138 results on '"Residency training"'
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2. From Private Practice to Academia: The Experience of a General Academic Pediatrician.
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Kum-Nji P
- Abstract
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., Competing Interests: The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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3. For the People and the Profession
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William O. Richards
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media_common.quotation_subject ,Advisory Committees ,education ,Personnel Staffing and Scheduling ,History, 21st Century ,Accreditation ,Excellence ,Presidential address ,Humans ,Medicine ,Professional Autonomy ,Duty ,media_common ,Surgeons ,Medical education ,business.industry ,Surgical care ,Internship and Residency ,General Medicine ,History, 20th Century ,Quality Improvement ,Surgical training ,United States ,Work (electrical) ,Education, Medical, Graduate ,General Surgery ,Surgical Procedures, Operative ,Clinical Competence ,business ,Autonomy ,Residency training - Abstract
In 1982 Dean Warren delivered the presidential address “Not for the Profession… For the People” in which he identified substandard surgical residency programs graduating residents who were unable to pass American Board of Surgery exams. Drs. Warren and Shires as members of the independent ACGME began to close the substandard programs in order to improve surgical care for average Americans i.e. “for the people”. By 2003 these changes dramatically reduced the failure rate for the ABS exams and trained good surgeons who could operate independently however the residents were on duty for every other or every third night. In 2003 the ACGME mandated duty hour restrictions in order improve resident wellness and improve the training environment for the profession. However, work hour restrictions reduced the time surgical residents spent in the hospital environment primarily when residents had more autonomy and had exposure to emergency cases which degraded readiness for independent practice. Surgical educators in the 2 decades after the work hour restrictions have improved techniques of training so graduates could not only pass the board exams but also be prepared for independent practice. Surgical residency training has improved by both the changes implemented by the independent ACGME in 1981 and by the work hour restrictions mandated in 2003. Five recommendations are made to ensure that Dr Warren's culture of excellence in surgical training continues in an environment that enhances wellbeing of the trainee i.e. “For the People and the Profession”.
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- 2021
4. Evaluation of Neurotoxin and Filler Injection Training in Otolaryngology Residency
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Alexander J. Caniglia and Robert T. Cristel
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Medical education ,medicine.medical_specialty ,Filler (packaging) ,Otorhinolaryngology ,business.industry ,Residency curriculum ,medicine ,business ,Residency training - Abstract
Introduction: Residency training courses are fundamental to an Otolaryngology (ENT) residency curriculum. Neurotoxin and filler injections have become common during ENT residency, and the outcomes of training courses have not been previously evaluated. We hypothesize that after participating in the course, resident knowledge, skill, and likelihood of using neurotoxin and filler injections in future practice will significantly improve. Materials and Methods: A prospective study was designed among ENT residents undergoing neurotoxin and filler injection educational training courses from April 2019 to November 2020. After the completion of the course and injections, residents completed a self-evaluation to assess their level of knowledge and skill level with neurotoxin and filler injections. Results: The mean number of neurotoxin and filler injections besides within the course was 1.67 and 0.33, whereas during the course was 3.39 ( P = .008) and 1.39 ( P = .0009), respectively. Resident knowledge, skill, and likelihood of using neurotoxin and filler injections in future practice all significantly improved ( P < .05). This study found that a biannual training course for neurotoxin and injectable fillers was an effective strategy at improving resident knowledge, skill, and likelihood of use in future practice.
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- 2021
5. Analyzing the Administrative Burden of Competency Based Medical Education
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Kevin Cheung, Benjamin Yin Ming Kwan, Andrew D. Chung, and Christina Rogoza
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Medical education ,Education, Medical ,business.industry ,Qualitative evidence ,Internship and Residency ,General Medicine ,Faculty ,Competency-Based Education ,Documentation ,Humans ,Mandate ,Medicine ,Radiology, Nuclear Medicine and imaging ,Clinical Competence ,Faculty development ,Radiology ,business ,Residency training - Abstract
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.
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- 2021
6. Virtual Coaching Delivered by Pharmacists to Prevent COVID-19 Transmission
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Samah Bahy Mohammed Ebaed, Eman Merghani Ali, Osama Mohamed Ibrahim, Derar H. Abdel-Qader, Nadia Al Mazrouei, Husam El Sharu, Ahmad Z. Al Meslamani, and Asma' A El-Shara'
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Pharmacology ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Transmission (medicine) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,education ,Pharmacy ,030226 pharmacology & pharmacy ,Coaching ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Pandemic ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,business ,Residency training - Abstract
Background: While the role of pharmacists in the current pandemic control has been recognized worldwide, their coaching efforts to improve public’s behaviors that could prevent COVID-19 transmission has been rarely investigated. Objectives: To assess whether pharmacist-based virtual health coaching sessions could increase the proportion of people who practised healthy social behaviors, to test whether this model can increase the public acceptance of COVID-19 vaccines, and to measure whether these behaviors could actually prevent contracting COVID-19. Method: In this randomized controlled trial, adults who matched specific criteria were randomly allocated into 2 arms. The active arm received 12 pharmacist-based virtual coaching sessions delivered via Zoom® over a month. Participants allocated to the control arm received no coaching. At the end of the last coaching session, both groups were asked to complete a structured questionnaire for outcome assessment. Participants in the active group were followed up to 2 weeks after the end of the last coaching session to check if they contracted COVID-19 or not. The SPSS software version 26.0 (IBM Corp., Chicago, IL) was used for statistical analysis. Results: Of the 300 participants who gave consent for participation, 295 completed the study (147 from the active arm and 148 from the control arm). The proportion of those using face masks, avoiding crowds, and willing to be isolated if infected in the active arm was increased from 51.70%, 53.74%, and 59.86% at baseline to 91.83%, 80.27%, and 96.59% at the end of coaching, respectively (all with P
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- 2021
7. Promoting Access of Osteopathic Medical Students to Surgical Residency Training Programs
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Brandon S Petree, Jennifer S. Beaty, Matthew A. Heard, and Paul J. Schenarts
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Resident selection ,Medical education ,2019-20 coronavirus outbreak ,Students, Medical ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Internship and Residency ,General Medicine ,United States ,General Surgery ,Humans ,Osteopathic students ,Medicine ,business ,Osteopathic Medicine ,Residency training - Abstract
The COVID-19 pandemic has uncovered disparities for allopathic and osteopathic surgical applicants for the upcoming 2021 residency application cycle. It has provided an opportunity for change to the current paradigm in surgical resident selection. This study seeks to quantify the disproportionality of opportunities between allopathic and osteopathic students and provides solutions to level the playing field for all applicants.
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- 2020
8. How Much Do Nurses Know About Residents?
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Michael Kreider, Graal Diaz, Richa Asija, Constanze Rayhrer, Shireen Sachdeva, and Kelly Fairbairn
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Adult ,Male ,Medical education ,Inservice Training ,030504 nursing ,Attitude of Health Personnel ,business.industry ,Interprofessional Relations ,media_common.quotation_subject ,Internship and Residency ,General Medicine ,Nursing Staff, Hospital ,03 medical and health sciences ,0302 clinical medicine ,Work (electrical) ,Surveys and Questionnaires ,Institution ,Humans ,Medicine ,Female ,030212 general & internal medicine ,0305 other medical science ,business ,Residency training ,media_common - Abstract
Nurses work closely with residents on a daily basis but may not understand the details about residency training and experience. We investigated our institution to understand misconceptions nurses may have about residents and provide education. Nurses (n = 26) participated in a lecture about residents and were given identical surveys before and after the lecture. Twenty-two nurses (85%) were medical/surgical, 1 (4%) was obstetrical, and 3 (11%) were critical care. In the pre-education survey, nurses were able to correctly identify the main purpose of residency as educational. Most nurses knew that residents arrived at the hospital between 5:00 and 7:00 am and that residents could perform bedside procedures. A marked increase was found between correct pre- and post-survey answers in 4 questions: interns are doctors (15% vs. 77%), residents’ work hours (23% vs. 65%), correct average salary (39% vs. 92%), and correct paid time off (PTO) days per year (8% vs. 85%). Salaries were overestimated, and work hours and PTO were underestimated. Most nurses did not know interns are in fact doctors. Our post-educational survey demonstrated improved knowledge of resident credentials, challenges, and work environment. The mean result for the post-educational survey was significantly higher than the pre-educational survey results, indicating that the educational intervention was effective in improving nurses’ knowledge regarding residents.
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- 2020
9. Impact Evaluation of a Resident-Driven Research Training Workshop in Idaho: A Feasibility Study.
- Author
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Khan MA, Iqbal M, Mancilla TR, Grider J, Solomon J, and Suleta K
- Abstract
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., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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10. Assessing academic productivity of U.S. otolaryngology departments using the h (5) index.
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Desai D, Grosse PJ, and Snyderman CH
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Objectives: We aim to examine the h (5) index of U.S. otolaryngology programs to help assess current academic productivity., Methods: A total of 116 otolaryngology departments with residency programs were included. Our primary outcome was the h (5) index, calculated cumulatively for faculty MDs, DOs, and PhDs within the department. Audiologists and clinical adjunct faculty were excluded. This was calculated over a 5-year period (2015-2019) using Elsevier's database SCOPUS. Faculty affiliation within SCOPUS was confirmed by cross-referencing department websites. The h (5) indices were calculated and then correlated with other publication metrics, including total publications by department and publications in major otolaryngology journals., Results: The h (5) index was highly correlated positively with other metrics of academic productivity, including total publications and publications in top 10 otolaryngology journals. Greater variability in data was noted as the h (5) index increased. Similar trends were observed when the h (5) was compared to the number of residents accepted per year. Rankings of departments by Doximity and US News and World Report were positively correlated with h (5) though they remained weaker when compared to other correlations., Conclusions: h (5) indices are a valuable tool to objectively assess academic productivity for otolaryngology residency departments. They are a better indicator of academic productivity than national rankings., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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11. Delivering CaRMS Transparency: Applicant Review and Selection Process of a Single-Center Diagnostic Radiology Residency Training Program
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Raman Verma, Jason Chan, Matthew D. F. McInnes, Rebecca M. Hibbert, and Lindsay A. Cherpak
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Resident selection ,Canada ,medicine.medical_specialty ,Students, Medical ,020205 medical informatics ,Process (engineering) ,02 engineering and technology ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Selection (genetic algorithm) ,Career Choice ,business.industry ,Internship and Residency ,General Medicine ,Transparency (behavior) ,Education, Medical, Graduate ,Radiology ,business ,Residency training - Abstract
Purpose: To report the current application review and selection process in our Canadian diagnostic radiology program at the University of Ottawa for both Canadian and international medical graduates. Application Review and Selection Process: Submitted applications fulfilling institutional requirements were selected for a detailed file review after preliminary screening. A diverse group of file reviewers and interviewers was selected. Interviews were offered based on file review score sheet outcomes. Each interviewer generated a postinterview rank list. Applicants were reviewed and discussed from highest to lowest rank based on a preliminary compiled rank list generated from the average of the postinterview rank lists. Group discussion and a consensus model were used to create a final applicant rank list. Conclusions: We outlined our systematic, consistent selection process which aligns with current best practices. This description may inform other programs wishing to adopt or optimize strategies to improve candidate assessments and selection processes.
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- 2020
12. Impact of COVID-19 on Canadian Radiology Residency Training Programs
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Michael N. Patlas, Baljot S. Chahal, and Devang Odedra
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Canada ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,education ,Pneumonia, Viral ,emergency preparedness ,Article ,030218 nuclear medicine & medical imaging ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Radiologists ,Pandemic ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Pandemics ,virtual education ,SARS-CoV-2 ,business.industry ,pandemic ,COVID-19 ,Internship and Residency ,General Medicine ,030220 oncology & carcinogenesis ,Radiology ,medical education ,Coronavirus Infections ,business ,Residency training - Abstract
Purpose:The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19.Methods:A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark.Results:We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations.Conclusion:The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs.
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- 2020
13. Assessing the effectiveness of pediatric emergency medicine education in emergency medicine residency training: A national survey
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Wei-Chen Chen, Chung-Hsien Chaou, Yueh-Ping Liu, Yu-Che Chang, and Chip-Jin Ng
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Pediatric emergency medicine ,business.industry ,030225 pediatrics ,education ,Emergency medicine ,Emergency Medicine ,Medicine ,030208 emergency & critical care medicine ,business ,Residency training - Abstract
Background: Evaluating the effectiveness of pediatric emergency medicine training is essential to ensure that emergency physicians and emergency medicine residents have sufficient knowledge, skill, and confidence in optimizing care for acute pediatric visits. Although the field of pediatric emergency medicine has experienced phenomenal growth in past decades, it still faces challenges in how to best implement the curriculums in emergency medicine residency training programs. Objectives: Exploring emergency physicians’ and emergency residents’ perspectives on pediatric emergency medicine training in emergency residency training programs in Taiwan through a nationwide survey. Methods: The survey was distributed to 1281 emergency physicians and emergency medicine residents in 43 teaching hospitals. The survey inquired about demographic data, hospital type, rank of proctored trainers and assessors, and the setting of pediatric emergency medicine training. Participants’ confidence in managing acute pediatric visits and their satisfaction and reflections of their pediatric emergency medicine training were explored. Results: In all, 258 responses were received from 117 residents and 141 emergency physicians. Seventy-seven percent reported working in medical centers. Clinical supervision was primarily performed by pediatric attending physicians and emergency physicians. Fifty-eight percent of participants felt satisfied with their pediatric emergency medicine training. However, only 52.3% felt confident managing acute pediatric visits, which was attributed to inadequate exposure to pediatric patients. Residents noted lack of confidence in managing newborns, infants, and clinical procedures. Therefore, simulation training and point-of-care ultrasound learning were considered advantageous. Conclusion: The pediatric emergency medicine training in emergency medicine residency programs is diverse in intensive care training, supervisors, and assessors. Surveys demonstrate that learning experience in pediatric wards and emergency department rotations is associated with overall satisfaction with pediatric emergency medicine training; inadequate exposure to pediatric patients contributed to learners having less confidence. Emergency medicine residency program reform might focus on adequate hands-on pediatric patient care.
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- 2020
14. A Pilot Study on Diagnostic Radiology Residency Case Volumes From a Canadian Perspective: A Marker of Resident Knowledge
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Benedetto Mussari, Lynne Meilleur, Benjamin Y. M. Kwan, Pam Moore, Alexandre Menard, Don Soboleski, Nicholas Cofie, and Omar Islam
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Adult ,Male ,Canada ,medicine.medical_specialty ,Graduate medical education ,Guidelines as Topic ,Pilot Projects ,Workload ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Accreditation ,business.industry ,Perspective (graphical) ,Internship and Residency ,General Medicine ,Education, Medical, Graduate ,030220 oncology & carcinogenesis ,Female ,Radiology ,business ,Residency training - Abstract
Purpose: New guidelines from the Accreditation Council for Graduate Medical Education (ACGME) have proposed minimum case volumes to be obtained during residency. While radiology residency programs in Canada are accredited by the Royal College of Physicians and Surgeons of Canada, there are currently no minimum case volumes standards for radiology residency training in Canada. New changes in residency training throughout Canada are coming in the form of competency-based medical education. Using data from a pilot study, this article examines radiology resident case volumes among recently graduated cohorts of residents and determines whether there is a correlation between case volumes and measures of resident success. Materials and Methods: Resident case volumes for 3 cohorts of graduated residents (2016-2018) were extracted from the institutional database. Achievement of minimum case volumes based on the ACGME guidelines was performed for each resident. Pearson correlation analysis (n = 9) was performed to examine the relationships between resident case volumes and markers of resident success including residents’ relative knowledge ranking and their American College of Radiology (ACR) in-training exam scores. Results: A statistically significant, positive correlation was observed between residents’ case volume and their relative knowledge ranking ( r = 0.682, P < .05). Residents’ relative knowledge ranking was also statistically significant and positively correlated with their ACR in-training percentile score ( r = 0.715, P < .05). Conclusions: This study suggests that residents who interpret more cases are more likely to demonstrate higher knowledge, thereby highlighting the utility of case volumes as a prognostic marker of resident success. As well, the results underscore the potential use of ACGME minimum case volumes as a prognostic marker. These findings can inform future curriculum planning and development in radiology residency training programs.
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- 2020
15. Sexual Harassment during Residency Training: A Cross-Sectional Analysis
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Jessica L. Weaver, Amirreza T Motameni, William I McKinley, Elizabeth H. Bruenderman, Lindsay F. Arnold, Camille E Gordon, Michael E. Egger, Shiva Zargham, and Matthew V. Benns
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medicine.medical_specialty ,020205 medical informatics ,business.industry ,Cross-sectional study ,education ,Offensive ,MEDLINE ,Psychological intervention ,02 engineering and technology ,General Medicine ,Institutional support ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,0202 electrical engineering, electronic engineering, information engineering ,Harassment ,Medicine ,030212 general & internal medicine ,High incidence ,business ,Residency training - Abstract
The reality of sexual harassment is unmasking in many fields, and medical trainees constitute a vulnerable and at-risk group. We report the prevalence of sexual harassment among GI, internal medicine, and pediatric residents, with a focus on identifying underlying reasons for lack of victim reporting. A modified previously validated Department of Defense survey on sexual harassment was e-mailed to 261 GI, 132 pediatric, and 271 internal medicine program directors. Three hundred eighty-one residents responded to the survey. Female trainees were more likely to be subject to sexual harassment (83% vs 44%, P
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- 2020
16. Impact of Incorporating Pharmacy Residents Into a Pharmacist-Managed Culture Review Service During Weekend Staffing Commitments
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Kathryn Samai, Jeremy A Lund, Jaymes E Dean, and Melissa Campo
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Service (business) ,Medical education ,business.industry ,Pharmacy Residencies ,Staffing ,Pharmacist ,Pharmacy ,Emergency department ,Pharmacists ,030226 pharmacology & pharmacy ,Clinical pharmacy ,03 medical and health sciences ,0302 clinical medicine ,Learning opportunities ,Workforce ,Humans ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Pharmacy Service, Hospital ,business ,Residency training ,Retrospective Studies - Abstract
Background: Clinical pharmacy continues to rapidly evolve as does the need to incorporate unique learning opportunities in pharmacy residency training (eg, transitions of care). Objective: To describe the impact of incorporating pharmacy residents into a pharmacist-managed emergency department culture review service (CRS). Methods: This retrospective study included 500 cultures with positive results evaluated by a pharmacy resident during weekend staffing shifts for patients discharged from the emergency department or urgent care center (UCC). The primary outcome of this study was the number of interventions performed by pharmacy residents. Results: Of the 500 cultures evaluated, 275 (55%) required action by the pharmacy residents, resulting in 233 interventions. Modification of antimicrobial therapy occurred 70 times. When surveyed, a majority of residents strongly agreed that the CRS had a positive impact. Based on evaluations, residents achieved mastery of pertinent residency performance objectives. Conclusion: Incorporation of pharmacy residents into a pharmacist-managed emergency department CRS promotes safe and effective medication use to patients discharged from an emergency department or UCC while providing residents additional experience in designing a therapeutic regimen, providing education to patients, and communicating with health-care teams to manage medication therapy.
- Published
- 2019
17. Craniomaxillofacial Trauma Experience in Otolaryngology Residency: A National Survey of Program Directors
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Oswaldo A. Henriquez, Anita B. Sethna, and Melissa S. Oh
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medicine.medical_specialty ,Case volume ,business.industry ,education ,Trauma center ,Graduate medical education ,medicine.disease ,Otorhinolaryngology ,Family medicine ,medicine ,Surgery ,Oral Surgery ,business ,Residency training ,Pediatric trauma ,Accreditation ,Graduation - Abstract
This article aimed to assess the depth and volume of craniomaxillofacial (CMF) trauma exposure and education in otolaryngology residency training in the United States. This is a cross-sectional survey. A 15-question web-based survey was distributed to program directors of 106 Accreditation Council for Graduate Medical Education (ACGME)-approved otolaryngology residency programs to inquire about program size and demographics, trauma coverage, case volume, and education. Responses were collected anonymously. A total of 77 responses were received, representing 73% of residency programs. Seventy-five programs (97%) reported that their residents rotated at a level 1 trauma center, and 72 (94%) covered CMF trauma. Sixty-one programs (79%) included pediatric CMF trauma. The majority of programs (76%) allocated less than 10% of residency-dedicated didactic lecture time to CMF trauma. Residents in all programs typically logged at least 11 to 20 cases before graduation with 24% of programs averaging more than 50 cases per resident. Ninety percent of respondents described the training as “somewhat” to “very adequate.” CMF coverage by the otolaryngology department, number of cases, and dedicated didactic lecture time to CMF trauma were significant factors on the perception of adequate training. The majority of program directors felt that the training in CMF trauma was adequate. Reasons for this may include that most residents rotate at level 1 trauma centers, have exposure to pediatric trauma, encounter an adequate volume of cases, and have dedicated didactic time to CMF education.
- Published
- 2019
18. Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy
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Kurt Weibel, Tina Aramaki, and Brian L. Erstad
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Pharmacology ,Strategic planning ,Medical education ,Service (systems architecture) ,business.industry ,Process (engineering) ,media_common.quotation_subject ,Pharmacy ,Experiential learning ,Director’s Forum ,Negotiation ,Medicine ,Pharmacology (medical) ,business ,Residency training ,media_common ,Healthcare system - Abstract
Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.
- Published
- 2019
19. Prevalence of Burnout and Associated Factors Among Family Medicine Residency in Thailand
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Achariya Charoentanyarak, Panitee Poonpetcharat, Thunyarat Anothaisintawee, and Ruankwan Kanhasing
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lcsh:LC8-6691 ,lcsh:R5-920 ,medicine.medical_specialty ,lcsh:Special aspects of education ,residency training ,business.industry ,education ,Burnout ,03 medical and health sciences ,family medicine ,0302 clinical medicine ,030225 pediatrics ,Family medicine ,Medicine ,030212 general & internal medicine ,lcsh:Medicine (General) ,business ,Residency training ,psychological phenomena and processes ,Original Research - Abstract
Objectives: To assess the prevalence of burnout and associated factors among family medicine residents in Thailand. Materials and Methods: This cross-sectional study was conducted by all Thai Family Medicine residents year 1 to 3 during February 2019. Self-reported questionnaires, including demographic data, and the Thai version of the Maslach Burnout Inventory were distributed to 703 residents via electronic transmissions, including e-mail, Facebook, and Line instant communication application. Burnout was diagnosed by the following criteria: high-level emotional exhaustion, high-level depersonalization, and low-level personal accomplishment. Factors associated with burnout were explored by the univariate logistic regression model. Multivariate logistic regression analysis was applied to examine the independent risk factors of burnout among Thai Family Medicine residents. Results: There were 149 residents who participated in this study, with a response rate of 21% (n = 703). As no residents diagnosed with burnout using the proposed criteria, burnout was, therefore, redefined as residents reporting high-level emotional exhaustion and high-level depersonalization. The prevalence of burnout in family medicine residents in this study was 10.74% (95% confidence interval [CI]: 6.26%-16.85%). Our study found that having relationship problems with patients, having relationship problems with colleagues, and having thought of resigning from the training program were independently associated with burnout with odds ratios of 6.93 (95% CI: 1.64-29.27), 6.31 (95% CI: 1.89-21.12), and 4.16 (95% CI: 1.09-15.81), respectively. Conclusions: Burnout at high level in emotional exhaustion and high level in depersonalization can occur among family medicine residents. Concerning factors were found to be patient and colleague relationship problems and having thought of resigning from the residency program. Other factors that may contribute to burnout were type of training programs, insufficient income, and family relationship. We recommend that the training institute should be able to monitor residents’ stress level and to help prevent those who have burnout and reduce its impact.
- Published
- 2020
20. Supervisor, Colleague, or Assistant: General Surgery Resident Perceptions of Advanced Practitioners
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John Migaly, Leah M. Sieren, Jeffrey E Carter, Amy N. Hildreth, Clancy J. Clark, and John H. Stewart
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Resident training ,General surgery ,ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS ,MEDLINE ,Workload ,Resident education ,General Medicine ,030230 surgery ,Process of care ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Perception ,Medicine ,Topic areas ,business ,Residency training ,media_common - Abstract
Integration of advanced practitioners (APs) into academic medical centers can improve processes of care and decrease physician workload but may adversely impact general surgery residency training. The aim of the present study was to characterize general surgery resident perceptions of APs and their impact on resident training. We conducted an institutional review board–approved survey covering five topic areas: knowledge of AP training, interaction with APs, scope-of-practice of APs, role of APs in the health-care team, and impact of APs on physician training. The survey was administered to general surgery residents at six large academic medical centers. One hundred eighteen general surgery residents completed the survey. The majority (43.6%) of respondents were junior residents. All respondents had interactions with APs with 90.7 per cent having worked directly with an AP in the last month. Residents reported minimal formal educational involvement by APs with 6.8 per cent reporting participation in didactics and 22.2 per cent teaching operative techniques. Almost half (44.1%) of the respondents reported that APs played an important role in their education, and 42.4 per cent of respondents disagreed or strongly disagreed that the role of the AP is well defined in their hospital. Today's general surgery residents work closely with APs who seem to positively impact resident education. Although residents perceive significant benefit with integration of APs, well-defined roles are lacking.
- Published
- 2018
21. Increasing lengths of rank order lists of applicants and programs of US medical residencies
- Author
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Kevin Newsome, Adel Elkbuli, Dino Fanfan, Mark McKenny, and Brendon Sen-Crowe
- Subjects
business.industry ,Medicine ,General Medicine ,Surgical education ,business ,Residency training ,Demography - Abstract
Background To match medical students into residency training programs, both the program and student create rank order lists (ROLs). We aim to investigate temporal trends in ROL lengths across 7 match cycles between 2014 and 2021 for both matched and unmatched residency applicants and programs. Methods retrospective study of ROLs of 7 match cycles, 2014-2021. Residency match and ROL data were extracted from the NRMP database to assess the number of programs filled and unfilled, length of ROLs, position matched, and average ranks per position for osteopathic (DO) and allopathic (MD) medical programs. Results For filled residency programs, the average ROL length consistently increased from 70.72 in 2015 to 88.73 in 2021 ( P = .003), with ROL lengths consistently longer for filled vs unfilled residency programs ( P < .001). The average ROL length for matched applicants increased consistently from 10.41 in 2015 to 12.35 in 2021 ( P = .002), with matched applicants having consistently longer ROLs than unmatched applicants ( P < .001). From 2015 to 2021, in both MD and DO applicants, progressively lower proportions of applicants matched their first and second choices. Conclusion Trends across the past 7 residency match cycles suggest that ROL lengths for both programs and applicants have been increasing with matched programs and applicants submitting significantly longer ROLs than unmatched applicants. Additionally, fewer applicants are matching at their preferred programs over time. Our findings support the mounting evidence that the Match has become increasingly congested and we discuss the possible factors that may be contributing to the current state of the Match as well as potential solutions.
- Published
- 2021
22. Changes in Pharmacy Residency Training Design Between 2012 and 2017: A Perspective of Academic Medical Centers
- Author
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Luke A. Probst, Robert W. Seabury, William Darko, Anne Krasniak, and Christopher D. Miller
- Subjects
Pharmacology ,Medical education ,medicine.medical_specialty ,business.industry ,education ,Perspective (graphical) ,Pharmacy ,Articles ,030226 pharmacology & pharmacy ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,Post graduate ,Medicine ,lipids (amino acids, peptides, and proteins) ,Pharmacology (medical) ,Pharmacy practice ,030212 general & internal medicine ,business ,Baseline (configuration management) ,Residency training - Abstract
Purpose:The role of health-system pharmacists continues to expand, and this area of pharmacy practice increasingly requires augmented baseline training. It is unclear how Post Graduate Year 1 (PGY-1) pharmacy residencies may be changing to meet these needs.The objectives of our survey were to describe PGY-1 pharmacy residency program design among academic medical centers, characterize program changes enacted over 5-year period, and describe career paths among PGY-1 pharmacy residency graduates. Methods: A 32-item questionnaire was developed independently, which was reviewed and validated by 4 residency program directors. The survey was uploaded to an online survey tool and sent electronically to residency program directors of 109 Vizient academic medical centers with PGY-1 pharmacy residency programs. Residency program directors were identified from a list of Vizient-participating hospitals. The survey was re-sent at 2-week intervals on 4 occasions to improve response rates. SPSS version 23.0 was used to analyze the data. Results: Overall, 49 (45%) of hospitals responded to the survey. Survey responses showed statistically significant increases over the 5-year survey period in the following areas: the number of PGY-1 resident positions offered ( P = .001), percent of time spent on teaching experiences ( P = .001), and percentage of PGY-1 residents pursuing PGY-2 or fellowship training ( P = .026). Conclusion: We found that PGY-1 pharmacy residency programs at Vizient academic medical centers have undergone limited changes over the 5-year survey period and substantial variation exists between program designs. The most common change to program design was an increase in the percentage of time residents spend on teaching experiences. There was an increase in residents pursuing PGY-2 or fellowship training, which may suggest a shift toward increased specialization in clinical pharmacy practice or may reflect changes in the availability of job opportunities.
- Published
- 2017
23. Global Health Imaging in Radiology Residency: A Survey of Canadian Radiology Residents
- Author
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Ian Ross and Rebecca Zener
- Subjects
Adult ,Male ,Canada ,medicine.medical_specialty ,Attitude of Health Personnel ,Developing country ,Global Health ,Unmet needs ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Global health ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Response rate (survey) ,business.industry ,Advanced stage ,Internship and Residency ,General Medicine ,Outreach ,030220 oncology & carcinogenesis ,Family medicine ,Female ,Radiology ,business ,Cultural competence ,Residency training - Abstract
Purpose The study sought to determine Canadian radiology resident perception of and interest in global health imaging (GHI) and the barriers they encounter in pursuing GHI experiences during residency training. Methods A peer-reviewed, online, anonymous, multiple-choice survey was distributed to Canadian radiology residents at English-language programs. Results Fifty residents responded to the survey (∼16% response rate); 72% of respondents perceived an unmet need for medical imaging in the developing world. A majority of residents (60%) would have been likely to participate in a GHI experience if one had been available during their residency; 65% planned on pursuing international outreach work as future radiologists, 81% of whom with on-site collaboration in education and training of local staff. However, 82% of respondents were uncertain or believed they would not be adequately prepared to help improve access and availability of medical imaging services in developing countries upon completion of residency. Overall, residents believed a GHI program would increase their knowledge of infectious diseases, increase their exposure to diseases at advanced stage presentation, enhance their knowledge of basic imaging modalities, and improve their cultural competence. Lack of information about opportunities, lack of funding, and lack of infrastructure were ranked as the most important barriers to participating in a radiology rotation in a developing country during residency. Conclusion While many Canadian radiology residents are interested in participating in GHI, their preparation to do so may be inadequate. Formalizing international GHI rotations may alleviate barriers impeding their pursuit.
- Published
- 2017
24. Analyzing the Administrative Burden of Competency Based Medical Education.
- Author
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Cheung K, Rogoza C, Chung AD, and Kwan BYM
- Subjects
- Clinical Competence, Competency-Based Education methods, Faculty, Humans, Education, Medical, Internship and Residency, Radiology education
- Abstract
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.
- Published
- 2022
- Full Text
- View/download PDF
25. Resident Training Experiences Providing Spanish-Language Concordant Care: Implications for Growing Health Equity Efforts Within Graduate Medical Education.
- Author
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Hernandez RG, Tanaka K, McPeak K, and Thompson DA
- Subjects
- Communication Barriers, Education, Medical, Graduate, Health Promotion, Humans, Language, Health Equity, Internship and Residency
- Abstract
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.
- Published
- 2022
- Full Text
- View/download PDF
26. Virtual Coaching Delivered by Pharmacists to Prevent COVID-19 Transmission.
- Author
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Abdel-Qader DH, Al Meslamani AZ, Al Mazrouei N, El-Shara AA, El Sharu H, Merghani Ali E, Mohammed Ebaed SB, and Mohamed Ibrahim O
- Abstract
Background: While the role of pharmacists in the current pandemic control has been recognized worldwide, their coaching efforts to improve public's behaviors that could prevent COVID-19 transmission has been rarely investigated. Objectives: To assess whether pharmacist-based virtual health coaching sessions could increase the proportion of people who practised healthy social behaviors, to test whether this model can increase the public acceptance of COVID-19 vaccines, and to measure whether these behaviors could actually prevent contracting COVID-19. Method: In this randomized controlled trial, adults who matched specific criteria were randomly allocated into 2 arms. The active arm received 12 pharmacist-based virtual coaching sessions delivered via Zoom
® over a month. Participants allocated to the control arm received no coaching. At the end of the last coaching session, both groups were asked to complete a structured questionnaire for outcome assessment. Participants in the active group were followed up to 2 weeks after the end of the last coaching session to check if they contracted COVID-19 or not. The SPSS software version 26.0 (IBM Corp., Chicago, IL) was used for statistical analysis. Results: Of the 300 participants who gave consent for participation, 295 completed the study (147 from the active arm and 148 from the control arm). The proportion of those using face masks, avoiding crowds, and willing to be isolated if infected in the active arm was increased from 51.70%, 53.74%, and 59.86% at baseline to 91.83%, 80.27%, and 96.59% at the end of coaching, respectively (all with P < .05). In addition, the proportion of behaviors, such as disinfecting surfaces, not touching the T-zone, and avoid sharing personal belongings with colleagues at work was increased from 36.05%, 27.89%, and 46.93% at baseline to 63.94%, 52.38%, and 87.75% at the end of coaching, respectively (all with P < .05). Avoid touching the T-zone (OR = 0.43; 95% CI, 0.24-0.89) and using disposable tissues (OR = 0.30; 95% CI, 0.18-0.77), each versus using face masks appropriately were more likely to get COVID-19. Conclusion: Pharmacist-based virtual health coaching could be a potential strategy to increase the proportion of behaviors that could curtail the spread of COVID-19., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)- Published
- 2022
- Full Text
- View/download PDF
27. Targeted Wellness Initiatives Are Most Effective for Reducing Otolaryngology Resident Burnout
- Author
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Niels Kokot, Lia K. Jacobson, Michael M. Johns, Dorothy W Pan, Joseph R Acevedo, Jamie A. Schlacter, Ronica Yalamanchili, Tamara Chambers, and Bhavishya S. Clark
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,05 social sciences ,Burnout ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,Family medicine ,0502 economics and business ,medicine ,030212 general & internal medicine ,business ,050203 business & management ,Residency training - Abstract
Objective: Investigate the effect of a targeted wellness program on burnout in Otolaryngology residents. Methods: Residents and faculty collaboratively developed a program aimed at improving resident wellness. Program implementation began in July of 2018 and after 1 year, residents evaluated the program’s effects on burnout. We used the Maslach Burnout Inventory (MBI) and a Likert scale to evaluate the effects of the program. Results: After 1 year of the resident wellness program, the MBI results showed an increase in the number of residents in the “engaged” category and a decrease in those rated as “burnout.” Residents rated favorably initiatives grouped into the following themes: time away from work, faculty engaging with residents outside of the hospital environment, efforts to enhance residents’ self-efficacy, fostering a positive culture among residents, and providing easy access to physical activity. The majority of initiatives were targeted to the “culture of wellness” domain, as defined by the Stanford Well MD framework. Our program targeted to a lesser extent the other 2 domains, “efficiency of practice” and “personal resilience.” Conclusion: After 1 year, the wellness program resulted in a trend toward improving burnout. Future efforts should be focused on targeting the multidimensional drivers of burnout as defined by established wellness frameworks. Realizing new stressors brought on by the COVID-19 pandemic will also be an area of active effort and research.
- Published
- 2021
28. Learning Curve Associated With an Automated Laparoscopic Suturing Device Compared With Laparoscopic Suturing
- Author
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Yahya Daoud, Sanket Chauhan, Ganesh Sankaranarayanan, Lizzy Wooley, Steven G. Leeds, and James W. Fleshman
- Subjects
Male ,medicine.medical_specialty ,Cross-Over Studies ,business.industry ,General surgery ,Suture Techniques ,Internship and Residency ,Surgical procedures ,Knot tying ,Automation ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Task Performance and Analysis ,Humans ,Medicine ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Surgery ,Prospective Studies ,Surgical education ,business ,Learning Curve ,Residency training - Abstract
Background. Laparoscopic suturing has proved to be a challenging skill to master which may prevent surgical procedures from being started, or completed, in a minimally invasive fashion. The aim of this study is to compare the learning curves between traditional laparoscopic techniques with a novel suturing device. Methods. In this prospective single blinded nonrandomized controlled crossover study, we recruited 19 general surgery residents ranging from beginner (PGY1-2, n = 12) to advanced beginner (PGY3-5, n = 7). They were assigned to perform a knot tying and suturing task using either Endo360 or traditional laparoscopic technique (TLT) with needle holders before crossing over to the other method. The proficiency standards were developed by collecting the data for task completion time (TCT in seconds), dots on target (DoT in numbers), and total deviation (D in mm) on 5 expert attending surgeons (mean ± 2SD). The test subjects were “proficient” when they reached these standards 2 consecutive times. Results. Number of attempts to complete the task was collected for Endo360 and TLT. A significant difference was observed between mean number of attempts to reach proficiency for Endo360 versus TLT ( P = .0027) in both groups combined, but this was not statistically significant in the advanced beginner group. TCT was examined for both methods and demonstrated significantly less time to complete the task for Endo360 versus TLT ( P < .0001). There were significantly less DoT for Endo360 as compared with TLT ( P < .0001), which was also associated with significantly less D ( P < .0001) indicating lower accuracy with Endo360. However, no significant difference was observed between the groups for increasing number of trials for both DoT and D. Conclusions. This novel suturing device showed a shorter learning curve with regard to number of attempts to complete a task for the beginner group in our study, but matched the learning curve in the advanced beginner group. With regard to time to complete the task, the device was faster in both groups.
- Published
- 2017
29. Impact of the COVID-19 Pandemic on Otolaryngology Residency: A Real-Life Experience
- Author
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Michele Petrosino, Egidio De Bonis, Matteo Calvanese, Vito Colacurcio, Donato Troisi, Pietro De Luca, Pasquale Marra, and Antonella Bisogno
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,Disease ,Betacoronavirus ,Otolaryngology ,03 medical and health sciences ,0302 clinical medicine ,Pandemic ,otorhinolaryngologic diseases ,medicine ,Humans ,030223 otorhinolaryngology ,Head and neck ,Pandemics ,SARS-CoV-2 ,business.industry ,COVID-19 ,Internship and Residency ,University hospital ,medicine.disease ,Otorhinolaryngology ,Education, Medical, Graduate ,030220 oncology & carcinogenesis ,Medical emergency ,Coronavirus Infections ,business ,Residency training ,Healthcare system - Abstract
The coronavirus disease (COVID-19) pandemic as been rapidly spreading worldwide. In our country, the entire Italian Healthcare System has been forced to adapt to this unprecedented condition in this century. The Head and Neck Department clinical and surgical activity was substantially reduced. In this situation, the Ear, Nose and Throat (ENT) residents in University Hospitals find themselves in an uncertain position; we are physicians, facing a deadly disease about which much remains unknown, but we are also trainees, and there is a high risk for our residency training to be affected. With this Letter, we would like to give a testimony of our experience and give some advices to bridge the training gap.
- Published
- 2020
30. The Integrative Psychiatry Curriculum: Development of an Innovative Model
- Author
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Noshene Ranjbar, Amelia Villagomez, and Mari Ricker
- Subjects
integrative medicine ,medicine.medical_specialty ,Stress management ,Group setting ,education ,030204 cardiovascular system & hematology ,Experiential learning ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Curriculum development ,ComputingMilieux_COMPUTERSANDEDUCATION ,whole-person care ,psychiatry training ,030212 general & internal medicine ,model curriculum ,Psychiatry ,Curriculum ,lcsh:R5-920 ,lcsh:Public aspects of medicine ,Feature Article ,Treatment options ,lcsh:RA1-1270 ,General Medicine ,physician wellness ,Integrative medicine ,Psychology ,lcsh:Medicine (General) ,Residency training - Abstract
The Integrative Psychiatry Curriculum (IPC) was developed to train psychiatry residents and fellows to apply an Integrative Medicine (IM) approach for patients presenting with psychiatric disorders. Launched in 2015, IPC includes interactive online courses, in-person experiential sessions, and a clinical component with supervision. Twenty-one residents and fellows have completed the curriculum. The purpose of the IPC is 2-fold: to enhance patient wellness through training residents and fellows in evidence-based whole-person care and to improve physician well-being through enhanced stress management and self-awareness utilizing the practice of mind–body skills within a supportive small group setting. Course participants are trained in a broad range of prevention and treatment options and learn about their evidence base; they then practice incorporating IM into diagnosis and treatment plans through supervised clinical experience. This article describes the development of IPC and its elements. Efforts are underway to further develop and standardize the offerings and increase the portability of the course, making it easier for Psychiatry training programs with limited faculty expertise in IM to provide the curriculum for residents and fellows. To reach the goal of disseminating such a curriculum for integrative psychiatry, further funding and collaboration with multiple residency training programs is needed.
- Published
- 2019
31. How Competitive is the Canadian Diagnostic Radiology Residency Match? Application and Matching Trends from 1991-2014
- Author
-
Stephanie A. Kenny, Kaisra Esmail, Rebecca M. Hibbert, and Matthew D. F. McInnes
- Subjects
Adult ,Resident selection ,Canada ,Competitive Behavior ,medicine.medical_specialty ,Matching (statistics) ,Specialty ,Positive correlation ,Job market ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Reimbursement ,Medical education ,Career Choice ,business.industry ,Internship and Residency ,General Medicine ,Work environment ,030220 oncology & carcinogenesis ,Family medicine ,Radiology ,business ,Residency training - Abstract
Purpose The study sought to evaluate application trends in Canadian diagnostic radiology residency programs and to assess the relative competitiveness of radiology as a specialty. Methods The Canadian Residency Matching Service Reports from 1991–2014 for Canadian graduates were used to extract the total residency positions and radiology residency positions, number of applicants to all specialties and to radiology, number of first-choice radiology applicants, number of unmatched radiology positions, and number of positions and applicants to each specialty. Ratios were calculated: radiology positions to applicants and first-choice applicants, first-choice radiology applicants to applicants for all specialties, and training positions to applicants in each specialty. Data trends and correlation coefficients were analysed. Results The number of radiology residency positions offered increased, with strong positive correlation (r = 0.91, P < .001), while the number of applicants increased with only a moderate positive correlation (r = 0.49, P = .03). Radiology was the most competitive in 1997, with a ratio of 0.32 positions/applicant. There was an increase of positions/applicant over time (decreasing competitiveness; r = 0.76, P < .001) but no change in positions/first-choice applicant (r = 0.11, P = .65). The highest percentage of applicants who ranked radiology as their first choice was in 2003 at 6.5% with a decrease in this percentage over time (r = −0.36, P = .13). Radiology is moderately competitive for positions/overall applicants and very competitive for positions/first-choice applicants compared to other specialties. Conclusions The number of radiology residency positions has increased while the number of applicants has not grown commensurately. The match was most competitive in 1997, and decreased in subsequent years. Possible reasons include job market, reimbursement, and work environment.
- Published
- 2016
32. Diagnostic Radiology Residency Application Trends: Canadian Match Results From 2010-2020.
- Author
-
Li D, Yi PH, Islam N, Verma R, and McInnes MDF
- Subjects
- Canada, Humans, Career Choice, Education, Medical, Graduate methods, Education, Medical, Graduate statistics & numerical data, Internship and Residency methods, Internship and Residency statistics & numerical data, Radiology education
- Abstract
Introduction: Rapid advancements in artificial intelligence (AI) have generated uncertainty about the future of radiology among medical students. However, it is unclear whether this has affected radiology residency applications. The purpose of this study was to evaluate recent trends in the Canadian radiology residency match., Methods: Canadian Resident Matching Service annual data reports from 2010-2020 were collected. Statistics were extracted for Canadian medical graduates applying to radiology in the R-1 main residency match and analyzed using linear regression., Results: The number of available radiology residency positions decreased ( P = .01); declining from 84 in 2010 to 81 in 2020 (mean = 83.1). The overall number of applicants did not change ( P = .08, mean = 131.8). The proportion of applicants with radiology as their first choice decreased ( P = .001); declining from 4.5% in 2010 to 3.1% in 2020 (mean = 3.4%). The number of applicants applying exclusively to radiology also decreased ( P = .02); declining from 39 in 2010 to 16 in 2020 (mean = 23). Positions per applicant ( P = 0.24, mean = 0.64), and positions per applicant with radiology as their first choice did not change ( P = 0.07, mean = 0.91)., Conclusion: While the overall number of students applying to radiology did not change, the number of applicants ranking radiology as their first or only choice decreased sharply. This analysis corroborates recent reports of increased workload, burnout, and declining reimbursement as well as uncertainty about the future of radiology due to advances in AI.
- Published
- 2021
- Full Text
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33. Selecting the best and brightest: A comparison of residency match processes in the United States and Canada
- Author
-
Jason Williams, EM Krauss, and M Bezuhly
- Subjects
Response rate (survey) ,Medical education ,business.industry ,media_common.quotation_subject ,education ,Medical school ,Likert scale ,Personality ,Medicine ,Original Article ,Quality (business) ,Surgery ,Class rank ,business ,Simulation ,Residency training ,media_common - Abstract
Selecting candidates for plastic surgery residency training remains a challenge. In the United States, academic measures (United States Medical Licensing Exam Step I scores, medical school class rank and publications) are used as primary criteria for candidate selection for residency. In contrast, Canadian medical education de-emphasizes academic measures by using a pass-fail grading system. As a result, choosing residents from many qualified applicants may pose a challenge for Canadian programs without objective measures of academic success.A 25-question online survey was distributed to program directors of Canadian plastic surgery residency-training programs. Program directors commented on number of yearly residents and applicants; application sections (ranked in importance using a Likert scale); interview invitation and rank-order list determination; and their satisfaction with the selection process.Ten Canadian plastic surgery program directors responded (90.9% response rate). The most important application components determining invitation to interview were letters of reference from a plastic surgeon (mean importance of 5.0 on the Likert scale), clinical electives in plastic surgery (mean 4.6) and electives with their program (mean 4.5). Applicants invited for interview were assessed on the quality of their responses to questions, maturity and personality. The majority of program directors agreed that a clinical elective with their program was important for consideration on their rank-order list. Program directors were neutral on their satisfaction with the selection process.Canadian plastic surgery residency programs emphasize clinical electives with their program and letters of reference from colleagues when selecting applicants for interviews. In contrast to their American counterparts, Canadian program directors rely on clinical interactions with prospective residents in the absence of objective academic measures.Il est difficile de sélectionner les candidats à la résidence en chirurgie plastique. Aux États-Unis, des mesures de réussite (notes à l’étape I de l’examen de médecine des États-Unis, rang dans la classe de la faculté de médecine et publications) sont les principaux critères de sélection des candidats à la résidence. En revanche, au Canada, les mesures de réussite de la formation en médecine sont atténuées par un système de classement réussite-échec. Il peut donc être difficile de sélectionner les résidents au sein des programmes canadiens ne disposant pas de mesures objectives de réussite.Les directeurs des programmes canadiens de résidence en chirurgie plastique ont reçu un sondage virtuel de 25 questions. Ils ont commenté le nombre de résidents et de candidats chaque année, les sections des candidatures (classées par ordre d’importance selon une échelle de Likert), les invitations aux entrevues, la détermination de la liste de classement et leur satisfaction à l’égard du processus de sélection.Dix directeurs de programmes canadiens de chirurgie plastique ont répondu au sondage (taux de réponse de 90,9 %). Les principaux volets des candidatures pour déterminer les invitations aux entrevues étaient une lettre de référence d’un plasticien (importance moyenne de 5,0 sur l’échelle de Likert), des stages cliniques facultatifs en chirurgie plastique (moyenne de 4,6) et des stages facultatifs au sein de leur programme (moyenne de 4,5). Les candidats convoqués en entrevue étaient évalués selon la qualité de leurs réponses aux questions, leur maturité et leur personnalité. La majorité des directeurs de programmes convenaient que, pour leur liste de classement, il était important d’avoir participé à un stage clinique au sein de leur programme. Le taux de satisfaction des directeurs de programmes envers le processus de sélection était neutre.Pour sélectionner les candidats aux entrevues, les programmes canadiens de résidence en chirurgie plastique accordent plus d’importance aux stages cliniques dans leur programme et aux lettres de référence de collègues. Contrairement à leurs homologues américains, en l’absence de mesures scolaires objectives, les directeurs de programmes canadiens se fient aux interactions cliniques avec les résidents prospectifs.
- Published
- 2015
34. National Survey regarding the Importance of Leadership in PGY1 Pharmacy Practice Residency Training
- Author
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Jonathan C. Cho and Jonathan P. Girnys
- Subjects
Pharmacology ,Medical education ,Leadership development ,business.industry ,Medicine ,Pharmacology (medical) ,Pharmacy practice ,Pharmacy ,Obligation ,Preceptor Development Series ,business ,Administration (government) ,Residency training - Abstract
Background Leadership is considered a professional obligation for all pharmacists. It is important to integrate leadership training in residency programs to meet the leadership needs and requirements of the profession. Objective To evaluate the importance of leadership development during postgraduate year 1 (PGY1) pharmacy practice residency training as perceived by new practitioners. Methods A 15-question online survey was distributed to residency-trained new practitioners to assess (1) amount of time dedicated to leadership training during residency training, (2) different leadership tools utilized, (3) residents’ participation in various committees or councils, (4) perceived benefit of increased leadership training, (5) importance of having a mentor, (6) understanding of the residency organization's strategic objectives, (7) discussion of Pharmacy Practice Model Initiative (PPMI) during residency training, and (8) adequacy of leadership training in preparation to become a pharmacy practice leader. Results Although the majority of resident respondents had less than 20% of their residency devoted to leadership, nearly all survey participants acknowledged that leadership is an important component of PGY1 residency training. Residents agreed that their residency experience would have benefited from increased leadership opportunities. Most residents were knowledgeable about their organization's strategic objectives but did not have a full understanding of pharmacy initiatives such as the PPMI. Conclusion Feedback from residents indicates that an optimal dedication to leadership training would range between 20% and 30% of the residency year. Increased focus on PPMI, mentorship, and expanded use of leadership tools can serve as a way to help meet the future leadership needs of the pharmacy profession and help to better prepare residents to become pharmacy practice leaders.
- Published
- 2015
35. Are Stethoscopes, Coats, and Pagers Potential Sources of Healthcare Associated Infections?
- Author
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Deepak Kamat, Harbir Singh Arora, Nahed Abdel-Haq, Basim I. Asmar, and Swati Choudhry
- Subjects
Healthcare associated infections ,medicine.medical_specialty ,business.product_category ,Stethoscope ,education ,Pediatrics ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Bacterial colonization ,law ,healthcare associated infections ,Internal medicine ,medicine ,Colonization ,030212 general & internal medicine ,pager ,0303 health sciences ,030306 microbiology ,business.industry ,Nosocomial transmission ,lcsh:RJ1-570 ,coat ,lcsh:Pediatrics ,Pediatrics, Perinatology and Child Health ,Original Article ,Pager ,business ,Care staff ,Residency training - Abstract
We conducted a study to determine the rate of bacterial colonization of stethoscopes, coats, and pagers of residents at a pediatric residency training program as compared to that of badges, sleeves, and pagers of non-patient care staff (control group). Among 213 cultures obtained from 71 residents, 27 potential pathogens were isolated from 22 residents (27/213, 12.7%) as compared to 10 potential pathogens out of 162 samples obtained from 54 control participants (10/162, 6.2%) ( P = .0375). The most common pathogen isolated from residents and control participants was methicillin sensitive Staphylococcus aureus (MSSA). The source of positive cultures among the residents was the stethoscope (8/22, 36.3%), pager (8/22, 36.3%), and coat sleeve (11/22, 50%). The rates of colonization with potential pathogens were higher among residents than control participants and about 12% of residents’ stethoscopes, coats and pagers were colonized with bacterial pathogens. These are potential sources of nosocomial transmission of pathogenic organisms.
- Published
- 2020
36. Report and Recommendations of the Association of Pathology Chairs’ Autopsy Working Group
- Author
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Julia C. Iezzoni, Billie Fyfe, Charles F. Timmons, Marcus B. Nashelsky, Wesley Y. Naritoku, Jody E. Hooper, Priscilla Markwood, Gayle L. Winters, Robert D. Hoffman, Jacob J. Steinberg, Rebecca L. Johnson, Barbara A. Sampson, James R. Stubbs, and Gregory G. Davis
- Subjects
medicine.medical_specialty ,Pathology ,education ,Autopsy ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,autopsy ,rapid autopsy ,lcsh:Pathology ,Medicine ,Rapid autopsy ,030212 general & internal medicine ,anatomic pathology ,Training curriculum ,autopsy service director ,business.industry ,Program director ,Anatomical pathology ,Regular Article ,pathology training ,030220 oncology & carcinogenesis ,Informatics ,business ,Training program ,residency ,Residency training ,entrustable activities ,lcsh:RB1-214 - Abstract
Autopsy has been a foundation of pathology training for many years, but hospital autopsy rates are notoriously low. At the 2014 meeting of the Association of Pathology Chairs, some pathologists suggested removing autopsy from the training curriculum of pathology residents to provide additional months for training in newer disciplines, such as molecular genetics and informatics. At the same time, the American Board of Pathology received complaints that newly hired pathologists recently certified in anatomic pathology are unable to perform an autopsy when called upon to do so. In response to a call to abolish autopsy from pathology training on the one hand and for more rigorous autopsy training on the other, the Association of Pathology Chairs formed the Autopsy Working Group to examine the role of autopsy in pathology residency training. After 2 years of research and deliberation, the Autopsy Working Group recommends the following: Autopsy should remain a component of anatomic pathology training. A training program must have an autopsy service director with defined responsibilities, including accountability to the program director to record every autopsy performed by every resident. Specific entrustable activities should be defined that a resident must master in order to be deemed competent in autopsy practice, as well as criteria for gaining the trust to perform the tasks without direct supervision. Technical standardization of autopsy performance and reporting must be improved. The current minimum number of 50 autopsies should not be reduced until the changes recommended above have been implemented.
- Published
- 2018
37. Article Commentary: Person First and Patient First: Tailoring Language to Individual Patient Needs
- Author
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Jasleen Salwan
- Subjects
Social stigma ,education ,MEDLINE ,Medicine (miscellaneous) ,Primary care ,Patient-centered care ,Patient preference ,humanities ,Psychiatry and Mental health ,Addiction medicine ,Nursing ,Needs assessment ,Psychology ,health care economics and organizations ,Residency training - Abstract
Since I started residency training in 2016, I have had a keen interest in pursuing a career in primary care/addiction medicine. As my interest has developed, so too has my devotion to act as a chan...
- Published
- 2019
38. How Well Are Radiology Residents Prepared for Practice After Training? A Survey of French-Speaking Quebec Recent Graduates and Department Chiefs.
- Author
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Labranche R, Lapierre C, and Trop I
- Subjects
- Female, Humans, Magnetic Resonance Imaging, Male, Physician Executives, Quebec, Radiology, Interventional education, Self Efficacy, Surveys and Questionnaires, Tomography, X-Ray Computed, Ultrasonography, Clinical Competence, Consumer Behavior, Curriculum standards, Internship and Residency standards, Radiology education
- Abstract
Objective: Radiology residents must fulfill a standardized curriculum to complete residency and pass a certification exam before they are granted a licence to practice. We sought to evaluate how well residency prepares trainees for practice as perceived by recent graduates and their department chiefs. Subjects and Methods: Radiologists who graduated from the 4 Quebec radiology residency programs between 2005 and 2016 (n = 237) and Quebec radiology department chiefs (n = 98) were anonymously surveyed. Two electronic surveys were created, for recent graduates (74 questions) and for department chiefs (11 questions), with multiple-choice questions and open questions covering all fields of radiology. Surveys were administered between April and June 2016 using the Association des radiologistes du Québec database., Results: Response rate was 75 (31.6%) of 237 from recent graduates and 96% rated their training as excellent or good. Satisfaction with training in computed tomography and magnetic resonance imaging was high, with musculoskeletal (MSK) imaging, particularly MSK ultrasound (US), as well as pediatric, cardiac, and vascular imaging needing more training. Thirty-nine (39.8%) of 98 department chiefs answered the survey and highlighted weaknesses in the interpretation of conventional radiography, obstetrical US, and invasive procedures, as well as limited leadership and administrative skills. Recent graduates and department chiefs both reported difficulties in the ability to interpret daily volume of examinations as scheduled and invasive procedure competency., Conclusion: This survey highlights areas of the radiology curriculum which may benefit from more emphasis during training. Adjustments in the residency program would ensure graduates are successful both in their certification exams and clinical practice.
- Published
- 2021
- Full Text
- View/download PDF
39. Baylor Pediatric SBIRT Medical Residency Training Program: Model Description and Evaluation
- Author
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Vicki Waters, Erin M. Allen, James H. Bray, Alicia Kowalchuk, Elizabeth H Shilling, and Larry Laufman
- Subjects
Male ,medicine.medical_specialty ,Substance-Related Disorders ,education ,Motivational interviewing ,Medicine (miscellaneous) ,Pediatrics ,Skills training ,medicine ,Humans ,Program Development ,Referral and Consultation ,Curriculum ,Medical education ,Program model ,business.industry ,Internship and Residency ,Texas ,Psychiatry and Mental health ,Family medicine ,Psychotherapy, Brief ,Female ,Clinical Competence ,Substance use ,Brief intervention ,Training program ,business ,Residency training ,Program Evaluation - Abstract
Background The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment methods for alcohol and substance use problems. Methods This paper describes the training program created for pediatric residents and provides an evaluation of the program. Ninety-five first-year pediatric residents participated in the training program. They were assessed on satisfaction with the program, self-rated skills, observed competency, and implementation into clinical practice. Results The program was successfully incorporated into the residency curricula in two pediatric residencies. Evaluations indicate a high degree of satisfaction with the program, self-reported improvement in SBIRT skills, observed proficiency in SBIRT skills, and utilization of SBIRT skills in clinical practice. Conclusions SBIRT skills training can be incorporated into pediatric residency training, and residents are able to learn and implement the skills in clinical practice.
- Published
- 2014
40. Targeted Wellness Initiatives Are Most Effective for Reducing Otolaryngology Resident Burnout.
- Author
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Acevedo JR, Schlacter JA, Chambers TN, Jacobson LK, Yalamanchili R, Clark B, Pan D, Kokot NC, and Johns MM 3rd
- Abstract
Objective: Investigate the effect of a targeted wellness program on burnout in Otolaryngology residents., Methods: Residents and faculty collaboratively developed a program aimed at improving resident wellness. Program implementation began in July of 2018 and after 1 year, residents evaluated the program's effects on burnout. We used the Maslach Burnout Inventory (MBI) and a Likert scale to evaluate the effects of the program., Results: After 1 year of the resident wellness program, the MBI results showed an increase in the number of residents in the "engaged" category and a decrease in those rated as "burnout." Residents rated favorably initiatives grouped into the following themes: time away from work, faculty engaging with residents outside of the hospital environment, efforts to enhance residents' self-efficacy, fostering a positive culture among residents, and providing easy access to physical activity. The majority of initiatives were targeted to the "culture of wellness" domain, as defined by the Stanford Well MD framework. Our program targeted to a lesser extent the other 2 domains, "efficiency of practice" and "personal resilience.", Conclusion: After 1 year, the wellness program resulted in a trend toward improving burnout. Future efforts should be focused on targeting the multidimensional drivers of burnout as defined by established wellness frameworks. Realizing new stressors brought on by the COVID-19 pandemic will also be an area of active effort and research.
- Published
- 2021
- Full Text
- View/download PDF
41. Technique in Medicine and its Implications for the Biopsychosocial Model
- Author
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Joseph Gibes
- Subjects
Biopsychosocial model ,Physician-Patient Relations ,Medical education ,medicine.medical_specialty ,business.industry ,Alternative medicine ,Internship and Residency ,Models, Psychological ,Medical teaching ,Psychiatry and Mental health ,Physical medicine and rehabilitation ,Humans ,Medicine ,Family Practice ,business ,Residency training - Abstract
One of the challenges of integrating the biopsychosocial model into medical teaching and practice is the effect of technique on medicine. Relying heavily on the thought of Jacques Ellul, this article defines technique as the systematic application of machine principles to all domains of life, and the evaluation and adjustment of all human activity according to the criterion of efficiency. The article then considers the tension between technique and the biopsychosocial model of medicine, and explores ways to offset the problems technique causes while preserving the good that technique achieves, with particular reference to the teaching of family medicine residents.
- Published
- 2014
42. Factors Impacting Self-Perceived Readiness for Residency Training
- Author
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Terrill T. L. Tang, Mitchell J. Barnett, Eric J. Ip, Katherine K. Knapp, Janet L. Teeters, and Julie T. Truong
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Pharmacy Residencies ,education ,Surveys and Questionnaires ,medicine ,Humans ,Self perceived ,Pharmacology (medical) ,Time management ,Prospective Studies ,Project management ,Medical education ,business.industry ,Communication ,Pharmacy education ,Education, Pharmacy, Graduate ,Self Efficacy ,Clinical Practice ,Knowledge ,Family medicine ,Female ,Pharmacy practice ,Clinical Competence ,Postgraduate training ,business ,Residency training - Abstract
Objective: To examine the factors impacting postgraduate year 1 (PGY1) residents’ self-perceived readiness for residency. Methods: A total of 1801 residents who matched in American Society of Health-System Pharmacists (ASHP)-accredited PGY1 programs were e-mailed individualized invitations to take an online survey. The survey collected self-ratings of readiness for residency training competencies including time management and organization, foundational knowledge, clinical practice, project management, and communication. Key Findings: Data from 556 completed surveys were analyzed. Residents agreed they were ready to perform activities requiring time management and organization (median = 4, mean = 4.08), foundational knowledge (median = 4, mean = 3.83), clinical practice (median = 4, mean = 3.67), and communication (median = 4, mean = 4.05). Residents who completed at least 1 academic advance pharmacy practice experience (APPE), 5 clinical APPEs, or held a bachelors degree felt more confident than their counterparts in regard to project management ( P < .001, Conclusion: PGY1 residents generally felt prepared for time management and organization, foundational knowledge, and communication residency training competencies. This was significant for those who completed 1 or more academic APPEs, 5 or more clinical rotations, or a bachelors degree. Study results may assist pharmacy schools in preparing students for residency training, prospective resident applicants in becoming more competitive candidates for residency programs, and residency program directors in resident selection.
- Published
- 2014
43. Balancing Clinical Experience in Outpatient Residency Training
- Author
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Blair Fosburgh, Xiaoling Gao, Hari Balasubramanian, James E. Stahl, and Steven Overko
- Subjects
medicine.medical_specialty ,Outpatient Clinics, Hospital ,Primary Health Care ,business.industry ,Cost effectiveness ,Health Policy ,Resident training ,Internship and Residency ,Primary care ,Disease ,Family medicine ,medicine ,Humans ,Disease category ,General hospital ,business ,Algorithms ,Residency training - Abstract
Background. To receive adequate training experience, resident panels in teaching clinics must have a sufficiently diverse patient case-mix. However, case-mix can differ from one resident panel to another, resulting in inconsistent training. Method. Encounter data from primary care residency clinics at Massachusetts General Hospital from July 2008 to May 2010 (64 residents and ~3800 patients) were used to characterize patients by gender, age, major disease category (both acute and chronic, e.g., Cardio Acute, Cardio Chronic, etc., for a total of 44 disease categories), and number of disease categories. Imbalance across resident panels was characterized by the standard deviation for disease category, patient panel size, and annual visit frequency. To balance case-mix in resident panels, patient reassignment algorithms were proposed. First, patients were sorted by complexity; then patients were allocated sequentially to the panel with the least overall complexity. Patient reassignment across resident panels was considered under 3 scenarios: 1) within preceptor, 2) within a group of preceptors, and 3) across the entire practice annually. Results were compared with case-mix (pre-July 2012) and post-July 2012. Results. All 3 reassignment algorithms produced significant reductions in standard deviation of either number of disease categories or diagnoses across residents when compared with baseline (pre-July 2012) and actual July 2012 reassignment. Reassignment across the clinic and group provided the best and second best scenarios, respectively, although both came at the cost of initially reduced patient-preceptor continuity. Conclusion. Systematically reallocating patient panels in teaching clinics potentially can improve the consistency and breadth of the educational experience. The method in principle can be extended to any target of health care system reform where there is patient or clinician turnover.
- Published
- 2014
44. Forensic Pathology in Canada: A 'New' Subspecialty
- Author
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Michael J. Shkrum
- Subjects
medicine.medical_specialty ,Forensic pathology ,business.industry ,Family medicine ,education ,Medicine ,business ,Subspecialty ,Residency training ,Pathology and Forensic Medicine ,Accreditation - Abstract
Forensic Pathology was recognized as a subspecialty by the Royal College of Physicians and Surgeons of Canada (Royal College, formerly RCPSC) in 2003. In 2008, following a series of recommendations made by a government inquiry into systemic failures in the provision of pediatric forensic pathology service in Ontario, there was impetus for the Royal College's Forensic Pathology Specialty Committee to develop standards of training, assess proposed residency programs, and establish a certification mechanism for pathologists practicing forensic pathology in Canada.
- Published
- 2014
45. SESC Practice Committee Survey: Surgical Practice in the Duty-hour Restriction Era
- Author
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Spence M. Taylor and Don K. Nakayama
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,education ,Clinical performance ,Graduate medical education ,Workload ,General Medicine ,Clinical Practice ,Family medicine ,Actual practice ,Medicine ,business ,Duty ,Residency training ,Accreditation ,media_common - Abstract
Debate continues as to the relevance of Accreditation Council for Graduate Medical Education (ACGME) duty-hour restrictions in actual practice and the adequacy of resident training in surgery. A survey of the membership of the Southeastern Surgical Congress using an Internet-based questionnaire was conducted: adherence to duty-hour restrictions, evidence of sleepiness and fatigue, opinions regarding the training, and clinical performance of surgeons who had trained after the institution of duty-hour restrictions in 2003 (termed “recently trained surgeons”). One hundred seventy-seven members respondents out of 1008 (18%). Most (101 of 170 [59%]) worked more than 80 hours in a week and half (86 of 174 [49%]) more than 24 hours consecutively once or more a month. Falling asleep inappropriately was reported by 6 to 12 per cent. Forty per cent (71 of 176) thought that graduates of residencies today are prepared for clinical practice. Those who had hired a recently trained surgeon believed the latter was sufficiently trained (61 of 123 [50%]) more often than those who had not hired one (10 of 51 [20%]; P = 0.006). Those with a new colleague gave first assistant help in 75 per cent (91 of 121) during the first year. Surgeons in practice regularly violate ACGME duty-hour restrictions. Many surgeons have doubts whether new graduates of residency training programs have adequate training to practice surgery. Those who have hired a new surgeon trained under duty-hour restrictions are more likely to be satisfied with the latter's training. Most new trainees receive direct assistance from their practice partners, continuing their training beyond residency.
- Published
- 2013
46. Training Family Medicine Residents to Practice Collaboratively with Psychology Trainees
- Author
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William Murdoch, Christina Kimbrough, John H. Porcerelli, Tsveti Markova, and Shannon L. Fowler
- Subjects
Adult ,Training curriculum ,medicine.medical_specialty ,Medical education ,Psychological intervention ,Internship and Residency ,Collaborative Care ,Residency program ,Patient care ,Psychiatry and Mental health ,Nursing ,Family medicine ,medicine ,Humans ,Psychology ,Psychological testing ,Curriculum ,Education, Graduate ,Cooperative Behavior ,Family Practice ,Residency training - Abstract
Objective: This article will describe a training curriculum for family medicine residents to practice collaboratively with psychology (doctoral) trainees at the Wayne State University/Crittenton Family Medicine Residency program. Methods: The collaborative care curriculum involves a series of patient care and educational activities that require collaboration between family medicine residents and psychology trainees. Activities include: 1) clinic huddle, 2) shadowing, 3) pull-ins and warm handoffs, 4) co-counseling, 5) shared precepting, 6) feedback from psychology trainees to family medicine residents regarding consults, brief interventions, and psychological testing, 7) lectures, 8) video-observation and feedback, 9) home visits, and 10) research. The activities were designed to teach the participants to work together as a team and to provide a reciprocal learning experience. Results: In a brief three-item survey of residents at the end of their academic year, 83% indicated that they had learned new information or techniques from working with the psychology trainees for assessment and intervention purposes; 89% indicated that collaborating with psychology trainees enhanced their patient care; and 89% indicated that collaborating with psychology trainees enhanced their ability to work as part of a team. Informal interviews with the psychology trainees indicated that reciprocal learning had taken place. Conclusions: Family medicine residents can learn to work collaboratively with psychology trainees through a series of shared patient care and educational activities within a primary care clinic where an integrated approach to care is valued.
- Published
- 2013
47. Has the Middle-Level Anaesthesia Manpower Training Program of the West African College of Surgeons Fulfilled its Objectives?
- Author
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CO Bode, J O Olatosi, Ibironke Desalu, and Amposah G
- Subjects
Rural Population ,Databases, Factual ,Nigeria ,Audit ,Critical Care and Intensive Care Medicine ,West africa ,Sierra leone ,Middle level ,Anesthesiology ,Surveys and Questionnaires ,Medicine ,Uganda ,Health Workforce ,Prospective Studies ,Fellowships and Scholarships ,Fellowship training ,business.industry ,Emigration and Immigration ,Africa, Western ,West african ,Cross-Sectional Studies ,Anesthesiology and Pain Medicine ,Anesthesia ,Training program ,business ,Goals ,Residency training - Abstract
An audit of the West African College of Surgeons' middle-level Diploma in Anaesthesia program was carried out to determine the current status of the diplomates. Using the West African College of Surgeons' database, social media and personal communications, the current status of Diploma in Anaesthesia graduates spanning 20 years was determined. A total of 303 (97%) out of 311 of graduates were traced. Eighty percent were still practising anaesthesia, while 5% were now in other disciplines. Two hundred and four (67.3%) still resided in West Africa (183 in Nigeria, 50 in Ghana, one in Sierra Leone), while 69 (22.7%) were abroad: 35 (11.5%) in the United Kingdom, 21 (6.9%) in the United States of America and four (1.3%) in Canada. More Ghanaian than Nigerian graduates had emigrated (41 vs 14%, respectively). Only 9% of diplomates remained in rural communities (as originally envisaged), while 31% were now consultants (as fellows) and 30% were registrars in fellowship training. These findings indicate that most diplomates moved on to acquire further qualifications and a significant proportion migrated. The program did not appear to have achieved the objectives of meeting rural middle-level manpower needs in anaesthesia as envisaged. It has, however, boosted the recruitment drive for residency training in anaesthesia. Perhaps a less migrant cadre such as nurses may better serve this function if recruited into a suitably designed training program in countries desiring to use middle-level manpower in anaesthesia.
- Published
- 2013
48. A Pilot Study on Diagnostic Radiology Residency Case Volumes From a Canadian Perspective: A Marker of Resident Knowledge.
- Author
-
Kwan BYM, Mussari B, Moore P, Meilleur L, Islam O, Menard A, Soboleski D, and Cofie N
- Subjects
- Adult, Canada, Education, Medical, Graduate, Female, Guidelines as Topic, Humans, Male, Pilot Projects, Internship and Residency, Radiology education, Workload statistics & numerical data
- Abstract
Purpose: New guidelines from the Accreditation Council for Graduate Medical Education (ACGME) have proposed minimum case volumes to be obtained during residency. While radiology residency programs in Canada are accredited by the Royal College of Physicians and Surgeons of Canada, there are currently no minimum case volumes standards for radiology residency training in Canada. New changes in residency training throughout Canada are coming in the form of competency-based medical education. Using data from a pilot study, this article examines radiology resident case volumes among recently graduated cohorts of residents and determines whether there is a correlation between case volumes and measures of resident success., Materials and Methods: Resident case volumes for 3 cohorts of graduated residents (2016-2018) were extracted from the institutional database. Achievement of minimum case volumes based on the ACGME guidelines was performed for each resident. Pearson correlation analysis (n = 9) was performed to examine the relationships between resident case volumes and markers of resident success including residents' relative knowledge ranking and their American College of Radiology (ACR) in-training exam scores., Results: A statistically significant, positive correlation was observed between residents' case volume and their relative knowledge ranking ( r = 0.682, P < .05). Residents' relative knowledge ranking was also statistically significant and positively correlated with their ACR in-training percentile score ( r = 0.715, P < .05)., Conclusions: This study suggests that residents who interpret more cases are more likely to demonstrate higher knowledge, thereby highlighting the utility of case volumes as a prognostic marker of resident success. As well, the results underscore the potential use of ACGME minimum case volumes as a prognostic marker. These findings can inform future curriculum planning and development in radiology residency training programs.
- Published
- 2020
- Full Text
- View/download PDF
49. Preceptor Development: Providing Effective Feedback
- Author
-
Holly Phillips, Rick Couldry, Brian Buck, and Samaneh T. Wilkinson
- Subjects
Pharmacology ,Medical education ,business.industry ,Original Series ,media_common.quotation_subject ,education ,Graduate medical education ,Preceptor ,Pharmacy ,Residency program ,Medicine ,Pharmacology (medical) ,Quality (business) ,business ,Function (engineering) ,Residency training ,Accreditation ,media_common - Abstract
Feedback plays a significant role in precepting and is indispensable in residency training. As described by the Accreditation Council for Graduate Medical Education, the goal of any postgraduate residency program is to prepare individual trainees to function as qualified practitioners. Although feedback and evaluations have traditionally been synonymous, our goal is to differentiate the two and describe the role of each within resident performance. The goal of this article is to provide preceptors with the tools to provide timely, effective, and quality feedback to residents on a regular basis. Although the focus of this article is on residency training, these concepts can be utilized in student rotations as well.
- Published
- 2013
50. Training Pathology Residents to Practice 21st Century Medicine
- Author
-
Michael B. Prystowsky, Jacob J. Steinberg, W. Stephen Black-Schaffer, and Jon S. Morrow
- Subjects
Value (ethics) ,Pathology ,medicine.medical_specialty ,residency training ,media_common.quotation_subject ,education ,Information access ,Population health ,Training (civil) ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Social skills ,Extant taxon ,lcsh:Pathology ,medicine ,Quality (business) ,progressive responsibility ,030212 general & internal medicine ,media_common ,business.industry ,Professional development ,competency ,030220 oncology & carcinogenesis ,business ,lcsh:RB1-214 ,Regular Articles - Abstract
Scientific advances, open information access, and evolving health-care economics are disrupting extant models of health-care delivery. Physicians increasingly practice as team members, accountable to payers and patients, with improved efficiency, value, and quality. This change along with a greater focus on population health affects how systems of care are structured and delivered. Pathologists are not immune to these disruptors and, in fact, may be one of the most affected medical specialties. In the coming decades, it is likely that the number of practicing pathologists will decline, requiring each pathologist to serve more and often sicker patients. The demand for increasingly sophisticated yet broader diagnostic skills will continue to grow. This will require pathologists to acquire appropriate professional training and interpersonal skills. Today’s pathology training programs are ill designed to prepare such practitioners. The time to practice for most pathology trainees is typically 5 to 6 years. Yet, trainees often lack sufficient experience to practice independently and effectively. Many studies have recognized these challenges suggesting that more effective training for this new century can be implemented. Building on the strengths of existing programs, we propose a redesign of pathology residency training that will meet (and encourage) a continuing evolution of American Board of Pathology and Accreditation Council for Graduate Medical Education requirements, reduce the time to readiness for practice, and produce more effective, interactive, and adaptable pathologists. The essence of this new model is clear definition and acquisition of core knowledge and practice skills that span the anatomic and clinical pathology continuum during the first 2 years, assessed by competency-based metrics with emphasis on critical thinking and skill acquisition, followed by individualized modular training with intensively progressive responsibility during the final years of training. We anticipate that implementing some or all aspects of this model will enable residents to attain a higher level of competency within the current time-based constraints of residency training.
- Published
- 2016
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