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The article discusses some strategies on how to achieve success in critical care residency training for pharmacists. Topics mentioned include the factors that contribute to the progressive overload of residency training programs, the application of the Pareto principle to residency training and the complexity of residency accreditation standards and competencies.

Background: Residency programs are required to incorporate simulation into their training program. Ideally, simulation provides a safe environment for a trainee to be exposed to both common and challenging clinical scenarios. The purpose of this review is to detail the current state of the most commonly used laparoscopic, endoscopic, and robotic surgery simulation programs in general surgery residency education, including resources required for successful implementation and benchmarks for evaluation. Materials and methods: Members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Resident and Fellow Task Force (RAFT) Committee performed a literature review using PubMed and training websites. Information regarding the components of the most commonly used laparoscopic, endoscopic, and/or robotic simulation curriculum, including both formal and informal benchmarks for evaluating training competence, were collected. Results: Laparoscopic simulation revolves around the Fundamentals of Laparoscopic Surgery (FLS). Proficiency-based as well as virtual simulation have been utilized for FLS training curricula. Challenges include less direct translation to the technical complexities that can arise in laparoscopic surgery. Endoscopic simulation focuses on the Fundamentals of Endoscopic Surgery. There are virtual reality simulation platforms that can be used for skills assessment and training. Challenges include simulator types and access, as well as structured mentoring and feedback. Robotic simulation training curricula have not been standardized. Simulation includes one primary technology, which can be prohibitive based on cost and requirements for onboarding. Conclusions: While surgical simulation seems to be a fundamental and integrated part of surgical training, it requires a significant number of resources, which can be daunting for residency training programs. Regardless of the barriers outlined, the need for surgical simulation in laparoscopy, endoscopy, and robotics at surgical education training programs is clear. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The current study focused on predicting future trends in obstetrics by examining obstetricians' approaches to specific challenging vaginal delivery that require special experience, such as breech presentation, macrosomic fetus, twin pregnancy, and vacuum use, compared with their residency training experience.The cross‐sectional study was conducted in two phases. The first phase was qualitative and the second phase was quantitative. The “interview” and “survey” techniques served as data collection tools. In total, 20 obstetricians participated in the interviews, and 400 obstetricians took part in the survey. Data from the interviews were analyzed using the Maxqda 2020 qualitative data analysis program, and survey data were analyzed using SPSS version 25.0.Over the past 2 decades, there has been a gradual shift from vaginal deliveries to cesarean deliveries in cases involving breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. While medicolegal concerns are undeniable, the prevalent belief among obstetricians that cesarean delivery is safer than vaginal delivery significantly influences this trend. Comparatively, young obstetricians often complete their residency training without acquiring sufficient knowledge and skills in vaginal delivery.Young obstetricians currently lack adequate experience in managing vaginal deliveries for breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. This experience is at risk of disappearing entirely within the next decade as senior obstetricians retire. Policymakers should take this into consideration when shaping future healthcare policies. [ABSTRACT FROM AUTHOR]

This research letter discusses the factors that may influence the application and acceptance rates for Higher Surgical Training (HST) in urology in the United Kingdom. The study found that while more than 50% of medical students and foundation trainees are women, the number drops significantly as doctors progress in their careers, with women making up only 12% of urology consultants. Ethnic minority doctors also face challenges, with lower pass rates in postgraduate examinations and underrepresentation in surgical leadership. The study found that gender was associated with receiving an offer for HST, favoring women, but age, ethnicity, socioeconomic status, and educational factors did not show an increased likelihood of obtaining an offer. The authors hope that these findings, along with initiatives by organizations and the NHS, will contribute to a more diverse senior workforce in urology. [Extracted from the article]

Background There has been a fivefold increase of neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1,000 neurosurgical residents employed at training hospitals. Little is known about the overall training experience and career opportunities for these trainees. Methods In our role as resident representatives, we implemented a mailing list for interested German neurosurgical trainees. Thereafter, we created a survey including 25 items to assess the trainees' satisfaction with their training and their perceived career prospects, which we then distributed through the mailing list. The survey was open from April 1 until May 31 2021. Results Ninety trainees were enrolled in the mailing list and we received 81 completed responses to our survey. Overall, 47% of the trainees were very dissatisfied or dissatisfied with their training. Sixty-two percent of the trainees reported a lack of surgical training. Fifty-eight percent of trainees found it difficult to attend courses or classes and only 16% had consistent mentoring. There was an expressed desire for a more structured training program and mentoring projects. In addition, 88% of trainees were willing to relocate for fellowships outside their current hospitals. Conclusions Half of the responders were dissatisfied with their neurosurgical training. There are various aspects that require improvement, such as the training curriculum, structured mentoring, and reduction of the amount of administrative work. We propose the implementation of a modernized structured curriculum, which addresses the mentioned aspects, in order to improve neurosurgical training and, consecutively, patient care. [ABSTRACT FROM AUTHOR]

Background and Objectives: Despite use of standardized electronic health record templates, the structure of discharge summaries may hinder communication from inpatient settings to primary care providers (PCPs). We developed an enhanced electronic discharge summary template to improve PCP satisfaction with written discharge summaries targeting diagnoses, medication reconciliation, laboratory test results, specialist follow-up, and recommendations. Methods: Resident template usage was measured using statistical process control charts. PCP reviewers' discharge summary satisfaction was surveyed using 5-point Likert scales analyzed using the Mann- Whitney Utest. Residents were surveyed for satisfaction. Results: Resident template usage increased from 61% initially to 72% of discharge summaries at 6 months. The PCP reviewers reported increased satisfaction for summaries using the template compared with those without (4.3 vs 3.9, P= .003). Surveyed residents desired template inclusion in the default electronic discharge summary (93%). Conclusions: This system-level resident-initiated quality improvement initiative created a novel discharge summary template that achieved widespread usage among residents and significantly increased outpatient PCP satisfaction. [ABSTRACT FROM AUTHOR]

In the wake of their heightened role in addressing the emotional challenges of United States soldiers during World War II, American psychiatrists increasingly argued that their knowledge of human nature, based on interpretation of unconscious processes, was a powerful tool in effecting changes in society. As they turned to training an adequate supply of psychiatrists to meet expanding demand, educators in psychiatry residency programs faced questions about whom to entrust with the power of psychiatric interpretation, how educators' knowledge about trainees' own unconscious processes should be harnessed, and how much to adhere to strict psychoanalytic doctrine in training. During the 1970s, social and cultural upheavals outside and inside psychiatry began to dismantle the grand claims of the postwar generation of psychiatrists, while shifts in the 1980s led educators to focus more on seemingly objective educational measures. Trainees' and critics' serious questioning of authority and structures in American society, and within psychiatry training programs, was perhaps as much of a factor – if not more – in the shift away from an emphasis on the interpretive power of psychoanalysis in favor of more eclectic and ultimately biological approaches in academic psychiatry. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aims to provide insight regarding the different qualities of international medical graduates (IMGs) involved in US orthopedic residency programs. METHODS: Orthopedic residency programs accredited by the ACGME and listed in the AMA database were screened. Data on program size and location, IMG year of training, the geographic region of IMG's medical schools, their research experiences and number of gap years were included. RESULTS: A total of 167(80.3%) orthopedic residency programs were included. A total of 3838 residents were identified, of which 44 (1.15%) were IMGs. The United Kingdom and Ireland had the highest number of matched IMGs with four (9.1%) each. Massachusetts was the state with the highest number of enrolled IMGs. On average, IMGs had 26.3 publications and joined US orthopedic residency 4.66 years following medical school graduation. CONCLUSION: Despite the many hurdles experienced by IMGs, a decent number succeeds in matching into US orthopedic residency programs each year. [ABSTRACT FROM AUTHOR]

Objectives: Otomatch.com is an online forum for residency applicants to discuss the otolaryngology match process including academic metrics. The purpose of this study is to assess the accuracy of self-reported match data on Otomatch relative to official data reported by the National Residency Match Program (NRMP) and the Association of American Medical Colleges (AAMC). Methods: Data was collected from publicly editable Otomatch forums (2017-2018, 2018-2019, 2019-2020) and curated Otomatch survey responses (2018-2019, 2019-2020) whose results are released after Match Day. Aggregated data was collected from the NRMP 2018 and 2020 Charting Outcomes in the Match and AAMC Report on Residents (2017-2018, 2018-2019). Measures of interest included Step 1 scores, Step 2 CK scores, publications, number of interview invitations, number of interviews attended, and AOA status. ANOVA and 2 tailed T tests were performed to compare variables within each match year. Results: Average Step 2 CK score was significantly higher on publicly editable Otomatch forums than AAMC in 2017-2018 (257vs 253, P <.05) and 2018-2019 (258vs 252, P <.05). Interviews attended were significantly higher on Otomatch survey responses than the publicly editable forum in 2019-2020 (13vs 9, P -value <.05). Step 1 scores, interview invitations, and AOA status were not statistically significantly different when data was available. Conclusion: Applicant statistics from online forums, online surveys, NRMP, and AAMC are consistent, except for Step 2 CK scores. Self-reported data on the Otomatch forum is an accurate estimate of academic metrics of otolaryngology residency applicants. [ABSTRACT FROM AUTHOR]

To provide effective care physicians must attend, not just to medical issues, but also to the social determinants of health — racial factors, food insecurity, housing instability, transportation barriers and beyond. Social determinants also include a largely underrecognized dimension: legal vulnerabilities such as rental evictions and debt adjudications. Yet rarely do medical trainees have an opportunity to witness legal vulnerabilities, firsthand. [ABSTRACT FROM AUTHOR]

The opinions of the faculty members on the assistant physicians' use of leave of absence after night shift matter, given that they play an essential role in their training. In this context, this study was carried out to review the opinions of faculty members on the consequences of assistant physicians' use of leave of absence after night shift. This single-center, cross-sectional survey study, based on voluntary participation, was conducted with the faculty members of Van Yuzuncu Yil University Faculty of Medicine between February and March 2023. The study population consisted of faculty members in surgical and internal medical science departments. Faculty members in basic medical science departments were not included in the study since assistant physicians in basic medical science departments do not work the night shift. The survey consisted of nine items with checkboxes on participants' demographic data and the consequences of assistant physicians' use of a leave of absence after night shift on the clinic's functioning, medical specialty training, patient turnovers, and relationships inside and outside the clinic. Of the 137 faculty members, 98 (71.53%) faculty members, 46 in surgical medical science departments and 52 in internal medical science departments, participated in the survey between February and March 2023 in an electronic environment. Of the respondents, 76 (77.5%) were male, and 22 (22.5%) were female. The mean age of the participants was 42.72 ± 4.9 (min. 34, max. 57) years. Of the 98 faculty members who participated in the survey, 84.0% and 79.6% stated that assistant physicians' use of leave of absence after night shift adversely affected the medical specialty training and the clinic's functioning, respectively. In general, faculty members expressed the opinion that assistant physicians' use of leave of absence after night shift negatively affected the medical specialty training, the functioning of the clinic, and the work carried out in collaboration with other clinics. There is a need for more comprehensive studies on assistant physicians' use of leave of absence after night shift. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the outcomes of a hands‐on simulation‐based course with emphasis on procedural techniques, clinical reasoning, and communication skills developed to improve junior Otolaryngology – Head and Neck Surgery (OHNS) residents' preparedness in managing otolaryngologic emergencies. Methods: Junior OHNS residents and faculty from residency programs in California, Nevada, and Arizona participated in this workshop in 2020 and 2021. The stations featured airway management techniques, ultrasound‐guided needle aspiration, nasoseptal hematoma evacuation, and facial fracture repair using various models and cadavers. Participants completed a pre‐workshop survey, post‐workshop survey, and 2‐month follow‐up survey that assessed resident anxiety and confidence in three OHNS emergency situations across knowledge, manual skills, and teamwork using a 5‐point Likert scale. Results: Pre‐workshop surveys reported the least anxiety and most confidence in teamwork, but the most anxiety and least confidence in technical skills and knowledge related to foreign body retrieval and airway management. Immediately post‐workshop participants reported significant reductions in anxiety and increases in confidence, largest in the manual skills domain, in foreign body retrieval (anxiety: −0.99, confidence: +0.95, p <.01) and airway management stations (anxiety: −0.68, confidence: +1.07, p <.01). Data collected for the epistaxis station showed decreasing confidence and increasing anxiety following the workshop. Conclusion: Our findings demonstrate the effectiveness of a workshop in preparing junior residents in potentially lifesaving otolaryngologic techniques that residents will encounter. Optimizing use of simulation centered training can inform the future of residency education, improving confidence and decreasing anxiety in residents responsible for the safety of patients. Level of Evidence: III. [ABSTRACT FROM AUTHOR]

A 3-hour hands-on EEG workshop was conducted as a part of resident rotation in clinical neurophysiology to determine its feasibility and educational value for neurology residents, medical students, and EEG technologists, with the learning objectives of motivating interest in clinical electroencephalography, enhancing ability to recognize a normal EEG and identify physiological and non-physiological artifacts, and enhancing teaching, organizational and communication skills of EEG technologists. The workshop included a demonstration of EEG electrode placement according to the 10–20 System on a resident volunteer by the EEG technologist. Activation procedures (photic stimulation and hyperventilation) were demonstrated to the residents during the 25-minute recording. A board-certified epileptologist later reviewed the record with the residents. Resident and EEG technologist feedback on the workshop was obtained via non-formal e-mail request. All residents rated the workshop highly and found it more engaging and motivating than the didactic EEG lecture in which basics of EEG recording are reviewed. The residents gained improved awareness and appreciation of the role of the technologist and the skill and time involved in obtaining an EEG record. The EEG technologist appreciated the face-to-face interaction with the residents and felt part of the patient care team. A hands-on EEG workshop as a part of resident clinical neurophysiology rotation is feasible, effective, and motivating in teaching residents and medical students the basis of EEG recording and recognition of common physiological and non-physiological artifacts in a normal record. [ABSTRACT FROM AUTHOR]

The article discusses how international pharmacy graduate (IPG), refugee, and asylee candidates encounter many barriers when pursuing residency training. Topics include the challenges in navigating the residency application process, limited knowledge of immigration matters of many faculty and residency program directors (RPDs), and inequity in the pharmacy residency application process.

Background: Relatively little data describe how diet and food choices impact trainee well-being despite evidence that diet impacts both physical and mental health. The objective was to describe food options available to emergency medicine (EM) residents when on duty. Methods: A survey utilizing closed-ended, binary, rank-order responses was developed by experts in graduate medical education and wellness; it was piloted, revised, and then electronically distributed to 211 EM residency programs over 2 weeks in 2021. The program director (PD) or associate PD was invited to participate. Results: A total of 114 EM programs participated (54%). The primary teaching site included 43 community hospitals, 23 county hospitals, and 48 university hospitals. Resident access to an onsite hospital cafeteria was most common (97%); other onsite options were vending machines (87%), fresh food fridges (34%), national chains (32%), local restaurants (25%), food trucks (30%), and farmer's markets (11%). More than one-third (38%) reported that onsite options did not include healthy food, 26% reported being dissatisfied with onsite food, and 35% rarely or never purchased food onsite. Most programs (89%) do not have a dedicated "meal break" for residents while on duty. Few residency programs include diet or nutrition classes or counseling. When programs sponsor meals during residency events, nutritional value and dietary considerations were ranked less important than cost of food and convenience. Conclusions: Access to healthy food options is not always available during scheduled resident work hours, and dedicated meal breaks are infrequent. These data should inform institutional initiatives to improve the health and well-being of resident physicians. [ABSTRACT FROM AUTHOR]

Competency‐based medical education (CBME) is an outcomes‐focused approach to educating medical professionals that will be central to future efforts to improve resident training in otolaryngology. The transition to CBME for otolaryngology in the United States will require the development of specialty‐specific assessments and benchmarks, the financial and administrative support for implementation, the professional development of faculty and learners, and the cooperation of all major stakeholders in graduate medical education. In this article, we describe the need for evidence‐based innovation in surgical training, the history of CBME in the United States, and the progress towards defining "entrustable professional activities" as the building blocks of assessments for CBME. We explore what such a paradigm shift in surgical education could mean for academic otolaryngologists by examining innovative educational practices in other surgical specialties and discussing foreseeable challenges in implementation for the American healthcare system. [ABSTRACT FROM AUTHOR]

Graduate medical education (GME) in the USA is an increasingly organized and formalized process overseen by regulatory bodies, notably the American Council of Graduate Medical Education (ACGME), and associated specialty-specific Residency Review Committees (RRCs) to ensure that trainees, including residents and fellows, receive comprehensive, high-quality didactic education, clinical training, and research experience. Among the required elements of GME, performance of independent research is emphasized less than clinical and didactic education. In general, there are no ACGME requirements that trainees successfully publish papers in the peer reviewed. Indeed, unlike as is the case with procedure case logs, there are no minimum thresholds for specific numbers of abstracts presented, posters accepted, or manuscripts published. As such, while residencies and fellowships in certain disciplines or institutions may require considerable, documented research activity, others may not. Since future attending physicians are expected to be experts in their fields, able to digest relevant medical knowledge, critically evaluate emerging findings in the literature, and lead multi-professional healthcare teams, they must have a level of facility with the medical literature than can only be acquired by having performed research and having published papers themselves. Publishing one paper during training is easily attainable for all trainees. Having this be an ACGME requirement will necessitate protected time, research methods education, and mentorship for trainees. This can be accomplished without disrupting the other elements of resident and fellow training. From an ACGME perspective, required scholarly activity will support the competencies of practice-based learning and improvement as well as professionalism. In lay terms, benefits will be a higher level of education and attainment for trainees, and a potentially higher standard of health care for our patients. [ABSTRACT FROM AUTHOR]

After pediatric residency, the author worked in a rural community where he was able to immediately practice skills acquired during training such as intubations, bag-mask ventilation, IV placement, ear irrigation, foreign body removal from eyes and ears, abscess incision and drainage, intraosseous placement for rapid hydration of a severely dehydrated infant, EKG, X-ray readings, and ear-irrigations to cite but a few examples. Furthermore, the writer acquired other high-valued procedural skills such as neonatal male circumcision, frenotomy, ligation of supernumerary digits, and manual separation of labial adhesions. The author feels that he could only have acquired and maintained these skills by working in a busy rural pediatric practice. When the writer later became a faculty member, he was able to effectively train medical students and pediatric residents to acquire these same skills. Even though there is a paucity of research information on procedural skills acquisition among general pediatric residents, the writer proposes that the recruitment of full-time general academic pediatricians with real-world experience may be potentially beneficial for the training of medical students and pediatric residents. [ABSTRACT FROM AUTHOR]

Objectives: Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine. Methods: Workshop comprised of expert presentations, with assessment of difference in knowledge with a pretest and post-test. The sessions were organized around the core competencies of Institute of Medicine. Suggestions were also gathered from the audience. A pretest and post-test based on 13 questions was administered to the participants to assess change in research-related knowledge. Comments and suggestions of the participants were also recorded. Wilcoxon rank test was applied to determine statistical difference across each question and cumulative knowledge score. Conventional content analysis was applied to explore the comments and feedback. Results: The mean score of participants improved across all 12 questions. Statistically significant results were observed for the questions about types of studies qualifying as qualitative research. The cumulative score of participants increased in the post-test from 8.57 to 9.35. The participants gained new knowledge (94.3%), and felt more comfortable in application of research methods (74.3%). Encouraging feedback was obtained from the audience. They stated that they had benefited from the workshop and felt more prepared and motivated to indulge in scholarly activities. Conclusion: The study shows improvement in research-related knowledge of clinical residents attending a 1-day training workshop. We recommend inclusion of such workshops in the curriculum of residents for skill building and enhanced indulgence in research activities in order to prepare them as future leaders in quality improvement, health policy, and hospital administration. [ABSTRACT FROM AUTHOR]

Phenomenon: While part-time clinical work options are popular for physicians, part-time residency training is uncommon. Some residency training programs have offered trainees the option to complete their training on a modified schedule in the past. These part-time tracks often involved extending training in order to complete equivalent hours on a part-time basis. Having experience with trainees in such programs, we sought to explore the impact of completing residency training part-time on the professional and private lives of physicians. Approach: Between 2019 and 2020, we conducted interviews with physicians who completed portions of their residency training part-time between 1995 and 2005 in our institution's pediatrics, combined medicine-pediatrics, and family medicine programs. Findings: Seven female physicians who completed at least some portion of residency part-time were interviewed. To better characterize their experiences, we chose phenomenology as our analytic framework. Members of the research team independently coded each interview and met to resolve conflicts. Codes were then combined and discussed to determine four overarching themes as reasons and benefits of part-time training: The pursuit of extended-time training, logistics, effects on career trajectory, and wellness. These themes highlighted the utility of part-time training and the need for programmatic support to ensure their success. Insights: Based on our findings, adaptability for training and a sense of agency from their part-time experiences persisted throughout interviewees' careers. Each felt empowered to make career choices that fit their personal and professional needs. These findings suggest further investigation into the benefits of offering time-variable training in residency programs. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of standardized patients assisted by WeChat platform combined with case-introduction teaching method in residency training of cerebralvascular disease residents physicians. Methods A total of 70 trainees who received residents training in the Department of Neurology, Lanzhou University Second Hospital from March 2020 to March 2023 were recruited in this study. They were randomly divided into control group and observation group, with 35 in each group. While the control group adopted the traditional teaching method, the observation group used WeChat to send the information of classic cerebrovascular disease cases in advance, then discussed and summarized, and carried out the simulated diagnosis and treatment process for corresponding standardized patients. Compared comprehensive theoretical performance and practical skills of the two groups, as well as satisfaction with the teaching after four months. Results The scores of the observation group were (89.74±2.53) points in comprehensive theory assessment and (90.31±2.54) points in clinical practice skill operation assessment, which were higher than those in the control group (84.26±3.94) points in comprehensive theory assessment and (84.20±3.33) points in clinical practical skill operation assessment, respectively. The difference was statistically significant (P<0.05). The satisfaction rate of the trainees in the observation group was 91.43%, which was significantly higher compared with the control group of 60.00% (P<0.05). Conclusions The application of standardized patients combined with the case-introduction teaching method in the neurology residents training based on the WeChat platform can improve the comprehensive theoretical performance and practical skills of the trainees. It should be promoted and applied. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder and intellectual disability are associated with psychiatric comorbidities, yet a 2009 study of US child and adolescent psychiatry program directors indicated that psychiatry residents receive insufficient training in autism spectrum disorder/intellectual disability. This follow-up study surveyed child and adolescent psychiatry and general psychiatry program directors to assess (1) the current extent of residency training in autism spectrum disorder/intellectual disability, (2) program director perceptions of educational topics and resident competency in autism spectrum disorder/intellectual disability, and (3) preferred resources to strengthen autism spectrum disorder/intellectual disability training. As in 2009, many child and adolescent psychiatry program directors reported few lecture hours, although current child and adolescent psychiatry residents saw slightly more patients with autism spectrum disorder but not intellectual disability. General psychiatry program directors reported fewer lecture hours in autism spectrum disorder/intellectual disability and fewer patients with autism spectrum disorder than child and adolescent psychiatry program directors. Both child and adolescent psychiatry and general psychiatry program directors recognized the importance of a range of educational topics in autism spectrum disorder/intellectual disability. Child and adolescent psychiatry program directors reported higher resident competency, and lecture hours and patients seen moderately correlated with resident competency. Program directors indicated that online videos and other resources would help improve autism spectrum disorder/intellectual disability training in their programs. Collectively, these findings suggest minimal improvements in autism spectrum disorder/intellectual disability training over the past decade and highlight the urgent need to advance psychiatry training in this field through dissemination of resources. Children, adolescents, and adults with autism spectrum disorder and intellectual disability experience high rates of co-occurring psychiatric conditions throughout their lifetime. However, there is a shortage of psychiatrists to treat these populations. We evaluated how much education psychiatrists-in-training receive on how to care for individuals with autism spectrum disorder/intellectual disability. We found that in many psychiatry programs, residents receive limited training experiences in autism spectrum disorder/intellectual disability involving lectures and patient contact and that psychiatry program directors would benefit from more resources to strengthen education in autism spectrum disorder/intellectual disability. [ABSTRACT FROM AUTHOR]

Background As the coronavirus disease 2019 virus made its way throughout the world, there was a complete overhaul of our day-to-day personal and professional lives. All aspects of health care were affected including academics. During the pandemic, teaching opportunities for resident training were drastically reduced. Consequently, medical universities in many parts across the globe implemented online learning, in which students are taught remotely and via digital platforms. Given these developments, evaluating the existing mode of teaching via digital platforms as well as incorporation of new models is critical to improve and implement. Methods We reviewed different online learning platforms used to continue regular academic teaching of the plastic surgery residency curriculum. This study compares the four popular Web conferencing platforms used for online learning and evaluated their suitability for providing plastic surgery education. Results In this study with a response rate of 59.9%, we found a 64% agreement rate to online classes being more convenient than normal classroom teaching. Conclusion Zoom was the most user-friendly, with a simple and intuitive interface that was ideal for online instruction. With a better understanding of factors related to online teaching and learning, we will be able to deliver quality education in residency programs in the future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic forced a sudden change from in-person to virtual interviews for the general surgery residency match. General surgery programs and applicants adopted multiple strategies to best mimic in-person recruitment. The purpose of this study was to evaluate applicant opinions of the virtual recruitment format. Postinterview survey responses for applicants interviewing at a single general surgery residency program in the 2020-2021 and 2021-2022 cycles were evaluated. All interviewed applicants were sent an anonymous survey assessing the virtual interview structure, their impression of the program, and their opinions on recruitment in the future. The response rate was 31.2% (n = 60). Most (88.4%) respondents reported a more favorable view of the program after a virtual interview. Factors that were most likely to create a favorable impression were residents (89.6%) and culture (81.0%). 50.8% of applicants favored virtual-only interviews. The majority of applicants (60.3%), however, preferred the virtual interview remain a component of the application process, 34.4% recommended that virtual interviews be used as an initial screen before in-person invites, while 19.0% suggested applicants should interview in-person or virtually without penalty. 62.1% favored capping the number of interviews offered by programs and accepted by applicants. The virtual interview format for general surgery residency allows applicants to effectively evaluate a residency program. Applicants are in favor of a combination of virtual and in-person interviews in the future. Innovation in the recruitment process, including limiting the number of applications and incorporating virtual events, is supported by applicants. [ABSTRACT FROM AUTHOR]

Introduction: The reorganization of healthcare systems to face the COVID-19 pandemic has led to concerns regarding psychological distress of healthcare workers, and training requirements of physician residents. Objective: To assess the influence of COVID-19 pandemic on depression, anxiety, burnout and training schedules of residents. Methods: Two independent cross-sectional studies (the first in November 2019 [control], the second in June 2020, during the first wave of COVID-19 pandemic) enrolling physician residents from Brazil, using online surveys. In each of them, we collected demographic and training program data, and assessed depression, anxiety and burnout through PHQ-2, GAD-2 and MBI (2-item version) scales, respectively. We controlled confounding variables with logistic regression analysis. Results: The COVID-19 cohort (n = 524) presented a briefer workload and had at least 1 day off per week more frequently, in relation to the control cohort (n = 1 419). The majority of residents (464/524, 89.5%) had a reduction in their duty hours, and believed they would need an extra training period after the end of the pandemic (399/524, 76.2%). The frequency of depression increased (46.0% vs. 58.8%, aOR = 1.64, 95% CI = 1.32–2.05), anxiety did not change (56.5% vs. 56.5%, aOR = 1.24, 95% CI = 0.99–1.55) and burnout decreased (37.0% vs. 26.1%, aOR = 0.77, 95% CI = 0.60–0.99). Sensitivity analysis did not change these results. Conclusion: Mental distress is frequent among residents and associated with both training program and social environments. The consequences of the COVID-19 pandemic on training requirements should be specifically addressed by supervisors and policymakers, in a case-by-case basis. Psychological support must be provided to healthcare workers. [ABSTRACT FROM AUTHOR]

Objectives: During the past decade, educational supervision (ES) has gained popularity as a key support mechanism in residents' training. However, few studies have mapped physicians' understanding of their roles as educational supervisors. This study aims to explore how supervisors experience this role and how they approach providing support to residents. Methods: We employed qualitative methodology and conducted semi-structured interviews with 13 senior hospital physicians regarding their experiences as educational supervisors. Participants were recruited via e-mail and snowball sampling. Interview transcripts were analysed using inductive systematic text condensation following a four-step procedure: (i) total impression (ii) identifying and sorting meaning units (iii) condensation from code to meaning (iv) synthesising condensation from description and concepts. Results: Our analysis yielded four main themes. We found that while ES was considered important in theory, its purpose appeared unclear in everyday practise. Second, ES was associated with filling multiple and sometimes contradictory expectations. Third, establishing a good relationship between residents and supervisors was considered critical for effective ES. Finally, being a supervisor was described as experiencing a personal cost in the absence of support and resources. Conclusions: The many roles embedded in attending physicians' understanding of ES indicate a wide definition of the supervisory role. Supervisors contribute to residents' training by ensuring educational quality while upholding quality in patient care. Educational supervisors considered themselves to be vital sources of support for residents, but found their role unclear in everyday practice. They strove to manage different expectations resulting from lack of supportive organisational structures. [ABSTRACT FROM AUTHOR]

The emergence of the coronavirus disease 2019 pandemic forced us to adapt our recently developed informatics training serving a variety of students as well as faculty and staff. The successful flipped classroom course series (a hybridformat with both asynchronous online learning and in-person synchronous components) was shifted to a fully online format with the synchronous portion now held via web-based video conference. We repeated our participant survey at the end of each of the 3 one-credit courses to compare student satisfaction and learning outcomes achievement to the original offering. The responses were overall very positive again with a slight response distribution improvement in some measures of satisfaction. Likewise, students reported similar achievement of the learning outcomes across all courses with some Unixcourse objectives receiving higher competency agreement in the new, fully online version. Overall, the fully online version of the course series was equally successful, if not more so, than the original version with a physical classroom session each week. Given that participants also had strong agreement with a new question that they would prefer online class meetings instead of in a classroom, even if there wasn’t a global pandemic (citing a variety of logistical reasons such as “convenience of screen sharing,” parking issues, and job-related time constraints), the fully online version of the informatics training will be retained. [ABSTRACT FROM AUTHOR]

Objective: To investigate emergency clinicians' comfort level in assessing neurological emergencies and to identify opportunities to foster enhanced training of clinical neurology in the emergency room. Design: Internet‐based survey. Setting: University teaching hospitals and private referral centers. Subjects: One hundred and ninety‐two emergency and critical care specialists and resident trainees (ECC) and 104 neurology specialists and resident trainees (NEUR) in clinical practice. Interventions: An internet‐based survey was distributed via veterinary professional organizations' listserves and message boards and responses were collected between March and April 2020. ECC completed a survey evaluating stress levels associated with neurological emergencies, confidence with neurological examinations, and neuroanatomical localization. NEUR completed a similar survey to report their perception of their ECC colleagues' confidence in the assessment of neurological cases. Chi‐square and Mann–Whitney U‐tests were used to compare categorical responses and confidence scores between groups. P < 0.002 was considered significant. Measurements and Main Results: Fifty‐two percent of ECC found neurological emergencies slightly challenging, whereas 85% of NEUR found them moderately to extremely challenging for ECC (P < 0.0001). ECC's median self‐reported confidence score in performing a neurologic examination on a scale of 0–100 was 75 (interquartile range [IQR], 27), while NEUR reported a median ECC confidence of 44 (IQR, 25; P < 0.0001). Median self‐reported ECC confidence in localizing intracranial, spinal, and neuromuscular disease was 67 (IQR, 40), 88 (IQR, 21), and 60 (IQR, 37), respectively, which was significantly higher than median NEUR‐reported ECC confidence of 35 (IQR, 38), 51 (IQR, 31), and 18 (IQR, 20), respectively (all P < 0.0001). Following case transfer, 34% of ECC received NEUR feedback in >75% of cases. Conclusions: Noticeable discrepancies between ECC and NEUR perceptions of ECC clinical confidence were seen, while no firm evidence of neurophobia could be inferred. Improvements in interdepartmental communication and teaching of clinical neurology may be warranted. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine. METHODS: Workshop comprised of expert presentations, with assessment of difference in knowledge with a pretest and post-test. The sessions were organized around the core competencies of Institute of Medicine. Suggestions were also gathered from the audience. A pretest and posttest based on 13 questions was administered to the participants to assess change in research-related knowledge. Comments and suggestions of the participants were also recorded. Wilcoxon rank test was applied to determine statistical difference across each question and cumulative knowledge score. Conventional content analysis was applied to explore the comments and feedback. RESULTS: The mean score of participants improved across all 12 questions. Statistically significant results were observed for the questions about types of studies qualifying as qualitative research. The cumulative score of participants increased in the post-test from 8.57 to 9.35. The participants gained new knowledge (94.3%), and felt more comfortable in application of research methods (74.3%). Encouraging feedback was obtained from the audience. They stated that they had benefited from the workshop and felt more prepared and motivated to indulge in scholarly activities. CONCLUSION: The study shows improvement in research-related knowledge of clinical residents attending a 1-day training workshop. We recommend inclusion of such workshops in the curriculum of residents for skill building and enhanced indulgence in research activities in order to prepare them as future leaders in quality improvement, health policy, and hospital administration. [ABSTRACT FROM AUTHOR]

Occupational and environmental medicine (OEM) is an ACGME-accredited preventive medicine specialty focused on work as a social determinant of health and population health. OEM providers recognize and mitigate workplace and environmental hazards, treat resultant injuries and illnesses, and promote the health, wellness and resiliency of workers and communities. Multidisciplinary residency training in clinical medicine, epidemiology, public and population health, toxicology, exposure and risk assessment, and emergency preparedness equips them with the skill set needed for leadership roles in diverse settings. These include clinical practice, academia, corporate settings, and governmental agencies. Despite robust job opportunities, a shortage of formally trained OEM physicians remains and is expected to worsen given a declining number of training programs. We examine root causes of the system-level issues impacting the supply of OEM physicians and potential solutions. [ABSTRACT FROM AUTHOR]

Objective: In an era of limited medical training funds and challenges for teaching centers to maintain their academic mission, the importance of accurate documentation to ensure commensurate coding and billing for services is critical. We sought to develop a practical program that would teach residents documentation skills with the goal of more accurately capturing the work being done in a tertiary care academic medical center. Methods: A case–control study was performed. Otolaryngology inpatient and Emergency Department consultation notes at a single tertiary medical center were reviewed and knowledge gaps and shortcomings in documentation identified. Three short educational sessions were provided on documentation skills. During the same timeframe, templates in the electronic medical record were standardized to help maintain thoroughness of documentation within the consultation note. Results: A total of 1476 consultations performed by the Otolaryngology department during a 9‐month period in FY17/18 (preintervention) were compared to a total of 1622 consultations performed during the same 9‐month period in FY19/20 (postintervention). The percent of billable consultations increased from 42.4% to 50.9% (p <.001). Similarly, the percentage of consultations coding at a higher level of complexity rose from 51.6% to 59.5% (p =.002). This improvement led to an increase in consultation charges of more than $130,000. Conclusion: This study demonstrates that a simple documentation and coding curriculum and workflow interventions can lead to more thorough and improved consult documentation as evidenced by a significant increase in the percentage and complexity of billable Otolaryngology consultations at a tertiary academic center. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Background: To meet ACGME-I (Accreditation Council for Graduate Medical Education–International) training and duty hour requirements, we converted our 3-week-long pediatric emergency medicine induction program to an eLearning program. Objectives: The study aimed to identify areas of the eLearning program residents perceived useful and the components that helped them prepare for clinical work. Methods: The qualitative study took place in a tertiary pediatric emergency department. Twenty-seven residents from family medicine, emergency medicine, and pediatric medicine participated in focus group discussions to explore how they perceived the eLearning program helped prepare them for work. The interviews were audio-recorded, and transcripts were analyzed and coded into categories and themes. Results: Four themes emerged from the data analysis: residents' access to the eLearning program, instructional methods, eLearning design elements, and supplementary learning. Residents valued autonomy to control their pace of learning and use online features that matched their preferred learning styles. Design features such as the use of questions and quizzes helped stimulate learning, but attention had to be paid to the order of questions in the modules and the format of the questions. Written guidelines served as a good reference for learners and face-to-face sessions accompanying the eLearning program helped reinforce knowledge and offered opportunities to interact with faculty members to clarify questions. Conclusion: Systematic planning focusing on access, instructional methods, and design is essential when creating eLearning programs for residency training. eLearning programs can be enhanced by the incorporation of team-based learning and having accompanying written content to reference. [ABSTRACT FROM AUTHOR]

Objectives: The transition from the first year of urology residency (PGY1) to the second year (PGY2) is overwhelming for most residents due to their sudden involvement in decision-making regarding urology patients after only general surgical training during PGY1. Therefore, this study tested the effectiveness of a newly developed one-day Preparatory Urology (Prep-U) training course among second-year urology residents in Saudi Arabia. Materials and methods: Urology residents from different regions participated in our Prep-U course over the 3-year study period at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Two surveys were given to all participants following completion of the course and 9 months after urology training (PGY2). Our outcomes included participants' satisfaction with the course, its content, and speakers' experience. Results: A total of 117 completed the first survey, a response rate of 90.7%. Most (90.6%) were satisfied with the course overall, consistent with their satisfaction with the content (94.0%) and speakers' experience (94.8%). The majority (95.7%) felt that the course added value to their urology training. During the 9-month assessment period, 92 respondents (85.9%) found the knowledge acquired during the course very helpful, 72.8% reported that the course helped them maintain their mental wellbeing, and 39.11% found the skills acquired from the course very helpful on beginning urology training. Conclusion: A significant need exists for an annual urology preparatory course before the beginning of training. This will have a positive outcome on residents' training, confidence, and mental wellbeing. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The purpose of this study was to evaluate the accuracy of visual joint angle assessments by orthopaedic surgery trainees amongst various levels of training. METHODS: Sagittal plane photographs of several joints at various angles were distributed to trainees within an orthopaedic residency program. Joint angles were estimated and compared to those obtained with a goniometer. Inter-and intra-rater reliability and ANOVA were conducted to assess differences between groups. RESULTS: Twenty trainees were studied. The percent error for knee measurements differed at 23.1%, 26.2% and 11.1% for the PGY 2-3, PGY 4-5 and PGY 6 groups, respectively (P=0.024). Percentage error for ankles showed the greatest variability at 69.7-96.3%. Intra-rat-er reliabilities for all visual joint angle assessment were similar amongst groups. CONCLUSIONS: Visual joint angle assessments vary amongst trainees, with PGY 6s most accurately identifying knee joint angles. Visual assessment is inaccurate compared to goniometric measurements, thus limiting visual measurements during patient encounters. [ABSTRACT FROM AUTHOR]

Introduction: Students applying for urology residency often have limited resources for obtaining information on prospective programs. Applicants commonly rely on institutional websites to compare program elements. The information on these websites can attract or deter applicants and can have a major impact on application costs, rank lists, and career goals. The objective of this study was to determine the accessibility and content of urology residency program websites. Materials and Methods: A list of accredited urology residency programs was obtained from the American Urological Association residency directory in 2020. A total of 141 program websites were evaluated for the presence of 53 criteria, which were categorized into five groups: Personnel information, applicant information, program information, training/research, and resident benefits. Residencies lacking an available website or functional links were excluded from the study. Results: Of the 53 criteria analyzed, only 24 were featured on more than 50% of the websites. Less than 10% of the programs had available information regarding resident contact information (5.67%), alumni contact information (2.84%), frequently asked questions (9.22%), electives (9.93%), night float (5.67%), and board pass rates (5.67%). The three factors most commonly available included program description (100%), coordinator contact information (88.65%), and clinical sites (87.94%). None of the 141 programs had all 53 criteria available on their website. Conclusions: The majority of current urology residency websites may lack the accessibility and content necessary for candidates to make application decisions for desired programs. Residency programs should consider revising their websites to enhance resident recruitment and facilitate applicants' decision-making process. [ABSTRACT FROM AUTHOR]

Nearly half of obstetrics and gynecology (OB/GYN) residency programs in the United States lost access to local training in abortion care following the 2022 Dobbs v Jackson Supreme Court decision. We aimed to determine whether OB/GYN residency candidates who desire abortion training apply to programs in states where abortion is restricted/banned. In 2023, we conducted an anonymous electronic survey of residency interviewees at three large academic OB/GYN programs about the importance of various program characteristics in their selection process. We chose to represent both very restrictive and protective environments for abortion care. We stratified respondents by importance of abortion training in applying to programs (essential or very important [high preference group] vs moderately, slightly, or not important [low preference group]). We analyzed 175 completed surveys (response rate 56%). Of 175 respondents, most (n = 115, 66%) stated that access to abortion training was essential (33%) or very important (33%) when applying to programs. Both high preference group (82%) and low preference group respondents (98%) applied in states where abortion is banned or restricted. Respondents applied in banned/restricted states due to geography, concern about applying to too few programs, and expectation that the program would provide out-of-state training nonetheless. The majority of survey respondents who reported that access to abortion training during residency is essential or very important applied to programs where abortion training is not locally available. Most of these applicants expected programs in restricted states to provide training regardless. Residency programs should be aware of the importance of abortion training to applicants, as well as abortion training expectations, and work to develop opportunities and strengthen training networks in abortion care to meet candidates' needs and ensure adequate learning opportunities exist for all. [ABSTRACT FROM AUTHOR]

Background: Evidence-based prescribing (EBP) results in decreased morbidity and reduces medical costs. However, pharmaceutical marketing influences medication requests and prescribing habits, which can detract from EBP. Media literacy, which teaches critical thinking, is a promising approach for buffering marketing influences and encouraging EBP. The authors developed the "SMARxT" media literacy education program around marketing influences on EBP decision-making. The program consisted of six videos and knowledge assessments that were delivered as an online educational intervention through the Qualtrics platform. Methods: In 2017, we assessed program feasibility, acceptability, and efficacy of enhancing knowledge among resident physicians at the University of Pittsburgh. Resident physicians (n=73) responded to pretest items assessing prior knowledge, viewed six SMARxT videos, and responded to post-test items. A 6-month follow-up test was completed to quantitatively assess sustained changes in knowledge and to qualitatively assess summative feedback about the program (n=54). Test scores were assessed from pre- to post-test and from pretest to follow-up using paired-sample t-tests. Qualitative results were synthesized through content analysis. Results: Proportion of correct knowledge responses increased from pre-test to immediate post-test (31% to 64%, P<0.001) at baseline. Correct responses also increased from pre-test to 6-month followup (31% to 43%, P<0.001). Feasibility was demonstrated by 95% of enrolled participants completing all baseline procedures and 70% completing 6-month follow-up. Quantitative measures of acceptability yielded positive scores and qualitative responses indicated participants' increased confidence in understanding and countering marketing influences due to the intervention. However, participants stated they would prefer shorter videos, feedback about test scores, and additional resources to reinforce learning objectives. Conclusion: The SMARxT media literacy program was efficacious and acceptable to resident physicians. Participant suggestions could be incorporated into a subsequent version of SMARxT and inform similar clinical education programs. Future research should assess program impact on real-world prescribing practices. [ABSTRACT FROM AUTHOR]

As chief of surgery at Grady Memorial Hospital in Atlanta Roger Sherman trained generations of trauma surgeons, including me. Our relationship had three phases, each with a specific lesson that stayed with me throughout my career: first, the interview for a fellowship; second, my training at Grady, or "Grady 101;" and third, relating to important people outside of surgical practice, which I understood to be "that 10 percent" that really, really disliked me.I was caught during a time when there was a severe contraction of the number of training programs in surgery. Despite the red flag of having gone to four different residencies, Dr. Sherman still decided to offer me fellowship position. Training at Grady meant seeing more patients with severe trauma and burns than most surgeons see in a lifetime, with an autonomy that was coupled with responsibility and the expectation of accountability. The 10 percent often included non-surgical consultants and administrators that might be adversarial at first but could provide support if they were informed about the impact of their decisions on patients.Being part of Dr. Sherman's staff was a privilege. In his words "surgery … is an awesome responsibility afforded to only a few … a high honor surpassed only by being trusted to teach others this demanding and marvelous craft." [ABSTRACT FROM AUTHOR]

Objectives: Formal nighttime education is becoming increasingly necessary as more internal medicine (IM) residency programs adopt night-float rotations (NFRs); however, the efficacy of an NFR curriculum throughout an academic year and which topics in an NFR curriculum increase trainee confidence are unknown. We implemented a 12-module, self-paced NFR curriculum for 76 postgraduate year-1 residents at an academic IM residency program. We evaluated the impact of this curriculum on postgraduate year-1 residents' clinical confidence, as well as longitudinal efficacy of the curriculum.Methods: Night-float interns' (NFIs) clinical confidence regarding specific curricular topics was evaluated overall and during specific timeframes within the academic year. Pre- and post-NFR surveys using Likert scales for each topic were administered to NFIs from June 24, 2020 to March 2, 2021, representing 32 week-long NFR cycles.Results: NFIs' pre- and postrotation confidence in managing clinical scenarios significantly improved for all 12 topics in the NFR curriculum. The NFR curriculum resulted most significantly in improved confidence during the first 4 months of the academic year, with 11 of 12 curricular topics reaching the threshold for statistical significance. Modules on altered mental status, hypotension, narrow-complex tachyarrhythmias, new fever, and sepsis and antibiotic escalation maintained their efficacy for the longest periods of time.Conclusions: It may be especially important to emphasize an NFR curriculum at the beginning of the academic year. IM residency programs also may wish to carefully consider that certain topics may maintain their efficacy throughout the year, whereas other topics should potentially be replaced with more complex modules as the academic year progresses. [ABSTRACT FROM AUTHOR]

Background: The emergence of COVID-19 had a massive impact on the health system globally. While there are many kinds of literature reporting the impact on postgraduate medical training in other parts of the world, this cannot be said about Nigeria. Methodology: This was a national cross-sectional study among Resident doctors via an online google form survey for 8-months. Stratified cluster design where the entire country was stratified into the six geopolitical zones, and Tertiary Health Institutions (THI) were randomly selected from each of these zones. Data from the 47-itcm google form were analysed with Statistical Package for Social Science (SPSS) version 23, and internal consistency reliability was measured by Cronbach's alpha coefficient. Categorical variables were compared using chi-square, and the p-value was <0.05. Results: A total of 239 residents from THI in all six geopolitical zones completed the survey. The mean± standard deviation of the age of respondents, years in practice, and years in residency were 36.3±4.4); 10.2±7.6 years, and 4.2±2.6 years, respectively. The Cronbach's alpha coefficient was 0.95. Less than half had delayed the progression of residency (44.4%). The least strongly positive impacts were related to recruitments (4.2%), laboratory testing (4.2%), and ward rounds (4.2%); and the more strongly positive disruptive impact was on postgraduate seminars (9.2%), research (8.4%), professional examinations (8.0%) and residents' clinical schedules (8.0%). Conclusion: COVID-19 has caused a considerable delay in residents' training programs, and resident doctors have great concerns regarding the pandemic. This impact is perceived by them in almost all aspects of the training. [ABSTRACT FROM AUTHOR]

Objective To plan and execute a teaching and assessment strategy to engage the residents in academics to minimize the potential loss in their training during COVID-19 pandemic. Methods At the start of COVID-19 pandemic in the country (from 4th week of March 2020), we started online academic activities for our 28 post graduate residents, by incorporating smart phone applications ("WhatsApp" and "Zoom") and during following one and half year, our teaching strategy evolved through following four stages. (i) Pure Online Learning, (ii) Online plus Physical Learning, (iii) Predominantly Physical Learning, (iv) Reengagement in a "new normal" environment. Results All components of residency curriculum (theoretical knowledge, professional competencies, skills enhancement) were achieved through frequent MCQs tests, clinical slide sessions, patient-based real time teaching, case presentations, Mock viva and TOACS exams and hands on workshops. Conclusion Hybrid model using smart phones with WhatsApp and Zoom applications is a feasible, cost-effective, and appropriate alternate to traditional medical education during COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Health care inequity is corrected more readily when safe, high-quality care is provided by physicians who reflect the gender, race, and ethnicity of patient communities. It is important to train and evaluate racially diverse physicians involved in residency training.Objective: This study sought to determine any test-taking differences for black Emergency Medicine (EM) residents and whether any such differences would narrow as residency progressed.Methods: This was an observational, cross-sectional study that reviewed performance (scaled scores) on the American Board of Emergency Medicine (ABEM) In-Training Examination (ITE) for 2018, 2019, and 2020. The study included EM residents in 3-year programs who took the ITE. A linear regression model was used for the variables of race, which included black physicians and white physicians (reference group), and level of training (EM resident year 1 [EM1] as the reference group).Results: There were 9591 residents included; 539 were black and 9052 were white. Mean scaled scores were higher as a function of training level. Regression showed a scaled score intercept of 73.51. The ITE score increased for all groups as a function of training level (EM2 β = +5.45, p < 0.0001; EM3 β = +8.09, p < 0.0001). The regression coefficient for black residents was -5.87 (p < 0.0001). There was relative improvement by training level compared with improvement in the reference group, but this difference was not materially or statistically significant.Conclusion: In this study of the ABEM ITE, a test-taking performance gap identified early in residency for black physicians persisted into late residency. [ABSTRACT FROM AUTHOR]

Residents in multiple surgical specialties are trained to perform peripheral nerve surgery (PNS), but the extent of exposure to this field varies among specialties. This study evaluates trends in volume of PNS performed during residency for neurologic surgery trainees compared to those in plastic and orthopedic surgery between 2009 and 2019. We queried ACGME for neurologic, plastic, and orthopedic surgery resident case-logs and compared mean number of PNS between graduating residents of each specialty using a one-way analysis of variance test. Linear regression was utilized to determine trends within and across the specialties over the study period. Neurosurgery residents (24.76 ± 3.41) performed significantly fewer PNS than their counterparts in orthopedic (54.56 ± 6.85) and plastic surgery (71.96 ± 12.20), P < 0.001. Residents in neurologic surgery reported over 1.5-fold as many cases as their ACGME-required minimum, in contrast to plastic (2.5-fold) and orthopedic (5-fold). Plastics residents (3.46 cases/year) demonstrated the greatest longitudinal increase in PNS, followed by neurosurgery residents (0.81 cases/year). PNS accounted for a mean of 5.81% of neurosurgery resident cases, 4.20% of plastic surgery resident cases, and 2.98% of orthopedic surgery resident cases (P < 0.001). Neurosurgery residents exceeded the required minimum number of PNS and were increasingly more exposed to PNS. However, compared with their counterparts in orthopedic and plastic surgery, neurosurgery residents performed significantly fewer cases. Exposure for neurosurgery residents remains unchanged over the study period while plastic surgery residents experienced an increase in case volume. The deficiency in exposure for neurosurgical residents must be addressed to harness interest and proficiency in PNS. [ABSTRACT FROM AUTHOR]

Instagram (IG) is becoming one of the larger resource tools within medicine. Since the onset of the COVID-19 pandemic, it is becoming important for programs to improve virtual presence and outreach. We evaluated the adoption of IG by OB/GYN residency programs in the United States and aimed to see if highly ranked programs had higher utilization rates. IG presence and engagement metrics were extracted for all ACGME accredited OB/GYN programs. Doximity residency navigator tool was used to obtain nationwide program rankings, and statistical analysis was performed to prove any significant correlation. Mann–Whitney U test, Cochran-Armitage test and Analysis of variance were used for analysis. IRB exemption was obtained. Seventy percent of programs (202/287) have IG presence, with the majority creating presence after the COVID pandemic began (115/202; 57%). Seventy-two percent (83/115) of these programs created their IG account once virtual interviews were announced. The top 25% of programs, as ranked on Doximity, have a higher number of posts, followers and likes when compared to the rest of the programs. The COVID-19 pandemic has led to increased adoption of IG by residency programs. Highly ranked and reputed programs have higher rates of activity, popularity, and engagement on IG. [ABSTRACT FROM AUTHOR]

Collective interest in global health training during US obstetrics/gynecology (Ob/Gyn) residency has grown over the past decade. The benefits of participation in global health electives have been well described. This review seeks to determine what literature exists regarding the use of Accreditation Council for Graduate Medical Education (ACGME) Milestones in Ob/Gyn residency as an assessment tool to evaluate global health programs. The PubMed database was searched from July 14, 2020 to August 20, 2021, using six search phrases: “global health curriculum(s) and ACGME”; “international health and ACGME”; “global health and Ob/Gyn residency”; “international health and Ob/Gyn residency”; “global health and Ob/Gyn residents”; and “global health curriculum(s) and Ob/Gyn residency.” Publications that described global health programming outside of residency, within other medical specialties, and/or at non-US institutions were excluded from this review. In total, 259 publications resulted from the preliminary search. Five articles described US global health residency training in Ob/Gyn in some capacity. Only one publication described a specific global health elective and its evaluation with respect to ACGME Milestones. Despite growing popularity of global health electives among residency programs, few are assessing the educational value of these offerings using ACGME Milestones or describing these efforts in the literature. [ABSTRACT FROM AUTHOR]

Objective: Residency training programs are challenging for young physicians with heavy workloads. Although ultrasonography (USG) is an imaging method that is frequently used in obstetrics practice, some basic USG skills can be acquired late in this intensive learning process. Likewise determining the fetal heart axis is an elementary evaluation but can turn into a challenging and time-consuming process, especially for inexperienced clinicians. Material and Methods: Pregnant women between 20 and 37 weeks of gestation were recruited. Two observers assessed the axis of fetal heart by standard, Bronshtein and clock position methods. Fetal heart axis evaluation times were compared. Inter-observer and intra-observer agreements of the three methods were measured. One factor learning rates were calculated. Results: A total of 31 pregnant patients between the ages of 18 and 40 years were included in the study. Fetal heart axis evaluation time by the clock position method was shorter than the Bronshtein and standard method in both observers. Furthermore diagnostic accuracy for both observers was 100% with the clock position method, while this fell to 100% in observer-1 and 96.8% in observer-2 using the Bronshtein method. The clock position method was learned faster than either of the other methods. Conclusion: Clock position method is an easy and feasible method for inexperienced resident physicians in terms of learning and application to determine the fetal heart axis. The advantages of this method increase when patient numbers are higher. [ABSTRACT FROM AUTHOR]

Training experiences where residents provide Spanish-language concordant care (SLCC) have not been widely described despite their increasing need and prevalence in graduate medical education. In this qualitative study, we enrolled nonnative Spanish-speaking residents (n = 21) within SLCC training clinics from 3 geographically unique programs. Participants completed semistructured interviews focused on their overall SLCC training experience. Major themes identified included (1) high levels of satisfaction in their SLCC experience, (2) concern about ongoing language barriers, (3) demonstration of high levels of cultural humility in caring for patients with limited English proficiency, and (4) identification of several valuable programmatic and clinical resources. Based on these findings, we conclude that SLCC training experiences are of significant value to trainees in becoming pediatricians able to promote health equity. Themes identified could help inform how graduate medical education programs utilize SLCC to grow health-equity based efforts to deliver more effective and compassionate care to our linguistically diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen's University Diagnostic Radiology program. Methods and Materials: Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. Results: The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. Conclusions: This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine is a remote medical practice that is progressively expanding in France. In 2018, regulatory changes authorised telemedicine to become part of daily clinical practice. Telemedicine education and training (ET), however, has not been widespread, despite its integration in the medical curriculum since 2009. The objective of this study was to examine the self-perceived knowledge, attitudes and practices (KAP) and ET of telemedicine ET from medical students and residents in France.Methods: A national survey was distributed online (15 December 2018 to 3 March 2019) to approximately 135,000 medical students and residents in medical schools (n = 38). The survey consisted of a total of 24 binary and Likert-scale questions covering telemedicine ET and KAP.Results: In total, 3,312 medical students and residents completed the survey. Synchronous video consultation was the most well-known telemedicine activity (86.9%); asynchronous tele-expertise was the least recognised (40.3%). Most respondents (84.8%) stated they were not familiar with telemedicine regulations. The relevance of telemedicine for improving access to care was acknowledged by 82.8% of students and residents; 14% of respondents stated they had previously practised telemedicine during their studies; 14.5% stated they had received telemedicine ET; however, 97.9% stated they were not sufficiently trained.Discussion: This is the first national scale study on telemedecine ET by medical students and residents, to date. Despite positive attitudes, participants were found to have limited telemedicine ET, knowledge and practices. The demand for telemedicine ET is increasing. Such studies that incorporate the perspectives of medical students and residents may strengthen the implementation of telemedicine ET in the future. [ABSTRACT FROM AUTHOR]