age correlated with higher h-index (r=0.48, P=0.0002). The average duration from fellowship graduation to FD appointment was 9.6±6.7 and 6.9±6.1 years from institutional hire. Sixteen FDs (29%) had additional graduate level degrees. Almost all (52/55, 95%) FDs completed orthopaedic surgery residencies and all graduated fellowship training. Twenty-nine percent (16/55) completed more than 1 fellowship. Most FDs (51/55, 93%) completed a fellowship in pediatric orthopaedic surgery. Ten FDs (18%) completed pediatric orthopaedic surgery fellowships that included spine-specific training. One-third of all current FDs were fellowship-trained at either Boston Children's Hospital (9/55, 16%) or Texas Scottish Rite Hospital for Children (9/55, 16%). CONCLUSIONS Pediatric orthopaedic FDs are typically early-career to mid-career when appointed, with a strong research background. Nearly a third completed additional graduate degrees or multiple fellowships. Although male dominated, there are more female FDs leading pediatric orthopaedic programs compared with adult reconstruction, trauma, and spine fellowships. As fellowships continue to grow and diversify, this research will provide a baseline to determine changes in FD leadership.
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Affiliation(s)
- Lara L Cohen
- University of Miami Miller School of Medicine, Miami, FL
| | - Andrew J Sama
- University of Miami Miller School of Medicine, Miami, FL
| | | | | | | | - Benjamin J Shore
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
| | - Michael P Glotzbecker
- Department of Orthopaedic Surgery, Rainbow Babies and Children's Hospital, Cleveland, OH
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Turner DA, Schwartz A, Carraccio C, Herman B, Weiss P, Baffa JM, Chess P, Curran M, Dammann C, High P, Hsu D, Pitts S, Sauer C, Aye T, Fussell J, Kesselheim J, Mahan J, McGann K, Myers A, Mink R. Continued Supervision for the Common Pediatric Subspecialty Entrustable Professional Activities May Be Needed Following Fellowship Graduation. Acad Med 2021; 96:S22-S28. [PMID: 34183598 DOI: 10.1097/acm.0000000000004091] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary for graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions of the minimum level of supervision required for a trainee to successfully graduate. METHOD In 2017, SPIN surveyed all FPDs of accredited fellowships for 14 subspecialties. For each EPA, the minimum supervision level for graduation (ranging from observation only to unsupervised practice) was set such that no more than 20% of FPDs would accept a lower level. RESULTS The survey response rate was 82% (660/802). The minimum supervision level for graduation varied across the 7 EPAs from 2 (direct) to 4 (indirect for complex cases), with significant differences between EPAs. The percentage of FPDs desiring a lower minimum supervision level ranged from 3% to 17%. Compared with the 4 nonclinical EPAs (quality improvement, management, lead within the profession, scholarship), the 3 clinical EPAs (consultation, handover, lead a team) had higher minimum supervision graduation levels (P < .001), with less likelihood that an FPD would graduate a learner below their minimum level (P < .001). CONCLUSIONS Consensus among FPDs across all pediatric subspecialties demonstrates the potential need for ongoing supervision for graduates in all 7 common pediatric subspecialty EPAs after fellowship. As CBME programs are implemented, processes and infrastructure to support new graduates are important considerations for leaders.
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Affiliation(s)
- David A Turner
- D.A. Turner is vice president of competency-based medical education, American Board of Pediatrics, Chapel Hill, North Carolina, and consulting professor, Duke University Medical Center, Durham, North Carolina. At the time this work was completed, he was associate professor, Duke University Medical Center, Durham, North Carolina
| | - Alan Schwartz
- A. Schwartz is the Michael Reese Endowed Professor of Medical Education, interim head, Department of Medical Education, and research professor, Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Carol Carraccio
- C. Carraccio was vice president of competency-based medical education, American Board of Pediatrics, Chapel Hill, North Carolina at the time this work was completed
| | - Bruce Herman
- B. Herman is professor and vice chair of education, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Pnina Weiss
- P. Weiss is vice chair of education and associate professor, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Jeanne M Baffa
- J.M. Baffa is emeritus associate professor of pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Patricia Chess
- P. Chess is professor, University of Rochester Medical Center, Rochester, New York
| | - Megan Curran
- M. Curran is associate professor, Department of Pediatrics, University of Colorado-Denver, Denver, Colorado
| | - Christiane Dammann
- C. Damman is professor, Department of Pediatrics, Tufts Children's Hospital, Boston, Massachusetts
| | - Pamela High
- P. High is professor, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Deborah Hsu
- D. Hsu is professor, Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Sarah Pitts
- S. Pitts is assistant professor, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Cary Sauer
- C. Sauer is associate professor, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Tandy Aye
- T. Aye is associate professor, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Jill Fussell
- J. Fussell is professor, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jennifer Kesselheim
- J. Kesselheim is associate professor, Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts
| | - John Mahan
- J. Mahan is professor, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kathleen McGann
- K. McGann is vice chair of education and professor, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Angie Myers
- A. Myers is professor of pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Richard Mink
- R. Mink is professor of pediatrics, The David Geffen School of Medicine at University of California Los Angeles (UCLA) and The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
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Hobday PM, Borman-Shoap E, Cullen MJ, Englander R, Murray KE. The Minnesota Method: A Learner-Driven, Entrustable Professional Activity-Based Comprehensive Program of Assessment for Medical Students. Acad Med 2021; 96:S50-S55. [PMID: 34183602 DOI: 10.1097/acm.0000000000004101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PROBLEM Assessment has been the Achilles heel of competency-based medical education. It requires a program of assessment in which outcomes are clearly defined, students know where they are in the development of the competencies, and what the next steps are to attaining them. Achieving this goal in a feasible manner has been elusive with traditional assessment methods alone. The Education in Pediatrics Across the Continuum (EPAC) program at the University of Minnesota developed a robust program of assessment that has utility and recognizes when students are ready for the undergraduate to graduate medical education transition. APPROACH The authors developed a learner-driven program of assessment in the foundational clinical training of medical students in the EPAC program based on the Core Entrustable Professional Activities for Entering Residency (Core EPAs). Frequent workplace-based assessments, coupled with summative assessments, informed a quarterly clinical competency committee and individualized learning plans. The data were displayed on real time dashboards for the students to review. OUTCOMES Over 4 cohorts from 2015 to 2019, students (n = 13) averaged approximately 200 discrete Core EPA workplace-based assessments during their foundational clinical training year. Assessments were completed by an average of 9 different preceptors each month across 8 different specialties. The data were displayed in a way students and faculty could monitor development and inform a clinical competency committee's ability to determine readiness to transition to advanced clinical rotations and residency. NEXT STEPS The next steps include continuing to scale the program of assessment to a larger cohort of students.
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Affiliation(s)
- Patricia M Hobday
- P.M. Hobday is assistant professor, course director, Education in Pediatrics Across the Continuum (EPAC), and associate pediatric residency program director, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Emily Borman-Shoap
- E. Borman-Shoap is vice chair of education, pediatric residency program director, and associate professor, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Michael J Cullen
- M.J. Cullen is director of evaluation for graduate medical education, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Robert Englander
- R. Englander is associate dean for undergraduate medical education and professor, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Katherine E Murray
- K.E. Murray is assistant dean for curriculum and associate professor, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
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Schwartz A, Borman-Shoap E, Carraccio C, Herman B, Hobday PM, Kaul P, Long M, O'Connor M, Mink R, Schumacher DJ, Turner DA, West DC. Learner Levels of Supervision Across the Continuum of Pediatrics Training. Acad Med 2021; 96:S42-S49. [PMID: 34183601 DOI: 10.1097/acm.0000000000004095] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To describe trajectories in level of supervision ratings for linked entrustable professional activities (EPAs) among pediatric learners in medical school, residency, fellowship. METHOD The authors performed secondary analyses of 3 linked datasets of level of supervision ratings for the Core EPAs for Entering Residency, the General Pediatrics EPAs, and the Subspecialty Pediatrics EPAs. After identifying 9 activities in common across training stages and aligning the level of entrustment-supervision scales across the datasets, piecewise ordinal and linear mixed effects models were fitted to characterize trajectories of supervision ratings. RESULTS Within each training period, learners were rated as needing less supervision over time in each activity. When transitioning from medical school to residency or during the first year of residency, learners were rated as needing greater supervision in activities related to patient management, teamwork, emergent care, and public health/QI than in earlier periods. When transitioning from residency to fellowship, learners were always rated as needing greater supervision than they had been accorded at the end of residency and sometimes even more than they had been accorded at the start of residency. CONCLUSIONS Although development over training is often imagined as continuous and monotonically increasing competence, this study provides empirical evidence supporting the idea that entrustment is a set of discrete decisions. The relaxation of supervision in training is not a linear process. Even with a seamless curriculum, supervision is tightly bound to the training setting. Several explanations for these findings are discussed.
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Affiliation(s)
- Alan Schwartz
- A. Schwartz is Michael Reese Endowed Professor of Medical Education and research professor, pediatrics, University of Illinois College of Medicine, Chicago, Illinois, and network director, Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN), McLean, Virginia; ORCID: http://orcid.org/0000-0003-3809-6637
| | - Emily Borman-Shoap
- E. Borman-Shoap is associate professor, residency program director, and vice chair of education, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0001-7514-7793
| | - Carol Carraccio
- C. Carraccio was vice president for competency-based medical education, American Board of Pediatrics, Chapel Hill, North Carolina, at the time the work was completed; ORCID: https://orcid.org/0000-0001-5473-8914
| | - Bruce Herman
- B. Herman is professor and vice chair of education, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Patricia M Hobday
- P.M. Hobday is assistant professor and director, Education in Pediatrics Across the Continuum (EPAC), Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Paritosh Kaul
- P. Kaul is professor and associate director, EPAC, Department of Pediatrics, University of Colorado, School of Medicine, Denver, Colorado; ORCID: https://orcid.org/0000-0003-4155-7406
| | - Michele Long
- M. Long is professor and director, EPAC, Department of Pediatrics, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-8399-5589
| | - Meghan O'Connor
- M. O'Connor is assistant professor and director, EPAC, Department of Pediatrics, University of Utah, Salt Lake City, Utah; ORCID: https://orcid.org/0000-0002-5403-923X
| | - Richard Mink
- R. Mink is professor of pediatrics, David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, California, pediatric critical care fellowship program director, Harbor-UCLA Medical Center, Torrance, California, and director, APPD Subspecialty Pediatrics Investigator Network, McLean, Virginia; ORCID: http://orcid.org/0000-0002-7998-4713
| | - Daniel J Schumacher
- D.J. Schumacher is associate professor, Department of Pediatrics, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0001-5507-8452
| | - David A Turner
- D.A. Turner was associate professor, Division of Pediatric Critical Care, Department of Pediatrics, and associate director, Graduate Medical Education, Duke University Hospital and Health System, Durham, North Carolina, at the time the work was completed
| | - Daniel C West
- D.C. West is professor and senior director of medical education, Department of Pediatrics, Children's Hospital of Philadelphia and The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-0909-4213
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Kuziez M, Abbasi D, Gómez E. From Natural Disasters to the COVID-19 Crisis: Maintaining Courage and Connection in a Puerto Rican Residency Program. Acad Med 2021; 96:945. [PMID: 34183487 DOI: 10.1097/acm.0000000000004009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Mohamed Kuziez
- Second-year resident, Department of Pediatrics, Saint Lukes Episcopal Medical Center, Ponce, Puerto Rico;
| | - Denise Abbasi
- Second-year resident, Department of Pediatrics, Saint Lukes Episcopal Medical Center, Ponce, Puerto Rico
| | - Evelyn Gómez
- Second-year resident, Department of Pediatrics, Saint Lukes Episcopal Medical Center, Ponce, Puerto Rico
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Pivert KA, Boyle SM, Halbach SM, Chan L, Shah HH, Waitzman JS, Mehdi A, Norouzi S, Sozio SM. Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey. J Am Soc Nephrol 2021; 32:1236-1248. [PMID: 33658283 PMCID: PMC8259681 DOI: 10.1681/asn.2020111636] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/21/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic's effects on nephrology fellows' educational experiences, preparedness for practice, and emotional wellbeing are unknown. METHODS We recruited current adult and pediatric fellows and 2020 graduates of nephrology training programs in the United States to participate in a survey measuring COVID-19's effects on their training experiences and wellbeing. RESULTS Of 1005 nephrology fellows-in-training and recent graduates, 425 participated (response rate 42%). Telehealth was widely adopted (90% for some or all outpatient nephrology consults), as was remote learning (76% of conferences were exclusively online). Most respondents (64%) did not have in-person consults on COVID-19 inpatients; these patients were managed by telehealth visits (27%), by in-person visits with the attending faculty without fellows (29%), or by another approach (9%). A majority of fellows (84%) and graduates (82%) said their training programs successfully sustained their education during the pandemic, and most fellows (86%) and graduates (90%) perceived themselves as prepared for unsupervised practice. Although 42% indicated the pandemic had negatively affected their overall quality of life and 33% reported a poorer work-life balance, only 15% of 412 respondents who completed the Resident Well-Being Index met its distress threshold. Risk for distress was increased among respondents who perceived the pandemic had impaired their knowledge base (odds ratio [OR], 3.04; 95% confidence interval [CI], 2.00 to 4.77) or negatively affected their quality of life (OR, 3.47; 95% CI, 2.29 to 5.46) or work-life balance (OR, 3.16; 95% CI, 2.18 to 4.71). CONCLUSIONS Despite major shifts in education modalities and patient care protocols precipitated by the COVID-19 pandemic, participants perceived their education and preparation for practice to be minimally affected.
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Affiliation(s)
- Kurtis A. Pivert
- Data Science and Public Impact, American Society of Nephrology, Washington, DC
| | - Suzanne M. Boyle
- Section of Nephrology, Hypertension, and Kidney Transplantation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Susan M. Halbach
- Department of Pediatrics, Division of Nephrology, University of Washington and Seattle Children’s Hospital, Seattle, Washington
| | - Lili Chan
- Charles Bronfman Institute of Personalized Medicine, Department of Genetics and Genomics; Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hitesh H. Shah
- Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York
| | - Joshua S. Waitzman
- Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ali Mehdi
- Department of Nephrology and Hypertension—Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Sayna Norouzi
- Department of Nephrology, Loma Linda University Medical Center, Loma Linda, California
| | - Stephen M. Sozio
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine; and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Wallis KE, Mulé C, Mittal S, Cerda N, Shaffer R, Scott A, Langkamp D, Augustyn M, Perrin E, Soares N, Blum NJ. Use of Telehealth in Fellowship-Affiliated Developmental Behavioral Pediatric Practices During the COVID-19 Pandemic. J Dev Behav Pediatr 2021; 42:314-321. [PMID: 33350655 DOI: 10.1097/dbp.0000000000000897] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 08/13/2020] [Accepted: 10/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to describe the use of telehealth in developmental behavioral pediatric (DBP) fellowship-affiliated practices during the coronavirus disease 2019 (COVID-19) global pandemic. METHODS An electronic survey was disseminated to all DBP fellowship-associated practice locations to determine the use of telehealth in DBP care provision, before and since the beginning of the COVID-19 pandemic. We analyzed responses using descriptive statistics. RESULTS A total of 35 of 42 eligible practice sites responded (83% response rate). Most sites (51.4%) reported using telehealth less than once per month before the COVID-19 pandemic. Since the onset of COVID-19, 100% of programs reported conducting video-based telehealth visits multiple days per week. Most sites reported conducting evaluations and follow-up visits for attention-deficit/hyperactivity disorder, autism spectrum disorder, behavioral concerns, developmental delay, genetic disorders, and learning disability. Most sites were able to continue medication management by telehealth (>88%), offer interpreter services for families with limited English proficiency participating in telehealth visits (>90%), and incorporate trainees and interdisciplinary team members in telehealth visits (>90%). Greater variability was observed in sites' ability to collect telehealth practice evaluation measures. CONCLUSION Most sites are providing evaluations and ongoing care for DBP conditions through telehealth. The rapid adoption of telehealth can have ramifications for the way that DBP care is delivered in the future; therefore, it is imperative to understand current practice patterns and variations to determine the best use of telehealth.
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Affiliation(s)
- Kate E Wallis
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Christina Mulé
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
- Department of Pediatrics, Tufts University School of Medicine, Boston, MA
| | - Shruti Mittal
- Developmental and Behavioral Pediatrics of the Carolinas, Atrium Health, Charlotte, NC
| | - Natalie Cerda
- Developmental Medicine Center, Boston Children's Hospital, Boston, MA
| | - Rebecca Shaffer
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical School, Cincinnati, OH
| | - Angela Scott
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Diane Langkamp
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH
- Department of Pediatrics, Northeast Ohio Medical University, Rootstown, OH
| | - Marilyn Augustyn
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Ellen Perrin
- Division of Developmental-Behavioral Pediatrics, Tufts Children's Hospital, Boston, MA
| | - Neelkamal Soares
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Nathan J Blum
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Mahat N, Zubaidi SA, Soe HHK, Nah SA. Paediatric surgical response to an 'adult' COVID-19 pandemic. Med J Malaysia 2021; 76:284-290. [PMID: 34031324] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The Coronavirus Disease 2019 (COVID-19) has dramatically affected global healthcare systems. We aimed to determine the response of our paediatric surgical fraternity to a disease that overwhelmingly affects adults. MATERIALS AND METHODS We conducted a cross-sectional questionnaire-based study over 6 weeks during a federally mandated lockdown. Using snowball sampling, we recruited paediatric surgeons, trainees and medical officers from paediatric surgical units in Malaysia. The anonymous online questionnaire covered sociodemographic information, changes in patient care, redeployment, concerns regarding family members, and impact on training. Mental well-being was assessed using the Depression, Anxiety and Stress Scale (DASS-21). Kruskal-Wallis, ANOVA and multiple regression analysis was used, with significance level 0.05. RESULTS Of the 129 eligible participants, 100(77%) responded. Junior doctors had clinically higher levels of depression, anxiety, and stress. Age <30 years was significantly associated with anxiety. Junior doctors believed that redeployment led to loss of surgical skills (p<0.001) and trainees felt that clinical application of knowledge had reduced (p<0.020). CONCLUSION Specific to our paediatric surgical community, this study highlights areas of concern, particularly among junior doctors. It is likely that recurrent cycles of the pandemic will occur soon. These issues must be addressed to preserve the mental and emotional well-being of all health care workers.
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Affiliation(s)
- N Mahat
- University of Malaya, Faculty of Medicine, Department of Surgery, Division of Paediatric Surgery, Kuala Lumpur, Malaysia
| | - S A Zubaidi
- University of Malaya Medical Centre, Faculty of Medicine, Department of Surgery, Division of Paediatric Surgery, Kuala Lumpur, Malaysia
| | - H H K Soe
- Melaka Manipal Medical College, Department of Community Medicine, Melaka, Malaysia
| | - S A Nah
- University of Malaya, Faculty of Medicine, Department of Surgery, Division of Paediatric Surgery, Kuala Lumpur, Malaysia.
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Cristóvão Ferreira A, Videira da Silva A, Freira S, Fonseca H. Adolescent medicine during specialized paediatric training: the past, the present and the future. Int J Adolesc Med Health 2021; 33:83-88. [PMID: 33855842 DOI: 10.1515/ijamh-2021-0006] [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: 01/13/2021] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Paediatricians increasingly need to take care of adolescents, a life stage with specific needs, however many of them admit a limitation in their medical education regarding Adolescent Medicine. The objective of this paperwork is to evaluate the formative model adopted in the Department of Paediatrics, Hospital de Santa Maria, and assess the impact of the training in Adolescent Medicine. METHODS We surveyed the current Paediatric Residents and those who graduated as Paediatricians from the Department in the past five years, in order to get feedback on the one-month compulsory training at the Adolescent Medicine Division during their Residency. RESULTS Both groups considered it as a very interesting/useful training. Paediatricians considered that the training had an insufficient duration, with statistical difference comparing to the current Residents' opinion. Conversely, Residents considered more often that the acquired competencies would be useful in their future clinical practice, when compared to Paediatricians. CONCLUSIONS In order to potentiate learning and training during such a short period of time, a few changes were identified as beneficial to be implemented.
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Affiliation(s)
| | | | - Sílvia Freira
- Department of Paediatrics, Adolescent Medicine Clinic, Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - Helena Fonseca
- Department of Paediatrics, Adolescent Medicine Clinic, Hospital de Santa Maria, CHULN, Lisbon, Portugal
- University of Lisbon Medical School, Lisbon, Portugal
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Martínez Cardona JA, Esquivel Treviño PJ. [Perception of medical students in Mexico during their clinical teaching during the COVID-19 pandemic]. Aten Primaria 2021; 53:102078. [PMID: 33906093 PMCID: PMC8020078 DOI: 10.1016/j.aprim.2021.102078] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jorge A Martínez Cardona
- Pediatría, Neonatología, Programa Multicéntrico de Especialidades Médicas, Tecnológico de Monterrey, Monterrey, México.
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Young J, Rodrigues KK, Imam B, Johnson-Agbakwu C. Female Genital Mutilation/Cutting-Pediatric Physician Knowledge, Training, and General Practice Approach. J Immigr Minor Health 2021; 22:668-674. [PMID: 31602532 DOI: 10.1007/s10903-019-00938-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Female genital mutilation/cutting (FGM/C) is outlawed in much of the world but still mainly occurs from infancy-age 15. Many at-risk and FGM/C-affected girls live in the US. No standard pediatric training exists. A questionnaire assessing FGM/C education, knowledge, diagnostic confidence and external genital examination (EGE) approach was sent to pediatric listservs at 3 hospitals and a child abuse pediatrician (CAP) network. Analysis used χ2 and Fisher's exact tests. Compared to general pediatricians, CAP reported more FGM/C education (RR 2.0 [95% CI 1.3-3.2]), awareness of ICD-9/10 codes (RR 3.2 [95% CI 1.4-7.3]), confidence in identifying sub-types (RR 4.5 [95% CI 2.3-8.7]) and discussing FGM/C (RR 4.2 [95% CI 2.3-7.6]). For 6-12 month olds, 10% of general pediatricians reported never performing EGE at female well child visits (WCV), increasing to > 50% for 17-18 year olds. Pediatric physicians are not trained to diagnose or manage FGM/C. EGE are not done at WCVs and FGM/C diagnoses are missed.
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Affiliation(s)
- Janine Young
- Department of General Pediatrics, Denver Health and Hospital Authority, University of Colorado School of Medicine, 1001 Yosemite St., Denver, CO, 80230, USA.
| | - Kristine Knuti Rodrigues
- Department of General Pediatrics, Denver Health and Hospital Authority, University of Colorado School of Medicine, 1001 Yosemite St., Denver, CO, 80230, USA
| | - Basel Imam
- Department of Pediatric and Adolescent Gynecology, Phoenix Children's Hospital, Phoenix, AZ, USA
- Department of Obstetrics and Gynecology, Edward Hospital, Naperville, IL, USA
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Coutinho Baldoto Gava Chakr V. Impact of COVID-19 on a Mentorship Program for Pediatrics Residents. Andes Pediatr 2021; 92:318-319. [PMID: 34106174 DOI: 10.32641/andespediatr.v92i2.3700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Damari E, Fargel A, Berger I, Ron R, Yeshayahu Y. Pediatric Residents' Perception of Medical Education, General Wellness and Patient Care Following the Shortening of Shifts during the COVID-19 Pandemic. Isr Med Assoc J 2021; 23:214-218. [PMID: 33899352] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The effect of extended shift length on pediatric residency is controversial. Israeli residents perform shifts extending up to 26 hours, a practice leading to general dissatisfaction. In early 2020, during the coronavirus disease-2019 (COVID-19) pandemic, many Israeli hospitals transitioned from 26-hour shifts to 13-hour shifts in fixed teams (capsules) followed by a 24-hour rest period at home. The regulation changes enacted by the Israeli government during the COVID-19 pandemic provided a rare opportunity to assess perception by residents regarding length of shifts before and after the change. OBJECTIVES To assess perception of pediatric residency in three aspects: resident wellness, ability to deliver quality healthcare, and acquisition of medical education following the change to the shorter shifts model. METHODS We performed a prospective observational study among pediatric residents. Residents completed an online self-assessment questionnaire before and after the COVID-19 emergency regulations changed toward shorter shifts. RESULTS Sixty-seven residents answered the questionnaires before (37) and after (30) the shift changes. The average score was significantly better for the 13-hour shifts versus the 26-hour shifts, except for questions regarding available time for research. There was a positive perception regarding the shorter night shifts model among pediatric residents, with an increase in general satisfaction and improvement in perception of general wellness, ability to deliver quality healthcare, and medical education acquisition. CONCLUSIONS Following the change to shorter shift length, perception of pediatric residents included improvement in wellness, ability to deliver quality healthcare, and availability of medical education.
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Affiliation(s)
- Eytan Damari
- Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Fargel
- Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Itai Berger
- Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- School of Social Work and Social Welfare, Hadassah-Hebrew University Medical Center (Mount Scopus Campus), Jerusalem, Israel
| | - Reut Ron
- Health Policy Research Analyst, Assuta Health Services Research Institute, Tel Aviv, Israel
| | - Yonatan Yeshayahu
- Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Coleman N, Beasley M, Briskin S, Chapman M, Cuff S, Demorest RA, Halstead M, Hornbeck K, Kinsella SB, Logan K, Liu R, Mooney C, Myers RA, Ruparell S, Santana J, Walter KD, Waterbrook AL, Wolf SF. Musculoskeletal and Sports Medicine Curriculum Guidelines for Pediatric Residents. Curr Sports Med Rep 2021; 20:218-228. [PMID: 33790194 DOI: 10.1249/jsr.0000000000000830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Musculoskeletal (MSK) and sports-related conditions are relatively common in the pediatric population. Pediatric residencies should provide residents with the knowledge and skills to assess and manage both acute and chronic MSK and sports injuries and complaints. Residents should develop the competencies and attitudes to safeguard and promote a healthy and active lifestyle for youth. Programs can use a variety of educational tools, both in the clinic and on the field, to provide a well-rounded MSK curriculum throughout the residency years. This article provides a review of general pediatric sports medicine curriculum guidelines and suggested implementation strategies.
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Affiliation(s)
- Nailah Coleman
- Children's National Hospital, The Goldberg Center for Community Pediatric Health, Washington, DC
| | - Michael Beasley
- Boston Children's Hospital, Sports Medicine Division, Boston, MA
| | - Susannah Briskin
- Rainbow Babies and Children's Hospital, Division of Sports Medicine, Solon, OH
| | | | - Steven Cuff
- Nationwide Children's Hospital, Sports Medicine, Westerville, OH
| | - Rebecca A Demorest
- Webster Orthopedics, Pediatric and Young Adult Sports Medicine, Dublin, CA
| | | | - Kimberly Hornbeck
- Medical College of Wisconsin, Children's Wisconsin Primary Care Sports Medicine, Milwaukee, WI
| | | | - Kelsey Logan
- Cincinnati Children's Hospital Medical Center, Division of Sports Medicine, Cincinnati, OH
| | - Ruikang Liu
- Penn State Health-Children's Hospital, Department of Pediatrics, Hershey, PA
| | | | - Rebecca A Myers
- University of Colorado, Department of Family Medicine, Longmont, CO
| | - Sonia Ruparell
- Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Chicago, IL
| | - Jonathan Santana
- Baylor College of Medicine, Department of Pediatrics, Section of Adolescent and Sports Medicine, Houston, TX
| | - Kevin D Walter
- Medical College of Wisconsin, Departments of Orthopaedic Surgery & Pediatrics, Children's Wisconsin Primary Care Sports Medicine, Delafield, WI
| | - Anna L Waterbrook
- The University of Arizona, Department of Emergency Medicine, Tucson, AZ
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Heffernan MJ, Song B, Bovid KM, Leonardi C, Fornari ED. Assessing the Impact of the Pediatric Orthopaedic Society of North America (POSNA) Visiting Scholar Program. J Pediatr Orthop 2021; 41:197-201. [PMID: 33534369 DOI: 10.1097/bpo.0000000000001729] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND The primary objective of the Pediatric Orthopaedic Society of North America (POSNA)-Children's Orthopaedics in Underserved Regions (COUR) Visiting Scholar Program is to engage emerging leaders from low-income and middle-income countries (LMICs) in POSNA educational offerings. This study aims to outline the educational and leadership activities pursued by the alumni of the POSNA-COUR Visiting Scholars Program. We hypothesized that there may be a discrepancy between visiting scholar interest level and actual participation in key follow-up educational and leadership activities. METHODS A 32-question online survey developed by the POSNA-COUR committee was electronically delivered to the POSNA-COUR visiting scholarship recipients from 2007 to 2019. The survey inquired about scholars' educational background, clinical practice, and academic interests. Respondents also reported educational, research, and leadership activities that occurred following program participation. RESULTS Fifty-seven percent (44/77) of the previous scholars participated in the survey. Sixty-eight percent reported that >75% of their practice was comprised of pediatric patients. The COUR scholarship afforded 15 scholars the opportunity to attend their first educational conference in North America. The majority (86%) of respondents consulted POSNA members on care-related issues, 52% organized a POSNA member's visit to their country, and 13% have become members of POSNA. Scholars shared their knowledge with colleagues through lectures (73%), demonstration of surgical skills (63%), mentorship (59%), hosting local courses (43%), and research (14%). There was a significant discrepancy between interest and actual participation in research (98% vs. 16%, P<0.0001), hosting a regional course (98% vs. 43%, P<0.0001), and becoming a member of POSNA (96% vs. 13%, P<0.0001). CONCLUSIONS The POSNA-COUR Visiting Scholar Program is effective at providing beneficial educational opportunities to orthopaedic surgeons from LMICs. There is, however, a significant discrepancy between reported scholar interest and actual engagement in leadership endeavors including: research, organization of regional courses, and POSNA membership. The impact of the POSNA-COUR visiting scholar program can be enhanced through collaboration with scholarship alumni in these key areas. LEVEL OF EVIDENCE Level IV-case series.
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Affiliation(s)
| | | | - Karen M Bovid
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Claudia Leonardi
- School of Public Health, LSU Health Sciences Center, New Orleans, LA
| | - Eric D Fornari
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY
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El Amrousy D. Global Pediatric Research Investigator: Doaa El Amrousy. Pediatr Res 2021; 89:719. [PMID: 33293681 DOI: 10.1038/s41390-020-01283-8] [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: 10/04/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 02/08/2023]
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Gisondo CM, Weiner G, Stanley K. A Video and Case-Based Transport Curriculum for Neonatal-Perinatal Medicine Trainees Using a Flipped Classroom Methodology. MedEdPORTAL 2021; 17:11097. [PMID: 33598540 PMCID: PMC7880257 DOI: 10.15766/mep_2374-8265.11097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/06/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Neonatal-perinatal medicine (NPM) providers actively manage medical transports. However, there is wide variation in transport education among fellowship programs. Using the flipped classroom methodology, we developed a video and case-based transport education curriculum. METHODS A national needs assessment identified safety, communication skills, and physiology as the most important aspects of transport management. Three 10-minute video modules and two 20-minute case-based discussions were developed to address this content. Using the flipped classroom format, seven NPM fellows from all three postgraduate years of training took part in the curriculum by individually viewing each video followed by participation in group case-based discussions. Cognitive and affective outcomes were assessed using a knowledge and attitude pretest, individual video module posttests, and a postcurriculum follow-up survey. RESULTS NPM fellows showed significant improvements in transport knowledge and reported increased confidence in their ability to perform important transport roles. Case discussions were adaptable to learners who had different levels of training and had variable transport experience. Case discussions were successfully executed both in person and by video telecommunications during the 2020 COVID-19 pandemic. DISCUSSION This transport curriculum addressed a national education gap in NPM fellowship training. Using the flipped classroom methodology, cognitive and affective objectives were achieved by improving knowledge and confidence in transport skills among NPM learners. The video and case-based formats were easily implemented, applicable to multiple types of learners, and adaptable to different environments.
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Affiliation(s)
- Carly M. Gisondo
- Fellow, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Medical School
| | - Gary Weiner
- Associate Professor, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Medical School
| | - Kate Stanley
- Assistant Professor, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Medical School
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Ingram MA, Pearman JL, Estrada CA, Zinski A, Williams WL. Are We Measuring What Matters? How Student and Clerkship Characteristics Influence Clinical Grading. Acad Med 2021; 96:241-248. [PMID: 32701555 DOI: 10.1097/acm.0000000000003616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Given the growing emphasis placed on clerkship performance for residency selection, clinical evaluation and its grading implications are critically important; therefore, the authors conducted this study to determine which evaluation components best predict a clinical honors recommendation across 3 core clerkships. METHOD Student evaluation data were collected during academic years 2015-2017 from the third-year internal medicine (IM), pediatrics, and surgery clerkships at the University of Alabama at Birmingham School of Medicine. The authors used factor analysis to examine 12 evaluation components (12 items), and they applied multilevel logistic regression to correlate evaluation components with a clinical honors recommendation. RESULTS Of 3,947 completed evaluations, 1,508 (38%) recommended clinical honors. The top item that predicted a clinical honors recommendation was clinical reasoning skills for IM (odds ratio [OR] 2.8; 95% confidence interval [CI], 1.9 to 4.2; P < .001), presentation skills for surgery (OR 2.6; 95% CI, 1.6 to 4.2; P < .001), and knowledge application for pediatrics (OR 4.8; 95% CI, 2.8 to 8.2; P < .001). Students who spent more time with their evaluators were more likely to receive clinical honors (P < .001), and residents were more likely than faculty to recommend clinical honors (P < .001). Of the top 5 evaluation items associated with clinical honors, 4 composed a single factor for all clerkships: clinical reasoning, knowledge application, record keeping, and presentation skills. CONCLUSIONS The 4 characteristics that best predicted a clinical honors recommendation in all disciplines (clinical reasoning, knowledge application, record keeping, and presentation skills) correspond with traditional definitions of clinical competence. Structural components, such as contact time with evaluators, also correlated with a clinical honors recommendation. These findings provide empiric insight into the determination of clinical honors and the need for heightened attention to structural components of clerkships and increased scrutiny of evaluation rubrics.
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Affiliation(s)
- Mary A Ingram
- M.A. Ingram is pediatrics intern, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama
| | - Joseph L Pearman
- J.L. Pearman is internal medicine intern, University of California, Davis, Sacramento, California; ORCID: http://orcid.org/0000-0001-5780-3689
| | - Carlos A Estrada
- C.A. Estrada is staff physician, Birmingham Veterans Affairs Medical Center, and professor of medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; ORCID: http://orcid.org/0000-0001-6262-7421
| | - Anne Zinski
- A. Zinski is assistant professor, Department of Medical Education, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; ORCID: http://orcid.org/0000-0003-0414-248X
| | - Winter L Williams
- W.L. Williams is clerkship codirector and assistant professor of medicine, Department of Medicine, University of Alabama at Birmingham, and staff physician at the Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; ORCID: http://orcid.org/0000-0002-4015-9409
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Affiliation(s)
- Marta Cognigni
- Pediatric Department, University of Trieste, Trieste 34149, Italy
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Ryan MS, Lee B, Richards A, Perera RA, Haley K, Rigby FB, Park YS, Santen SA. Evaluating the Reliability and Validity Evidence of the RIME (Reporter-Interpreter-Manager-Educator) Framework for Summative Assessments Across Clerkships. Acad Med 2021; 96:256-262. [PMID: 33116058 DOI: 10.1097/acm.0000000000003811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The ability of medical schools to accurately and reliably assess medical student clinical performance is paramount. The RIME (reporter-interpreter-manager-educator) schema was originally developed as a synthetic and intuitive assessment framework for internal medicine clerkships. Validity evidence of this framework has not been rigorously evaluated outside of internal medicine. This study examined factors contributing to variability in RIME assessment scores using generalizability theory and decision studies across multiple clerkships, thereby contributing to its internal structure validity evidence. METHOD Data were collected from RIME-based summative clerkship assessments during 2018-2019 at Virginia Commonwealth University. Generalizability theory was used to explore variance attributed to different facets through a series of unbalanced random-effects models by clerkship. For all analyses, decision (D-) studies were conducted to estimate the effects of increasing the number of assessments. RESULTS From 231 students, 6,915 observations were analyzed. Interpreter was the most common RIME designation (44.5%-46.8%) across all clerkships. Variability attributable to students ranged from 16.7% in neurology to 25.4% in surgery. D-studies showed the number of assessments needed to achieve an acceptable reliability (0.7) ranged from 7 in pediatrics and surgery to 11 in internal medicine and 12 in neurology. However, depending on the clerkship each student received between 3 and 8 assessments. CONCLUSIONS This study conducted generalizability- and D-studies to examine the internal structure validity evidence of RIME clinical performance assessments across clinical clerkships. Substantial proportion of variance in RIME assessment scores was attributable to the rater, with less attributed to the student. However, the proportion of variance attributed to the student was greater than what has been demonstrated in other generalizability studies of summative clinical assessments. Overall, these findings support the use of RIME as a framework for assessment across clerkships and demonstrate the number of assessments required to obtain sufficient reliability.
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Affiliation(s)
- Michael S Ryan
- M.S. Ryan is assistant dean for clinical medical education and associate professor of pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0003-3266-9289
| | - Bennett Lee
- B. Lee is associate professor of internal medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Alicia Richards
- A. Richards is a doctoral student in the department of biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Robert A Perera
- R.A. Perera is associate professor of biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Kellen Haley
- K. Haley is a resident in neurology at the University of Michigan School of Medicine, Ann Arbor, Michigan. At the time of initial drafting of this manuscript, Dr. Haley was a fourth-year medical student at Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Fidelma B Rigby
- F.B. Rigby is associate professor and clerkship director of obstetrics and gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Yoon Soo Park
- Y.S. Park is associate professor and associate head, department of medical education, and director of research, office of educational affairs, University of Illinois at Chicago College of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-8583-4335
| | - Sally A Santen
- S.A. Santen is senior associate dean for evaluation, assessment and scholarship, and professor of emergency medicine Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0002-8327-8002
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Bode S, Dürkop A, Wilcken H, Peters S, Straub C. Interprofessional learning during SARS-CoV-2 (COVID-19) pandemic conditions: the learning project I-reCovEr as a substitute for a rotation on an interprofessional training ward. GMS J Med Educ 2021; 38:Doc13. [PMID: 33659618 PMCID: PMC7899098 DOI: 10.3205/zma001409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/20/2020] [Accepted: 11/24/2020] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic has led to massive and aprupt changes in the training of health care professionals. Especially hands-on training can no longer take place in the usual form in everyday clinical practice. Rotations on the interprofessional training ward in Pediatrics (IPAPAED) at the University Medical Center Freiburg, had to be suspended starting March 2020. This report presents the interprofessional Covid-19 Replacement Program (I-reCovEr) as an alternative learning format for a rotation on the IPAPAED at the Center for Pediatric and Adolescent Medicine. I-reCovEr offers opportunities for pediatric nursing trainees (n=6) and medical students (n=9) to learn together, taking hygienic and distancing measures into account. Based on a case study, selected learning aspects regarding interprofessional cooperation and communication are targeted. The participants report increased knowledge about the work of the other professional group in the evaluation using the Interprofessional Socialization and Valuing Scale (ISVS) -9A. In comparison to participants of the IPAPAED, however, the self-evaluation did not reveal any self-perceived acquisition of other interprofessional skills or competences. I-reCovEr can therefore serve as an introduction to interprofessional training, but it cannot replace interprofessional learning and working on an interprofessional training ward.
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Affiliation(s)
- Sebastian Bode
- University of Freiburg, Medical Faculty, Medical Center, Department of general pediatrics, adolescent medicine, and neonatology, Center for Pediatrics, Working Group for Teaching and Teaching, Freiburg/Brsg., Germany
| | - Alexandra Dürkop
- University of Freiburg, Medical Faculty, Medical Center, Department of general pediatrics, adolescent medicine, and neonatology, Center for Pediatrics, Working Group for Teaching and Teaching, Freiburg/Brsg., Germany
- University of Freiburg, Medical Faculty, Center for Pediatrics, University Hospital Freiburg, Practical Nurse Training Unit, Nursing Management, Freiburg/Brsg., Germany
| | - Helena Wilcken
- University of Freiburg, Medical Faculty, Center for Pediatrics, University Hospital Freiburg, Practical Nurse Training Unit, Nursing Management, Freiburg/Brsg., Germany
| | - Stephanie Peters
- University of Freiburg, Medical Faculty, Center for Pediatrics, Practical Nurse Training Unit „Moro“ ward, Freiburg/Brsg., Germany
| | - Christine Straub
- University of Freiburg, Medical Faculty, Medical Center, Department of general pediatrics, adolescent medicine, and neonatology, Center for Pediatrics, Working Group for Teaching and Teaching, Freiburg/Brsg., Germany
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