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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.

Social work and social work student placements in general practice [GP] can contribute to wholistic healthcare. The overall aims of this research were to develop, implement and evaluate a field education placement curriculum for social work student placements in GP clinics. Between December 2021 and June 2022, six students completed their social work placements in four GP practices in North Queensland. Data collection included student records and an online survey that invited students, field educators, task supervisors, mentors, allied health professionals and GPs to provide feedback about the usefulness of the developed materials, the benefits and challenges of the placements, the services provided by the students, patient outcomes and feedback, social work learning, service delivery overall and the value of, and satisfaction with, the social work GP placements. Social work student placements in GP practices offer a valuable broadening of field education learning opportunities for social work and can benefit GP settings. Such placements need to be particularly carefully scaffolded and supported through a comprehensive curriculum, supervision, and a welcoming GP setting. Students interested in embarking in such a learning journey need to be highly confident and competent in social work practice. [ABSTRACT FROM AUTHOR]

Objectives: To perform a systematic review of the published literature on pathology graduate medical education, with a focus on novel educational curricula.Methods: We systematically searched the PubMed and Embase databases for relevant articles published between 2000 and 2021.Results: We analyzed 612 articles and selected 19 peer-reviewed, full-length, English language articles published between 2003 and 2021 describing unique curricula for final review. Details on the general characteristics, conceptualization, design, implementation, and assessment were collected and discussed.Conclusions: This systematic review highlights a recent increase in published curricular endeavors specifically addressing topics of educational need that are otherwise not commonly taught in traditional residency training. Curricula are diverse in their teaching methods, implementation, and originating institutions. The lack of meaningful evaluated outcomes and available curricular materials may hinder wider use of such curricula; these should be considered by future pathology educators undertaking their design. [ABSTRACT FROM AUTHOR]

Purpose: Point-of-care ultrasound (POCUS) is ultrasound brought to the patient's bedside and performed in 'real time' by the healthcare provider. The utility of POCUS to facilitate management of the acutely ill patient has been demonstrated for multiple pathologies. However, the integration of ultrasonography and echocardiography training into residency curriculum varies across the acute care specialties.Study Design: After an institutional review board approval, anaesthesiology, emergency medicine, family medicine, internal medicine, paediatrics and general surgery programme directors (PDs) were surveyed. The survey consisted of 11 questions evaluating the primary bedside assessment tool for common acute care situations, POCUS topics that the PDs were comfortable practising and topics that the PDs felt were useful for their specialty. Barriers to POCUS use, certification and documentation were also surveyed.Results: Overall, 270 PD surveys were completed. The preferred primary assessment tool for common acute care situations varied with specialty; emergency medicine PDs consistently responded that POCUS was the diagnostic modality of choice (p<0.0001). The majority of the PDs reported lack of educational opportunities as the primary barrier to learning POCUS (64%). Most PDs indicated that POCUS examinations should be documented (95.7%), and 39% reported that departmental certification would be sufficient.Conclusions: This study is the first to evaluate differences in the preferred initial bedside assessment tool between the acute care specialties. Although POCUS is a superior tool for evaluating acute pathologies, disconnect between education and utilisation remains. This study highlights the need to incorporate POCUS into the acute care specialty curriculum. [ABSTRACT FROM AUTHOR]

Purpose Of the Study: This study aimed to investigate whether, in the UK, medical school attended influences the propensity to apply to and be successful in obtaining an offer from the Academic Foundation Programme (AFP), thus taking the first step to embarking on a clinical-academic career.Study Design: A retrospective observational study was performed. Using the UK Foundation Programme's yearly statistical report data, mean application rates to, and mean offer rates from the AFP were calculated by medical school, between the years 2017-2019. Mean application and mean offer rates were subsequently correlated with metrics of medical school academic performance and research focus.Results: Mean application rates to the AFP were higher in medical schools that had a mandatory intercalated degree as part of the undergraduate medical curriculum (mean=33.99%, SD=13.93 vs mean=19.44%, SD=6.88, p<0.001), lower numerical rank in the Times Higher Education 2019 World Rankings (correlation with higher numerical rank, r=-0.50, p=0.004), and lower numerical rank in the Research Excellence Framework 2014 UK rankings (correlation with higher numerical rank, r=-0.37, p=0.004). Mean offer rates from the AFP were not correlated with any metric of medical school academic performance or research focus.Conclusions: Students attending a medical school with greater academic performance and research focus are more likely to apply and subsequently embark on a clinical-academic career. However, students wishing to embark a clinical-academic career from any medical school have an equal chance of success. [ABSTRACT FROM AUTHOR]

The concept of continuity in medical education reflects the progressive professional and personal development that physicians need in education. The aim of this study is investigating the views of the residents about the adequacy of undergraduate and postgraduate education in the context of preparing them for the next stage and their perceptions about the transition period. This phenomenological study was conducted at Hacettepe University Medical School. The study group consisted of medical and surgical sciences residents in the first year and last year of postgraduate medical education. Four focus group interviews were held with the participation of 21 residents. The participants emphasised that practising with real patients under supervision by taking an active role in healthcare teams was important for their preparation for the next stage in their carrier. However, their educational experiences during undergraduate medical education differed in community-based education, scientific research training, learning in small groups, internship and guidance of clinical educators. The transition period has been expressed with the concepts of identity change, high responsibilities and expectations required by the new identity, adaptation to the healthcare team, institution, and health system, meeting the expectations in an overly busy work environment, and feelings of incompetence. Participants pointed out that curriculum, which was declared and taught, educational environments, assessment approaches, consultancy systems and practices differed between the clinical departments. In line with the principles of competency-based education, practices related to the development and assessment of the competencies with all professional aspects in postgraduate medical education can be strengthened. [ABSTRACT FROM AUTHOR]

Introduction: Identifying costs and values in healthcare interventions as well as the ability to measure and consider costs relative to value for patients are pivotal in clinical decision-making and medical education. This study explores residents' preferences in educating value-based healthcare (VBHC) during postgraduate medical education. Exploring residents' preferences in VBHC education, in order to understand what shapes their choices, might contribute to improved medical residency education and healthcare as a whole.Methods: A discrete choice experiment (DCE) examined which conditions for educating VBHC are preferred by residents. DCE gives more insight into the trade-off's residents make when choosing alternatives, and which conditions for educating VBHC have the most influence on residents' preference.Results: This DCE shows that residents prefer knowledge on both medical practice as well as the process of care-to be educated by an expert on VBHC together with a clinician. They prefer limited protected time to conduct VBHC initiatives (thus while at work) and desire the inclusion of VBHC in formal educational plans.Conclusion: When optimising graduate and postgraduate medical education curricula, these preferences should be considered to create necessary conditions for the facilitation and participation of residents in VBHC education and the set-up of VBHC initiatives. [ABSTRACT FROM AUTHOR]

Background The Ending the HIV Epidemic initiative, which aims to decrease the annual incidence of HIV infections in the United States (US) by 90% over the next decade, will require growth of a limited HIV provider workforce. Existing HIV training pathways within Family Medicine (FM) and Internal Medicine (IM) residency programs may address the shortage of HIV medical providers, but their curricula and outcomes have not previously been assessed. Methods We identified HIV residency pathways via literature review, Internet search, and snowball sampling and designed a cross-sectional study of existing HIV pathways in the US. This survey of pathway directors included 33 quantitative items regarding pathway organization, curricular content, graduate outcomes, and challenges. We used descriptive statistics to summarize responses. Results Twenty-five residency programs with dedicated HIV pathways in the US were identified (14 FM and 11 IM), with most located in the West and Northeast. All 25 (100%) pathway directors completed the survey. Since 2006, a total of 228 residents (77 FM and 151 IM) have graduated from these HIV pathways. Ninety (39%) of 228 pathway graduates provide primary care to persons with HIV (PWH). Conclusions HIV pathways are effective in graduating providers who can care for PWH, but generally are not located in nor do graduates practice in the geographic areas of highest need. Our findings can inform quality improvement for existing programs, development of new pathways, and workforce development strategies. Specifically, expanding pathways in regions of greatest need and incentivizing pathway graduates to work in these regions could augment the HIV workforce. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss issues in physical therapist professional education programs in the U.S. as of April 2021, particularly on whether to include residency education (ResEd) in said programs. Topics include the states of the professional doctor of physical therapy (DPT) and postprofessional physical therapist residency programs (PRP), and the need to foster maturation of the physical therapy profession.

Introduction: Lack of obstetric and gynecologic (OBGYN) procedure exposure during general surgery residency was recognized as a training gap for military general surgery residents by U.S. Navy trauma and general surgeons serving as simulation leads for the Naval Medical Center Portsmouth general surgery resident program. Program faculty requested the authors develop and implement a recurring simulation curriculum to address this training gap. The primary goal of the simulation curriculum was to increase exposure to and confidence in performing four commonly encountered OBGYN procedures in a deployed setting: spontaneous vaginal delivery (SVD), Bartholin's cyst incision and drainage with Word catheter placement, cesarean delivery, and total abdominal hysterectomy (TAH). We hypothesized that trainees exposed to the new simulation curriculum would demonstrate an increase in knowledge and confidence in these four commonly encountered OBGYN procedures.Materials and Methods: The study utilized a pre- and postdesign to determine the efficacy of a newly developed simulation curriculum as measured by participants' knowledge and confidence levels. The annual curriculum was 4 hours in duration and included a targeted lecture followed by the administration of the four OBGYN simulation skills stations: SVD, Bartholin's, cesarean delivery, and total abdominal hysterectomy. Proctors for the simulation stations consisted of OBGYN teaching faculty who had at least 5 years of clinical teaching experience and were experienced simulation instructors. Precourse and postcourse knowledge and confidence were self-rated on a 5-point Likert scale. The learners rated the course using the Simulation Design Scale. Likert scale data were analyzed using the paired Wilcoxon rank sum test. Descriptive statistics were reported for the Simulation Design Scale. P < 0.05 was considered to be statistically significant. This project was classified as nonhuman subjects' research by the Naval Medical Center Portsmouth Institutional Review Board.Results: Over the 2 years since curriculum implementation, 34 trainees participated in the curriculum; no trainees have had the curriculum twice. All trainees confirmed training gaps on baseline self-assessment of knowledge and confidence of all four OBGYN procedures with the most confidence reported for SVD (2.83 mean). Self-rated knowledge and confidence levels improved significantly in all four of the simulated procedures for all 34 participants (P < 0.001). Postcurricular surveys (82% response rate, 28/34) indicated a high satisfaction with all areas of the simulation training (4.74/5.0).Conclusions: The implemented curriculum increased general surgery trainees' knowledge and confidence in four commonly encountered OBGYN procedures and demonstrated a high level of learner satisfaction and sustainability. The curriculum exhibits high educational impact and could be a valuable adjunctive training for other non-OBGYN physicians who may need to provide OBGYN care in military environments. [ABSTRACT FROM AUTHOR]

Purpose We describe the structure, implementation, and initial evaluation of a formal residency research certificate program (RRCP) designed to further advance residents' knowledge and skills in research in an effort to better prepare residents for research involvement during their careers. Summary Pharmacy residency programs vary in the degree of emphasis on research education and training and the structure of resident research activities. Limited data describing formal research education and training for pharmacy residents are available. To better educate and prepare residents in the research process, State University of New York Upstate University Hospital developed and implemented a formal RRCP designed to educate and train residents in essential areas of the research process. Research seminars are delivered by preceptors with experience and training in research throughout the academic year to align with residency project tasks. Residents are also required to complete at least 1 residency project and submit a manuscript suitable for publication in a peer-reviewed journal. Upon successful completion of the program and project requirements, residents earn a certificate of completion. Initial data collected through formal resident assessments before and after RRCP completion demonstrated significant improvement in research knowledge (from an average score of 61.3% out of 100% to an average score of 84.7%, P = 0.002). Conclusion Post-RRCP assessment showed improvements in residents' confidence in several areas of research, including but not limited to research project design, ethical and regulatory principles of research, data collection, selection of appropriate statistical tests, manuscript writing, and the publication process. Residents strongly agreed that the RRCP improved their overall knowledge and perceptions of research. [ABSTRACT FROM AUTHOR]

Objectives: To assess current pathology resident training in genomic and molecular pathology.Methods: The Training Residents in Genomics (TRIG) Working Group has developed survey questions for the pathology Resident In-Service Examination (RISE) since 2012. Responses to these questions, as well as knowledge questions, were analyzed.Results: A total of 2,529 residents took the 2019 RISE. Since 2013, there has been an increase in postgraduate year 4 (PGY4) respondents indicating training in genomic medicine (58% to approximately 80%) but still less than almost 100% each year for molecular pathology. In 2019, PGY4 residents indicated less perceived knowledge and ability related to both genomic and traditional molecular pathology topics compared with control areas. Knowledge question results supported this subjective self-appraisal.Conclusions: The RISE is a powerful tool for assessing the current state and also trends related to resident training in genomic pathology. The results show progress but also the need for improvement in not only genomic pathology but traditional molecular pathology training as well. [ABSTRACT FROM AUTHOR]

Reports of antibiotic stewardship (AS) integration into the > 1000 United States internal medicine and family practice residency core curricula are scarce, but residents value such training. To help address this gap, and the projected shortage of physicians with training for establishing and leading an AS program (ASP), we describe the rationale for, and the output and shortcomings of, a dedicated AS rotation. Residents critically review, in real-time, inpatient antibiotic orders, provide feedback to the prescribers, learn the mechanics and requirements of an ASP, and complete a preliminary quality improvement project. Program evaluations are uniformly positive, noting limited opportunities otherwise to clarify optimal antibiotic choices or discuss antibiotics in depth. Nine posters at national conferences and 1 publication have roots in this rotation. Three alumni matriculated to accredited US infectious diseases fellowships. We invite others to join us in calling for more AS training opportunities during residency. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the prevalence, general interest, and barriers to implementing global health curricula in pathology residency programs.Methods: We conducted a survey of 166 US pathology residency programs.Results: Thirty-two (195) of 166 programs responded. Of these, 13% have a formalized global health program (n = 4), and the majority indicated at least some general interest in global health among trainees (88%, n = 28) and faculty (94%, n = 30), albeit at a low to moderate level. Funding limitations, regulatory constraints, and insufficient knowledge of global health were frequently cited barriers to developing a global health program.Conclusions: Few US pathology departments incorporate global health education into postgraduate training. The importance of pathology in global health has been underappreciated, despite its critical role in the delivery of health care in resource-limited settings. One solution is for pathology departments to expand global health educational opportunities for trainees. [ABSTRACT FROM AUTHOR]

Introduction: The role of the Emergency Medicine (EM) physician in the U.S. military continues to expand, and current Accreditation Council for Graduate Medical Education general training requirements do not optimally prepare military EM graduates to be successful in postresidency operational assignments. To address this gap, the Naval Medical Center San Diego EM residency program introduced a Military Unique Curriculum (MUC) culminating in a capstone event, the Joint Emergency Medicine Exercise (JEMX).Methods: Part of an approved Quality Improvement project, annual survey results from 2012 to 2017 evaluated graduate opinion on the strengths and weaknesses of the MUC. We describe a pilot project conceived by tri-service EM physicians to evaluate the feasibility of the JEMX.Results: Forty-eight graduate residents responded to surveys, 18 of which were administered pre-MUC implementation. With a 100% response rate from graduate residents, overall trends showed greater perceived readiness for postresidency operational assignments after MUC implementation. Written comments received cited the MUC as areas where the Naval Medical Center San Diego EM program excelled and the successful JEMX evolutions as the most valuable curricular component of the MUC.Conclusion: An integrated MUC with a capstone exercise, such as our JEMX, provides a feasible and effective educational experience that improves operational readiness of graduating EM residents. [ABSTRACT FROM AUTHOR]

With the ongoing implementation of a competency-based medical education (CMBE) model for residency programs in North America, emphasis on the duration of training has been refocused onto ability and competence. This study aims to determine the exposure of burn-related core procedural competencies (CPCs) in Canadian Plastic Surgery Residents in order to enhance curricular development and help define its goals. A retrospective review of burn-related resident case logs encompassing all 10 English-speaking plastic surgery residency programs from 2004 to 2014 was performed, including analysis of personal competence scores and resident role by Postgraduate Year (PGY)-year. Case logs of a total of 55 graduating plastic surgery residents were included in the study. Overall, 4033 procedures in burn and burn-related care were logged, accounting for 6.8% of all procedures logged. On average, each resident logged 73 burn procedures, 99% of which were CPCs. The most frequently performed procedure was harvest and application of autograft, allograft, or xenograft, while emergent procedures such as escharotomy and compartment release were performed on average less than one time per resident. Personal competence scores as well as role of the resident (surgical responsibility) increased as PGY-year progressed during residency. Canadian plastic surgery residency programs provide adequate exposure to the majority of the scope of burn care and surgery. However, infrequently encountered but critical procedures such as escharotomy and fasciotomy may require supplementation through dedicated educational opportunities. CMBE should identify these gaps in learning through facilitation of resident competency evaluation. With consideration for the amount of exposure to burn-related CPCs as identified, plastic surgery residency programs can work toward achieving competency in all aspects of burn care and surgery prior to the completion of residency. [ABSTRACT FROM AUTHOR]

The article highlights the celebration of 95 years of pharmacy residency programs of the University of Michigan Health on July 22-23, 2022. Topics discussed include statement from Chief Pharmacy Officer Stan Kent about the event, remarks given by ASHP Chief Executive Officer Paul W. Abramowitz on behalf of ASHP during the banquet, and one of the noteworthy residency options at Michigan University according to Kent.

Introduction: Women's participation in medicine has increased dramatically during the last 50 years, yet Office for National Statistics data (2016) regarding annual pay continue to show an unequivocal 34% deficit in female doctors' remuneration compared with their male counterparts. This study aimed to identify whether there are measurable differences in the training, career vectors and profiles of higher general surgical trainees (HSTs), related to gender.Method: The Deanery roster supplemented with Intercollegiate Surgical Curriculum Programme and Scopus data was used to identify the profiles of 101 consecutive HSTs (38 women, 63 men, single UK deanery). Primary outcome measures were training programme attrition rate, time to completion of training and achievement of third level 4 competence (3L4C) in indicative operations. Secondary outcomes were publication number, citations and Hirsch Indices (HIs).Results: Attrition rates were similar irrespective of gender (female n=3 (7.9%) vs male n=6 (9.5%), p=0.871). Training duration was on average 16 months longer in women (94 (72-134) months) than men (78 (72-112), p=0.002). Operative learning curve trajectories were similar; median operations required to achieve 3L4C was 380 (f) versus 410 (m, p=1.00). Academic profiles of men were stronger than women, specifically higher degrees; men (n=31, 83.8%), women (n=6, 16.2%, p=0.001); median (range) publication number 8 (0-57) versus 3 (0-38, p=0.003), citations 43 (0-1600) versus 9 (0-774, p=0.001), and HI 3 (0-26) versus 2 (0-12, p=0.002).Conclusion: A complex variable gender gap was apparent related to time in training and academic profile, but not training attrition or operative learning curve trajectory. [ABSTRACT FROM AUTHOR]

Background: Fifty percent of graduating U.S. Navy post-graduate year (PGY)-1 physicians will practice in the operational environment before returning to residency training. However, current internship structure is less rotational and focuses more on specialty-specific training. Therefore, these physicians may not be fully prepared for this primary care role.Methods: Based on the U.S. Navy privileges for General Medical Officers, a comprehensive didactic and simulation curriculum was developed. Twenty-three procedural skill competencies (SK) and five validated standardized patient (SP) scenarios were identified. During the SK portion, learners reviewed instructional videos, read reference materials, and practiced with partial task trainers before small-group sessions with subject matter experts (SME). Separate SP round-robin sessions were conducted and feedback provided by SMEs and SPs. Learners demonstrated competency or were remediated.Results: One hundred and three PGY-1 trainees participated over 2 yr. All trainees met requirements during the SK phase. During the SP phase, seven learners required remediation. All learners ultimately met requirements for privileging.Conclusion: The Simulation Training for Operational Medicine Providers curriculum for future General Medical Officers is an effective tool for primary care skill training and credentialing. Plans for export to other Graduate Medical Education sites are underway and further evaluation of skills retention is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns.Design: Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine. Our topics were as follows: introduction to value-based care; telemetry utilisation; lab ordering; optimal approach to thrombophilia work-ups and fresh frozen plasma use; optimal approach to palliative care referrals; antibiotic stewardship; and optimal approach to imaging for low back pain. Our curriculum was implemented at the Stanford Internal Medicine residency programme over the course of two academic years (2014 and 2015), during which 100 interns participated in our high value care curriculum. After each high value care session, interns were offered the opportunity to complete surveys regarding feedback on the curriculum, self-reported improvements in knowledge, skills and attitudinal module objectives, and quiz-based knowledge assessments.Results: The overall survey response rate was 67.1%. Overall, the material was rated as highly useful on a 5-point Likert scale (mean 4.4, SD 0.6). On average, interns reported a significant improvement in their self-rated knowledge, skills and attitudes after the six seminars (mean improvement 1.6 points, SD 0.4 (95% CI 1.5 to 1.7), p<0.001).Conclusions: We successfully implemented a novel high value care curriculum that specifically targets intern physicians. [ABSTRACT FROM AUTHOR]

Background: Training in literature appraisal and statistical interpretation is one of the residency training requirements outlined by the Accreditation Council for Graduate Medical Education. Frequently, a journal club format is used to teach this competency although this teaching modality is not standardized or well studied in regard to its efficacy.Methods: This study sought to determine the effect of a structured journal club curriculum that incorporated The Lancet Handbook of Essential Concepts in Clinical Research on objective and self-assessed knowledge pertaining to study design and interpretation. The study was a retrospective observational study evaluating the effect of a structured journal club curriculum using the Lancet text with pre- and postimplementation assessment using a resident self-assessment survey. The study examined a monthly journal club curriculum that covered 1 topic/chapter from the assigned text, paired with a contemporary article to highlight the chapter topic. Resident self-assessed and objective knowledge was evaluated and compared using a survey taken before and after the curriculum change. The study was completed during 1 academic year at Madigan Army Medical Center in Tacoma, Washington, an academic military medical training and tertiary care center. Study surveys were distributed to all 17 obstetrics and gynecology residents throughout the 4 residency training years. Of the 17 potential participants, 13 (76%) participated in the precurriculum assessment and 14 (82%) participated after its completion.Findings: There was no significant improvement in resident self-assessed knowledge following curriculum implementation. There was a trend toward improved objective knowledge pertaining to study design and interpretation after curriculum completion, but this was not statistically significant.Discussion: There is a lack of standardized and well-studied methods to teach residents how to evaluate and appraise medical literature and research. The Lancet Handbook of Essential Concepts in Clinical Research may be a useful tool to teach some of these tenets in the residency training environment, but this limited study did not prove this assertion.Impact: Three is a dearth of proven and well-studied means to teach the tenets of study design, statistical interpretation, and critical literature appraisal to trainees with any consistency or validity. This study demonstrated a trend toward better objective knowledge related to study design, interpretation, and understanding after a change in our training curriculum that implemented The Lancet Handbook of Essential Concepts in Clinical Research into the monthly journal club curriculum. Resident self-rated knowledge and proficiency in their abilities to understand research and study design were not significantly changed with the curriculum.Recommendations: Better evidence is needed to guide future educational curricula directed toward teaching the competency of medical literature review and appraisal. [ABSTRACT FROM AUTHOR]

Objectives: A clinical laboratory management (CLM) curriculum that can objectively assess the Accreditation Council for Graduate Medical Education pathology systems-based practice milestones and can provide consistent resident training across institutions is needed.Methods: Faculty at Emory University created a curriculum that consists of assay verification exercises and interactive, case-based online modules. Beta testing was done at Emory University and Johns Hopkins. Residents were required to obtain a score of more than 80% in the online modules to achieve levels 3 to 4 in the milestones. In addition, residents shadowed a laboratory director, performed an inspection of a laboratory section, and completed training in human subjects research and test utilization.Results: Fourteen residents took and evaluated the laboratory administration curriculum. The printed certificates from the modules were used for objective faculty evaluation of mastery of concepts. Of all the activities the residents performed during the rotation, the online modules were ranked most helpful by all residents. A 25-question knowledge assessment was performed before and after the rotation and showed an average increase of 8 points (P = .0001).Conclusions: The multimodal CLM training described here is an easily adoptable, objective system for teaching CLM. It was well liked by residents and provided an objective measurement of mastery of concepts for faculty. [ABSTRACT FROM AUTHOR]

Quality Issue: Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas.Initial Assessment: Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required.Choice Of Solution: An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions.Implementation: Experts in QI and educational assessment at the 5 University of California medical campuses developed a course comprised of 3 quizzes on Introduction to QI, Patient Safety and Care Transitions. Each quiz contained 20 questions and utilized an online educational quiz-based reinforcement system that leveraged spaced learning.Evaluation: Approximately 500 learners completed the course (completion rate 66-86%). Knowledge acquisition scores for all quizzes increased after completion: Introduction to QI (35-73%), Patient Safety (58-95%), and Care Transitions (66-90%). Learners reported that the quiz-based system was an effective teaching modality and preferred this type of education to classroom-based lectures. Suggestions for improvement included reducing frequency of presentation of questions and utilizing more questions that test learners on application of knowledge instead of knowledge acquisition.Lessons Learned: A multi-campus online quiz-based reinforcement system to train residents in QI, patient safety and care transitions was feasible, acceptable, and increased knowledge. The course may be best utilized to supplement classroom-based and experiential curricula, along with increased attention to optimizing frequency of presentation of questions and enhancing application skills. [ABSTRACT FROM AUTHOR]

Background: General surgery (GS) residents are often required to provide immediate preliminary interpretations of radiological images, especially in critical situations. It is unclear whether residents in Accreditation Council for Graduate Medical Education-accredited GS programmes receive sufficient radiological training to deliver adequate patient care.Objectives: Determine the utilisation of radiology rotations (RR) during GS residency.Methods: Between February and March 2015, a pilot voluntary 19-item survey was electronically distributed to GS programme directors (PDs) regarding the availability and value of a RR during GS training.Results: A total of 234 PDs received the questionnaire and the response rate was 36.8% (n=86). Sixty-five (77.4%) PDs expected their trainees to interpret imaging studies in the acute setting; however, only 8.3% of programmes had a dedicated RR. RRs are more prevalent among community-based than university-based programmes (71.4% vs 27.9% p=0.003). The implementation of a RR may be limited due to insufficient number of GS residents in the department (p=0.002). 75.4% of PDs expect GS residents to confirm their findings with a radiologist. In those programmes with RR, most PDs (85.7%) believed that a dedicated rotation improved GS residents' understanding of radiological imaging.Conclusion: The majority of PDs are currently not confident that GS residents are capable of interpreting radiological imaging independently; however, the implementation of a mandatory RR in GS residency curriculum yet seems to be controversial. Given the expectation of PDs and the continued need to improve patient care, the integration of a dedicated RR in GS training should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose. The impact of an interprofessional faculty development fellowship (FDF) on pharmacy graduates' careers is described. Summary. The FDF instructional approach is a longitudinal acquisition and application of knowledge, skills, and attitudes fostered by clinical care delivery, teaching experiences, structured reflection, the giving and receiving of feedback, research and scholarly projects, and leadership development and exercises. Interprofessional FDF fellows teach, learn, and provide care together in both inpatient and outpatient clinical settings as a part of the evidence-based medicine curriculum, providing educational sessions for medical students, pharmacy students, medical residents, attending family medicine physicians, and clinical pharmacy faculty throughout the year. Twenty-seven of the 30 pharmacist graduates of the fellowship (90% response rate) responded to an electronic survey about the influence of the FDF on their careers. Overall, pharmacy graduates were very satisfied with the fellowship. The fellowship fostered a clear pattern of continued, collaborative learning. While additional training beyond a pharmacy residency program is not necessary for a successful clinical career, 41% of graduates pursued additional training after completing the fellowship. Open-ended responses for motivations for completing the FDF and influences the FDF had on their careers fell unforced into the FDF curriculum domains, which reinforced the belief that these are the right areas to target for development. Conclusion. Pharmacy residents participated in a broad, interprofessional faculty development curriculum, which fostered teaching, scholarship, leadership, professional development, and clinical skills. Pharmacist graduates indicated that the experience significantly influenced their careers and professional development. [ABSTRACT FROM AUTHOR]

Purpose. The implementation of an interprofessional clinical pharmacology selective (CPS) learning experience for pharmacy residents and medical students is described. Summary. The opportunity for pharmacy residents to provide didactic lectures at a college of pharmacy and to develop teaching and preceptor skills with experiential pharmacy students may be limited by institutionspecific affiliations and geographic location. In order to overcome these barriers, the Mayo Clinic Hospital postgraduate year 1 (PGY1) pharmacy residency program implemented an interprofessional learning experience in which pharmacy residents serve the role of preceptors for first- and second-year medical students on a CPS. Medical students at the Mayo Medical School (MMS) work alongside the PGY1 resident to develop patient-specific, medication problem lists and gain an appreciation for pharmacy-focused interventions. Medical students teach pharmacy residents diagnostic, pathophysiologic, and patient-assessment considerations related to the medical school's curriculum. The clinical rounds component of the CPS allows for resident achievement of ASHP competency area R4, which focuses on the design of an effective educational activity; selection of a preceptor role; employment of instruction, modeling, coaching, and facilitation; use of effective presentation skills; generation of objective-based learner assessment questions; and identification of areas for continuous improvement. Conclusion. The Mayo Clinic Hospital PGY1 pharmacy residency program and MMS successfully implemented an innovative learning experience to promote interprofessional education between pharmacy residents and medical students. The program establishes collaborative relationships early in students' professional careers and allows for attainment of the ASHP-required competency area R4 through delivery of a CPS to medical students. [ABSTRACT FROM AUTHOR]

Introduction: The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) is the largest group of residency programs in the Department of Defense. In an effort to provide improved Quality Improvement and Patient Safety (QI/PS) training for its residents, SAUSHEC created the position of Chief of QI/PS for Residents in the academic year 2014-2015. The Chief of QI/PS for Residents was based in the Internal Medicine residency program but also assisted with SAUSHEC-wide QI/PS projects. This is the first such job in the Department of Defense.Methods: Here, we detail the accomplishments during this first academic year, including the alignment of the job with the stated QI/PS-related goals of the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review. Efforts focused within the Internal Medicine residency program included QI/PS curriculum development, improvement upon monthly morbidity and mortality (M&M) conferences, and facilitating resident participation in QI projects. The 2014-2015 academic year Internal Medicine residency QI/PS project focused on increasing comfort and discussions with patients regarding advance directives; this also served to emphasize the humanistic side of potential QI/PS projects. The Chief of QI/PS for Residents also spearheaded hospital-wide initiatives, including the creation of a quarterly hospital-wide M&M conference, coordinating resident involvement in QI/PS-related committees, and facilitating feedback of patient safety report responses to trainees.Results: We focus on the portion of the QI/PS curriculum involving the presentation of a mock Root Cause Analysis (RCA) and provide the results of a pre- and postpresentation survey of resident knowledge of RCAs. In order to quantify the efforts over the entire academic year, we also report the results of a resident self-assessment of QI/PS aptitude and competencies, including changes in these measures over the academic year. Finally, we discuss challenges faced and outline future goals for the position.Conclusion: The SAUSHEC Chief of QI/PS for Residents is the first such designated position in the Department of Defense. As QI/PS continues to increase as a focus area for physician training, we anticipate that other programs will create similar positions. We provide ideas for how a Chief of QI/PS for Residents can be involved at a program and hospital-wide level and quantify the success of different efforts. [ABSTRACT FROM AUTHOR]

Background: Specialty-specific 'boot camps' boost the competence and confidence of medical school graduates as they prepare to enter a residency programme.Objective: We sought to evaluate the efficacy of a specialty-neutral Internship Preparation Camp (IPC) that we developed and made available to senior medical students at our medical school. The primary goal of the IPC is to educate students in the cognitive and procedural skills that are applicable to postgraduate year 1 trainees in all fields of specialisation.Methods: The curriculum was developed through input from senior medical students and faculty from multiple specialties. The course used small-group sessions and skills labs led by distinguished speakers from various professions (medicine, nursing and pharmacy) to teach senior medical students the information and skills common to the needs of all new physicians, regardless of the specialty they have chosen. The course was presented across 3 half-days and was offered just prior to graduation.Results: Of 166 possible participants, 65 attended the course; 39 (60%) of them completed evaluations immediately following the course and 29 (45%) of participants completed a follow-up evaluation 3 months later. All respondents reported increased confidence in caring for patients in all subject areas taught. In the follow-up survey, 82% of respondents reported using information learned during the course on an hourly, daily or weekly basis in their care of patients.Conclusions: A specialty-neutral IPC is of benefit to its attendees, regardless of the medical specialty in which they train. [ABSTRACT FROM AUTHOR]

Objective: To identify whether the clinical maturity of medical trainees impacts upon the level of trainee competency in evidence-based medicine (EBM).Materials and Methods: Undergraduate and graduate-entry medical trainees entering their first year of training in the clinical environment were recruited for this study. Competency in EBM was measured using a psychometrically validated instrument. EBM competency scores were analysed using Student's t tests, in order to differentiate between undergraduate and graduate-entry trainee performance. Ten focus group discussions were conducted with undergraduate and graduate-entry trainees. Audio transcripts were thematically analysed.Results: Data on a total of 885 medical trainees were collected over a 5-year period. Undergraduate trainees had significantly higher EBM competency scores during years in which the programme was presented in a didactic format (mean difference (MD)=1.24 (95% CI)CI 0.21 to 2.26; 1.78 (0.39 to 3.17); 2.13 (1.16 to 3.09)). Graduate trainee EBM competency scores increased when a blended learning approach to EBM was adopted, demonstrating no significant difference in EBM competency scores between undergraduate and graduate cohorts (-0.27 (-1.38 to 0.85); -0.39 (-1.57 to 0.79). Qualitative findings indicated that differences in learning and teaching preference among undergraduate and graduate-entry trainees influenced the level of competency obtained in EBM.Conclusions: Clinical maturity is the only one factor that may influence medical trainees' competency in EBM. Other predictors of EBM competency may include previous training and exposure to epidemiology, biostatistics and information literacy. While graduate-entry medical students may have more 'life' experience, or maturity, it does not necessarily translate into clinical maturity and integration into the clinical environment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine whether an association exists between the publication of journal articles before and during paediatrics residency. METHODS: A retrospective search of PubMed was conducted for publications by all 567 Canadian paediatricians certified between 2009 and 2012, inclusive. Paediatricians were separated into groups based on the number of articles published preresidency (0 or ≥1) and during residency (0 or ≥1). The methodology was validated using a group of local paediatricians who were contacted to verify whether their publications were identified accurately. RESULTS: A total of 160 of 567 (28%) certified paediatricians had preresidency publications; of these, 93 (58%) subsequently published during their residency period. Among the remaining 407 (72%) paediatricians without preresidency publications, 129 (32%) published during residency. The association between publication before and during paediatric residency was statistically significant (OR 2.98 [95% CI 2.04 to 4.36]; P<0.001). Results from the validation analysis suggested the methodology correctly identified pre- and during residency publication status with 87% and 90% accuracy, respectively. CONCLUSION: Individuals with previous publications were more likely to publish as residents; however, 42% of individuals with preresidency publications did not publish as residents. Residency selection committees may find these data helpful in assessing the publication potential of their applicants. In addition, this information may assist in building more targeted and individualized research curricula within residency programs. [ABSTRACT FROM AUTHOR]

Purpose: Quality, patient safety and value are important topics for graduate medical education (GME). Spaced education delivers case-based content in a structured longitudinal experience. Use of spaced education to deliver quality and safety education in GME at an institutional level has not been previously evaluated.Objectives: To implement a spaced education course in quality, safety and value; to assess learner satisfaction; and to describe trainee knowledge in these areas.Methods: We developed a case-based spaced education course addressing learning objectives related to quality, safety and value. This course was offered to residents and fellows about two-thirds into the academic year (March 2014) and new trainees during orientation (June 2014). We assessed learner satisfaction by reviewing the course completion rate and a postcourse survey, and trainee knowledge by the per cent of correct responses.Results: The course was offered to 1950 trainees. A total of 305 (15.6%) enrolled in the course; 265/305 (86.9%) answered at least one question, and 106/305 (34.8%) completed the course. Fewer participants completed the March programme compared with the orientation programme (42/177 (23.7%) vs 64/128 (50.0%), p<0.001). Completion rates differed by specialty, 80/199 (40.2%) in non-surgical specialties compared with 16/106 (24.5%) in surgical specialties (p=0.008). The proportion of questions answered correctly on the first attempt was 53.2% (95% CI 49.4% to 56.9%). Satisfaction among those completing the programme was high.Conclusions: Spaced education can help deliver and assess learners' understanding of quality, safety and value principles. Offering a voluntary course may result in low completion. Learners were satisfied with their experience and were introduced to new concepts. [ABSTRACT FROM AUTHOR]

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge—the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. [ABSTRACT FROM AUTHOR]

The article features Kornelia Kulig, a physical therapist, educator and scholar whose research explores the mechanisms behind the causes and treatment of recurrent pain of seemingly musculoskeletal origin. Kulig has presented at the Annual International Conference on Foot Biomechanics and Orthotic Therapy and is a well-known lecturer. She also served on the Board of Directors of the Orthopaedic Section of the American Physical Therapy Association.

Purpose. The development of a residency interviewing preparatory seminar (RIPS) is described. Summary. The RIPS elective at Nova Southeastern University College of Pharmacy was designed to assist pharmacy students during their last professional year in preparing for the residency application process. The learning objectives of the course focused on improving students' interviewing and presentation skills, professionalism, and developing their curriculum vitae (CV) and personal statement. Course and instructor evaluations and demographic data collected via anonymous surveys were used to ascertain students' perspectives about the course. The class was purposely scheduled to begin in October and end in November, right before the ASHP Midyear Clinical Meeting in early December. Due to limited faculty availability on the scheduled evenings and the desire to provide tailored, in-depth feedback, enrollment was limited. The RIPS was an intensive eight-week elective completed by 10 fourth-year pharmacy students. The course began with an overview of the residency application process, and students submitted their CVs and personal statements to faculty mentors for critique. To simulate residency interview components, students completed several timed activities in class and participated in mock interviews. Students stated that the course improved their application materials, interview skills, and confidence in their ability to obtain a residency. Overall, 78% of RIPS participants matched with a residency program. Conclusion. The RIPS elective was successful in improving residency candidate confidence at the ASHP Midyear Clinical Meeting. Students reported that the course was helpful and improved their confidence and ability to interview. [ABSTRACT FROM AUTHOR]

Purpose. An elective rotation specifically designed to prepare postgraduate year 1 (PGY1) pharmacy residents for careers in academia is described, with insights on challenges faced and benefits gained during the first offering of the rotation. Summary. Through a collaboration of the University of Florida (UF) college of pharmacy's St. Petersburg campus and the community-based Lee Memorial Hospital (LMH), a four-week elective rotation was incorporated into an existing PGY1 pharmacy residency program to provide trainees with structured and intensive exposure to the three basic components of a career in academia: teaching, service, and scholarship. Designed to expand on knowledge and skills acquired in a PGY1 teaching certificate program, the academic teaching rotation comprised a variety of experiences, including (1) daily participation in several large- and small-group teaching activities, (2) opportunities for participation in admission interviews of prospective college of pharmacy students and other service activities, and (3) independent scholarship activities such as the preparation of an article suitable for publication in the professional literature. Recent data indicate that nearly 33% of vacant teaching positions at U.S. schools of pharmacy remained unfilled during the 2009-10 academic year due to a lack of qualified candidates. Broader implementation of formal teaching rotations such as the UF-LMH program could help address the faculty staffing shortfall. Conclusion. An academic teaching rotation can provide a PGY1 pharmacy resident with experiences in teaching, service, and scholarly activities beyond those typically offered in residency programs. [ABSTRACT FROM AUTHOR]

Purpose. The development, implementation, and early evaluation of a postgraduate year 1 (PGY1) pharmacy residency program at a large tertiary care hospital are described. Summary. In keeping with long-range initiatives by the American Society of Health- System Pharmacists (ASHP) and other pharmacy organizations to increase pharmacists' involvement in direct patient care and expand opportunities for advanced training, a PGY1 program was developed at Baystate Medical Center (BMC), a 653- bed hospital in Massachusetts. A residency advisory committee appointed in the fall of 2006 led the program development process, including curriculum planning, establishment of initial funding, recruitment procedures, and integration of faculty at an affiliated school of pharmacy (Massachusetts College of Pharmacy and Health Sciences). Recruitment efforts began in the fall of 2006; in the summer of 2007 the first group of PGY1 residents began a curriculum of 12 one-month core and elective learning experiences, as well as longitudinal direct-care experiences (e.g., performing medication reconciliations and related duties at an affiliated outpatient pharmacotherapy clinic) and teaching and management requirements. In the spring of 2009, the residency program received ASHP accreditation and federal funding for program expansion. The residency advisory committee's evaluation of early experience with the program guided adjustments in areas such as recruitment, applicant screening, resident selection, preceptor scheduling, monitoring of residents' progress through the program, and accreditation survey preparation. Conclusion. A PGY1 residency at BMC was developed to enhance the pharmacy department's clinical services. Residents were successfully recruited, and the program received accreditation within two years. [ABSTRACT FROM AUTHOR]

Purpose. A hospital-based pharmacy internship program is described. Summary. The University of Pittsburgh Medical Center (UPMC) is a 19-hospital partnership affiliated with the University of Pittsburgh Schools of the Health Sciences, serving over 4 million patients per year through its community and teaching hospitals, community care programs, and managed care insurance product. UPMC created a structured pharmacy internship program that provides students with the skills to prepare them for future employment in a hospital or institutional pharmacy setting and creates a hiring and benefits infrastructure focused on student retention after graduation. During the first year of the internship, the training for the student pharmacist focuses on hands-on learning in hospital pharmacy operations. Subsequent years provide the opportunity to learn from pharmacists in a variety of practice sites, training side by side and working on a project with a pharmacist in a specialty area of the student's choice. A pathway of sequential job classifications with increasing salary and the advantage of accruing years of service with UPMC was established through administrative approval. Additional financial incentives offer encouragement for students to accept pharmacist positions at UPMC after graduation. Since the internship's inception in 2004, eight interns have completed the program. Of these, four are employed by UPMC as hospital pharmacists, and another is completing a postgraduate year 1 residency at UPMC. Conclusion. A four-year, structured pharmacy internship program at UPMC provided students with early experience in hospital pharmacy practice and resulted in successful training and retention of the interns as pharmacists at UPMC. [ABSTRACT FROM AUTHOR]

As the body of medical literature continues to expand, physicians must develop the necessary skills to keep up with the vast amount of information available. The journal club provides a forum to allow residents to remain current with the literature while also teaching them the methods to evaluate it critically. Those readers wishing to start a journal club or revive an existing one should begin by designating a leader and defining the conference goals. Emphasizing the importance of this conference in the educational process while allowing it to be structured to optimise resident interest and attendance will help to ensure its success. Periodic evaluation of this conference will allow the organisers to assess the concordance of the resident's goals with those of the faculty. Formal evaluation will also provide an objective assessment of the knowledge gained by the house-staff through participation in journal club. [ABSTRACT FROM AUTHOR]

The article discusses a five-step process on how to deliver a lecture and improve teaching skills during residency. The steps include planning and mentorship, live rehearsals of planned lectures, presentation delivery, evaluation and feedback, and refinement through repetition. The article suggests that providing a structured and mentored process to support residents can help in building their lecturing skills effectively.

Purpose. A summer health-system pharmacy internship program developed outside the doctor of pharmacy curriculum is described. Summary. The summer pharmacy internship program was implemented in 2002. The main goal of the internship program is to develop the profession of pharmacy by providing pharmacy students an opportunity to work in various practice settings within a health system. The internship is also designed to develop students' interest in health-system pharmacy by allowing them to meet and shadow pharmacists in various specialties. Learning objectives include the development of career goals, pharmacy technical skills (e.g., sterile preparation), drug literature review (e.g., journal club), pharmacy practice and practice leadership. Students are required to start their internship one week after the end of the school year and end it one week before the beginning of their next semester of classes. The internship is a paid position, with pay being commensurate with the student's current pharmacy school year. Students spend 40 hours per week in the program, with one weekend commitment. Approximately 75% of the intern's time is spent dispensing medications, and 25% is spent in meetings, working on projects, and shadowing pharmacists. Interns meet one-on-one each week with an assigned preceptor to discuss relevant pharmacy questions and career opportunities and to provide updates about current projects. Of the six interns who have graduated from pharmacy school since this program's inception, five have pursued careers in health-system pharmacy. Conclusion. The summer pharmacy internship program at Johns Hopkins Hospital exposes pharmacy students to various practice settings and helps them realize the career opportunities available in health-system pharmacy. [ABSTRACT FROM AUTHOR]

The article offers information on Pharmaci Practice Modile Initiative (PPMI). Topics discussed include Accreditation Council for Pharmacy Education (ACPE), advanced pharmacy practice experiences (APPEs) and the curriculum revision at the college of pharmacy in University of Georgia. The need for pharmacy students to assume direct patient care roles, work collaboratively in interprofessional teams and make evidence-based clinical decisions and recommendations is discussed.

A letter to the editor is presented in response to the article "Teaching and Learning Curriculum Programs: Recommendations for Postgraduate Pharmacy Experiences in Education" by E. A. Wright, B. Brown, and J. Gettig published in the "American Journal of Health-System Pharmacy" in 2014.

The article offers an overview of a web-based survey, to asses the scope and structure of information (DI) activities within the American Society of Health-System Pharmacists (ASHP), accredited postgraduate year 1 residency programs. Procedural elements related to the survey is presented, which revealed that one third of responding programs reported lacking a DI rotation site and a dedicated DI preceptor. Also included the results that found the domination of the longitudinal DI activities.

The article focuses on the experiential education for pharmacy students in the U.S. The experiential rotations for pharmacy students constitutes about one fourth of the typical pharmacy school’s curriculum. Many believed that this program is working effectively while others are concerned about serious problems such as insufficient or absent incentives for practice sites, inadequacies in oversight by some colleges, and shortages and poor quality of some practice sites.