Rachal, James; Lacy, Timothy J.; Warner, Christopher H.; Whelchel, Jennifer
Objective: To evaluate how family practice-psychiatry residency programs meet the challenges of rigorous accreditation demands, clinical supervision, and boundaries of practice. Method: A 54-question survey of program directors of family practice-psychiatry residency programs outlining program demographic data, curricula, coordination, resident…
Shanmugalingam, Arany; Ferreria, Sharon G; Norman, Ross M G; Vasudev, Kamini
Objective: To determine the current status of research experience in psychiatry residency programs across Canada. Method: Coordinators of Psychiatric Education (COPE) resident representatives from all 17 psychiatry residency programs in Canada were asked to complete a survey regarding research training requirements in their programs. Results: Among the 17 COPE representatives, 15 completed the survey, representing 88% of the Canadian medical schools that have a psychiatry residency program. Among the 15 programs, 11 (73%) require residents to conduct a scholarly activity to complete residency. Some of these programs incorporated such a requirement in the past 5 years. Ten respondents (67%) reported availability of official policy and (or) guidelines on resident research requirements. Among the 11 programs that have a research requirement, 10 (91%) require residents to complete 1 scholarly activity; 1 requires completion of 2 scholarly activities. Eight (53%) residency programs reported having a separate research track. All of the programs have a research coordinator and 14 (93%) programs provide protected time to residents for conducting research. The 3 most common types of scholarly activities that qualify for the mandatory research requirement are a full independent project (10 programs), a quality improvement project (8 programs), and assisting in a faculty project (8 programs). Six programs expect their residents to present their final work in a departmental forum. None of the residency programs require publication of residents’ final work. Conclusions: The current status of the research experience during psychiatry residency in Canada is encouraging but there is heterogeneity across the programs. PMID:25565474
Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen
Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…
Varley, Christopher K.; Jibson, Michael D.; McCarthy, Mary; Benjamin, Sheldon
OBJECTIVE: The authors report a survey of the American Association of Directors of Psychiatry Residency Training (AADPRT) on interactions between the pharmaceutical industry and psychiatry residency programs. METHODS: American Association of Directors of Psychiatry Residency Training membership was anonymously surveyed by e-mail and by paper…
Lee, Terry G.; Cox, Julia R.; Walker, Sarah C.
Objective: This study surveys child psychiatry residency program directors in order to 1) characterize child welfare training experiences for child psychiatry residents; 2) evaluate factors associated with the likelihood of program directors' endorsing the adequacy of their child welfare training; and 3) assess program directors'…
Khawaja, Imran S; Dickmann, Patricia J; Hurwitz, Thomas D; Thuras, Paul D; Feinstein, Robert E; Douglass, Alan B; Lee, Elliott Kyung
To assess the current state of sleep medicine educational resources and training offered by North American psychiatry residency programs. In June 2013, a 9-item peer-reviewed Sleep Medicine Training Survey was administered to 39 chief residents of psychiatry residency training programs during a meeting in New York. Thirty-four percent of the participating programs offered an elective rotation in sleep medicine. A variety of innovative approaches for teaching sleep medicine were noted. The majority of the chief residents felt comfortable screening patients for obstructive sleep apnea (72%), half felt comfortable screening for restless legs syndrome (53%), and fewer than half were comfortable screening for other sleep disorders (47%). This is the first report in the last decade to provide any analysis of current sleep medicine training in North American psychiatry residency training programs. These data indicate that sleep medicine education in psychiatry residency programs is possibly in decline.
Reardon, Claudia L.; Walaszek, Art
Objective: Minimal literature exists on neurology didactic instruction offered to psychiatry residents, and there is no model neurology didactic curriculum offered for psychiatry residency programs. The authors sought to describe the current state of neurology didactic training in psychiatry residencies. Methods: The authors electronically…
Suzuki, Joji; Ellison, Tatyana V; Connery, Hilary S; Surber, Charles; Renner, John A
Psychiatrists are well suited to provide office-based opioid treatment (OBOT), but the extent to which psychiatry residents are exposed to buprenorphine training and OBOT during residency remains unknown. Psychiatry residency programs in the USA were recruited to complete a survey. Forty-one programs were included in the analysis for a response rate of 23.7 %. In total, 75.6 % of the programs currently offered buprenorphine waiver training and 78.1 % provided opportunities to treat opioid dependence with buprenorphine under supervision. Programs generally not only reported favorable beliefs about OBOT and buprenorphine waiver training but also reported numerous barriers. The majority of psychiatry residency training programs responding to this survey offer buprenorphine waiver training and opportunities to treat opioid-dependent patients, but numerous barriers continue to be cited. More research is needed to understand the role residency training plays in impacting future practice of psychiatrists.
Capasso, Rebecca; Adler, Laura
The teaching hospitals of the New York University psychiatry residency program were evacuated and then closed for a minimum of 3 months in the aftermath of Superstorm Sandy. Faculty and residents were deployed to alternate clinical sites. The authors examine the consequences of Superstorm Sandy and its implications for the New York University psychiatry residency training program. A survey was administered to faculty and residents. The authors tabulated 98 surveys, for which 24 % of faculty and 84 % of residents responded. Among respondents, 61 % believed that being involved in the evacuation of the hospitals was a positive experience. During deployment, most (85 %) found being placed with peers and supervisors to be beneficial, but there were significant disruptions. Despite facing multiple challenges including closed facilities, deployment to nonaffiliated hospitals, and exhausted personal resources, the training program continued to provide accredited clinical experiences, a core curriculum, and supervision for psychiatry residents during and after Superstorm Sandy.
Reardon, Claudia L; Bentman, Adrienne; Cowley, Deborah S; Dunaway, Kristen; Forstein, Marshall; Girgis, Christina; Han, Jaesu; Hung, Erick; Jones, Jeralyn; Keeble, Tanya; McCarron, Robert M; Varley, Christopher K
Integrated care models are an evidence-based approach for integrating physical and behavioral health services. The American Association of Directors of Psychiatric Residency Training Integrated Care Task Force sought to describe current practices for providing training in integrated care to general and child and adolescent psychiatry residents. Directors of US general and child and adolescent psychiatric residency training programs were anonymously surveyed to examine current practices in educating their residents in integrated care. Based on themes that emerged from the survey, the authors make recommendations for integrated care education of general and child and adolescent psychiatry residents. Fifty-two of 197 (26%) general and 36 of 111 (32%) child and adolescent program directors responded. Results demonstrate that a majority of responding general psychiatry (78%) and child and adolescent psychiatry (CAP) (72%) training programs offer integrated care rotations, many of which are electives for senior residents. The Veterans Health Administration (VA) and Federally Qualified Health Centers are common venues for such rotations. Sustainable funding of these rotations is a concern. Fewer than half of programs offer integrated care didactics. This report is intended to help program directors consider options for starting or optimizing their own integrated care curricula. Future research should examine the educational value, and the overall value to health care systems, of training in the integrated care model.
Carvalho Aguiar Melo, Matias; das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth
Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. © The Author(s) 2016.
Gupta, Mona; Forlini, Cynthia; Lenton, Keith; Duchen, Raquel; Lohfeld, Lynne
The authors describe the hidden ethics curriculum in two postgraduate psychiatry programs. Researchers investigated the formal, informal, and hidden ethics curricula at two demographically different postgraduate psychiatry programs in Canada. Using a case study design, they compared three sources: individual interviews with residents and with faculty and a semi-structured review of program documents. They identified the formal, informal, and hidden curricula at each program for six ethics topics and grouped the topics under two thematic areas. They tested the applicability of the themes against the specific examples under each topic. Results pertaining to one of the themes and its three topics are reported here. Divergences occurred between the curricula for each topic. The nature of these divergences differed according to local program characteristics. Yet, in both programs, choices for action in ethically challenging situations were mediated by a minimum standard of ethics that led individuals to avoid trouble even if this meant their behavior fell short of the accepted ideal. Effective ethics education in postgraduate psychiatry training will require addressing the hidden curriculum. In addition to profession-wide efforts to articulate high-level values, program-specific action on locally relevant issues constitutes a necessary mechanism for handling the impact of the hidden curriculum.
Woo, Benjamin K P; Ma, Albert Y
The University of California, Los Angeles (UCLA), along with Kern Medical Center (KMC) and Kern County Mental Health (KCMH), established a new psychiatry residency program in 2004. In this study, we compared psychiatric care at a county psychiatric facility serving a population of 760,000 inhabitants before and after the initiation of this psychiatry residency program. Medical charts for all patients admitted to the psychiatric inpatient service during the year before the inception of the psychiatry residency program (2003-2004) and during the first year in which there was full implementation of residents after inception of the psychiatry residency program (2005-2006) were reviewed. Baseline characteristics, demographics, and various outcomes of the two groups were compared. After the residency program was established, the mean length of stay increased from 8.8 to 9.8 days (p psychiatric inpatient setting. More research is needed to identify strategies, such as guidelines to eliminate over-utilization of resources and methods to improve residents' competency, that may successfully enhance the quality of care provided by residents to psychiatric inpatients.
Ditton-Phare, Philippa; Sandhu, Harsimrat; Kelly, Brian; Kissane, David; Loughland, Carmel
Mental health clinicians can experience difficulties communicating diagnostic information to patients and their families/carers, especially about distressing psychiatric disorders such as schizophrenia. There is evidence for the effectiveness of communication skills training (CST) for improving diagnostic discussions, particularly in specialties such as oncology, but only limited evidence exists about CST for psychiatry. This study evaluated a CST program specifically developed for psychiatry residents called ComPsych that focuses on conveying diagnostic and prognostic information about schizophrenia. The ComPsych program consists of an introductory lecture, module booklets for trainees, and exemplary skills videos, followed by small group role-plays with simulated patients (SPs) led by a trained facilitator. A standardized patient assessment (SPA) was digitally recorded pre- and post-training with a SP using a standardized scenario in a time-limited (15 min) period. Recorded SPAs were independently rated using a validated coding system (ComSkil) to identify frequency of skills used in five skills categories (agenda setting, checking, questioning, information organization, and empathic communication). Thirty trainees (15 males and 15 females; median age = 32) undertaking their vocational specialty training in psychiatry participated in ComPsych training and pre- and post-ComPsych SPAs. Skills increased post-training for agenda setting (d = -0.82), while questioning skills (d = 0.56) decreased. There were no significant differences in any other skills grouping, although checking, information organization, and empathic communication skills tended to increase post-training. A dose effect was observed for agenda setting, with trainees who attended more CST sessions outperforming those attending fewer. Findings support the generalization and translation of ComPsych CST to psychiatry.
Crisp-Han, Holly; Chambliss, R. Bryan; Coverdale, John
Objective: Because there have been no previously published national surveys on teaching psychiatry residents about how to teach, the authors surveyed United States psychiatry program directors on what and how residents are taught about teaching. Methods: All psychiatry training programs across the United States were mailed a semistructured…
Dvir, Yael; Moniwa, Emiko; Crisp-Han, Holly; Levy, Dana; Coverdale, John H.
Objective: The authors sought to determine the prevalence of threats and assaults by patients on psychiatry residents, their consequences, and the perceived adequacy of supports and institutional responses. Method: Authors conducted an anonymous survey of 519 psychiatry residents in 13 psychiatry programs across the United States. The survey…
Forensic psychiatry is still obscure a discipline amongst the practising psychiatrists; so awareness should be created in the young residents pursuing this stream. It is prudent of setting a curriculum for the general psychiatry residents to learn the relevant topics of forensic psychiatry through didactic lectures, seminars, case-discussions and witnessing case proceedings. This topic could enable budding psychiatrists to acquire the skills of the legal aspects of psychiatry. This challenging yet little known branch of medicine can rejuvenate trainee psychiatry residents to specialise further orconduct research activities.
Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver
Resident physicians training in psychiatry in the U.S. are required to master a body of knowledge related to cultural psychiatry; are expected to adopt attitudes that endorse the principles of cultural competence; and finally are expected to acquire specific cultural competence skills that facilitate working effectively with diverse patients. This article first provides an overview of the Accreditation Council for Graduate Medical Education (ACGME) competencies related to cultural competence, as well as the American Academy of Child and Adolescent Psychiatry's (AACAP) recommendations for the cultural competence training of child/adolescent fellows. Next, numerous print and electronic resources that can be used in cultural competence education in psychiatry are reviewed and discussed. Finally, we conclude by providing recommendations for psychiatry residency programs that we culled from model cultural competence curricula.
Torous, John; Franzan, Jamie; O'Connor, Ryan; Mathew, Ian; Keshavan, Matcheri; Kitts, Robert; Boland, Robert
Psychiatry residents have numerous online educational resources readily available to them although currently there are no data regarding residents' use and perception of such websites. A survey was offered to 62 residents from all four years of training as well as recent graduates of a single psychiatry residency training program. Residents reported utilizing online resources on average 68 % of the time, in comparison to 32 % on average for printed materials. Residents reported UpToDate, PubMed, and Wikipedia as the most visited websites and ranked each highly but for different purposes. Thirty-five percent of residents felt that insufficient faculty guidance was a barrier to use of these educational websites. Pilot data indicate psychiatry residents use online resources daily for their education in various settings. Resident perceptions of individual website's trustworthiness, ease of use, and sources of clinical decision-making and personal learning suggest potential opportunities for educators to better understand the current use of these resources in residency training. Reported barriers including lack of faculty guidance suggest opportunities for academic psychiatry. Further study is necessary at multiple sites before such results may be generalized.
Sockalingam, Sanjeev; Stergiopoulos, Vicky; Maggi, Julie D.; Zaretsky, Ari; Stovel, Laura; Hodges, Brian
Objectives: With the emergence of physician-manager (PM) curricula in medical education, more effective assessment tools are needed to evaluate psychiatry trainees in this role. The aim of this study was to determine psychiatry residents', program directors', and PM educators' perceptions about PM role-assessment. Methods: Psychiatry residents at…
Posporelis, Sotirios; Sawa, Akira; Smith, Gwenn S; Stitzer, Maxine L; Lyketsos, Constantine G; Chisolm, Margaret S
With the shift of interest in psychiatry towards patient-oriented research with clinically relevant outcomes, there is a critical need for well-trained psychiatrist-scientists. The authors report on two developmentally tailored, longitudinal research training curricula designed to use peer mentoring to bridge the gap between physicians and scientists and to promote careers in academic research. The authors instituted two independent research training curricula, one for first-year and one for second-to-fourth-year psychiatry residents, spanning two campuses of one institutional residency training program. Each curriculum's participants included psychiatry residents and peer scientific investigators, and both were attended by senior scientists and departmental leaders. The authors developed and administered an anonymous survey at the end of the first cycle of the first-year resident curriculum to assess participant attitudes. The first-year and second-to-fourth-year resident curricula have been implemented for 3 and 2 years, respectively. The authors observed overall participant satisfaction with the first-year curricula, independent of trainee status. Furthermore, first-year psychiatry residents reported increased interest in academic research careers after exposure to the curricula. Results suggest that it is possible to encourage academic research careers using peer mentoring, an innovative approach that requires minimal funding, causes little disruption to the residents' schedule and engages the gamut of individuals involved in psychiatry care and research: psychiatrists-in-training and young non-clinician scientists-in-training.
Rej, Soham; Laliberté, Vincent; Rapoport, Mark J; Seitz, Dallas; Andrew, Melissa; Davidson, Marla
In spite of a rapidly increasing need, there remains a shortage of geriatric psychiatrists in North America. The factors associated with psychiatric residents' interest in geriatric psychiatry have not yet been examined in a nationally representative sample. Cross-sectional study. Web-based online survey of Canadian psychiatry residents. 207 psychiatry residents (24.3% response rate). The main outcome was interest in becoming a geriatric psychiatrist. Bivariate and multivariate analyses were performed to better understand what demographic, educational, and vocational variables were associated with interest in becoming a geriatric psychiatrist. A number of respondents had an interest in becoming a geriatric psychiatrist (29.0%, N = 60); in doing a geriatric psychiatry fellowship (20.3%, N = 42); or an interest in doing geriatric psychiatry as a part of the clinical practice (60.0%, N = 124). Demographic characteristics (age, gender, ethnicity) did not correlate with interest in geriatric psychiatry. The variables most robustly associated with interest in geriatric psychiatry were: 1) completion of geriatric psychiatry rotation(s) before the third year of residency (OR: 5.13, 95% CI: 1.23-21.4); 2) comfort working with geriatric patients and their families (OR: 18.6, 95% CI: 2.09-165.3); 3) positive experiences caring for older adults prior to medical school (OR: 12.4, 95% CI: 1.07-144.5); and 4) the presence of annual conferences in the resident's field of interest (OR: 4.50, 95% CI: 1.12-18.2). Exposing medical students and junior psychiatry residents to clinical geriatric psychiatry rotations that increase comfort in working with older adults may be potential future strategies to improve recruitment of geriatric psychiatrists. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Griffith, James L
Psychiatry residencies with a commitment to humanism commonly prioritize training in psychotherapy, cultural psychiatry, mental health policy, promotion of human rights, and similar areas reliant upon dialogue and collaborative therapeutic relationships. The advent of neuroscience as a defining paradigm for psychiatry has challenged residencies with a humanistic focus due to common perceptions that it would entail constriction of psychiatric practice to diagnostic and psychopharmacology roles. The author describes a neuroscience curriculum that has taught psychopharmacology effectively, while also advancing effectiveness of language-based and relationship-based therapeutics. In 2000, the George Washington University psychiatry residency initiated a neuroscience curriculum consisting of (1) a foundational postgraduate year 2 seminar teaching cognitive and social neuroscience and its integration into clinical psychopharmacology, (2) advanced seminars that utilized a neuroscience perspective in teaching specific psychotherapeutic skill sets, and (3) case-based teaching in outpatient clinical supervisions that incorporated a neuroscience perspective into traditional psychotherapy supervisions. Curricular assessment was conducted by (1) RRC reaccreditation site visit feedback, (2) examining career trajectories of residency graduates, (3) comparing PRITE exam Somatic Treatments subscale scores for 2010-2012 residents with pre-implementation residents, and (4) postresidency survey assessment by 2010-2012 graduates. The 2011 RRC site visit report recommended a "notable practice" citation for "innovative neurosciences curriculum." Three of twenty 2010-2012 graduates entered neuroscience research fellowships, as compared to none before the new curriculum. PRITE Somatic Treatments subscale scores improved from the 23rd percentile to the 62nd percentile in pre- to post-implementation of curriculum (p neuroscience curriculum for a residency committed to humanistic psychiatry
Laliberté, Vincent; Rapoport, Mark J; Andrew, Melissa; Davidson, Marla; Rej, Soham
Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents' future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. © The Author(s) 2015.
Sockalingam, Sanjeev; Stergiopoulos, Vicky; Maggi, Julie
To determine Canadian psychiatry residents' perceived gaps in physician-manager competencies during their residency training. Residents at 16 Canadian psychiatry residency programs were mailed an 11-item questionnaire (a copy is available from the authors) assessing their perceived deficiencies in selected managerial knowledge (GSk) and skill (GSs) areas as determined by gap scores (GS). GSs are defined as the difference between residents' perceived current and desired level of knowledge or skill in selected physician-manager domains. Residents' educational preferences were also elicited in the questionnaire. Among the 494 psychiatry residents who were sent the survey, 237 residents (48%) responded. Residents reported the greatest GSk in Program Planning and the greatest GSs in Personal and Professional Self-Care. Predictors of greater total GSks included a lack of previous administrative education during medical school, higher training level, and female sex. Only sex was a significant predictor of total GSss. More than 50% of residents preferred workshops, small groups, mentoring, and didactic learning methods for furthering their knowledge and skills. Residents report significant gaps in specific physician-manager training areas, specifically Program Planning, and Personal and Professional Self-Care. The results of this national survey can inform the development of formal physician-manager curricula. To appeal to residents, such curricula should incorporate more interactive pedagogical methods combined with mentoring opportunities.
Annamalai, Aniyizhai; Rohrbaugh, Robert M; Sernyak, Michael J
With the current emphasis on integrated care, the role of psychiatrists is expanding to either directly provide medical care or coordinate its delivery. The purpose of this study was to survey general psychiatry programs on the extent of general medicine training provided during residency. A short web-based survey was sent to 173 residency program directors to recruit participants for a larger survey. Thirty-seven participants were recruited and surveyed, and of these, 12 (32.4%) responded. The survey assessed the extent of general medicine training and didactics during and after the first postgraduate year and attitudes towards enhancing this training in residency. This study was approved by the local institutional review board. Seventy-five percent of programs require only the minimum 4 months of primary care in the first postgraduate year, and didactics during these months is often not relevant to psychiatry residents. Some programs offer elective didactics on chronic medical conditions in the fourth postgraduate year. Respondents are in favor of enhancing general medicine training in psychiatry but indicate some resistance from their institutions. These results suggest that very few programs require additional clinical training in relevant medical illnesses after the first postgraduate year. Respondents indicated favorable institutional support for enhancing training, but also expected resistance. The reasons for resistance should be an area of future research. Also important is to determine if enhancing medical didactics improves patient care and outcomes. The changing role of psychiatrists entails a closer look at resident curricula.
Prochaska, Judith J.; Fromont, Sebastien C.; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.
Objective Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. Method The authors recruited training directors to complete a survey of their program’s curriculum related to tobacco treatment, attitudes related to treating tobacco in psychiatry, and perceptions of residents’ skills for addressing nicotine dependence in psychiatric patients. Results Respondents were representative of the national pool. Half of the programs provided training in tobacco treatments for a median duration of 1 hour. Content areas covered varied greatly. Programs with tobacco-related training expressed more favorable attitudes toward addressing tobacco in psychiatry and were more likely to report confidence in their residents’ skills for treating nicotine dependence. Programs without tobacco training reported a lack of faculty expertise on tobacco treatments. Most training directors reported moderate to high interest in evaluating a model tobacco curriculum for psychiatry and stated they would dedicate an average of 4 hours of curriculum time. Conclusions The findings demonstrate the need for and interest in a model tobacco treatment curriculum for psychiatry residency training. Training psychiatrists offers the potential of delivering treatment to one of the largest remaining groups of smokers: patients with mental disorders. PMID:17021144
Brasch, Jennifer; Glick, Rachel Lipson; Cobb, Thomas G.; Richmond, Janet
Objective: Describe training goals, objectives and requirements in emergency psychiatry to assist residency programs in developing comprehensive training programs to ensure psychiatric residents acquire the necessary skills and knowledge to competently assess and manage patients with psychiatric emergencies. Methods: The American Association for…
Sockalingam, Sanjeev; Wiljer, David; Yufe, Shira; Knox, Matthew K; Fefergrad, Mark; Silver, Ivan; Harris, Ilene; Tekian, Ara
To examine the relationship between lifelong learning (LLL) and academic motivation for residents in a psychiatry residency program, trainee factors that influence LLL, and psychiatry residents' LLL practices. Between December 2014 and February 2015, 105 of 173 (61%) eligible psychiatry residents from the Department of Psychiatry, University of Toronto, completed a questionnaire with three study instruments: an LLL needs assessment survey, the Jefferson Scale of Physician Lifelong Learning (JeffSPLL), and the Academic Motivation Scale (AMS). The AMS included a relative autonomy motivation score (AMS-RAM) measuring the overall level of intrinsic motivation (IM). A significant correlation was observed between JeffSPLL and AMS-RAM scores (r = 0.39, P motivation identification domain (mean difference [M] = 0.38; 95% confidence interval [CI] [0.01, 0.75]; P = .045; d = 0.44) compared with senior residents. Clinician scientist stream (CSS) residents had significantly higher JeffSPLL scores compared with non-CSS residents (M = 3.15; 95% CI [0.52, 5.78]; P = .020; d = 0.57). The use of rigorous measures to study LLL and academic motivation confirmed prior research documenting the positive association between IM and LLL. The results suggest that postgraduate curricula aimed at enhancing IM, for example, through support for learning autonomously, could be beneficial to cultivating LLL in learners.
Ozer, Urun; Ceri, Veysi; Carpar, Elif; Sancak, Baris; Yildirim, Fatma
This study aimed to investigate the factors affecting the choice of psychiatry among psychiatry residents, identify the fulfillment of expectations, and assess their satisfaction level. Anonymous questionnaires were administered to 98 psychiatry residents, and sociodemographic and professional data were collected. Among the reasons for choosing psychiatry, the opportunity to cultivate interest in humanities, importance of social and relational issues, and intellectual challenge were most frequently selected. The opportunity for complete use of medical training, salary, and opportunity to practice psychotherapy were the expectations least met. The largest group of participants was satisfied to have chosen psychiatry (41.5%), decided on psychiatry training after medical school (35.4%), and attached importance to becoming a clinician (70.7%). Although the satisfaction level was high in this study, addressing the areas in which expectations were not met may increase the satisfaction of psychiatry residents and the selection of psychiatry as a specialty.
Marrero, Isis; Bell, Michael; Dunn, Laura B.; Roberts, Laura Weiss
Background: Professionalism is one of the fundamental expectations and a core competency in residency education. Although programs use a variety of evaluative methods, little is known about residents' views of and preferences regarding various methods of assessment. Method: The authors surveyed residents at seven psychiatry residency programs…
Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina
Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…
This research study was conducted to explore the phenomenon of the third-year experiences of the psychiatry residents. A review of the literature identified themes and subthemes related to the third-year of psychiatry education. The study was conducted at a university health science center. Data were collected from five residents using participant…
Rios, Francisco Javier Mesa; Munoz, Maria Del Carmen Lara
Background: Various rates of alcoholism, drug abuse, mental illness, and suicide among physician have been reported, generally higher than those in the general population. Psychiatry residents, as other specializing physicians, seem to be prone to suffering them. The prevalence of psychological symptoms among psychiatry residents has not been…
Grujich, Nikola N.; Razmy, Ajmal; Zaretsky, Ari; Styra, Rima G.; Sockalingam, Sanjeev
Objective: The authors sought to determine psychiatry residents' perceptions on the current method of evaluating professional role competency and the use of multi-source feedback (MSF) as an assessment tool. Method: Authors disseminated a structured, anonymous survey to 128 University of Toronto psychiatry residents, evaluating the current mode of…
Iannucci, Rocco; Sanders, Kathy; Greenfield, Shelly F.
Objective: The authors describe an addiction psychiatry curriculum integrated in a general psychiatry training program to demonstrate comprehensive and practical approaches to educating general psychiatric residents on the recognition and treatment of substance use disorders. Methods: The Massachusetts General Hospital/McLean Hospital adult…
Nguyen, Tuong-Vi; Sockalingam, Sanjeev; Granich, Annette; Chan, Peter; Abbey, Susan; Galbaud du Fort, Guillaume
Psychosomatic medicine (PM) is recognized as a psychiatric subspecialty in the US, but continues to be considered a focused area of general psychiatric practice in Canada. Due to the unclear status of PM in Canada, a national survey was designed to assess the perception of and training experiences in PM among psychiatry residents. Residents enrolled at one of 13 psychiatry programs in Canada participated in the study. Logistic regression analyses were conducted to assess the effect of PM training experiences and career interest in PM on the perception of PM, controlling for number of months already completed in PM, training level, and residency program. The response rate was 35%, n = 199. 68% of respondents identified PM as a definite subspecialty, with the majority of respondents believing that PM was as important a subspecialty as child (53%), forensic (67%) and geriatric psychiatry (75%). Eighty percent of the respondents believed a PM specialist should complete more than 3 months of additional training to be competent/qualified. There was significant heterogeneity in training experiences across programs, with a differential effect of certain training components-seminar, journal club-associated with a more favorable perception of PM as a subspecialty. The above results challenge the notion that PM represents only a focused area of general psychiatric practice in Canada. PM appears to require additional training beyond residency for trainees to feel competent and qualified. Results from this survey suggest Canada should follow the US lead on recognizing PM as a subspecialty. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
Jain, Shaili; Dunn, Laura B.; Warner, Christopher H.; Roberts, Laura Weiss
Objective: The authors assess the perspectives of psychiatry residents about the goals of receiving education in professionalism and ethics, how topics should be taught, and on what ethical principles the curriculum should be based. Method: A written survey was sent to psychiatry residents (N = 249) at seven U.S. residency programs in Spring 2005.…
Hoop, Jinger G
In addition to learning about confidentiality, civil commitment, informed consent, and other ethical issues, psychiatry residents must deal with less visible ethical dilemmas that arise from the training process itself. Residents grapple with three inherent conflicting duties between their dual roles as physician and learner, as physician and supervisee, and as physician and employee of a training institution. These conflicts must be negotiated at a time of high stress, when residents are plagued with self-doubt, fear, fatigue, and other vulnerabilities that can lead good doctors to make ethically dubious decisions. While such conflicts and stressors are common to residency training in most specialties, they may be heightened in psychiatric residency. This paper proposes a model for understanding covert elements of ethical decision making during psychiatric residency and recommends strategies training programs can use to help residents navigate an ethical minefield.
Touchet, Bryan; Walker, Ashley; Flanders, Sarah; McIntosh, Heather
In the first year of training, psychiatry residents progress from direct supervision to indirect supervision but factors predicting time to transition between these levels of supervision are unknown. This study aimed to examine times for transition to indirect levels of supervision and to identify resident factors associated with slower progression. The authors compiled data from training files from years 2011-2015, including licensing exam scores, age, gender, medical school, month of first inpatient psychiatry rotation, and transition times between levels of supervision. Correlational analysis examined the relationship between these factors. Univariate analysis further examined the relationship between medical school training and transition times between supervision levels. Among the factors studied, only international medical school training was positively correlated with time to transition to indirect supervision and between levels of indirect supervision. International medical graduate (IMG) interns in psychiatry training may benefit from additional training and support to reach competencies required for the transition to indirect supervision.
Berger-Vergiat, A; Chauvelin, L; Van Effenterre, A
For many years, the numerus clausus limiting the number of medical students has increased in France. The government wants to reform the residency process to homogenize medical studies. However, the suggested residency program changes would imply changes in the length of residency, in the mobility of residents after residency, their access to unconventional sectors, and more generally, the responsibility of the resident and his/her status in the hospital. In this context, we have investigated the future plans of all psychiatry residents in France. To study the desires of psychiatry residents in France, regarding their training, their short and long-term career plans, and to analyze the evolution of those desires over the last 40 years. A survey was carried out among residents in psychiatry from November 2011 to January 2012. An anonymous questionnaire including four parts (resident's description, residency training and trainees choice, orientation immediately after residency, professional orientation in 5-10 years) was sent by the French Federative Association of Psychiatrists Trainees (AFFEP) to all French psychiatrist trainees, through their local trainee associations (n=26) and through an on line questionnaire. The questionnaire was answered by 853 of the 1615 psychiatry residents (53%), of which 71% were women. At the end of the residency, 76% of residents reported that they would like to pursue a post-residency position (chief resident, senior physician assistant university hospitals); 22% reported wanting to work in another city. Between 5 to 10 years after completion of the residency, 71% reported wanting to work in a hospital, and 40% preferred to have their own private practice. Almost a third of the trainees wished to work in the child and adolescent psychiatry field, for some of them in an exclusive way, for others, combined with a practice in adult psychiatry. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Randall, Melinda; Lowe, Marissa; Aillon-Sohl, Lara
Understanding how psychiatry residents learn to prescribe is important for the future of psychiatry. Prescribing is a complicated act that involves much more than signing a prescription. During residency, psychiatrists develop seminal attitudes and habits about prescribing. There have been no published studies focusing on psychiatry residents' experience when learning to prescribe. Qualitative methodology lends itself to a deep exploration of the process of learning how to prescribe. We undertook a qualitative study questioning psychiatry residents about their prescribing. Psychiatry residents were recruited from three residency programs and focus groups were conducted at each program. The focus groups were audiotaped and transcribed by a professional service. Thematic analysis was used to analyze the data and triangulation to increase the rigor of the study. A total of 12 residents participated. Three themes were identified concerning identity development as a psychiatrist, uncertainty and fear about prescribing, and the centrality of collaborating with the patient during the prescribing process. Psychiatry residents struggle with significant anxiety and frustration in their experience of learning to prescribe, suggesting a place for mentors and supervisors to focus.
Besterman, Aaron D; Williams, Jody K; Reus, Victor I; Pato, Michele T; Voglmaier, Susan M; Mathews, Carol A
For psychiatry research resident career development, there is a recognized need for improved cross-institutional mentoring and networking opportunities. One method to address this need is via regional conferences, open to current and recently graduated research residents and their mentors. With this in mind, we developed the biennial California Psychiatry Research Resident Retreat (CPRRR) and collected feedback from participants to 1) Assess resident satisfaction, 2) Determine the utility of the retreat as a networking and mentorship tool, and 3) Identify areas for improvement. We gathered survey data from resident attendees at the two first CPRRRs. We analyzed the data to look for trends in satisfaction as well as areas that need improvement. Thirty-two residents from five California training programs attended the CPRRR in 2013 while 33 attended from six programs in 2015. The residents were from all years of training, but concentrated in their second and third years. Approximately 41% and 49% of the attendees were female and 53% and 39% had an MD/PhD in 2013 and 2015, respectively. Twenty-four and 32 residents provided anonymous feedback in 2013 and 2015, respectively. Mean feedback scores were very high (> 4/5) for overall satisfaction, peer- and faculty-networking, the keynote speaker and the flash talks for both years. Mean feedback scores for the ethics debates and mentoring sessions were somewhat lower (≤ 4/5), however, both showed significant improvement from 2013 to 2015. The CPRRRs appear to be an effective mechanism for providing psychiatry research residents with a meaningful cross-institutional opportunity for networking and mentorship. Feedback-driven changes to the CPRRRs improved participant satisfaction for several components of the conference. Future efforts will be aimed at broadening mentorship and networking opportunities, optimizing teaching approaches for research ethics, and considering different feedback-gathering approaches to allow for
Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi
Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear
Puri, Neil V; Azzam, Pierre; Gopalan, Priya
Having gained subspecialty certification in 2003, the field of psychosomatic medicine (PM) addresses the mental health needs of individuals who suffer from general medical conditions. The rising prevalence of chronic illness, along with trends in medical delivery toward more collaborative models of care, underscores the value of recruitment to PM specialty programs. To foster interest and education in PM, we have developed and implemented a Psychosomatic Medicine Interest Group for trainees within a psychiatry residency program. Participants have found the Psychosomatic Medicine Interest Group to be an enjoyable experience that has improved their clinical practice and interest in PM. The Psychosomatic Medicine Interest Group has also been a successful vehicle to enhance clinical knowledge and mentoring opportunities during training, while bolstering residents' desire to pursue a career in PM. Copyright © 2015 The Academy of Psychosomatic Medicine. All rights reserved.
Objective: This article provides a brief overview of the history of psychiatry residency training in Canada,and outlines the rationale for the current training requirements, changes to the final certification examination,and factors influencing future trends in psychiatry education and training. Method: The author compiled findings and reports on…
Hanson, Mark D.; Szatmari, Peter; Eva, Kevin W.
Objective: The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Method: Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1)…
Seyed Saeed Sadr
Full Text Available Objective: The aim of this study was to investigate the current factors affecting the choice of psychiatry as a specialty and to detect the main factors in their choice.Method: This descriptive study included 75 first year psychiatry residents in the academic year of 2014/2015. A Likert-type anonymous questionnaire consisting of academic and demographic data with 43 questions, which evaluated the reason for choosing psychiatry as a specialty, was given to the residents.Results: The participants had a positive opinion about 28 items of the questionnaire, meaning that these items had a positive effect in choosing psychiatry as a specialty (questions with P value less than 0.05 and a positive mean. More than 80% of the residents had a positive opinion about six items of the questionnaire (amount of intellectual challenge, variety of knowledge fields relevant to psychiatry, emphasis on the patient as a whole person, the importance of treating mental illnesses in the future, work pressure and stress of the field during residency and coordinating with the person's life style. The participants had a negative opinion about two items of the questionnaire (questions with a P value less than 0.05 and a negative mean. They included experiencing mental illness personally through relatives or close friends as well as the income in psychiatry. Moreover, 36% of the residents with a more definite opinion mentioned that they chose psychiatry as a specialty because of the limitations in residency exam.Conclusion: Assistants had a positive opinion about most of the questions and this positive attitude seemed to be an important factor in their specialty choice. However, attending to the preventing factors may increase the selection of psychiatry as a specialty.
Sexson, Sandra B
Directing child and adolescent psychiatry (CAP) training for residents is a complex and challenging administrative task that encompasses the broad creativity of the orchestral conductor, the social and interpersonal effectiveness of the best politician, and the orientation to details of the finest accountant. This article examines these roles in detail, recognizing the leadership, administrative, and managerial achievements of the successful child and adolescent program director. Resources for optimizing the chances for success in each of these areas, and the common pitfalls to avoid, are identified and discussed. The article concludes with suggestions for CAP training directors to influence medical student education. Although challenging and sometimes frustrating, the role of the program director in CAP training is almost always exciting and rewarding.
Fung, Lawrence K; Akil, Mayada; Widge, Alik; Roberts, Laura Weiss; Etkin, Amit
The purpose of this study is to assess the attitudes of psychiatry trainees toward neuroscience education in psychiatry residency and subsequent training in order to inform neuroscience education approaches in the future. This online survey was designed to capture demographic information, self-assessed neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interest in specific neuroscience topics. Volunteers were identified through the American Psychiatric Association, which invited 2,563 psychiatry trainees among their members. Four hundred thirty-six trainees completed the survey. Nearly all agreed that there is a need for more neuroscience education in psychiatry residency training (94%) and that neuroscience education could help destigmatize mental illness (91%). Nearly all (94%) expressed interest in attending a 3-day course on neuroscience. Many neuroscience topics and modes of learning were viewed favorably by participants. Residents in their first 2 years of training expressed attitudes similar to those of more advanced residents and fellows. Some differences were found based on the level of interest in a future academic role. This web-based study demonstrates that psychiatry residents see neuroscience education as important in their training and worthy of greater attention. Our results suggest potential opportunities for advancing neuroscience education.
Posporelis, Sotirios; Sawa, Akira; Smith, Gwenn S.; Stitzer, Maxine L.; Lyketsos, Constantine G.; Chisolm, Margaret S.
Objective With the shift of interest in psychiatry towards patient-oriented research with clinically relevant outcomes, there is a critical need for well-trained psychiatrist-scientists. The authors report on two developmentally-tailored, longitudinal research training curricula designed to use peer mentoring to bridge the gap between physicians and scientists, and to promote careers in academic research. Methods The authors instituted two independent research training curricula, one for first-year and one for second-to-fourth year psychiatry residents, spanning two campuses of one institutional residency training program. Each curriculum’s participants included psychiatry residents and peer scientific investigators, and both were attended by senior scientists and departmental leaders. The authors developed and administered an anonymous survey at the end of the first cycle of the first-year resident curriculum to assess participant attitudes. Results The first-year and second-to-fourth-year resident curricula have been implemented for 3and 2 years respectively. The authors observed overall participant satisfaction with the first-year curricula, independent of trainee status. Furthermore, first-year psychiatry residents reported increased interest in academic research careers after exposure to the curricula. Conclusions Results suggest it is possible to encourage academic research careers using peer mentoring, an innovative approach that requires minimal funding, little disruption to the residents’ schedule, and engages the gamut of individuals involved in psychiatry care and research: psychiatrists-in-training and young non-clinician scientists-in-training. PMID:24497181
Lepetit, Alexis; Lavigne, Benjamin; Legros, Emilie; Herrmann, Mathieu; Sebbane, Déborah
Aging of the population is a growing concern in developed countries. Therefore, geriatric psychiatry has gradually emerged from general psychiatry. Many names have been proposed to term this sub-specialty: old age psychiatry (OAP), psychogeriatrics, geropsychiatry. A working group of the French federation of psychiatric trainees (AFFEP) set up an inventory of the theoretical instruction and clinical practice of OAP during the training of psychiatrists in France. Methods. A survey of both academic teaching and practical training for OAP was carried out in the 28 local AFFEP representatives of every French medical residency district, including overseas. We assessed the supply of general courses and seminars devoted to OAP during the training of French residents in psychiatry, and the offer of university or inter-university degrees as well as the possibility of specialized internship in every residency district. Results. 96% of French medical residency districts offered general courses of OAP with a mean volume of 11.5 hours along the four years of psychiatric training in France. Fifty percent of medical residency districts proposed at least one seminar devoted to OAP. Half of medical residency districts also offer a specialized university or inter-university degree. Concerning clinical practice, 86% of medical residency districts had one internship dedicated to OAP, in 39% of cases in teaching hospitals. Conclusion. Nationwide, there is an overall effort to make OAP available to French psychiatric residents by general courses and internship, but some disparity appeared in academic teaching (i.e. offering seminars and university/inter-university degrees) according to various residency districts.
Agarwal, Gaurava; Karpouzian, Tatiana
This exploratory study aims to measure work engagement levels in psychiatry residents at three psychiatry residency programs using the Utrecht Work Engagement Scale (UWES). In addition, the study investigates the relationship between total engagement and its subscales, resident satisfaction, and a depression screen. Recruitment of 53/79 residents from three psychiatry residency programs in Illinois was completed. The residents were administered a questionnaire consisting of the UWES, the Primary Care Evaluation of Mental Disorders (Prime-MD) depression screen, and a residency satisfaction scale. Statistical analysis using independent samples t test and a one-way analysis of variance was used to assess differences on engagement total score and subscales and satisfaction scale. A logistic regression was used with the engagement subscales and the satisfaction scale as predictors of belonging to the depressed or non-depressed group. Psychiatry residents scored in the high range for total engagement and all its subscales except for vigor which was in the moderate range. Residents who screened positive for depression reported lower total engagement than those who were negative on the depression screen. Vigor was the only significant predictor (p = .004) of being in the depressed group after logistic regression. Total engagement and the subscale of dedication significantly predicted overall residency satisfaction (β = .473, p = .016). Higher total UWES-15 and its subscales of vigor and dedication are correlated with a lower rate of screening positive for depression and higher residency satisfaction. This exploratory study lends support for further study of this psychological construct in medical training programs, but replication is needed.
Kozak, Leila; Boynton, Lorin; Bentley, Jacob; Bezy, Emma
A growing body of research suggests that religion and spirituality may have a positive effect on mental and physical health. Medical schools have been increasingly offering courses in spirituality and health, particularly about the multi-cultural dimensions of religion and spirituality. There is a trend towards integrating the teaching of cross-cultural issues related to spirituality and religion into medical education. This trend is particularly evident in the field of psychiatry, where an increasing number of residency programmes are developing curriculum in this area. This article describes a specific curriculum in spirituality, religion and culture that was introduced in 2003 at the University of Washington Psychiatry Residency Program in Seattle, Washington. Reflections about the present and future of subject areas such as spirituality and religion in medical education and psychiatry residency are discussed.
Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.
Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…
Gaffas, Eisha M; Sequeira, Reginald P; Namla, Riyadh A Al; Al-Harbi, Khalid S
The postgraduate training program in psychiatry in Saudi Arabia, which was established in 1997, is a 4-year residency program. Written exams comprising of multiple choice questions (MCQs) are used as a summative assessment of residents in order to determine their eligibility for promotion from one year to the next. Test blueprints are not used in preparing examinations. To develop test blueprints for the written examinations used in the psychiatry residency program. Based on the guidelines of four professional bodies, documentary analysis was used to develop global and detailed test blueprints for each year of the residency program. An expert panel participated during piloting and final modification of the test blueprints. Their opinion about the content, weightage for each content domain, and proportion of test items to be sampled in each cognitive category as defined by modified Bloom's taxonomy were elicited. Eight global and detailed test blueprints, two for each year of the psychiatry residency program, were developed. The global test blueprints were reviewed by experts and piloted. Six experts participated in the final modification of test blueprints. Based on expert consensus, the content, total weightage for each content domain, and proportion of test items to be included in each cognitive category were determined for each global test blueprint. Experts also suggested progressively decreasing the weightage for recall test items and increasing problem solving test items in examinations, from year 1 to year 4 of the psychiatry residence program. A systematic approach using a documentary and content analysis technique was used to develop test blueprints with additional input from an expert panel as appropriate. Test blueprinting is an important step to ensure the test validity in all residency programs.
Awaad, Rania; Ali, Sara; Salvador, Melina; Bandstra, Belinda
Although the importance of addressing issues of spirituality and religion is increasingly acknowledged within psychiatry training, many questions remain about how to best teach relevant knowledge, skills, and attitudes. Current literature on curricula highlights the importance of maintaining a clinical focus and the balance between didactic content and process issues. The authors present findings from a program evaluation study of a course on religion, spirituality, and psychiatry that deliberately takes a primarily process-oriented, clinically focused approach. Two six-session courses were offered. The first course targeted fourth-year psychiatry residents and the second targeted third-year psychiatry residents. Teaching sessions consisted of brief didactics combined with extensive process-oriented discussion. A two-person faculty team facilitated the courses. Clinical case discussions were integrated throughout the curriculum. A panel of chaplains was invited to participate in one session of each course to discuss the interface between spiritual counsel and psychiatry. A modified version of the Course Impact Questionnaire, a 20-item Likert scale utilized in previous studies of spirituality curricula in psychiatry, assessed residents' personal spiritual attitudes, competency, change in professional practice, and change in professional attitudes before and after the course (N = 20). Qualitative feedback was also elicited through written comments. The results from this study showed a statistically significant difference between the pre- and post-test scale for residents' self-perceived competency and change in professional practice. The findings suggest improvement in competency and professional practice scores in residents who participated in this course. This points toward the overall usefulness of the course and suggests that a process-oriented approach may be effective for discussing religion and spirituality in psychiatric training.
Woodside, Jack Richard; Miller, Merry Noel; Floyd, Michael R; McGowen, K Ramsey; Pfortmiller, Debi T
To investigate the relationship between burnout, work environment, and a variety of personal variables, including age, gender, marital, parental and acculturation status within a population of family medicine and psychiatry resident physicians. Between 2002 and 2005, 155 residents in family medicine and psychiatry at East Tennessee State University College of Medicine were surveyed at intervals using the Maslach Burnout Inventory and Work Environment Scale, form R, to assess their current state of emotional health and job satisfaction. Female residents had lower scores on the Depersonalization scale of the Maslach Burnout Inventory (t=3.37, p=0.001). Parenting was associated with lower Depersonalization (t=3.98, pburnout than family medicine residents on the Depersonalization and Emotional Exhaustion scales (t=2.49, p=0.014: t=2.05, p=0.042) and higher Physical Comfort on the Work Environment Scale (t=-2.60, p=0.011); while family medicine residents reported higher Peer Cohesion, Supervisor Support, and Autonomy (t=3.41, p=0.001; t=2.38, p=0.019; t=2.27, p=0.025). This study design, using well established, standard, and valid measures, identified important issues for further exploration: the relationship between acculturation to burnout, the potential role of parenting as a protective factor from burnout, and the recognition that women residents may not be as vulnerable to burnout as previously reported.
Lis, Lea DeFrancisci; Wood, William C; Petkova, Eva; Shatkin, Jess
Mentorship is an important component of graduate education. This study assessed the perceptions of general psychiatry chief residents regarding the adequacy of mentorship provided during training. The authors surveyed 229 chief residents participating in the APA National Chief Residents Leadership Program in 2004 and 2005. The survey assessed domains such as work hours, didactics, home and family life, and mentorship. Of the chief psychiatric residents surveyed, 49% reported that they did not have a clearly defined career development mentor, and 39% reported that they did not feel adequately mentored. Gender, race/ethnicity, marital status, moonlighting, medical school (American versus international), and type of residency program (academic versus community based) did not show significant association with either "having a clearly defined mentor" or "feeling adequately mentored," based on chi-squared tests for independence. Chief residents who had authored peer-reviewed publications were significantly more likely to report having a clearly defined mentor and to feel adequately mentored than those who did not author publications. Logistic regression analysis showed that having a clearly defined mentor was associated with twice the odds for feeling well prepared to practice psychiatry upon graduation compared with those who did not have a clearly defined mentor, even after controlling for gender, race, medical school, and residency program type. Half of the psychiatric chief residents surveyed reported the lack of a clearly defined career development mentor. In addition, a chief resident's response of lacking a clear mentor was associated with the perception of being less prepared to practice psychiatry upon graduation. Psychiatric residency training programs may benefit from further clarification and implementation of effective mentorship programs.
Full Text Available Eisha M Gaffas,1 Reginald P Sequeira,2 Riyadh A Al Namla,1 Khalid S Al-Harbi31Al-Amal Complex for Mental Health, Riyadh, Kingdom of Saudi Arabia; 2College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 3King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Kingdom of Saudi ArabiaBackground: The postgraduate training program in psychiatry in Saudi Arabia, which was established in 1997, is a 4-year residency program. Written exams comprising of multiple choice questions (MCQs are used as a summative assessment of residents in order to determine their eligibility for promotion from one year to the next. Test blueprints are not used in preparing examinations.Objective: To develop test blueprints for the written examinations used in the psychiatry residency program.Methods: Based on the guidelines of four professional bodies, documentary analysis was used to develop global and detailed test blueprints for each year of the residency program. An expert panel participated during piloting and final modification of the test blueprints. Their opinion about the content, weightage for each content domain, and proportion of test items to be sampled in each cognitive category as defined by modified Bloom's taxonomy were elicited.Results: Eight global and detailed test blueprints, two for each year of the psychiatry residency program, were developed. The global test blueprints were reviewed by experts and piloted. Six experts participated in the final modification of test blueprints. Based on expert consensus, the content, total weightage for each content domain, and proportion of test items to be included in each cognitive category were determined for each global test blueprint. Experts also suggested progressively decreasing the weightage for recall test items and increasing problem solving test items in examinations, from year 1 to year 4 of the psychiatry residence program.Conclusion: A systematic
Cooke, Brian K.; Cooke, Erinn O.; Sharfstein, Steven S.
Objective: The purpose of this study was to review the workload inventory of on-call psychiatry residents and to evaluate which activities were associated with reductions in on-call sleep. Method: A prospective cohort study was conducted, following 20 psychiatry residents at a 231-bed psychiatry hospital, from July 1, 2008 through June 30, 2009.…
Welton, Randon S; Hamaoka, Derrick A; Broderick, Pamela J; Schillerstrom, Jason E
Air Force psychiatry faces the task of training competent military psychiatrists in an era of continuing reductions. Beginning in the 1980s, the Air Force started collaborating with University partners to create hybrid training programs, civilian-military psychiatry residencies. These mergers provide stability for Air Force psychiatry training in the face of increased operational missions and uncertain military recruiting. As a result of these combined programs, Air Force psychiatry residents gain access to a broader range of civilian clinical experience and expertise while maintaining a focus on distinctive military requirements. The combining of programs opens up options for academic activities which may not have otherwise existed. Both military and civilian residents benefit from the occupational psychiatry experiences available within military clinical sites. These programs give civilian residents a chance to assist active duty members and their families and provide insight into the military "lifecycle." These collaborations benefit the universities by providing access to a larger pool of residents and faculty. The synthesis of the military and civilian programs raises some ongoing obstacles such as civilian residents' ability to gain access to military resources. The programs must also accommodate separate mechanisms for selecting residents (the National Residency Matching Program versus the Joint Selection Board for Graduate Medical Education). Military residents must also comply with military standards and requirements while maintaining the universities' standards of conduct and professionalism. Merging military training programs into university programs creates a vibrant opportunity to create exceptional military and civilian psychiatrists.
Miller, Brian J; Sexson, Sandra; Shevitz, Stewart; Peeples, Dale; Van Sant, Scott; McCall, W Vaughn
This study explores relationships between US Medical Licensing Examination (USMLE) and Psychiatry Resident In-Training Examination (PRITE) scores over a 10-year period at a university-affiliated program. For all MD general psychiatry residents who matriculated from 2003 to 2012 (n = 51), we extracted three-digit first-attempt and passing USMLE Step 1 and Step 2 clinical knowledge (CK) scores and PRITE percentile scores, stratified by global psychiatry and neurology scores, for postgraduate year (PGY)-1, 2, 3, and 4. A mixed model repeated measures analysis was performed to assess the association between USMLE and PRITE scores, adjusting for age, sex, and US medical graduate versus IMG status. Multiple linear regression models of USMLE and PGY-1 PRITE scores were also constructed. USMLE Steps 1 and 2 CK scores were significant predictors of PRITE psychiatry and neurology scores, both in PGY-1 as well as across all years of training (p < 0.01 for each). Given that PRITE scores are a significant predictor of success on the ABPN written examination, USMLE scores may be an important quantitative predictor of performance during residency.
Sadr, Seyed Saeed; Nayerifard, Razieh; Samimi Ardestani, Seyed Mehdi; Namjoo, Massood
Objective: The aim of this study was to investigate the current factors affecting the choice of psychiatry as a specialty and to detect the main factors in their choice. Method: This descriptive study included 75 first year psychiatry residents in the academic year of 2014/2015. A Likert-type anonymous questionnaire consisting of academic and demographic data with 43 questions, which evaluated the reason for choosing psychiatry as a specialty, was given to the residents. Results: The participants had a positive opinion about 28 items of the questionnaire, meaning that these items had a positive effect in choosing psychiatry as a specialty (questions with P value less than 0.05 and a positive mean). More than 80% of the residents had a positive opinion about six items of the questionnaire (amount of intellectual challenge, variety of knowledge fields relevant to psychiatry, emphasis on the patient as a whole person, the importance of treating mental illnesses in the future, work pressure and stress of the field during residency and coordinating with the person's life style). The participants had a negative opinion about two items of the questionnaire (questions with a P value less than 0.05 and a negative mean). They included experiencing mental illness personally through relatives or close friends as well as the income in psychiatry. Moreover, 36% of the residents with a more definite opinion mentioned that they chose psychiatry as a specialty because of the limitations in residency exam. Conclusion: Assistants had a positive opinion about most of the questions and this positive attitude seemed to be an important factor in their specialty choice. However, attending to the preventing factors may increase the selection of psychiatry as a specialty..
Sadr, Seyed Saeed; Nayerifard, Razieh; Samimi Ardestani, Seyed Mehdi; Namjoo, Massood
Objective: The aim of this study was to investigate the current factors affecting the choice of psychiatry as a specialty and to detect the main factors in their choice. Method: This descriptive study included 75 first year psychiatry residents in the academic year of 2014/2015. A Likert-type anonymous questionnaire consisting of academic and demographic data with 43 questions, which evaluated the reason for choosing psychiatry as a specialty, was given to the residents. Results: The participants had a positive opinion about 28 items of the questionnaire, meaning that these items had a positive effect in choosing psychiatry as a specialty (questions with P value less than 0.05 and a positive mean). More than 80% of the residents had a positive opinion about six items of the questionnaire (amount of intellectual challenge, variety of knowledge fields relevant to psychiatry, emphasis on the patient as a whole person, the importance of treating mental illnesses in the future, work pressure and stress of the field during residency and coordinating with the person's life style). The participants had a negative opinion about two items of the questionnaire (questions with a P value less than 0.05 and a negative mean). They included experiencing mental illness personally through relatives or close friends as well as the income in psychiatry. Moreover, 36% of the residents with a more definite opinion mentioned that they chose psychiatry as a specialty because of the limitations in residency exam. Conclusion: Assistants had a positive opinion about most of the questions and this positive attitude seemed to be an important factor in their specialty choice. However, attending to the preventing factors may increase the selection of psychiatry as a specialty. PMID:27928251
Sockalingam, Sanjeev; Hawa, Raed; Al-Battran, Mazin; Abbey, Susan E.; Zaretsky, Ari
Objective: Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.…
Zigman, Daniel; Young, Meredith; Chalk, Colin
Objective: This article examines the benefit and feasibility of introducing a new, simulation-based learning intervention for junior psychiatry residents. Method: Junior psychiatry residents were invited to participate in a new simulation-based learning intervention focusing on agitated patients. Questionnaires were used to explore the success of…
Bruno Mendonça Coêlho
Full Text Available INTRODUÇÃO: A psiquiatria evoluiu muito nas últimas décadas e seu estudo tornou-se, conseqüentemente, mais complexo. Os avanços em neurociências, aliados aos estudos clássicos de psicopatologia, psicofarmacologia, psicoterapia e neurologia, influenciaram grandemente o diagnóstico e o tratamento psiquiátricos. Apesar disso, a residência em psiquiatria no Brasil não se adequou a essa nova realidade. OBJETIVOS E MÉTODO: Partindo das recomendações da World Psychiatry Association (WPA, pesquisamos na Internet programas de residências brasileiros e de países das Américas e Europa. Comparamos nosso programa com as recomendações e dados do Institutional Program on the Core Training Curriculum for Psychiatry da WPA e propusemos um currículo mínimo para a residência em psiquiatria. DISCUSSÃO: Na maioria dos programas pesquisados, alguns pontos se destacam: duração mínima de 3 anos; estágio integral em neurologia por no mínimo um mês; conteúdo programático contendo psicopatologia, psicofarmacologia, teorias psicoterápicas, emergências psiquiátricas entre outras disciplinas; ensino e prática das diversas linhas psicoterápicas; abrangência das várias etapas da vida (crianças, adultos e idosos; álcool e drogas; espaços livres de que o residente pode dispor para sua formação (terapia, estudo ou pesquisa. CONCLUSÃO: O modelo brasileiro de residência em psiquiatria encontra-se defasado em relação à formação proposta pela WPA (observada em diversos países, mesmo latino-americanos. A residência necessita, seguindo modelo referenciado pela WPA e respeitando as diferenças regionais de cada escola, prover o mínimo para uma boa formação do psiquiatra.INTRODUCCIÓN: La psiquiatría evolucionó bastante en las últimas décadas y su estudio se hizo, consecuentemente, más complejo. Avances en las neurociencias, aliados a los estudios clásicos en psicopatología, psicofarmacología, psicoterapia y neurolog
John, Nadyah Janine; Shelton, P G; Lang, Michael C; Ingersoll, Jennifer
Professionalism is an abstract concept which makes it difficult to define, assess and teach. An additional layer of complexity is added when discussing professionalism in the context of digital technology, the internet and social media - the digital world. Current physicians-in-training (residents and fellows) are digital natives having been raised in a digital, media saturated world. Consequently, their use of digital technology and social media has been unconstrained - a reflection of it being integral to their social construct and identity. Cultivating the professional identity and therefore professionalism is the charge of residency training programs. Residents have shown negative and hostile attitudes to formalized professionalism curricula in training. Approaches to these curricula need to consider the learning style of Millennials and incorporate more active learning techniques that utilize technology. Reviewing landmark position papers, guidelines and scholarly work can therefore be augmented with use of vignettes and technology that are available to residency training programs for use with their Millennial learners.
Stuck, Craig; Campbell, Nioaka; Bragg, John; Moran, Robert
Objective: The authors describe an interdisciplinary training experience developed for psychiatry residents and seminary students that assessed each group's beliefs and attitudes toward the other's profession. The training was designed to enhance awareness, positive attitudes, and interaction between the disciplines. Methods: From 2005 to 2008,…
Dalack, Gregory W.; Jibson, Michael D.
Objective: The authors describe the implementation of Clinical Skills Verification (CSV) in their program as an in-training assessment intended primarily to provide formative feedback to trainees, strengthen the supervisory experience, identify the need for remediation of interviewing skills, and secondarily to demonstrating resident competence…
Dennis, Nora M; Swartz, Marvin S
This study examined psychiatry resident burnout in emergency departments and its association with residents' posttraining plans to care for Medicaid patients and others publicly insured. Between November and December 2013, psychiatry residents in North Carolina were recruited for a cross-sectional, Internet-based survey concerning emergency department experiences, attitudes about their roles, feelings of burnout, and posttraining intentions to treat Medicaid patients. The completion rate was 51% (N=91). In bivariate analyses (N=82 with an emergency psychiatry rotation), burnout was positively associated with frequent exhaustion (pburnout scores (pemergency department indicated decreased likelihood of treating publicly insured patients after training (Medicaid, odds ratio=.09, pemergency department during psychiatry residency appear to be linked to professional burnout and threaten to shape long-term plans regarding care for publicly insured patients.
Randall, Melinda; Romero-Gonzalez, Mauricio; Gonzalez, Gerardo; Klee, Anne; Kirwin, Paul
psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.
Full Text Available Background: Suicide is a commonly encountered and stressful event in professional life of any psychiatrist. Suicide risk assessment is a major gateway to patient treatment and management. It is a core competency requirement in training of psychiatry. The present study designed to assesseducational needsfor suicide prevention in residents of psychiatry in two medical schools in Iran, Isfahan University of Medical Sciences (IUMS and Shahid Beheshti Medical University (SBUMS inTehran. Methods: This was a qualitative triangulation study, conducted in two steps. The first step was based on a phenomenological approach and the second was based on focus groups. The studied population was the psychiatric residents of IUMS and SBUMS. Purposive sampling was implemented until saturation. Interviews were performed. Colaizzi method was used to analyze the data. In the second step, participants attended a session, in which all final codes of the first step were discussed, and regarding the views, educational priorities and needs were listed. Results: A total of 2047 codes, extracted from 31 interviews, analyzed through Colaizzi method, were categorized in three groups: Educational, facilities and processes, human resources. Conclusions: According to defects of current educational program, we suggest regular reevaluations and revisions of clinical training programs according to current needs.
Medlock, Morgan; Weissman, Anna; Wong, Shane Shucheng; Carlo, Andrew; Zeng, Mary; Borba, Christina; Curry, Michael; Shtasel, Derri
Mental health disparities based on minority racial status are well characterized, including inequities in access, symptom severity, diagnosis, and treatment. For African Americans, racism may affect mental health through factors such as poverty and segregation, which have operated since slavery. While the need to address racism in medical training has been recognized, there are few examples of formal didactic curricula in the psychiatric literature. Antiracism didactics during psychiatry residency provide a unique opportunity to equip physicians to address bias and racism in mental health care. With advocacy by residents in the Massachusetts General Hospital/McLean Psychiatry residency program, the Division of Public and Community Psychiatry developed a curriculum addressing racial inequities in mental health, particularly those experienced by African Americans. Four 50-minute interactive didactic lectures were integrated into the required didactic curriculum (one lecture per postgraduate training class) during the 2015-2016 academic year. Of residents who attended lectures and provided anonymous feedback, 97% agreed that discussing racism in formal didactics was at least "somewhat" positive, and 92% agreed that it should "probably" or "definitely" remain in the curriculum. Qualitative feedback centered on a need for more time to discuss racism as well as a desire to learn more about minority mental health advocacy in general. Teaching about racism as part of required training conveys the explicit message that this is core curricular material and critical knowledge for all physicians. These lectures can serve as a springboard for dissemination and provide scaffolding for similar curriculum development in medical residency programs.
Bennett, Jeffrey I; Handa, Kamna; Mahajan, Aman; Deotale, Pravesh
The authors queried attendees to a chief resident conference on whether program education and training in neuroscience or in translating neuroscience research into practice is sufficient and what changes are needed. The authors developed and administered a 26-item voluntary questionnaire to each attendee at the Chief Residents' Leadership Conference at the American Psychiatric Association 2013 annual meeting in San Francisco, CA. Out of 94 attendees, 55 completed and returned questionnaires (58.5%). A majority of respondents stated that their program provided adequate training in neuroscience (61.8%); opportunities for neuroscience research existed for them (78.2%), but that their program did not prepare them for translating future neuroscience research findings into clinical practice (78.9%) or educate them on the NIMH Research Domain Criteria (83.3%). A majority of respondents stated that the ACGME should require a specific neuroscience curriculum (79.6%). Chief residents believe that curricular and cultural change is needed in psychiatry residency neuroscience education.
Rait, Douglas Samuel
Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…
Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.
Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…
Rait, Douglas; Glick, Ira
Objective: The authors propose a family-systems training model for general residency training programs in psychiatry based on the couples and family therapy training program in Stanford's Department of Psychiatry and Behavioral Sciences. Methods: The authors review key elements in couples and family therapy training. Examples are drawn from the…
Cooke, Brian K; Garvan, Cynthia; Hobbs, Jacqueline A
The purpose of this study was to examine trends in the Psychiatry Resident-In-Training Examination (PRITE®) scores at one institution from 2001 to 2010. The authors hypothesized that two factors, the 2003 implementation of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour restrictions and the residency program's 2008 restructuring of its curriculum to a half-day per week of didactics, would lead to improved scores. Residents in the general psychiatry program at the University of Florida College of Medicine from 2001 to 2010 were included in this study. To examine the effect of the 2003 ACGME duty-hours change, the authors compared test results from 2001-2002 and 2003-2010. To examine the effect of the 2008 didactic restructuring, they compared test results from 2001-2007 and 2008-2010. There were 288 PRITE test scores from 2001 to 2010. The authors did not find a statistical difference between test results before and after the 2003 implementation of ACGME duty-hour restrictions or between test results before and after the 2008 restructuring of residency didactics. The hypothesis was rejected. The results of the literature review propose that examination scores are affected by other elements of residency training.
Residents work for between 80 and 168 hours per week (median, 92 hours), excluding call duty. Sixty-two ... of the current training program and the working conditions in the country, consultants should make .... introduction of the 1-year elective posting abroad. This elective posting had helped bridge the gap between our ...
Sudak, Donna M.; Goldberg, David A.
Objective: The authors sought to determine current trends in residency training of psychiatrists. Method: The authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic,…
Dopheide, Julie A; Bostwick, Jolene R; Goldstone, Lisa W; Thomas, Kelan; Nemire, Ruth; Gable, Kelly N; Cates, Marshall; Caballero, Joshua; Smith, Tawny; Bainbridge, Jacquelyn
Objective. To describe pharmacy curricula in psychiatry and neurology and to report on neuropsychiatric pharmacy specialists' views on optimal curriculum. Methods. Design and administer one electronic survey to accredited pharmacy programs asking them to report information on curricula in psychiatry and neurology for the 2014-2015 academic year. Design and administer a separate electronic survey to board certified pharmacists with an academic affiliation who are members of the College of Psychiatric and Neurologic Pharmacists (CPNP) asking about their teaching activities and their opinion on optimal curricula. Results. Fifty-six percent of pharmacy programs and 65% of CPNP members responded to the surveys. The program survey revealed greater than 80% of topics were taught by full-time faculty. Didactic lecturing, team-based learning, and case studies were the most common teaching methods. Programs dedicated the most didactics (3 to 5+ hours) to epilepsy, depression, schizophrenia, substance use disorders, and pain. Autism, traumatic brain injury, personality, and eating disorders were either not taught or given ≤ 1 hour of didactics in most programs. Inpatient psychiatry had the most APPE placements with a mean of 19.6, range 0-83. APPE electives in psychiatry outnumbered those in neurology 5 to 1. CPNP member survey results showed 2 out of 3 members agreed that curriculum could be improved with additional APPEs in psychiatry and neurology. Conclusion. Didactic hour distribution in psychiatry and neurology could be improved to better align with board certification in psychiatric pharmacy (BCPP) recommendations and disorder prevalence and complexity. Specialists recommend an experiential component in neurology and psychiatry to combat stigma and improve pharmacist knowledge and skills.
International psychiatry has its roots in Anglo-European societies of the 19th century. Ideas and methods on mental health and illness grew out of the modern concept of disease that had consolidated in the early ... and into the 20th century a medical, organic approach to mental ... It cannot be divorced from the history of the.
Cazares, Paulette T; Santiago, Patcho; Moulton, David; Moran, Scott; Tsai, Albert
Suicide is an event that is almost universally encountered by psychiatrists and psychiatry residents. Because psychiatric patients are at a higher risk for completing suicide than patients of other specialties, psychiatry residents are at risk for experiencing the suicide of a patient during their training. A review of the literature shows that there is continually growing research into the negative emotional effects of patient suicides on psychiatry residents and the need for clear response protocols when a suicide occurs, also known as postvention protocols. However, there are no Graduate Medical Education requirements to specifically train psychiatry residents about this, even with a well-voiced desire by residents to receive this training. In the National Capitol Consortium Psychiatry Residency, encounters with patient suicides by residents in a time of war led us to a place in which interventions were designed and instituted to care for the caregiver, in this case focusing on psychiatry trainees. Our process and product, described here, offers an example of a systematic postvention response. It addresses aspects of what is known in the research base, combined with acknowledgement of the human response and the institutional need for a consistent and objective response.
Veinot, Paula; Lin, William; Woods, Nicole; Ng, Stella
Background Ambulatory care (AC) experiences within medical education are garnering increasing attention. We sought to understand how faculty and residents’ describe their experiences of AC and ambulatory care education (ACEduc) within, between, and across disciplinary contexts. Methods We designed a Stakian collective case study, applying constructivist grounded theory analytic methods. Using purposive and snowball sampling, we interviewed 17 faculty and residents across three instrumental cases: family medicine, psychiatry, surgery. Through constant comparative analysis, we identified patterns within, between, and across cases. Results Family medicine and psychiatry saw AC as an inherent part of continuous, longitudinal care; surgery equated AC with episodic experiences in clinic, differentiating it from operating. Across cases, faculty and residents cautiously valued ACEduc, and in particular, considered it important to develop non-medical expert competencies (e.g., communication). However, surgery residents described AC and ACEduc as less interesting and a lower priority than operating. Educational structures mediated these views. Conclusion Differences between cases highlight a need for further study, as universal assumptions about ACEduc’s purposes and approaches may need to be tempered by situated, contextually-rich perspectives. How disciplinary culture, program structure, and systemic structure influence ACEduc warrant further consideration as does the educational potential for explicitly framing learners’ perspectives. PMID:29098047
Kamholz, Barbara W; Lawrence, Amy E; Liverant, Gabrielle I; Black, Shimrit K; Hill, Justin M
The goal of this project was to develop and evaluate a new residency training rotation focused on cognitive-behavioral therapies (CBT) and to assess outcomes across multiple domains. Data are presented from 30 psychiatry residents. Primary learning-related outcomes included content knowledge, self-efficacy, and attitudes and behavioral intentions towards evidence-based psychotherapies (e.g., CBT). Residents reported significant increases in CBT knowledge, CBT-specific self-efficacy, overall psychotherapy self-efficacy, belief in patient benefit from CBT, and behavioral intention to use CBT. However, there were almost no changes in attitudes towards evidence-based practice more broadly, with one significant finding showing an increase in skepticism towards such practices. This empirically based example of training program development, implementation, and evaluation appears largely successful and represents one approach for addressing the CBT competency goals outlined by the Accreditation Council for Graduate Medical Education (ACGME) and Milestone Project Guidelines. Despite these initial, positive findings, conclusions should be tempered by limitations of the project design (e.g., the lack of comparison group, absence of objective measures of resident behavioral change, or assessment of the effect of such changes on patient outcomes). Findings highlight the need for continued development and evaluation of training methods in CBT for residency programs.
Alves de Moura, Pedro; Serranheira, Florentino; Sacadura-Leite, Ema
Medical Doctors (MD), although at the front line of response to patients and their families, are seldom study subjects for occupational psychosocial risks and work related stress. Assess psychiatry and anaesthesiology residents in a central and university Portuguese Hospital for the presence of psychosocial risks at work. We used the Copenhagen Psychosocial Questionnaire version 2 (COPSOQ), which was applied face-to-face in two group settings, in April 2014. It comprised a sample of 19 Psychiatry residents and 20 Anaesthesiology residents. Statistical analysis was done by correlational analysis using Pearson's coefficient (r) and the t-student test for categorical variables. An occupational health risk (red flag) was found for residents in the "Cognitive demands" dimension of COPSOQ and a health risk (red flag) in the "Work influence" dimension for the female Anaesthesiology sub-group. A possible risk (yellow flag) was found in 17 dimensions. Results also showed moderate correlations between various COPSOQ dimensions and the emergency department workload, workload, home study, number of children, year of training and the medical specialty variables. These results suggest that residents have a health risk which derives from the cognitive demands of their work and that it increases with the workload. This implicates the need for occupational health measures to be taken to manage and reduce these psychological risks.
Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P
Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms
Wilkening, G Lucy; Gannon, Jessica M; Ross, Clint; Brennan, Jessica L; Fabian, Tanya J; Marcsisin, Michael J; Benedict, Neal J
This pilot study evaluated the utility of branched-narrative virtual patients in an interprofessional education series for psychiatry residents. Third-year psychiatry residents attended four interprofessional education advanced psychopharmacology sessions that involved completion of a branched-narrative virtual patient and a debriefing session with a psychiatric pharmacist. Pre- and post-assessments analyzed resident learning and were administered around each virtual patient. Simulation 4 served as a comprehensive review. The primary outcome was differences in pre- and post-assessment scores. Secondary outcomes included resident satisfaction with the virtual patient format and psychiatric pharmacist involvement. Post-test scores for simulations 1, 2, and 3 demonstrated significant improvement (p narrative virtual patient format and psychiatric pharmacist involvement was high throughout the series (100 %; n = 18). Although there are important methodological limitations to this study including a small sample size and absence of a comparator group, this pilot study supports the use of branched-narrative virtual patients in an interprofessional education series for advanced learners.
Rasminsky, Sonya; Lomonaco, Allison; Auchincloss, Elizabeth
The movement to limit work hours for house staff has gained momentum in recent years. The authors set out to review the literature on work hours reform, particularly as it applies to psychiatric residency training, and to provide two different viewpoints on the controversy. The authors present the historical background of work hours reform in the United States and review recent literature about resident work hours limitations. Using a debate format, the authors discuss whether the new regulations are having a positive or negative impact on residency training in psychiatry. Drs. Lomonaco and Auchincloss argue that currently-existing work hours restrictions may have unintended consequences for the health of patients and an untoward impact on residents' professional development and academic medicine's overall structure. Dr. Rasminsky argues that work hours restrictions do not go far enough in protecting residents and patients from the harmful effects of fatigue, and that our definition of professionalism needs to be reexamined in light of emerging scientific literature. There should be some limitation on resident work hours, with exact numbers to be determined by growing scientific knowledge about the effects of prolonged wakefulness. More study is needed, particularly in the area of psychiatric residency training.
Peeples, Dale; Guerrero, Anthony; Bernstein, Bettina; Hunt, Jeffrey; Ong, Say How; Santos, Cynthia; Sexson, Sandra; Skokauskas, Norbert
Problem-based learning (PBL) is one of the core components of medical education. To facilitate the spread and use of PBL in child and adolescent psychiatry (CAP) fellowship training, a special interest study group (SISG) was formed at the American Academy of Child and Adolescent Psychiatry (AACAP). Different approaches to the implementation of PBL between programs represented at the SISG are compared in this report. The authors distributed a survey to SISG participants after the 2015 annual AACAP meeting, which gathered information about the different approaches programs use to implement PBL in graduate medical education. Six CAP training programs responded to the survey, providing descriptions of the structure and content of PBL seminars. Programs chose to include a wide variety of topics in PBL courses and approach course organization in a number of ways. To the degree that PBL draws from identified reference texts, programs were similar in selecting definitive textbooks, practice parameters, and seminal articles. This small pilot study is intended to provide a snapshot of the state of PBL implementation in CAP fellowship programs. It reflects that programs can incorporate PBL in a variety of ways, tailored to the needs of the institution. Future directions of research include assessment of resident satisfaction with PBL, impact on resident education, and identifying successful methods of implementation of PBL.
Gipson, Shih; Torous, John; Boland, Robert; Conrad, Erich
Mobile technology ownership in the general US population and medical professionals is increasing, leading to increased use in clinical settings. However, data on use of mobile technology by psychiatry residents remain unclear. In this study, our aim was to provide data on how psychiatric residents use mobile phones in their clinical education as well as barriers relating to technology use. An anonymous, multisite survey was given to psychiatry residents in 2 regions in the United States, including New Orleans and Boston, to understand their technology use. All participants owned mobile phones, and 79% (54/68) used them to access patient information. The majority do not use mobile phones to implement pharmacotherapy (62%, 42/68) or psychotherapy plans (90%, 61/68). The top 3 barriers to using mobile technology in clinical care were privacy concerns (56%, 38/68), lack of clinical guidance (40%, 27/68), and lack of evidence (29%, 20/68). We conclude that developing a technology curriculum and engaging in research could address these barriers to using mobile phones in clinical practice.
Tariq Mahmood Hassan
Conclusions: At the level of residency training, psychiatrists are reporting barriers to disclosure and help-seeking if they were to experience mental illness. A majority of psychiatry residents would only disclose to informal supports. Those with a history of mental illness would prefer formal treatment services over informal services.
Arbuckle, Melissa R; Degolia, Sallie G; Esposito, Karin; Miller, Deborah A; Weinberg, Michael; Brenner, Adam M
The purpose of this study was to characterize associate training director (ATD) positions in psychiatry. An on-line survey was e-mailed in 2009 to all ATDs identified through the American Association of Directors of Psychiatric Residency Training (AADPRT). Survey questions elicited information regarding demographics, professional activities, job satisfaction, and goals. Of 170 ATDs surveyed, 73 (42.9%) completed the survey. Most respondents (71.3%) had been in their positions for 3 years or less. Many ATDs indicated that they were involved in virtually all aspects of residency training; 75% of respondents agreed that they were happy with their experience. However, specific concerns included inadequate time and compensation for the ATD role in addition to a lack of mentorship and unclear job expectations. Thoughtful attention to the construction of the ATD role may improve job satisfaction.
Jain, Gaurav; Mazhar, Mir Nadeem; Uga, Aghaegbulam; Punwani, Manisha; Broquet, Karen E.
Objectives: International medical graduates (IMGs) account for a significant proportion of residents in psychiatric training in the United States. Many IMGs may have previously completed psychiatry residency training in other countries. Their experiences may improve our system. Authors compared and contrasted psychiatry residency training in the…
Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas
The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most
DeBonis, Katrina; Blair, Thomas R; Payne, Samuel T; Wigan, Katherine; Kim, Sara
Web-based instruction in post-graduate psychiatry training has shown comparable effectiveness to in-person instruction, but few topics have been addressed in this format. This study sought to evaluate the viability of a web-based curriculum in teaching electrocardiogram (EKG) reading skills to psychiatry residents. Interest in receiving educational materials in this format was also assessed. A web-based curriculum of 41 slides, including eight pre-test and eight post-test questions with emphasis on cardiac complications of psychotropic medications, was made available to all psychiatry residents via email. Out of 57 residents, 30 initiated and 22 completed the module. Mean improvement from pre-test to post-test was 25 %, and all 22 completing participants indicated interest in future web-based instruction. This pilot study suggests that web-based instruction is feasible and under-utilized as a means of teaching psychiatry residents. Potential uses of web-based instruction, such as tracking learning outcomes or patient care longitudinally, are also discussed.
Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony
Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…
Mills, Stacia; Xiao, Anna Q; Wolitzky-Taylor, Kate; Lim, Russell; Lu, Francis G
The objective of this study was to assess whether a 1-hour didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves the cultural competence of general psychiatry residents. The main hypothesis was that teaching adult psychiatry residents a 1-hour session on the CFI would improve cultural competence. The exploratory hypothesis was that trainees with more experience in cultural diversity would have a greater increase in cultural competency scores. Psychiatry residents at a metropolitan, county hospital completed demographics and preintervention questionnaires, were exposed to a 1-hour session on the CFI, and were given a postintervention questionnaire. The questionnaire was an adapted version of the validated Cultural Competence Assessment Tool . Paired samples t tests compared pre- to posttest change. Hierarchical linear regression assessed whether pretraining characteristics predicted posttest scores. The mean change of total pre- and posttest scores was significant ( p = .002), as was the mean change in subscales Nonverbal Communications ( p Psychiatry residents' cultural competence scores improved irrespective of previous experience in cultural diversity. More research is needed to further explore the implications of the improved scores in clinical practice.
Full Text Available ... What Is Psychiatry? Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of ... written examination for a state license to practice medicine, and then complete four years of psychiatry residency. ...
Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C
Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305
Carson, Savanna L; Perkins, Kate; Reilly, Maura R; Sim, Myung-Shin; Li, Su-Ting T
Residency program leaders are required to support resident well-being, but often do not receive training in how to do so. Determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. National cross-sectional web-based survey of pediatric program directors, associate program directors, and coordinators in June 2015, on their experience supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. 39.3% (322/820) of participants responded. Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10% of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (pProgram leaders spend a significant amount of time supporting resident well-being. While they feel that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Primary care physicians (PCPs provide ~50 % of all mental health services in the U.S. Given the widening gap between patient mental health needs and resources available to meet those needs, there is an increasing demand for family medicine and psychiatry trainees to master competencies in both behavioral medicine and primary care counseling during residency-if for no other reason than to accommodate the realities of medical practice given the oft present gap between the need for psychiatric services and the availability, quality, and/or affordability of specialized psychiatric care. To begin to address this gap, a skills-based, interactive curriculum based on motivational interviewing (MI as a teaching method is presented. Methods The curriculum described in this paper is a four-week block rotation taught in the second year of residency. Motivational interviewing (MI is used as a teaching approach toward the goal of clinical behavior change. Residents’ strengths, personal choice and autonomy are emphasized. Each week of the rotation, there is a clinical topic and a set of specific skills for mastery. Residents are offered a “menu” of skills, role modeling, role/real play, practice with standardized patients (SP, and direct supervision in clinic. Results Thirty-nine residents have completed the curriculum. Based on residents’ subjective reporting using pre-post scales (i.e., importance and confidence, all participants to date have reported substantial increases in confidence/self-efficacy using primary care counseling skills in their continuity clinic. Conclusions This paper presents an innovative, empirically based model for teaching the essential skills necessary for physicians providing care for patients with mental/emotional health needs as well as health-behavior change concerns. Implications for training in the broader context, particularly as it relates to multi-disciplinary and collaborative models of
Renner, John A., Jr.; Karam-Hage, Maher; Levinson, Marjorie; Craig, Thomas; Eld, Beatrice
Objective: The authors attempt to better understand the recent decline in the number of applicants to addiction psychiatry training. Methods: The Corresponding Committee on Training and Education in Addiction Psychiatry of APA's Council on Addiction Psychiatry sent out a 14-question anonymous e-mail survey to all postgraduate-year 2 (PGY-2)…
Gramaglia, Carla; Jona, Amalia; Imperatori, Fredrica; Torre, Eugenio; Zeppegno, Patrizia
Medical schools are currently charged with a lack of education as far as empathic/relational skills and the meaning of being a health-care provider are concerned, thus leading to increased interest in medical humanities. Medical humanities can offer an insight into human illness and in a broader outlook into human condition, understanding of one self, responsibility. An empathic relation to patients might be fostered by a matching approach to humanities and sciences, which should be considered as subjects of equal relevance, complementary to one another. Recently, movies have been used in medical--psychiatric--trainees education, but mainly within the limits of teaching a variety of disorders. A different approach dealing with the use of cinema in the training of psychiatry residents is proposed, based on Jung and Hillman's considerations about the relation between images and archetypes, archetypal experience and learning. Selected full-length movies or clips can offer a priceless opportunity to face with the meaning of being involved in a care-providing, helping profession.
Lehmann, Susan W
The author describes the Association of Directors of Medical Student Education in Psychiatry's Education Scholars Program, a 2-year longitudinal, guided mentorship program, anchored by didactic instruction in the fundamental concepts of educational scholarship.
McKean, A J S; Palmer, B A
Psychiatry residents have tremendous potential as educators. The authors envisioned residents as small-group tutors, efficiently assessing and correcting knowledge deficits using cases with discussion prompts and teaching points. They empirically tested whether this improves knowledge acquisition. Senior residents delivered eight tutorials during clerkship, which covered child and adolescent psychiatry, anxiety, mood, psychotic, cognitive, and substance use disorders. A 50-item multiple-choice quiz was administered at the beginning and end of clerkship. National Board of Medical Examiners (NBME) shelf exam scores from intervention year were compared to the 4 years prior to resident involvement. Mean score on the initial quiz was 34.5 ± 3.7 and 41.8 ± 3.5 on second attempt (p exam during intervention year was 83.2 ± 8.9 and for the four prior years was 78.0 ± 9.3, which was significant (p = 0.002). Resident-led tutorials provide an effective means of increasing psychiatric knowledge and improving performance on NBME subject exams.
Aimee M. Rolston
Full Text Available Introduction: Choosing a residency program is a stressful and important decision. Doximity released residency program rankings by specialty in September 2014. This study sought to investigate the impact of those rankings on residency application choices made by fourth year medical students. Methods: A 12-item survey was administered in October 2014 to fourth year medical students at three schools. Students indicated their specialty, awareness of and perceived accuracy of the rankings, and the rankings’ impact on the programs to which they chose to apply. Descriptive statistics were reported for all students and those applying to Emergency Medicine (EM. Results: A total of 461 (75.8% students responded, with 425 applying in one of the 20 Doximity ranked specialties. Of the 425, 247 (58% were aware of the rankings and 177 looked at them. On a 1-100 scale (100=very accurate, students reported a mean ranking accuracy rating of 56.7 (SD 20.3. Forty-five percent of students who looked at the rankings modified the number of programs to which they applied. The majority added programs. Of the 47 students applying to EM, 18 looked at the rankings and 33% changed their application list with most adding programs. Conclusion: The Doximity rankings had real effects on students applying to residencies as almost half of students who looked at the rankings modified their program list. Additionally, students found the rankings to be moderately accurate. Graduating students might benefit from emphasis on more objective characterization of programs to assess in light of their own interests and personal/career goals
Teichman, J M; Anderson, K D; Dorough, M M; Stein, C R; Optenberg, S A; Thompson, I M
We evaluate behaviors and attitudes among resident applicants and program directors related to the American Urological Association (AUA) residency matching program and recommend changes to improve the match. Written questionnaires were mailed to 519 resident applicants and 112 program directors after the 1999 American Urological Association match. Subjects were asked about their observations, behaviors and opinions towards the match. Questionnaires were returned by 230 resident applicants and 94 program directors (44% and 83% response rates, respectively.) Of the resident applicants 75% spent $1,001 to $5,000 for interviewing. Of the program directors 47% recalled that applicants asked how programs would rank the applicant and 61% of applicants recalled that program directors asked applicants how they would rank programs. Dishonesty was acknowledged by 31% of program directors and 44% of resident applicants. Of program directors 82% thought applicants "lied", while 67% of applicants thought that programs "lied" (quotations indicate questionnaire language). Participants characterized their own dishonesty as "just playing the game" or they "did not feel badly." Of program directors 81% and of applicants 61% were "skeptical" or "did not believe" when informed they were a "high" or "number 1" selection. Being asked about marital status was recalled by 91% of male and 100% of female (p = 0. 02), if they had children by 53% of male and 67% of female, (p = 0. 03), and intent to have children by 25% of male and 62% of female (p gender. Interviews are costly for applicants. We recommend that 1) programs adopt policies to enhance fairness, 2) applications be filed electronically, 3) programs assist resident applicants with interview accommodation to reduce financial burden and 4) a post-interview code of limited or noncommunication be adopted.
Torous, John; Stern, Adam P; Padmanabhan, Jaya L; Keshavan, Matcheri S; Perez, David L
Despite increasing recognition of the importance of a strong neuroscience and neuropsychiatry education in the training of psychiatry residents, achieving this competency has proven challenging. In this perspective article, we selectively discuss the current state of these educational efforts and outline how using brain-symptom relationships from a systems-level neural circuit approach in clinical formulations may help residents value, understand, and apply cognitive-affective neuroscience based principles towards the care of psychiatric patients. To demonstrate the utility of this model, we present a case of major depressive disorder and discuss suspected abnormal neural circuits and therapeutic implications. A clinical neural systems-level, symptom-based approach to conceptualize mental illness can complement and expand residents' existing psychiatric knowledge. Copyright © 2015 Elsevier B.V. All rights reserved.
Beresin, Eugene V; Baldessarini, Ross J; Alpert, Jonathan; Rosenbaum, Jerrold
American psychiatric residency training programs are now required to teach principles of research ethics. This task is especially pressing in light of evolving guidelines pertaining to human subjects, including psychiatric patients, especially when psychopharmacology is involved. Residents need to understand principles of research ethics and implications of roles of psychiatrists as investigators and clinicians. We consider major contemporary ethical issues in clinical psychiatric research, with an emphasis on psychopharmacology, and implications of addressing them within residency training programs. We reviewed recent literature on ethical issues in clinical research and on medical education in bioethics. This report considers: (1) an overview of current training; (2) perceived needs and rationales for training in research ethics, (3) recommended educational content and methods; (4) issues that require further study (including demonstration of acquired knowledge, practice issues, and the treatment versus-investigation misconception); and (5) conclusions. Recommended components of residency training programs include basic ethical principles; scientific merit and research design; assessment of risks and benefits; selection and informed consent of patient-subjects; and integrity of the clinical investigator, including definition of roles, conflicts-of-interest, and accountability. Evaluation of educational effectiveness for both trainees and faculty is a recommended component of such programs. We recommend that psychiatric training include education about ethical aspects of clinical research, with a particular emphasis on psychopharmacology. These activities can efficiently be incorporated into teaching of other aspects of bioethics, research methods, and psychopharmacology. Such education early in professional development should help to clarify roles of clinicians and investigators, improve the planning, conduct and reporting of research, and facilitate career
Yousuf, Salman J.; Kwagyan, John; Jones, Leslie S.
Objective To determine the factors most important to applicants when selecting an ophthalmology residency program. Design Cross-sectional survey. Participants All 595 applicants who submitted a rank list to the Ophthalmology Residency Matching Program for the 2012 match. Methods Participants anonymously completed a 25-item questionnaire after the submission of their rank lists. A multiple-choice format and ordinal scale were used to query applicants on demographics, career plans, and the importance of factors related to program characteristics. One question allowed a free text response to identify factors that caused the applicant to rank a program lower than other programs or not at all (i.e., “red flag”). Main Outcome Measures Factors important to applicants when creating their rank lists. Results The response rate was 37% (218/595). The 3 most important factors affecting rank lists were resident–faculty relationships, clinical and surgical volume, and diversity of training. The fourth most important was the interview experience with faculty; poor interview experience was the most frequently cited “red flag.” Age, gender, and marital status did not affect how applicants rated factors. Applicants planning a post-residency fellowship or an academic career placed greater importance on opportunities for resident research and a program's prestige (Pophthalmology residency program. Future career plans and demographic factors influenced the rating of specific factors. The results of this study provide a useful resource to programs preparing for the match. PMID:23084123
Hafner, John W. Jr., MD, MPH
Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.
Svider, Peter F; Gupta, Amar; Johnson, Andrew P; Zuliani, Giancarlo; Shkoukani, Mahdi A; Eloy, Jean Anderson; Folbe, Adam J
Prior to applying or interviewing, most prospective applicants turn to the Internet when evaluating residency programs, making maintenance of a comprehensive website critical. While certain "intangibles" such as reputation may not be communicated effectively online, residency websites are invaluable for conveying other aspects of a program. Prior analyses have reported that certain criteria such as research experience and didactics are important considerations for applicants. To evaluate the comprehensiveness of otolaryngology residency websites. Review of otolaryngology residency program websites. Websites of 99 civilian residency programs were searched for the presence of 23 criteria. Presence of 23 criteria for application process, incentives, instruction, research, clinical training, and other. Only 5 programs contained at least three-quarters of the criteria analyzed; on average programs reported less than 50% of information sought. Among the 99 residency program websites, a description of the following criteria was noted: comprehensive faculty listing (88%), didactics (80%), contact e-mail (77%), current residents (74%), description of facilities (70%), intern schedule (70%), research requirements (69%), otolaryngology rotation schedule (64%), other courses (61%), ERAS (Electronic Residency Application Service) link (55%), year-to-year responsibility progression (47%), call schedule (40%), active/past research projects (37%), area information (34%), message from the program director (33%) or chair (23%), selection criteria (30%), salary (directly on site) (23%), surgical statistics (18%), parking (9%), and meal allowance (7%). The mean (SD) percentage present of factors encompassing "clinical training" was 55% (23%), significantly higher than the mean (SD) percentage of factors covered under the "incentives" category (19% [11%]; P = .01). The proportion of overall criteria present on websites did not differ on organizing programs by region (range, 42
Full Text Available ... Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical Students ... Disaster, Trauma Share Your Story Suicide Prevention Warning Signs of Mental Illness What is Psychiatry? What is ...
Award Number: W81XWH-12-2-0018 TITLE: NRC/AMRMC Resident Research Associateship Program PRINCIPAL INVESTIGATOR: Howard Gamble CONTRACTING...Associateship Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-2-0018 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Howard Gamble 5d. PROJECT NUMBER...final report. The productivity of these Associates is listed in the technical report. 15. SUBJECT TERMS- Associateship program , post-doc, awards 16
Fox, Harriette B; McManus, Margaret A; Klein, Jonathan D; Diaz, Angela; Elster, Arthur B; Felice, Marianne E; Kaplan, David W; Wibbelsman, Charles J; Wilson, Jane E
The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine. We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience. Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training. Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.
Klein, Ulrich; Storey, Bryan; Hanson, Peter D
This study's goal was to understand the extent, framework, and benefits of externships with prospective residency programs undertaken by predoctoral dental students or dentists interested in applying for a residency program. In 2012, a questionnaire was sent to all pediatric dentistry residents and program directors in the United States (63 percent and 74 percent return rate, respectively). Externships were offered by fifty-seven of the seventy-six programs. Most program directors (95 percent) agreed that externships are beneficial and compensate at least partially for the lack of numerical National Board Dental Examination scores or class rankings. Among the responding residents, 61 percent were female. The top reasons given by residents for choosing to extern with a certain program were its location and perceived reputation. Of the 249 respondents who did an externship, 47 percent externed with their current program. The acceptance rate into the number one choice of program was similar among those who did an externship vs. those who did not (73 percent vs. 75 percent). No relationship was found between gender and externships among the 341 respondents who were accepted into their top choice. Most of the residents (98.8 percent) felt that completing an externship was beneficial, and 88 percent got an increased understanding for the differences between university- and non-university-based residency programs.
Wiesenfeld, Lesley; Abbey, Susan; Takahashi, Sue Glover; Abrahams, Caroline
To examine factors influencing the choice of psychiatry as a career between residency program application and ranking decision making. Using an online questionnaire, applicants to the largest Canadian psychiatry residency program were surveyed about the impact of various factors on their ultimate decision to enter psychiatry residency training. Applicants reported that patient-related stigma was a motivator in considering psychiatry as a career, but that negative comments from colleagues, friends, and family about choosing psychiatry was a deterrent. Training program length, limited treatments, and insufficient clerkship exposure were noted as deterrents to choosing psychiatry, though future job prospects, the growing role of neuroscience, and diagnostic complexity positively influenced choosing psychiatry as a specialty. Research and elective time away opportunities were deemed relatively unimportant to ranking decisions, compared with more highly weighted factors, such as program flexibility, emphasis on psychotherapy, service- training balance, and training program location. Most applicants also reported continuing to fine tune ranking decisions between the application and ranking submission deadline. Stigma, exposure to psychiatry, diagnostic complexity, and an encouraging job market were highlighted as positive influences on the choice to enter psychiatry residency. Interview and information days represent opportunities for continued targeted recruitment activity for psychiatry residency programs.
Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested
Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...
Fuller, Patrick D
An innovative, structured approach to incorporating leadership development activities into pharmacy residency training is described. The American Society of Health-System Pharmacists (ASHP) has called for increased efforts to make leadership development an integral component of the training of pharmacy students and new practitioners. In 2007, The Nebraska Medical Center (TNMC) took action to systematize leadership training in its pharmacy residency programs by launching a new Leadership Development Series. Throughout the residency year, trainees at TNMC participate in a variety of activities: (1) focused group discussions of selected articles on leadership concepts written by noted leaders of the past and present, (2) a two-day offsite retreat featuring trust-building exercises and physical challenges, (3) a self-assessment designed to help residents identify and use their untapped personal strengths, (4) training on the effective application of different styles of communication and conflict resolution, and (5) education on the history and evolution of health-system pharmacy, including a review and discussion of lectures by recipients of ASHP's Harvey A. K. Whitney Award. Feedback from residents who have completed the series has been positive, with many residents indicating that it has stimulated their professional growth and helped prepared them for leadership roles. A structured Leadership Development Series exposes pharmacy residents to various leadership philosophies and principles and, through the study of Harvey A. K. Whitney Award lectures, to the thoughts of past and present pharmacy leaders. Residents develop an increased self-awareness through a resident fall retreat, a StrengthsFinder assessment, and communication and conflict-mode assessment tools.
Laeeq, Kulsoom; Weatherly, Robert A; Carrott, Alice; Pandian, Vinciya; Cummings, Charles W; Bhatti, Nasir I
Kolb portrays four learning styles depending on how an individual grasps or transforms experience: accommodating, assimilating, diverging, and converging. Past studies in surgery, medicine, and anesthesia identified the predominant learning style in each of these specialties. The prevalence of different learning styles and existence of a predominant style, if any, has not been reported for otolaryngology residency programs. The purpose of our study was to determine if otolaryngology residents have a preferred learning style that is different from the predominant learning styles reported for other specialties. We conducted a survey of the otolaryngology-head and neck surgery residents at two residency programs. Kolb's Learning Style Index (LSI) version 3.1 was administered to 46 residents from Johns Hopkins University and Kansas University Otolaryngology-Head and Neck Surgery programs. LSI is a widely used 12-item questionnaire, with each item followed by four options. The subjects graded the options depending on how the options applied to them. Forty-three otolaryngology residents completed the survey, with a response rate of 93.47%. The predominant learning style was converging (55.81%) followed by accommodating (18.61%), accounting for the learning styles of 74.42% of the total population. There were only 13.95% assimilating and 6.98% diverging learning styles. Two residents (4.65%) had their preference balanced across four learning styles. The predominant learning styles in otolaryngology were converging and accommodating, accounting for three fourths of the population. It would be desirable to modify our curriculum in a way that will optimize and facilitate learning.
Langdorf, M I; Bearie, B; Ritter, M S; Ferkich, A
1) To systematically describe emergency medicine (EM) program directors' perceptions of the benefits and risks of resident moonlighting. 2) To assess moonlighting policies of EM residencies, the degree of compliance with these policies, and the methods of dealing with residents who are out of compliance. A written survey was mailed or hand-delivered to all allopathic and osteopathic EM residency directors in the United States in 1992-93. Incomplete and ambiguous surveys were completed by phone. There was a 96% response rate (113/118). The average EM resident clinical workweek ranged from 38 to 50 hours while the resident was assigned to ED rotations. Most (90%) of the program directors believe moonlighting interferes with residency duties to some degree. Few (10%) programs prohibit moonlighting altogether, although 44% limit moonlighting to an average of 41.5 hours per month. Program directors believe residents moonlight primarily for financial reasons. Most (60%) of the program directors believe moonlighting offers experience not available in the residency, primarily related to autonomous practice. Fifteen programs reported residents who had been sued for malpractice while moonlighting, with one program director named along with the resident. One third of program directors have penalized residents for abuse of moonlighting privileges. EM residency directors are concerned about the effect of moonlighting on resident education. The directors' concerns regarding litigation, excessive work hours, and interference with residency duties are balanced by a general acceptance of the financial need to supplement residency income.
Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya
Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.
Full Text Available ... therapy is used to treat seasonal depression. Psychiatric Training To become a psychiatrist, a person must complete ... of psychiatry residency. The first year of residency training is typically in a hospital working with patients ...
Bailey, Sarah E; Franzese, Christine; Lin, Sandra Y
The purpose of this study was to survey program directors of the accredited otolaryngology residency programs and resident attendees of the 2013 American Academy of Otolaryngic Allergy (AAOA) Basic/MOC Course regarding resident education and participation as well as assessment of competency in otolaryngic allergy and immunotherapy. A multiple-choice questionnaire was sent to all accredited otolaryngology residency training programs in the United States as part of resident attendance at the 2013 AAOA CORE Basic/MOC Course. Following this, a similar multiple-choice survey was sent to all resident attendees from the programs that responded positively. Program directors reported that 73% of their academic institutions offer allergy testing and immunotherapy. More PDs than residents indicated that residents participate in allergy practice and perform/interpret skin testing and in vitro testing, and more residents (85%) than program directors (63%) reported inadequate or no allergy training. Program directors and residents equally indicated that residents do not calculate immunotherapy vial formulations or administer immunotherapy injections. The majority of program directors indicated that resident competency in allergy was assessed through direct observation, whereas residents more commonly perceived that no assessment of competency was being performed for any portion of allergy practice. This survey demonstrates a discrepancy between program directors and residents regarding resident involvement and adequacy of training in the allergy practice. Although the majority of otolaryngology residencies report offering otolaryngic allergy services and education, the vast majority of residents report inadequate allergy training and less participation in an allergy practice compared to the majority of program directors. © 2013 ARS-AAOA, LLC.
Freudenreich, Oliver; Henderson, David C.; Sanders, Kathy M.; Goff, Donald C.
Objective: The authors sought to develop a model educational clinic and curriculum for psychiatric residents, to increase knowledge and comfort about clozapine prescribing. This matters because clozapine is an important evidence-based treatment for refractory schizophrenia that remains underutilized in clinical practice. Method: This is a…
Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert
Stigma towards people with mental illness remains a burden for patients and healthcare providers. This study at a large US university examined the attitudes of psychiatry residents and fellows towards mental illness and its causes, and whether their attitudes differed from the medical student attitudes previously studied utilizing the same survey method. An electronic questionnaire examining attitudes toward people with mental illness, causes of mental Illness, and treatment efficacy was used to survey the attitudes of psychiatry residents and fellows. Exploratory factor analysis derived from the authors' medical student survey was used to examine attitudinal factors. The study response rate was 54.2% (n = 94). Factor analysis employed three factors previously identified reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Residents and fellows reporting more personal experiences with mental illness, both as a group and when compared with medical students, were significantly more willing to socialize with the mentally ill. Respondents who had more professional (work) experience other than medical school or post-graduate training were less likely to believe in supernatural causes of mental illness. Female residents and fellows were more willing to socialize with the mentally ill, and were less likely to believe in supernatural causes for mental illness than their male counterparts. In our study, increased social acceptance of the mentally ill relates to having personal experiences, advanced training in psychiatry, and female gender. Both professional experiences outside of training and female gender reduced the belief in supernatural causes.
Cain, Jeff; Scott, Doneka R; Smith, Kelly
Pharmacy residency program directors' attitudes and opinions regarding the use of social media in residency recruitment and selection were studied. A 24-item questionnaire was developed, pilot tested, revised, and sent to 996 residency program directors via SurveyMonkey.com. Demographic, social media usage, and opinions on social media data were collected and analyzed. A total of 454 residency program directors completed the study (response rate, 46.4%). The majority of respondents were women (58.8%), were members of Generation X (75.4%), and worked in a hospital or health system (80%). Most respondents (73%) rated themselves as either nonusers or novice users of social media. Twenty percent indicated that they had viewed a pharmacy residency applicant's social media information. More than half (52%) had encountered e-professionalism issues, including questionable photos and posts revealing unprofessional attitudes, and 89% strongly agreed or agreed that information voluntarily published online was fair game for judgments on character, attitudes, and professionalism. Only 4% of respondents had reviewed applicants' profiles for residency selection decisions. Of those respondents, 52% indicated that the content had no effect on resident selection. Over half of residency program directors were unsure whether they will use social media information for future residency selection decisions. Residency program directors from different generations had different views regarding social media information and its use in residency applicant selections. Residency program directors anticipated using social media information to aid in future decisions for resident selection and hiring.
Javad Sarabadani; Maryam Amirchaghmaghi; Yadolah Zarezadeh; Eshagh Yara; Hosein Souratgar
Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. ...
Heiberger, Michael H.
Explores cost implications of residency programs within the Veterans Administration health care system, particularly the costs and benefits of residencies in family medicine, osteopathic medicine, and general dentistry, because they resemble optometric residencies most closely. Costs of an existing vision therapy residency are examined, and…
Cline, Debbie; La Frentz, Kelly; Fellman, Bryan; Summers, Barbara; Brassil, Kelly
Nurse residency programs are widely implemented to enhance integration of new graduate nurses entering the workforce. This article presents a retrospective analysis of 10 years of residency data from an internally developed residency program that used the Casey-Fink Graduate Nurse Experience Survey. Outcomes of this program were similar to those from studies using commercially available products, suggesting that an internally developed residency curricula may be equally beneficial to the development of new graduate nurses.
... (Psychiatric News, February 3, 2012), according to Bruce Schwartz, M.D., the CRLC program director and deputy chair and professor in the Department of Psychiatry and Behavioral Sciences at the Albert Einstein College of Medicine. The most recent seminar took place this past summer in Armonk, N.Y., marking the 45th anniversary of the leadership semina...
Matthews, K L; Ticknor, C B
Examinations are an integral part of resident and program evaluation, but they are considered particularly stressful on residents. The department of psychiatry of the University of Texas Health Science Center at San Antonio administered the Psychiatry Resident-in-Training Examination (PRTTE) every other year to minimize stress and anxiety among residents. When questioned about their satisfaction with the PRTTE and its administration, the residents reported high levels of satisfaction and a desire to take the examination yearly. Dissatisfaction was limited to the physical environment in which the exam was administered.
Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B
Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.
Kuncharapu, Indumathi; Cass, Alvah R.; Carlson, Carol A.; Scott, Jack R.
Morning Report (MR) is a frequently held case conference in most Family Medicine (FM) residency programs among medical learners who discuss recent inpatient admissions before the day's care of patients. This study conducted a national survey of FM residency program directors to describe the roles of faculty and residents in facilitating MR.…
Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by
Sanders, Ari; Wilson, R Douglas
The integration of simulation into residency programs has been slower in obstetrics and gynaecology than in other surgical specialties. The goal of this study was to evaluate the current use of simulation in obstetrics and gynaecology residency programs in Canada. A 19-question survey was developed and distributed to all 16 active and accredited obstetrics and gynaecology residency programs in Canada. The survey was sent to program directors initially, but on occasion was redirected to other faculty members involved in resident education or to senior residents. Survey responses were collected over an 18-month period. Twelve programs responded to the survey (11 complete responses). Eleven programs (92%) reported introducing an obstetrics and gynaecology simulation curriculum into their residency education. All respondents (100%) had access to a simulation centre. Simulation was used to teach various obstetrical and gynaecological skills using different simulation modalities. Barriers to simulation integration were primarily the costs of equipment and space and the need to ensure dedicated time for residents and educators. The majority of programs indicated that it was a priority for them to enhance their simulation curriculum and transition to competency-based resident assessment. Simulation training has increased in obstetrics and gynaecology residency programs. The development of formal simulation curricula for use in obstetrics and gynaecology resident education is in early development. A standardized national simulation curriculum would help facilitate the integration of simulation into obstetrics and gynaecology resident education and aid in the shift to competency-based resident assessment. Obstetrics and gynaecology residency programs need national collaboration (between centres and specialties) to develop a standardized simulation curriculum for use in obstetrics and gynaecology residency programs in Canada.
Moore, Jared M; Wininger, David A; Martin, Bryan
Developing effective leadership skills in physicians is critical for safe patient care. Few residency-based models of leadership training exist. We evaluated residents' readiness to engage in leadership training, feasibility of implementing training for all residents, and residents' acceptance of training. In its fourth year, the Leadership Development Program (LDP) consists of twelve 90-minute modules (eg, Team Decision Making and Bias, Leadership Styles, Authentic Leadership) targeting all categorical postgraduate year (PGY) 1 residents. Modules are taught during regularly scheduled educational time. Focus group surveys and discussions, as well as annual surveys of PGY-1s assessed residents' readiness to engage in training. LDP feasibility was assessed by considering sustainability of program structures and faculty retention, and resident acceptance of training was assessed by measuring attendance, with the attendance goal of 8 of 12 modules. Residents thought leadership training would be valuable if content remained applicable to daily work, and PGY-1 residents expressed high levels of interest in training. The LDP is part of the core educational programming for PGY-1 residents. Except for 2 modules, faculty presenters have remained consistent. During academic year 2014-2015, 45% (13 of 29) of categorical residents participated in at least 8 of 12 modules, and 72% (21 of 29) participated in at least 7 of 12. To date, 125 categorical residents have participated in training. Residents appeared ready to engage in leadership training, and the LDP was feasible to implement. The attendance goal was not met, but attendance was sufficient to justify program continuation.
Baird, David S; Soldanska, Magdalena; Anderson, Bryan; Miller, Jeffrey J
Residents and physicians frequently find themselves in leadership roles. Current residency curricula focus on the development of clinical knowledge and technical skills. A previous survey of Penn State Dermatology graduates demonstrated the perceived need and benefit of a formalized leadership curriculum in this selected group. We sought to identify and measure the perceived need and benefit of formalized leadership training and investigate opinions regarding leadership theory from the perspective of dermatology residency program directors and chief residents nationally. A survey containing 26 questions related to leadership theory and training were mailed to all US dermatology residency programs. In all, 91% of program directors and chief residents agreed that leadership skills could be taught through observation and training. A total of 78% of respondents agreed that leadership training is important during dermatology residency training. In all, 66% agreed that a formalized leadership curriculum would help residents become better resident supervisors and physicians. Only 13% reported having a formalized leadership curriculum. Participants most frequently reported learning leadership through observation and modeled behavior. A total of 15% of chief residents believed their faculty did not effectively model leadership, whereas only 2% of the program directors believed the same (P = .01). In all, 62% (68/109) of programs surveyed returned at least one response from the program director or chief resident. A total of 39% (42/109) had responses from both the program director and the chief resident. Because of the voluntary nature of the survey, response bias could not be excluded. Most program directors and chief residents believe leadership skills can be cultivated through observation and training. Leadership curriculum is not part of most residency programs. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Thammasitboon, Satid; Darby, John B; Hair, Amy B; Rose, Karen M; Ward, Mark A; Turner, Teri L; Balmer, Dorene F
The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT) and emphasize the process of scholarly activity versus a scholarly product. The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents' intrinsic motivation to learn and to engage in scholarly activity. To this end, residents' engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Based on our experience, and in line with the SDT, supporting residents' autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products.
Wilson, Howard K.; And Others
Two internal medicine residency programs at Baylor College of Medicine are discussed. The traditional program emphasizes experience in the care of acute problems within a hospital inpatient environment. The primary care residency program emphasizes training in the outpatient environment and in noninternal medicine disciplines. (MLW)
Liauw, J; Dineley, B; Gerster, K; Hill, N; Costescu, D
To evaluate the current state of abortion training in Canadian Obstetrics and Gynecology residency programs. Surveys were distributed to all Canadian Obstetrics and Gynecology residents and program directors. Data were collected on inclusion of abortion training in the curriculum, structure of the training and expected competency of residents in various abortion procedures. We distributed and collected surveys between November 2014 and May 2015. In total, 301 residents and 15 program directors responded, giving response rates of 55% and 94%, respectively. Based on responses by program directors, half of the programs had "opt-in" abortion training, and half of the programs had "opt-out" abortion training. Upon completion of residency, 66% of residents expected to be competent in providing first-trimester surgical abortion in an ambulatory setting, and 35% expected to be competent in second-trimester surgical abortion. Overall, 15% of residents reported that they were not aware of or did not have access to abortion training within their program, and 69% desired more abortion training during residency. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, and residents desire more training in abortion. This suggests an ongoing unmet need for training in this area. Policies mandating standardized abortion training in obstetrics and gynecology residency programs are necessary to improve delivery of family planning services to Canadian women. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, does not meet resident demand and is unlikely to fulfill the Royal College of Physicians and Surgeons of Canada objectives of training in the specialty. Copyright © 2016 Elsevier Inc. All rights reserved.
Berger, Jeffrey S; Daneshpayeh, Negin; Sherman, Marian; Gaba, Nancy; Keller, Jennifer; Perel, Leon; Blatt, Benjamin; Greenberg, Larrie
The role of residents as teachers has grown over time. Programs have been established within various specialties to formally develop these skills. Anesthesiology residents are frequently asked to provide supervision for novice learners and have numerous opportunities for teaching skills and clinical decision making. Yet, there are no educational programs described in the literature to train anesthesiology residents to teach novice learners. To explore whether a resident-as-teacher program would increase anesthesiology residents' self-reported teaching skills. An 8-session interactive Anesthesiology Residents-as-Teachers (ART) Program was developed to emphasize 6 key teaching skills. During a 2-year period, 14 anesthesiology residents attended the ART program. The primary outcome measure was resident self-assessment of their teaching skills across 14 teaching domains, before and 6 months after the ART program. Residents also evaluated the workshops for quality with a 9-item, postworkshop survey. Paired t testing was used for analysis. Resident self-assessment led to a mean increase in teaching skills of 1.04 in a 5-point Likert scale (P < .001). Residents reported the greatest improvement in writing/using teaching objectives (+1.29, P < .001), teaching at the bedside (+1.57, P = .002), and leading case discussions (+1.64, P = .001). Residents rated the workshops 4.2 out of 5 (3.9-4.7). Residents rated their teaching skills as significantly improved in 13 of 14 teaching domains after participation in the ART program. The educational program required few resources and was rated highly by residents.
Adesunloye, Bamidele A; Aladesanmi, Oluranti; Henriques-Forsythe, Marshaleen; Ivonye, Chinedu
To determine the preferred learning style, as defined by David Kolb, and predictors of the different learning styles among residents and faculty members at an internal medicine residency program. A cross sectional study of internal medicine residents and faculty members at Morehouse School of Medicine was performed using the Kolb Learning Style Inventory (LSI) version 3.1. The Kolb LSI is a questionnaire of 12 sentences, each with four phrases for sentence completion that are to be ranked according to how they apply to the subject. Forty-two out of 59 questionnaires that were given out to residents and attending physicians were properly completed and returned. Assimilating style was the predominant learning style among residents (42%) and attending physicians (55%). There was no significant association between age, gender or medical education status, and learning styles. The understanding of residents' learning styles may facilitate instructional rapport between residents and attending physicians, thereby improving residents' academic performance.
Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.
McNichols, Colton H L; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur; Rasko, Yvonne
Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.
Lau, Timothy; Zamani, Delara; Lee, Elliott Kyung; Asli, Khashayar D; Gill, Jasbir; Brager, Nancy; Hawa, Raed; Song, Wei-Yi; Gill, Eunice; Fitzpatrick, Renee; Menezes, Natasja M; Pham, Vu H; Douglass, Alan Bruce; Allain, Suzanne; Meterissian, Greg B; Gagnon, Nadine; Toeg, Hadi; Murphy, Cheryl
There is a projected shortage of psychiatrists in Canada in forthcoming years. This study assessed factors in medical school education that are associated with students selecting psychiatry first and matching as a discipline. The Canadian Organization of Undergraduate Psychiatry Educators (COUPE) conducted telephone interviews and sent e-mail questionnaires to the 17 medical schools across Canada; all schools provided data for 2012. Relevant data were obtained from the Canadian Resident Matching Service. Statistics were performed using v12 STATA program, and significance was set at a p value of psychiatry as their first choice for residency. Final match results yielded similar numbers at 5.0 ± 0.6 %. Ten out of 17 programs filled all psychiatry residency positions, whereas the remaining 7 programs had vacancy rates from 5 to 100 % (mean = 43.4 ± 15.1 %). Medical students were exposed to an average of 2.8 ± 0.5 pre-clerkship psychiatry weeks and 6.2 ± 0.3 clerkship weeks. Linear regression analysis demonstrated that the percentage of graduating medical students entering a psychiatry residency program could be predicted from the number of weeks of pre-clerkship exposure (p = 0.01; R(2) = 0.36) but not from the number of clerkship weeks (p = 0.74). This study indicates that the duration of pre-clerkship exposure to psychiatry predicts the number of students selecting psychiatry as their first choice as a discipline. Thus, increasing the duration of pre-clerkship exposure may increase the enrollment of medical students into psychiatry.
Korte, Catherine; Smith, Andrew; Pace, Heather
There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents. A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors. The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators. Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult. © The Author(s) 2015.
Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian
Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery
Full Text Available ... order or perform a full range of medical laboratory and psychological tests which, combined with discussions with ... written examination for a state license to practice medicine, and then complete four years of psychiatry residency. ...
Full Text Available ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical Students International close menu Psychiatrists Education Practice Cultural Competency Awards & Leadership Opportunities Advocacy & APAPAC ...
Full Text Available ... Foundation APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical Students International close menu Psychiatrists Education Practice Cultural Competency Awards & Leadership Opportunities Advocacy & APAPAC ...
Full Text Available ... illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make ... written examination for a state license to practice medicine, and then complete four years of psychiatry residency. ...
Full Text Available ... become a psychiatrist, a person must complete medical school and take a written examination for a state ... A psychiatrist is a medical doctor (completed medical school and residency) with special training in psychiatry. A ...
Jibson, Michael D.; Broquet, Karen E.; Anzia, Joan Meyer; Beresin, Eugene V.; Hunt, Jeffrey I.; Kaye, David; Rao, Nyapati Raghu; Rostain, Anthony Leon; Sexson, Sandra B.; Summers, Richard F.
Objective: The American Board of Psychiatry and Neurology (ABPN) announced in 2007 that general psychiatry training programs must conduct Clinical Skills Verification (CSV), consisting of observed clinical interviews and case presentations during residency, as one requirement to establish graduates' eligibility to sit for the written certification…
Ryu, Won Hyung A; Chan, Sonny; Sutherland, Garnette R
The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion. We aimed to better understand the role of supplementary educational methods in Canadian neurosurgery residency training. An online survey was sent to program directors of all 14 Canadian neurosurgical residency programs and active resident members of the Canadian Neurosurgical Society (N=85). We asked 16 questions focusing on topics of surgeon perception, current implementation and barriers to supplementary educational models. Of the 99 surveys sent, 8 out of 14 (57%) program directors and 37 out of 85 (44%) residents completed the survey. Of the 14 neurosurgery residency programs across Canada, 7 reported utilizing laboratory-based teaching within their educational plan, while only 3 programs reported using VR simulation as a supplementary teaching method. The biggest barriers to implementing supplementary educational methods were resident availability, lack of resources, and cost. Work-hour restrictions threaten to compromise the traditional apprentice model of surgical training. The potential value of supplementary educational methods for surgical education is evident, as reported by both program directors and residents across Canada. However, availability and utilization of laboratory and VR simulations are limited by numerous factors such as time constrains and lack of resources.
Green, Alexander R; Betancourt, Joseph R; Park, Elyse R; Greer, Joseph A; Donahue, Elizabeth J; Weissman, Joel S
The Health Resources and Services Administration (HRSA) funds primary care residency programs through its Title VII training grants, with a goal of ensuring a well-prepared, culturally competent physician workforce. The authors sought to determine whether primary care residents in Title VII-funded training programs feel better prepared than those in nonfunded programs to provide care to culturally diverse patients. The authors analyzed data from a national mailed survey of senior resident physicians conducted in 2003-2004. Of 1,467 randomly selected family medicine, internal medicine, and pediatrics residents, 866 responded--403 in Title VII-funded programs and 463 in nonfunded programs (response rate = 59%). The survey included 28 Likert-response questions about residents' preparedness and perceived skills to provide cross-cultural care, sociodemographics, and residency characteristics. Residents in Title VII-funded programs were more likely than others to report being prepared to provide cross-cultural care across all 8 measures (odds ratio [OR] = 1.54-2.61, P experience related to cross-cultural care (e.g., role models, cross-cultural training, and attitudes of attending physicians) accounted for many of the differences in self-reported preparedness and skills. Senior residents in HRSA Title VII-funded primary care residency training programs feel better prepared than others to provide culturally competent care. This may be partially explained by better cross-cultural training experiences in HRSA Title VII-funded programs.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
Koller, Sarah E; Moore, Ryan F; Goldberg, Michael B; Zhang, Jeanette; Yu, Daohai; Conklin, Charles B; Milner, Richard E; Goldberg, Amy J
First-year residents often obtain informed consent from patients. However, they typically receive no formal training in this area before residency. We wished to determine whether an educational program would improve residents' comfort with this process. Our institution created an informed consent educational program, which included a didactic component, a role-play about informed consent, and a simulation exercise using standardized patients. Residents completed surveys before and after the intervention, and responses to survey questions were compared using the signed-rank test. This study took place at Temple University Hospital, a tertiary care institution in Philadelphia, PA. First-year surgery and emergency medicine residents at Temple University Hospital in 2014 participated in this study. Thirty-two residents completed the preintervention survey and 27 residents completed the educational program and postintervention survey. Only 37.5% had ever received formal training in informed consent before residency. After participating in the educational program, residents were significantly more confident that they could correctly describe the process of informed consent, properly fill out a procedure consent form, and properly obtain informed consent from a patient. Their comfort level in obtaining informed consent significantly increased. They found the educational program to be very effective in improving their knowledge and comfort level in obtaining informed consent. In all, 100% (N = 27) of residents said they would recommend the use of the program with other first-year residents. Residents became more confident in their ability to obtain informed consent after participating in an educational program that included didactic, role-play, and patient simulation elements. Copyright © 2017. Published by Elsevier Inc.
Ashish R. Panchal
Full Text Available Introduction: The ACGME requires that residents perform scholarly activities prior to graduation, but this is difficult to complete and challenging to support. We describe a residency research program, taking advantage of environmental change aligning resident and faculty goals, to become a contributor to departmental cultural change and research development. Methods: A research program, Scholar Quest (SQ, was developed as a part of an Information Mastery program. The goal of SQ is for residents to gain understanding of scholarly activity through a mentor-directed experience in original research. This curriculum is facilitated by providing residents protected time for didactics, seed grants and statistical/staff support. We evaluated total scholarly activity and resident/faculty involvement before and after implementation (PRE-SQ; 2003-2005 and POST-SQ; 2007-2009. Results: Scholarly activity was greater POST-SQ versus PRE-SQ (123 versus 27 (p<0.05 with an incidence rate ratio (IRR=2.35. Resident and faculty involvement in scholarly activity also increased PRE-SQ to POST-SQ (22 to 98 residents; 10 to 39 faculty, p<0.05 with an IRR=2.87 and 2.69, respectively. Conclusion: Implementation of a program using department environmental change promoting a resident longitudinal research curriculum yielded increased resident and faculty scholarly involvement, as well as an increase in total scholarly activity.
John, Natalie; Snider, Holly; Edgerton, Lisa; Whalin, Laurie
The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities. The majority of lean events correspond to the required competency areas evaluating leadership and management, teaching, and education. These events have included participation in and facilitation of various lean problem-solving and communication tools. The application of the 4 rules of lean has resulted in enhanced management of the programs and provides a set of tools by which continual quality improvement can be ensured. Regular communication and direct involvement of all invested parties have been critical in developing and sustaining new improvements. In addition to program enhancements, lean methodology offers novel methods by which residents may be incorporated into leadership activities. The incorporation of lean methodology into pharmacy residency programs has translated into a variety of realized and potential benefits for the programs, the preceptors and residents, and the health system. Specific areas of growth have included quality-improvement processes, the expansion of leadership opportunities for residents, and improved communication among program directors, preceptors, and residents. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Ford, Eric C; Nyflot, Matthew; Spraker, Matthew B; Kane, Gabrielle; Hendrickson, Kristi R G
Education in patient safety and quality of care is a requirement for radiation oncology residency programs according to accrediting agencies. However, recent surveys indicate that most programs lack a formal program to support this learning. The aim of this report was to address this gap and share experiences with a structured educational program on quality and safety designed specifically for medical physics therapy residencies. Five key topic areas were identified, drawn from published recommendations on safety and quality. A didactic component was developed, which includes an extensive reading list supported by a series of lectures. This was coupled with practice-based learning which includes one project, for example, failure modes and effect analysis exercise, and also continued participation in the departmental incident learning system including a root-cause analysis exercise. Performance was evaluated through quizzes, presentations, and reports. Over the period of 2014-2016, five medical physics residents successfully completed the program. Evaluations indicated that the residents had a positive experience. In addition to educating physics residents this program may be adapted for medical physics graduate programs or certificate programs, radiation oncology residencies, or as a self-directed educational project for practicing physicists. Future directions might include a system that coordinates between medical training centers such as a resident exchange program. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
McGrath, Jillian; Barrie, Michael; Way, David P
The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States. In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167). We adapted our survey instrument from one used by Brillman (1995). The survey was designed to assess the orientation program's purpose, structure, content, and teaching methods. The survey return rate was 63% (105 of 167). Most respondents (77%) directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3) and 13 non-clinical days (Std. Dev.=9.3). The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98%) and with other members of the department (91%). Many programs (87%) included special certification courses (ACLS, ATLS, PALS, NRP). Course content included the following: use of electronic medical records (90%), physician wellness (75%), and chief complaint-based lectures (72%). Procedural skill sessions covered ultrasound (94%), airway management (91%), vascular access (90%), wound management (77%), splinting (67%), and trauma skills (62%). Compared to Brillman (1995), we found that more programs (99%) are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty certifications. We also observed increases in
Horner, Michelle S.; Miller, Susan Milam; Rettew, David C.; Althoff, Robert; Ehmann, Mary; Hudziak, James J.; Martin, Andres
Objective: The authors assess changes in knowledge and feeling connected to the field of child and adolescent psychiatry (CAP) after participation in a brief mentoring program held at two CAP conferences. Methods: Similar mentorship programs were implemented at two CAP conferences, one national (N=119 participants), one international (N=53). The…
Ricciotti, Hope A; Dodge, Laura E; Head, Julia; Atkins, K Meredith; Hacker, Michele R
Residents play a significant role in teaching, but formal training, feedback, and evaluation are needed. Our aims were to assess resident teaching skills in the resident-as-teacher program, quantify correlations of faculty evaluations with resident self-evaluations, compare resident-as-teacher evaluations with clinical evaluations, and evaluate the resident-as-teacher program. The resident-as-teacher training program is a simulated, videotaped teaching encounter with a trained medical student and standardized teaching evaluation tool. Evaluations from the resident-as-teacher training program were compared to evaluations of resident teaching done by faculty, residents, and medical students from the clinical setting. Faculty evaluation of resident teaching skills in the resident-as-teacher program showed a mean total score of 4.5 ± 0.5 with statistically significant correlations between faculty assessment and resident self-evaluations (r = 0.47; p teacher evaluations were significantly correlated with faculty and resident evaluations, but not medical student evaluations. Evaluations from both the resident-as-teacher program and the clinical setting improved with duration of residency. The resident-as-teacher program provides a method to train, give feedback, and evaluate resident teaching.
Gaies, Michael G; Landrigan, Christopher P; Hafler, Janet P; Sandora, Thomas J
The objective of this study was to assess the opinions of pediatric program directors regarding procedural skills training of pediatric residents. We developed a survey based on the Residency Review Committee's guidelines for procedural training. It included items about the importance of 29 procedures encountered in pediatric training, estimates of residents' competence in performing them, and the teaching of procedural skills. The survey was sent to members of the Association of Pediatric Program Directors. The primary outcome was the perceived importance for residents to achieve competence in these procedures, rated on a 10-point Likert scale. Secondary outcomes included perception of resident competence to perform procedures and educational methods used by respondents for teaching procedural skills. Associations between demographic characteristics and perceived importance or competence were also assessed. Surveys were sent to 139 programs, and 112 responded. Thirteen procedures were rated 8 or higher by >75% of program directors. Seven skills that were prioritized by the Residency Review Committee did not achieve this level of consensus. Respondents reported that many residents failed to achieve competence by the end of training in 9 of 13 procedures that they rated as very important, including venipuncture, neonatal intubation, and administering injections. Residents who perform the majority of venipunctures and intravenous catheter placements at their institutions were more likely to be judged competent in performing these skills than residents who do not. The Residency Review Committee's list of procedures does not necessarily reflect the opinions of pediatric program directors on the most essential skills for trainees. Many residents may not develop competence in several important procedures by the end of residency, most notably vascular access and life-saving skills. A more robust and standardized method is needed for teaching procedural skills and for
Robert K. Kamei, M.D.
Full Text Available Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduates self-assessment and the graduates clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication as important. They specifically cited the graduates skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our programs curriculum and can be used to direct future educational initiatives of our training program
Metheny, W P; Ling, F W; Mitchum, M
To answer questions about obstetric-gynecologic resident salary, night call, vacation, outside employment, gender mix, and training experiences using data from a national directory of residency programs in obstetrics and gynecology. The 259 US civilian residency programs were analyzed, using information from the 1996 directory database. We compared programs by size (four or fewer residents per year versus more than four residents per year) and geographic region for each of the questions. We used parametric and nonparametric statistical tests to determine statistical significance. First-year residents earn an average of $31,414 annually and receive a 5% increase each year, although salary varies significantly by region. Residents are on call an average of every 3rd night (twice a week) in the 1st year and every 4th or 5th night in the chief year. Residents in small programs take more night call than those in large programs. A separate night call rotation was more common in large programs. Vacation time varied by year of training and region. Male-to-female ratios in training differed significantly by year in training, program size, and region. The median number of training experiences was identified in each of the categories required by the Residency Review Committee in obstetrics and gynecology. Training experiences varied significantly by program size in three of the 15 categories. Program size and geographic region should be considered when comparing programs with regard to pay, work, time off, outside employment, gender mix, and training experiences. Program advisors and potential applicants are encouraged to use this information in comparing programs.
Grant, Richard E.; Murphy, Laurie A.; Murphy, James E.
The Accreditation Council of Graduate Medical Education’s (ACGME) Data Accreditation System indicates 124 of 152 orthopaedic surgery residency program directors have 5 or fewer years of tenure. The qualifications and responsibilities of the position based on the requirements of orthopaedic surgery residency programs, the institutions that support them, and the ACGME Outcome Project have evolved the role of the program coordinator from clerical to managerial. To fill the void of information on...
Harris, Devin R; Teal, Philip; Turton, Matthew; Lahiffe, Brian; Pulfrey, Simon
Stroke and transient ischemic attack (TIA) are common disorders treated by Canadian emergency physicians. The diagnosis and management of these conditions is time-sensitive and complex, requiring that emergency physicians have adequate training. This study sought to determine the extent of stroke and TIA training in Canadian emergency medicine residency programs. A two-page survey was emailed to directors of all English-speaking emergency medicine residency programs in Canada. This included both the Fellow of the Royal College of Physicians of Canada (FRCPC) and the College of Family Physicians Enhanced Training [CCFP(EM)] residency programs. The number of mandatory and elective rotations, lectures, and examinations relevant to stroke and TIA were assessed. Nine FRCPC programs responded (of 11; RR=82%) and 11 CCFP(EM) programs responded (of 18; RR=61%), representing 20 of 29 programs in Canada (RR: 20/29=69%). Mandatory general neurology (3/9) and stroke neurology (2/9) rotations were offered in a minority of FRCPC programs and not at all in CCFP(EM) programs (0/11). Neuroradiology rotations were mandatory in 1/9 FRCPC programs and no CCFP(EM) programs (0/11). Acute ischemic stroke was allocated 3 hours of lecture time per year in all residency programs, regardless of route of training. Despite the fact that 100% of respondents train residents in facilities that administer thrombolysis for stroke, only 1/11 (9%) CCFP(EM) programs and 0/9 FRCPC programs have residents act as stroke team leaders. Formal training in stroke and TIA is limited in Canadian emergency medicine residency programs. Enhanced training opportunities should be developed as this disease is sudden, life-threatening, and can have disabling or fatal consequences, and therapeutic options are time sensitive.
Parker, Daniel C; Kocher, Neil; Mydlo, Jack H; Simhan, Jay
To determine longitudinal trends in resident exposure to urotrauma and to assess whether presence of Genitourinary Reconstructive Surgeon (GURS) faculty has impacted exposure and career choice. An identical, 31-question multiple-choice survey was sent to program directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited urology residency programs in 2006 and 2013. The areas of focus included program demographics, extent of urotrauma exposure, program director perceptions regarding educational value of urotrauma, and impact of GURS fellowship trained faculty. Responses were de-identified, compiled, and compared for differences. Response rates were 57% (64/112) and 43% (53/123) for the 2006 and 2013 survey, respectively (P = .03). Trauma Level 1 designation (56/64 [89%] vs 44/53 [88%], P = .84) and presence of GURS faculty (22/64 [34%] vs 22/53 [43%], P = .43) were similar between survey periods. Although survey respondents felt urotrauma volume had remained constant (34/64 [53%] vs 30/53 [56%], P = .71), more recent respondents reported that conservative management strategies negatively impacted resident exposure (14/64 [22%] vs 23/53 [43%], P = .01). Residencies with GURS faculty in 2013 (22/53, 42%) were positively associated with residents publishing urotrauma literature (9/22 [41%] vs 4/31 [13%], P = .02), the presence of multidisciplinary trauma and urology conferences (3/22 [14%] vs 0/31 [0%], P = .03), and residents matriculating to GURS fellowships (15/22 [68%] vs 10/31 [32%], P = .009). Many contemporary urology residencies report poor resident exposure to urotrauma during training. Although presence of GURS faculty may influence resident career choice, additional strategies may be warranted to expose residents to urotrauma during training. Copyright © 2015 Elsevier Inc. All rights reserved.
Yu, Miaoyu; Law, Samuel; Dang, Kien; Byrne, Niall
Psychiatry as a field and undergraduate psychiatry education (UPE) specifically have historically been in the periphery of medicine in China, unlike the relatively central role they occupy in the West. During the current economic reform, Chinese undergraduate medical education (UME) is undergoing significant changes and standardization under the auspices of the national accreditation body. A comparative study, using Bereday's comparative education methodology and Feldmann's evaluative criteria as theoretical frameworks, to gain understanding of the differences and similarities between China and the West in terms of UPE can contribute to the UME reform, and specifically UPE development in China, and promote cross-cultural understanding. The authors employed multi-sourced information to perform a comparative study of UPE, using the University of Toronto as a representative of the western model and Guangxi Medical University, a typical program in China, as the Chinese counterpart. Key contrasts are numerous; highlights include the difference in age and level of education of the entrants to medical school, centrally vs. locally developed UPE curriculum, level of integration with the rest of medical education, visibility within the medical school, adequacy of teaching resources, amount of clinical learning experience, opportunity for supervision and mentoring, and methods of student assessment. Examination of the existing, multi-sourced information reveals some fundamental differences in the current UPE between the representative Chinese and western programs, reflecting historical, political, cultural, and socioeconomic circumstances of the respective settings. The current analyses show some areas worthy of further exploration to inform Chinese UPE reform. The current research is a practical beginning to the development of a deeper collaborative dialogue about psychiatry and its educational underpinnings between China and the West.
Butteris, Sabrina M; Schubert, Charles J; Batra, Maneesh; Coller, Ryan J; Garfunkel, Lynn C; Monticalvo, David; Moore, Molly; Arora, Gitanjli; Moore, Melissa A; Condurache, Tania; Sweet, Leigh R; Hoyos, Catalina; Suchdev, Parminder S
Despite the growing importance of global health (GH) training for pediatric residents, few mechanisms have cataloged GH educational opportunities offered by US pediatric residency programs. We sought to characterize GH education opportunities across pediatric residency programs and identify program characteristics associated with key GH education elements. Data on program and GH training characteristics were sought from program directors or their delegates of all US pediatric residency programs during 2013 to 2014. These data were used to compare programs with and without a GH track as well as across small, medium, and large programs. Program characteristics associated with the presence of key educational elements were identified by using bivariate logistic regression. Data were collected from 198 of 199 active US pediatric residency programs (99.5%). Seven percent of pediatric trainees went abroad during 2013 to 2014. Forty-nine programs (24.7%) reported having a GH track, 66.1% had a faculty lead, 58.1% offered international field experiences, and 48.5% offered domestic field experiences. Forty-two percent of programs reported international partnerships across 153 countries. Larger programs, those with lead faculty, GH tracks, or partnerships had significantly increased odds of having each GH educational element, including pretravel preparation. The number of pediatric residency programs offering GH training opportunities continues to rise. However, smaller programs and those without tracks, lead faculty, or formal partnerships lag behind with organized GH curricula. As GH becomes an integral component of pediatric training, a heightened commitment is needed to ensure consistency of training experiences that encompass best practices in all programs. Copyright © 2015 by the American Academy of Pediatrics.
Moy, James Y. K.; Hales, Loyde W.
The purpose of this study was to investigate the leadership behavior of Residence Life staff members, the management styles of the organization and their relationship to each other. Staff members and students within the Residence Life Program at Ohio University comprised the sample used. Staff perceptions on the Profile on Organizational…
Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G
Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.
Gupta, Raghav; Moore, Justin M; Adeeb, Nimer; Griessenauer, Christoph J; Schneider, Anna M; Gandhi, Chirag D; Harsh, Griffith R; Thomas, Ajith J; Ogilvy, Christopher S
Efforts to address resident errors and to enhance patient safety have included systemic reforms, such as the Accreditation Council for Graduate Medical Education's (ACGME's) mandated duty-hour restrictions, and specialty-specific initiatives such as the neurosurgery Milestone Project. However, there is currently little data describing the basis for these errors or outlining trends in neurosurgical resident error. An online questionnaire was distributed to program directors of 108 U.S. neurosurgery residency training programs to assess the frequency, most common forms and causes of resident error, the resulting patient outcomes, and the steps taken by residency programs to address these errors. Thirty-one (28.7%) responses were received. Procedural/surgical error was the most commonly observed type of error. Transient injury and no injury to the patient were perceived to be the 2 most frequent outcomes. Inexperience or resident mistake despite adequate training were cited as the most common causes of error. Twenty-three (74.2%) respondents stated that a lower post graduate year level correlated with an increased incidence of errors. There was a trend toward an association between an increased number of residents within a program and the number of errors attributable to a lack of supervision (r = 0.36; P = 0.06). Most (93.5%) program directors do not believe that mandated duty-hour restrictions reduce error frequency. Program directors believe that procedural error is the most commonly observed form of error, with post graduate year level believed to be an important predictor of error frequency. The perceived utility of systemic reforms that aim to reduce the incidence of resident error remains unclear. Copyright © 2017. Published by Elsevier Inc.
Villwock, Jennifer A; Hamill, Chelsea S; Nicholas, Brian D; Ryan, Jesse T
Objective To delineate research resources available to otolaryngology residents and their impact on scholarly productivity. Study Design Survey of current otolaryngology program directors. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. Results Thirty-nine percent (n = 38) of queried programs responded. Fourteen (37%) programs had 11 to 15 full-time, academic faculty associated with the residency program. Twenty (53%) programs have a dedicated research coordinator. Basic science lab space and financial resources for statistical work were present at 22 programs (58%). Funding is uniformly provided for presentation of research at conferences; a minority of programs (13%) only funded podium presentations. Twenty-four (63%) have resident research requirements beyond the Accreditation Council for Graduate Medical Education (ACGME) mandate of preparing a "manuscript suitable for publication" prior to graduation. Twenty-five (67%) programs have residents with 2 to 3 active research projects at any given time. None of the investigated resources were significantly associated with increased scholarly output. There was no uniformity to research curricula. Conclusions Otolaryngology residency programs value research, evidenced by financial support provided and requirements beyond the ACGME minimum. Additional resources were not statistically related to an increase in resident research productivity, although they may contribute positively to the overall research experience during training. Potential future areas to examine include research curricula best practices, how to develop meaningful mentorship and resource allocation that inspires continued research interest, and intellectual stimulation.
Elias, Joseph Abraham; Morgenroth, David Crespi
The aim of this study was to assess amputee care-related educational offerings and barriers to further educational opportunities in United States physical medicine and rehabilitation residency programs. A two-part survey was distributed to all United States physical medicine and rehabilitation residency program directors. Part 1 assessed the use of educational tools in amputee education. Part 2 assessed the potential barriers to amputee care-related education. Sixty-nine percent of the program directors responded. Seventy-five percent or more of the programs that responded have didactic lectures; grand rounds; reading lists; self-assessment exam review; gait analysis training; training with prosthetists; faculty with amputee expertise; and amputee care during inpatient, outpatient, and consult rotations. Less than 25% of the programs use intranet resources. No more than 14% of the programs said any one factor was a major barrier. However, some of the most prominent major barriers were limited faculty number, finances, and patient volume. The factors many of the programs considered somewhat of a barrier included lack of national standardized resources for curriculum, resident time, and faculty time. This study identified the most commonly used amputee educational opportunities and methods in physical medicine and rehabilitation residencies as well as the barriers to furthering resident amputee education. Developing Web-based resources on amputee care and increasing awareness of physiatrists as perioperative consultants could improve resident amputee education and have important implications toward optimizing care of individuals with amputation.
Hébert, Tiffany Michele; Szymanski, James; Mantilla, Jose; McLemore, Lauren; Walsh, Ronald; Vasovic, Ljiljana; Steinberg, Jacob J; Prystowsky, Michael B
Onboarding is a system frequently used in the corporate world as a means of orienting incoming employees to their duties and inculcating the workplace values. The program aims to facilitate transition into new work roles and improve employee retention rates. At Montefiore, we have instituted an onboarding curriculum that is given to new anatomic and clinical pathology residents about a month prior to the start of residency. The program includes an introductory video series of basic histology and a series of anatomic and clinical case studies illustrating basic laboratory principles. This didactic content is tagged to learning objectives and short self-assessment modules. In addition, content related to the work ethos at Montefiore and the role of the core competencies and milestones in residency education are included. Finally, a broader component of the onboarding gives the incoming residents a social welcome to our area, including key information about living in the area surrounding Montefiore. The program has been well received by our residents for whom the content has helped to boost confidence when starting. We feel that the program is helpful in ensuring that all incoming residents start having received the same baseline didactic content. Transmitting this didactic content via onboarding allows our residents to begin the work of learning pathology immediately, rather than spending the first weeks of residency covering remedial content such as basic histology. Such a program may be useful to other pathology residencies, most of whom have residents from a range of backgrounds and whose prior exposure to pathology may be limited.
Lee, Andrew G.; Beaver, Hilary A.; Boldt, H. Culver; Olson, Richard; Oetting, Thomas A.; Abramoff, Michael; Carter, Keith
The Accreditation Council for Graduate Medical Education (ACGME) has mandated that all residency training programs teach and assess new competencies including professionalism. This article reviews the literature on medical professionalism, describes good practices gleaned from published works, and
Ascherman, Lee I.; Lamps, Christopher
OBJECTIVE: The Child and Adolescent Psychiatry Match was instituted in 1996 to establish fair and uniform resident recruitment practices. METHOD: The impetus for its use was the desire to protect applicants and training programs from premature decisions based on fears of not securing a training position or not filling a program. RESULTS: However,…
Webber, Grant R; Mullins, Mark E; Chen, Zhengjia; Meltzer, Carolyn C
The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. The Fellowship and Residency Electronic Interactive Database, as well as direct communication and programmatic Web site searches, were used to gather data regarding current US DR residency leadership. Data collected included the presence of additional leadership titles, including assistant PD, associate PD, and PD emeritus, and how many faculty members currently held each position. Programs were excluded if results could not be identified. Analysis of variance and t tests were used to estimate the correlations of the size of a residency with having additional or shared PD positions and the types of positions, respectively. Chi-square tests were used to assess for any regional differences. As of the time of this project, the Fellowship and Residency Electronic Interactive Database defined 186 US DR residency programs. A total of 173 programs (93%) were included in the analysis; the remainder were excluded because of unavailability of relevant data. Seventy-two percent (124 of 173) of programs had additional DR leadership positions. Of these, 30 programs (17%) had more than one such position. There were no significant differences in the sizes of the programs that used these additional positions (mean, 25 ± 12; range, 6-72) compared with those that did not (mean, 24 ± 12; range, 7-51). There were no significant differences between programs that had additional positions with respect to region of the country. The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one
Oliver, J. E., Jr.
Data from the 6th Symposium on Veterinary Medical Education, the Arthur D. Little, Inc. report, and the survey of the American College of Veterinary Internal Medicine are reported as they pertain to the need for more residency programs, program quality and accreditation. Program funding is also discussed. (JMD)
Bowe, Sarah N
The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Estrade Espinosa, M
At the ISSSTE, a community psychiatry program was created and is being developed in two areas: the population of beneficiaries who attend two clinics and groups of employees of those same clinics at their respective places of work. The main purpose is to carry out prevention in mental health. In this report only the work in the first session of eight employee operative groups is reported. The method, the difficulties and the characteristics of the groupings are explained. Some theoretical aspects are shown. Results showed: 1. Little correspondence between the internal reality of the beneficiaries. 2. Difficulties in communication which produce differences of criteria with the clinic. 3. Difficulties in the internal distribution of power. 4. Unnecessary expenditure of energy. 5. Suggestions to solve the problems handled in the group. 6. Resistance against responsibilities.
Park, Jong-Il; Oh, Keun-Young; Chung, Young-Chul
This paper reports the current status of Korean psychiatry. In 2011, there were 3005 psychiatrists and 75,000 psychiatric beds. There were 84 psychiatric residency-training hospitals in 2011, which produced about 150 psychiatry board-certified doctors annually. As for academic activity, there is the Korean Neuropsychiatric Association, a main association for neuropsychiatry, and 21 other research societies. Psychiatric residency is a 4-year training program, with different objectives for each grade. The Korean health system accepts National Health Insurance. When severely mentally ill patients register as having a mental disorder, they pay only 10% of their total medical costs. Private clinics usually see patients with less severe conditions such as anxiety, mood and eating disorders; general and university hospitals and special mental hospitals often deal with severe conditions such as schizophrenia and bipolar disorder. One great concern is an increasing trend to depend upon pharmacotherapy and neglect the role of psychotherapy. Additionally, conflicts among medical sectors are becoming fierce as other doctors request abolition of the current law that restricts them from prescribing anti-depressants for more than 60 days. The average hospitalization period of all mental care institutions was 166 days in 2010, substantially longer compared with developed countries. To win the heart of the general public, cutting edge research to improve the quality of treatment for mental diseases, reformation of psychiatric residency training programs, public campaigns to increase awareness of mental health value, and timely reflection on policy decisions should be pursued persistently. Copyright © 2012 Elsevier B.V. All rights reserved.
Benjamin, Sheldon; Travis, Michael J; Cooper, Joseph J; Dickey, Chandlee C; Reardon, Claudia L
The American Association of Directors of Psychiatric Residency Training (AADPRT) Task Force on Neuropsychiatry and Neuroscience Education of Psychiatry Residents was established in 2011 with the charge to seek information about what the field of psychiatry considers the core topics in neuropsychiatry and neuroscience to which psychiatry residents should be exposed; whether there are any "competencies" in this area on which the field agrees; whether psychiatry departments have the internal capacity to teach these topics if they are desirable; and what the reception would be for "portable curricula" in neuroscience. The task force reviewed the literature and developed a survey instrument to be administered nationwide to all psychiatry residency program directors. The AADPRT Executive Committee assisted with the survey review, and their feedback was incorporated into the final instrument. In 2011-2012, 226 adult and child and adolescent psychiatry residency program directors responded to the survey, representing over half of all US adult and child psychiatry training directors. About three quarters indicated that faculty resources were available in their departments but 39% felt the lack of neuropsychiatry faculty and 36% felt the absence of neuroscience faculty to be significant barriers. Respectively, 64 and 60% felt that neuropsychiatry and psychiatric neuroscience knowledge were very important or critically important to the provision of excellent care. Ninety-two percent were interested in access to portable neuroscience curricula. There is widespread agreement among training directors on the importance of neuropsychiatry and neuroscience knowledge to general psychiatrists but barriers to training exist, including some programs that lack faculty resources and a dearth of portable curricula in these areas.
Full Text Available Physical activity and exercise have recently been used as an effective method for the treatment of several mental disorders. In this systematic review, the objective is to evaluate the efficiency of the physical activity programs which are applied on the chronic psychiatric patients. The review is made in direction with the Centre for Reviews and Dissemination 2009 guide which is developed by the York University, National Health Care Research Institute. Seven studies are included within the scope of this research. The patients with chronic mental disorders who participate in the physical activity programs experience positive outcomes like that they feel themselves mentally better, they are more compatible with the medical treatment and therapeutic interventions, the programs diminish the anxiety, their perceptions of physical self are strengthened, the social functionality is increased, the duration of morning sleep is decreased and the quality of night sleep is increased. Accordingly, personalized, planned and continuous physical activity programs should be developed for all the psychiatric patients and these programs should be applied on such patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(4.000: 354-366
Handheld computers are valuable practice tools. It is important for residency programs to introduce their trainees and faculty to this technology. This article describes a formal strategy to introduce handheld computing to a family practice residency program. Objectives were selected for the handheld computer training program that reflected skills physicians would find useful in practice. TRGpro handheld computers preloaded with a suite of medical reference programs, a medical calculator, and a database program were supplied to participants. Training consisted of four 1-hour modules each with a written evaluation quiz. Participants completed a self-assessment questionnaire after the program to determine their ability to meet each objective. Sixty of the 62 participants successfully completed the training program. The mean composite score on quizzes was 36 of 40 (90%), with no significant differences by level of residency training. The mean self-ratings of participants across all objectives was 3.31 of 4.00. Third-year residents had higher mean self-ratings than others (mean of group, 3.62). Participants were very comfortable with practical skills, such as using drug reference software, and less comfortable with theory, such as knowing the different types of handheld computers available. Structured training is a successful strategy for introducing handheld computing to a residency program.
Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S
For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.
Yang, Chong; Richard, George; Durkin, Martin
The purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. Forty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. The probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). Further analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles.
Thomas, Sheila A; Dobbins, Mary I; Hill-Jordan, Janice; Thomas, Mark C; Lee, Stacy; Albers, Janet
The authors sought to better understand the attitudes of primary care physicians toward psychiatrists in order to assess their receptivity for further psychiatric education. A survey about attitudes toward psychiatrists in comparison to other specialties was distributed among four family medicine residency programs at Southern Illinois University. Respondents rated psychiatry lower than other specialties in the areas measured. However, family medicine physicians expressed a desire to work with psychiatrists and receive further education in psychiatry. Favorable attitudes toward psychiatrists and education in psychiatry suggest the potential for additional family medicine training in psychiatry.
Hamoda, Hesham M.; Sacks, Diane; Sciolla, Andres; Dewan, Mantosh; Fernandez, Antony; Gogineni, Rama Rao; Goldberg, Jeffrey; Kramer, Milton; Saunders, Ramotse; Sperber, Jacob; Rao, Nyapati R.
Objective: International medical graduates (IMGs) constitute a significant proportion of the psychiatric workforce in the United States. Observership programs serve an important role in preparing IMGs for U.S. residency positions; yet there are limited resources with information available on establishing these observerships, and none specific to…
Full Text Available The first formal orientation program for incoming emergency medicine (EM residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States. In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167. We adapted our survey instrument from one used by Brillman (1995. The survey was designed to assess the orientation program’s purpose, structure, content, and teaching methods. The survey return rate was 63% (105 of 167. Most respondents (77% directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3 and 13 non-clinical days (Std. Dev.=9.3. The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98% and with other members of the department (91%. Many programs (87% included special certification courses (ACLS, ATLS, PALS, NRP. Course content included the following: use of electronic medical records (90%, physician wellness (75%, and chief complaint-based lectures (72%. Procedural skill sessions covered ultrasound (94%, airway management (91%, vascular access (90%, wound management (77%, splinting (67%, and trauma skills (62%. Compared to Brillman (1995, we found that more programs (99% are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty certifications. We also observed increases in
Dannemeyer, Deborah; Jalandoni, Cecile; Vonderheide, Dawn
This article will explain one organization's experience in developing a licensed vocational nurse residency program in an ambulatory setting, the barriers and challenges, and program outcomes. It outlines results of the program in building competence and confidence for vocational nurses to perform as effective team members in the primary care office setting. Learnings from this experience may be applied to enhance new and transitioning employee orientation and education programs in ambulatory and inpatient settings.
Asch, D A; Ende, J
A variety of forces are converging to reduce the number of internal medicine residency positions offered in this country. This reduction, referred to as downsizing, has been proposed as the solution to several of the problems facing internal medicine. We examine the forces that underlie the current enthusiasm for downsizing; we consider the alternative strategies by which downsizing might be implemented; and we consider the implications of these alternatives on different groups of stakeholders. Although downsizing may represent a legitimate approach to real problems, any mechanism to reduce the number of training positions in internal medicine will have broad implications for medical education and patient care well into the next century. Special efforts must be taken to ensure that downsizing will not exacerbate the existing problem of overspecialization and limited access to care.
Kirmayer, Laurence J.; Rousseau, Cecile; Corin, Ellen; Groleau, Danielle
Objectives: The authors aim to summarize the pedagogical approaches and curriculum used in the training of researchers in cultural psychiatry at the Division of Social and Transcultural Psychiatry at McGill University. Method: We reviewed available published and unpublished reports on the history and development of the McGill cultural psychiatry…
Solomon, Ellen R; Muffly, Tyler M; Hood, Carrie; Attaran, Marjan
To estimate the prevalence of Pediatric and Adolescent Gynecology formal training in the United States Obstetric and Gynecology residency programs. Prospective, anonymous, cross-sectional study. United States program directors of Obstetrics and Gynecology residency programs, N = 242; respondents 104 (43%). 104 residency programs responded to our survey. Among the 104 residency programs, 63% (n = 65) have no formal, dedicated Pediatric and Adolescent Gynecology clinic, while 83% (n = 87) have no outpatient Pediatric and Adolescent Gynecology rotation. There is no significant difference in the amount of time spent on a Pediatric and Adolescent Gynecology rotation among residents from institutions with a Pediatric and Adolescent Gynecology fellowship (P = .359), however, the number of surgeries performed is significantly higher than those without a Pediatric and Adolescent Gynecology fellowship (P = .0020). When investigating resident competency in Pediatric and Adolescent Gynecology, program directors reported that residents who were taught in a program with a fellowship-trained Pediatric and Adolescent Gynecology faculty were significantly more likely to be able to interpret results of selected tests used to evaluate precocious puberty than those without (P = .03). Residency programs without fellowship trained Pediatric and Adolescent Gynecology faculty or an established Pediatric and Adolescent Gynecology fellowship program may lack formal training and clinical exposure to Pediatric and Adolescent Gynecology. This information enables residency directors to identify deficiencies in their own residency programs and to seek improvement in resident clinical experience in Pediatric and Adolescent training. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Byrne, John; Straub, Heather; DiGiovanni, Laura; Chor, Julie
The objective of the study was to assess the current status of ethics education in obstetrics-gynecology residency programs. A cross-sectional, web-based survey was designed in conjunction with a professional survey laboratory at the University of Chicago. The survey was piloted with a convenience sample of clinical medical ethics fellows to assess question content and clarity. The survey was deployed by e-mail to all obstetrics-gynecology residency program directors. Descriptive statistics were used to analyze participant responses. The University of Chicago's Institutional Review Board deemed this study exempt from institutional review board formal review. Of 242 eligible obstetrics-gynecology residency program directors, 118 (49%) completed the survey. Most respondents were from university-based programs (n = 78, 66%) that were not religiously affiliated (n = 98, 83%) and trained 4-6 residents per postgraduate year (n = 64, 70%). Although 50% of program directors (n = 60) reported having ethics as part of their core curriculum, most programs teach ethics in an unstructured manner. Fifty-seven percent of respondents (n = 66) stated their program dedicated 5 or fewer hours per year to ethics. The majority of program directors (n = 80, 73%) responded they would like more to a lot more ethics education and believed that ethics education should be required (n = 93, 85%) for residents to complete their training. Respondents identified that crowding in the curriculum was a significant barrier to increased ethics training (n = 50, 45%) and two-thirds (n = 74, 67%) reported a lack of faculty expertise as a moderate barrier to providing ethics education in the residency curriculum. This study found that a lack of structured curricula, inadequate faculty expertise, and limited time were important barriers for ethics education in obstetrics-gynecology programs across the nation. Despite these existing challenges, program directors have a strong interest in increasing ethics
Torbeck, Laura; Canal, David F; Choi, Jennifer
In an attempt to better define the success of our residency program with regard to resident development, we committed to develop an ongoing assessment of residency performance and devised an outcomes assessment system. We describe the process and structure that we used to construct an outcomes assessment system. We discuss the process we used to discern whether or not our program is successful as well as offer tips on what data to collect and track should other residency programs decide to devise a similar outcomes assessment database. Taking time to "step back" to take inventory of a residency program and ensure year over year and at the end of training residents have developed and matured as planned is an educationally sound practice. Structuring an outcomes assessment system like the one that we discuss here can aid program directors with this important task. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Aparecido Ferreira de Oliveira
Full Text Available Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46, taped interviews (18, and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.
Oliveira, Aparecido Ferreira de; Lederman, Henrique Manoel; Batista, Nildo Alves, E-mail: email@example.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina
Objective: to investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina - Universidade Federal de Sao Paulo, aiming at improving radiologists' education. Materials and methods: exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results: According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion: Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists. (author)
Grant, Richard E; Murphy, Laurie A; Murphy, James E
The Accreditation Council of Graduate Medical Education's (ACGME) Data Accreditation System indicates 124 of 152 orthopaedic surgery residency program directors have 5 or fewer years of tenure. The qualifications and responsibilities of the position based on the requirements of orthopaedic surgery residency programs, the institutions that support them, and the ACGME Outcome Project have evolved the role of the program coordinator from clerical to managerial. To fill the void of information on the coordinators' expanding roles and responsibilities, the 2006 Association of Residency Coordinators in Orthopaedic Surgery (ARCOS) Career survey was designed and distributed to 152 program coordinators in the United States. We had a 39.5% response rate for the survey, which indicated a high level of day-to-day managerial oversight of all aspects of the residency program; additional responsibilities for other department or division functions for fellows, rotating medical students, continuing medical education of the faculty; and miscellaneous business functions. Although there has been expansion of the role of the program coordinator, challenges exist in job congruence and position reclassification. We believe use of professional groups such as ARCOS and certification of program coordinators should be supported and encouraged.
Lacasse, Miriam; Ratnapalan, Savithiri
ABSTRACT OBJECTIVE To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. DATA SOURCES Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. STUDY SELECTION The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. SYNTHESIS Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs’ effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. CONCLUSION Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the
Weissbart, Steven J; Stock, Jeffrey A; Wein, Alan J
To investigate urology residency program directors' criteria for resident selection. In 2014, the urology residency program directors were surveyed using an email questionnaire. The generated questionnaire included the following 3 components: (1) assessing the factors used in selecting applicants for interviewing and matching, (2) rating the factors resulting in a negative decision for applicants for interviewing and matching, and (3) investigating the factors that gave applicants special attention or consideration from program directors. Analysis of variance testing and post hoc Student t tests were used to assess for differences in the mean importance score of the factors. Urology reference letters and United States Medical Licensing Examination (USMLE) scores were ranked as the most important factors for applicant selection. A USMLE Step 1 score ≤220 and a USMLE Step 2 score ≤220 were the most deleterious factors to applicants, with a previous match failure being no less deleterious to an applicant than a USMLE Step 1 or 2 score ≤220. Program directors gave special attention or consideration to gender (25%), minority status (36.8%), being from the same medical school as the program director (61.8%), completing an away rotation at the program director's institution (86.8%), being a child of an academic urologist (47.4%), and being a child of an academic nonurologic physician (15.8%). Although program directors consider a variety of factors during the residency selection process, USMLE performance, urology references, and completing an away rotation at the program directors' institution appear to be the most important factors to program directors during the residency selection process. Copyright © 2015 Elsevier Inc. All rights reserved.
R.C.A. Thompson and S.D. Blacksell. 2011. Hepatitis E virus is prevalent in the pig population of Lao People’s Democratic Republic and evidence...pending submission. Chen, Guojun 8/8/2011-5/14/2012 1 Virus -like particle for antisense ODN delivery 2 Peptide-oligonucleic acid conjugates for...Comments 18) PLEASE PROVIDE ANY SUGGESTIONS FOR PROGRAM IMPROVEMENT. Please do NOT scan to PDF . Send the Final Report as MSWord
Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer
Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.
Turner, Simon R; White, Jonathan; Poth, Cheryl; Rogers, W Todd
The preparation of medical students for clerkship has been criticized, in terms of both students understanding of their new role as clinical trainees and their ability to carry out that role. To begin to address this gap, the authors report the development, implementation, and assessment of a novel program in which first-year medical students shadow first-year residents during their clinical duties. The program matches each student to a single resident, whom they shadow for several hours, once per month, for eight months. In the programs inaugural year (2009-10), 83 student-resident pairs participated; over 70% responded to pre- and post-intervention questionnaires, which included an 18-item preparedness scale. The authors used those responses to evaluate the program. Compared to students in a control group, the students in the program assessed themselves as better prepared to learn in a clinical setting. The low-cost student-resident shadowing program described in this article provided an early and structured introduction to the clinical environment, which may help prepare students for the transition into clerkship.
Ahmad, Shireen; De Oliveira, Gildasio S; McCarthy, Robert J
The enhancement of resident research education has been proposed to increase the number of academic anesthesiologists with the skills and knowledge to conduct meaningful research. Program directors (PDs) of the U.S. anesthesiology residency programs were surveyed to evaluate the status of research education during residency training and to test the hypothesis that structured programs result in greater resident research productivity based on resident publications. Survey responses were solicited from 131 anesthesiology residency PDs. Seventy-four percent of PDs responded to the survey. Questions evaluated department demographic information, the extent of faculty research activity, research resources and research funding in the department, the characteristics of resident research education and resident research productivity, departmental support for resident research, and perceived barriers to resident research education. Thirty-two percent of programs had a structured resident research education program. Structured programs were more likely to be curriculum based, require resident participation in a research project, and provide specific training in presentation and writing skills. Productivity expectations were similar between structured and nonstructured programs. Forty percent of structured programs had > 20% of trainees with a publication in the last 2 years compared with 14% of departments with unstructured programs (difference, 26%; 99% confidence interval [CI], 8%-51%; P = 0.01). The percentage of programs that had research rotations for ≥2 months was not different between the structured and the nonstructured programs. A research rotation of >2 months did not increase the percentage of residents who had published an article within the last 2 months compared with a research rotation of research in structured compared with unstructured research education. In programs with research, 15% reported >20% of residents with a publication in the last 2 years compared
Bradley, Nori L; Bazzerelli, Amy; Lim, Jenny; Wu Chao Ying, Valerie; Steigerwald, Sarah; Strickland, Matt
Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met.
Wells, Lloyd A
I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer much but are hampered by the ubiquity and flaws of meta-analysis. I explore views of evidence-based medicine among psychiatry residents, as well as capacity for critical thinking in residents before and after a course in philosophy. I discuss decision making by experienced doctors and suggest possible futures of this issue. © 2015 John Wiley & Sons, Ltd.
Rothberg, Brian; Feinstein, Robert E; Guiton, Gretchen
Evidence-based medicine (EBM) has become an important part of residency education, yet many EBM curricula lack a valid and standardized tool to identify learners' prior knowledge and assess progress. We developed an EBM examination in psychiatry to measure our effectiveness in teaching comprehensive EBM to residents. We developed a psychiatry EBM test using the validated EBM Fresno Test of Competence for family medicine. The test consists of case scenarios with open-ended questions. We also developed a scoring rubric and obtained reliability with multiple raters. Fifty-seven residents provided test data after completing 3, 6, 25, or 31 EBM sessions. The number of sessions for each resident was based on their length of training in our program. The examination had strong interrater reliability, internal reliability, and item discrimination. Many residents showed significant improvement on their examination scores when data were compared from tests taken before and after a sequence of teaching sessions. Also, a threshold for the level of expert on the examination was established using test data from 5 EBM teacher-experts. We successfully developed a valid and reliable EBM examination for use with psychiatry residents to measure essential EBM skills as part of a larger project to encourage EBM practice for residents in routine patient care. The test provides information on residents' knowledge in EBM from entry level concepts through expert performance. It can be used to place incoming residents in appropriate levels of an EBM curriculum and to monitor the effectiveness of EBM instruction.
Cichon, Michelle; Feldman, Gerald L
Approximately 50% of medical genetics residency positions remain unfilled each year. This study was designed to assess current recruitment strategies used by program directors, to identify factors that influenced trainees to choose medical genetics as a career, and to use these results as a foundation to develop a strategic plan to address the challenges of recruitment. Two surveys were created, one for program directors and one for current medical genetics residents, to evaluate current recruiting efforts and institutional support for programs and to identify factors that helped trainees choose genetics as a career. Program directors identified the most successful recruiting methods as "direct contact with residents or medical students" and "word of mouth" (80%). Residents listed having a mentor (50%), previous research in genetics (35%), and genetics coursework (33%) as the top reasons that influenced them to enter the field. Geneticists should become more proactive in providing resources to students to help them understand a career as a medical geneticist and mentor those students/residents who show true interest in the field. Results of these surveys spurred the development of the Task Force on Medical Genetics Education and Training of the American College of Medical Genetics and Genomics.
Fastenberg, Judd H; Gibber, Marc J; Smith, Richard V
Transoral robotic surgery (TORS) is becoming an integral part of the otolaryngology resident experience. While there is widespread agreement that a formal, validated curriculum for TORS training is needed for residents, none presently exists. The primary objective of this study is to evaluate an introductory resident curriculum for TORS training that could be easily adopted at other institutions. This is a prospective study of otolaryngology residents (PGY1-5) in an academic medical center from 2015 to 2016. Trainees completed an introductory TORS training program consisting of online modules, logistic training, and hands-on training consisting of 12 tasks on the da Vinci Skills Simulator (dVSS). The primary outcomes were completion of training and time to completion. The secondary outcomes included resident attitudes regarding TORS as reflected on post-training survey. A total of 20 resident trainees participated in the study. 85% of trainees completed the hands-on robotic training in the allotted 3-h time limit. The average time to completion for those who finished was 91.53 min (SD 33.59 min). There was no statistically significant correlation between time to completion and PGY, number of robotic first assists, or total number of robotic cases. An introductory, resident-directed TORS training curriculum using the dVSS on an active surgical console is feasible in an academic medical center and may contribute to basic robotic competency among residents. Institutions with a dVSS may replicate this training in a resource-efficient manner prior to implementation of more comprehensive training. Robotic skills are likely trainable and independent from surgical skills learned during residency.
Robbins, Matthew S; Haut, Sheryl R; Lipton, Richard B; Milstein, Mark J; Ocava, Lenore C; Ballaban-Gil, Karen; Moshé, Solomon L; Mehler, Mark F
To describe and assess the effectiveness of a formal scholarly activity program for a highly integrated adult and pediatric neurology residency program. Starting in 2011, all graduating residents were required to complete at least one form of scholarly activity broadly defined to include peer-reviewed publications or presentations at scientific meetings of formally mentored projects. The scholarly activity program was administered by the associate residency training director and included an expanded journal club, guided mentorship, a required grand rounds platform presentation, and annual awards for the most scholarly and seminal research findings. We compared scholarly output and mentorship for residents graduating within a 5-year period following program initiation (2011-2015) and during the preceding 5-year preprogram baseline period (2005-2009). Participation in scholarship increased from the preprogram baseline (24 of 53 graduating residents, 45.3%) to the postprogram period (47 of 57 graduating residents, 82.1%, p Neurology.
Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas
Given the well-documented shortage of physicians in primary care and several other specialties, quantitative understanding of residency application and matching data among osteopathic and allopathic medical students has implications for predicting trends in the physician workforce. To estimate medical student interest in neurology and psychiatry based on numbers of applicants and matches to neurology and psychiatry osteopathic and allopathic residency programs. Also, to gauge students' previous academic experience with brain and cognitive sciences. The number of available postgraduate year 1 positions, applicants, and matches from graduating years 2011 through 2015 were collected from the National Matching Services Inc and the American Association of Colleges of Osteopathic Medicine for osteopathic programs and the National Resident Matching Program and the Association of American Medical Colleges for allopathic programs. To determine and compare osteopathic and allopathic medical students' interest in neurology and psychiatry, the number of positions, applicants, and matches were analyzed considering the number of total osteopathic and allopathic graduates in the given year using 2-tailed χ2 analyses with Yates correction. In addition, osteopathic and allopathic medical schools' websites were reviewed to determine whether neurology and psychiatry rotations were required. Osteopathic medical students' reported undergraduate majors were also gathered. Compared with allopathic medical students, osteopathic medical students had significantly greater interest (as measured by applicants) in neurology (χ21=11.85, Ppsychiatry (χ21=39.07, Ppsychiatry residency programs. Approximately 6% of osteopathic vs nearly 85% of allopathic medical schools had required neurology rotations. Nearly 10% of osteopathic applicants and matriculants had undergraduate coursework in brain and cognitive sciences. Osteopathic medical students demonstrated greater interest than allopathic
Langlois, Jean; Wells, George A.; Lecourtois, Marc; Bergeron, Germain; Yetisir, Elizabeth; Martin, Marcel
Spatial abilities have been related in previous studies to three-dimensional (3D) anatomy knowledge and the performance in technical skills. The objective of this study was to relate spatial abilities to residency programs with different levels of content of 3D anatomy knowledge and technical skills. The hypothesis was that the choice of residency…
Price, James H.; Thompson, Amy J.; Khubchandani, Jagdish; Mrdjenovich, Adam J.; Price, Joy A.
Objective: Most suicides (60%) are committed with firearms, and most (80%) of individuals attempting suicide meet diagnostic criteria for mental illness. This study assessed the prevalence of firearm injury prevention training in psychiatric residency programs. Methods: A three-wave mail survey was sent to the directors of 179 psychiatric…
Pugno, Perry A; McGaha, Amy L; Schmittling, Gordon T; DeVilbiss Bieck, Ashley D; Crosley, Philip W; Ostergaard, Daniel J
The results of the 2010 National Resident Matching Program (NRMP) reflect a small but promising increased level of student interest in family medicine residency training in the United States. Compared with the 2009 Match, 75 more positions (with 101 more US seniors) were filled in family medicine residency programs through the NRMP in 2010, at the same time that seven more positions were filled in primary care internal medicine (one more US senior), 14 fewer positions were filled in pediatrics-primary care (16 fewer US seniors), and 16 more positions were filled in internal medicine-pediatrics programs (58 more US seniors). Multiple forces including student perspectives of the demands, rewards, and prestige of the specialty; national dialogue about health care reform; turbulence in the economic environment; lifestyle issues; the advice of deans; and the impact of faculty role models continue to influence medical student career choices. Ninety-four more positions (90 more US seniors) were filled in categorical internal medicine. Fifty-seven more positions (29 more US seniors) were filled in categorical pediatrics programs. The 2010 NRMP results suggest that there is a small increase in primary care careers; however, students continue to show an overall preference for subspecialty careers. Despite matching the highest number of US seniors into family medicine residencies since 2004, in 2010 the production of family physicians remains insufficient to meet the current and anticipated need to support the nation's primary care infrastructure.
Abele, Misoo; Brown, Julie; Ibrahim, Hicham; Jha, Manish K
The authors report on the current status of motivational interviewing education and training director attitudes about providing it to psychiatry residents. Training directors of general, child/adolescent and addiction psychiatry training programs were invited to participate in an anonymous online survey. Of the 333 training directors who were invited to participate, 66 of 168 (39.3%) general, 41 of 121 (33.9%) child/adolescent, and 19 of 44 (43.2%) addiction psychiatry training directors completed the survey. The authors found that 90.9% of general, 80.5% of child/adolescent, and 100% of addiction psychiatry training programs provided motivational interviewing education. Most programs used multiple educational opportunities; the three most common opportunities were didactics, clinical practice with formal supervision, and self-directed reading. Most training directors believed that motivational interviewing was an important skill for general psychiatrists. The authors also found that 83.3% of general, 87.8% of child/adolescent, and 94.7% of addiction psychiatry training directors reported that motivational interviewing should be taught during general psychiatry residency. Motivational interviewing skills are considered important for general psychiatrists and widely offered by training programs. Competency in motivational interviewing skills should be considered as a graduation requirement in general psychiatry training programs.
Clarissa Mendonça Corradi-Webster
Full Text Available INTRODUÇÃO: O consumo de álcool por pacientes que fazem tratamento psiquiátrico pode trazer inúmeras consequências negativas. Os objetivos deste estudo foram identificar o uso problemático de álcool entre pacientes psiquiátricos ambulatoriais e verificar se esse consumo foi documentado nos prontuários por residentes de psiquiatria. MÉTODO: Estudo descritivo, transversal, realizado em serviço ambulatorial de clínica psiquiátrica de hospital universitário localizado em Ribeirão Preto (SP. Foi utilizada uma amostra de conveniência formada por pacientes psiquiátricos ambulatoriais (n = 127. A coleta de dados foi realizada por meio de entrevista (dados sociodemográficos e instrumento de rastreamento de abuso de álcool - CAGE e pela leitura de todas as anotações feitas por residentes de psiquiatria nos prontuários dos pacientes entrevistados (ficha para coleta de dados do prontuário. Para a análise dos dados, foram utilizados os pontos de corte > 1 e > 2 para o CAGE. RESULTADOS: Com CAGE > 1, 33,9% pontuaram positivo (n = 43 e, entre estes, 60,5% (n = 26 não tinham registros em seus prontuários sobre o uso de álcool (qui-quadrado = 20,12; p 2, 16,5% pontuaram positivo (n = 21 e, entre estes, 38,1% (n = 8 não tinham registros em seus prontuários referentes ao consumo de bebidas alcoólicas (qui-quadrado = 29,10; p INTRODUCTION: Consumption of alcohol by psychiatric patients can lead to many negative consequences. The objectives of this study were to identify the problematic use of alcohol in a group of psychiatric outpatients and to verify if this consumption was documented in their medical records by psychiatry medical residents. METHODS: Descriptive and cross-sectional study, carried out at the psychiatric outpatient clinic of a university hospital located in Ribeirão Preto, stat of São Paulo, Brazil. A convenience sample comprising 127 psychiatric outpatients was used. Data were collected using an interview
Biggs, Wendy S; Bieck, Ashley D; Pugno, Perry A; Crosley, Philip W
The results of the 2011 National Resident Matching Program (NRMP) reflect another small but promising increased level of student interest in family medicine residency training in the United States. Compared with the 2010 Match, family medicine residency programs filled 172 more positions (with 133 more US seniors) through the NRMP in 2011. In other primary care fields, 26 more primary care internal medicine positions filled (10 more US seniors), one more position in pediatrics-primary care (two fewer US seniors), and seven more positions in internal medicine-pediatrics programs (10 more US seniors). The 2011 NRMP results suggest a small increase in choosing primary care careers for the second year in a row; however, students continue to show an overall preference for subspecialty careers. Multiple forces continue to influence medical student career choices. Despite matching the highest number of US seniors into family medicine residencies since 2002, the production of family physicians remains insufficient to meet the current and anticipated need to support the nation's primary care infrastructure.
Van Cleave, Jeanne; Holifield, Chloe; Perrin, James M
The Massachusetts Child Psychiatry Access Project (MCPAP) provides telephone support from mental health specialists to primary care providers (PCPs). Understanding PCPs' use may inform implementation of similar programs. We sought to examine PCPs' decision-making process to use or not use MCPAP when encountering mental health problems. We analyzed data regarding calls from PCPs to MCPAP from October 1, 2010, to July 31, 2011, and interviewed 14 PCPs with frequent use (≥7 calls) and infrequent use (≤4 calls). PCPs were asked about recent patients with mental health problems, and they were asked to describe reasons for calling or not calling MCPAP. Frequent callers were asked what sustained use; infrequent callers were asked about alternative management strategies. Comparisons were made between these groups in qualitative analysis. PCPs (n = 993) made 6526 calls (mean = 6.6; median = 3). Factors influencing calling included: MCPAP's guidance is timely and tailored to individual scope of practice; MCPAP's ability to arrange therapy referrals exceeds PCPs' ability; providing a plan at point of care relieves anxious families; and MCPAP's assistance helps accommodate families' preference to keep mental health in primary care. Some infrequent callers had gained skills through MCPAP before 2010 and now called only for complex cases. Other reasons for infrequent calling: PCPs have other consultation sources, have fear of being asked to manage more than they are comfortable, or have misperceptions of MCPAP's offerings. MCPAP enhanced PCPs' ability to deliver mental health care consistent with families' preferences. PCPs applied knowledge gained from calls to subsequent patients. Promoting MCPAP components through outreach and tailoring guidance to PCPs' scope of practice may entice greater use. Copyright © 2018. Published by Elsevier Inc.
Pugno, Perry A; McGaha, Amy L; Schmittling, Gordon T; DeVilbiss, Ashley D; Ostergaard, Daniel J
The results of the 2009 National Resident Matching Program (NRMP) reflect a persistently low level of student interest in family medicine residency training in the United States. Compared with the 2008 Match, 70 fewer positions (with 89 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2009, at the same time that 18 fewer positions were filled in primary care internal medicine (11 fewer US seniors), one more position was filled in pediatrics-primary care (three more US seniors), and 13 more positions were filled in internal medicine-pediatrics programs (but with seven fewer US seniors). Multiple forces, including student perspectives of the demands, rewards and prestige of the specialty, the turbulence and uncertainty of the health care and economic environments, lifestyle issues, the advice of deans, and the impact of faculty role models, continue to influence medical student career choices. A total of 152 more positions (28 fewer US seniors) were filled in categorical internal medicine. Thirty-one more positions (72 more US seniors) were filled in categorical pediatrics programs. The 2009 NRMP results suggest that while interest in family medicine experienced a slight increase in the number of students choosing the specialty last year, overall interest in primary care careers continues to decline. With the nation continuing to call for the roles and services of family physicians, family medicine still matched too few graduates through the 2009 NRMP to effectively address the nation's needs for primary care physicians.
Pugno, Perry A; McGaha, Amy L; Schmittling, Gordon T; DeVilbiss, Ashley D; Ostergaard, Daniel J
The results of the 2008 National Resident Matching Program (NRMP) reflect a currently stable level of student interest in family medicine residency training in the United States. Compared with the 2007 Match, 91 more positions (with 65 more US seniors) were filled in family medicine residency programs through the NRMP in 2008, at the same time as 10 fewer (one fewer US senior) in primary care internal medicine, eight fewer positions were filled in pediatrics-primary care (10 fewer US seniors), and 19 fewer (27 fewer US seniors) in internal medicine-pediatrics programs. Multiple forces, including student perspectives of the demands, rewards, and prestige of the specialty, the turbulence and uncertainty of the health care environment, lifestyle issues, and the impact of faculty role models, continue to influence medical student career choices. Thirty-one more positions (20 fewer US seniors) were filled in categorical internal medicine. Thirty more positions (84 fewer US seniors) were filled in categorical pediatrics programs. The 2008 NRMP results suggest that while interest in family medicine experienced a slight increase in the number of students choosing the specialty, interest in other primary care careers continues to decline. With the needs of the nation calling for the roles and services of family physicians, family medicine still matched too few graduates through the 2008 NRMP to meet the nation's needs for primary care physicians.
Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine ...
Full Text Available ... certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some ...
DeSoucy, Erik S; Zakaluzny, Scott A; Galante, Joseph M
Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health. During the 2016 iteration attended by 10 interns, pre- and post-participation 10-item Likert scale surveys were administered. Questions focused on perceived preparedness for primary care role and overall enthusiasm for flight medicine. Open-ended surveys from 2013 to 2016 were also used to gauge the effect of the curriculum. The composite number of agreement responses (indicating increased comfort with presented material) increased 63% after course completion. Disagreement responses and neutral responses decreased 78% and 30%, respectively. Open-ended surveys from 14 participants showed an overall positive impression of the curriculum with all indicating it aided their transition to flight medicine. Survey responses indicate an overall perceived benefit from participation in the curriculum with more confidence in primary care topics and improved transition to a flight medicine tour. This model for supplemental aerospace medicine and primary care didactics should be integrated into any residency program responsible for training military preliminary interns who may serve as flight surgeons. Published by Elsevier Inc.
Full Text Available Sonja Lüer, Christoph Aebi Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Background: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals’ acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland.Methods: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages, and 2 alumni surveys (S1, S2. Results: In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%. Forty-six alumni (42% in private practice were eligible for alumni surveys. Response rates were 87% (S1 and 61% (S2. Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice varied widely (late-training decision to enter private practice. Mean employment level in private practice was 60% (range 20%–100%. Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically.Conclusion: A broadened view on outcomes – beyond individuals’ competency acquisition – provides informative insights into a training program, can allow for informed program updates, and guide future program development. Keywords: medical education, career choice, pediatrics, private practice
Topps, Maureen; Ellaway, Rachel H; Baron, Tara; Peek, Alison
The context for specialty residency training in pediatrics has broadened in recent decades to include distributed community sites as well as academic health science centers. Rather than creating parallel, community-only programs, most programs have expanded to include both community and large urban tertiary health center experiences. Despite these changes, there has been relatively little research looking at residents' experiences in these distributed graduate medical education programs. A longitudinal case study was undertaken to explore the experiences of residents in a Canadian pediatrics residency program that involved a combination of clinical placements in a large urban tertiary health center and in regional hospitals. The study drew on 2 streams of primary data: 1-on-1 interviews with residents at the end of each block rotation and annual focus groups with residents. A thematic analysis (using grounded theory techniques) of transcripts of the interviews and focus groups identified 6 high-level themes: access to training, quality of learning, patient mix, continuity of care, learner roles, and residents as teachers. Rather than finding that certain training contexts were "better" than others when comparing residents' experiences of the various training contexts in this pediatrics residency, what emerged was an understanding that the different settings complemented each other. Residents were adamant that this was not a matter of superiority of one context over any other; their experiences in different contexts each made a valuable contribution to the quality of their training.
Full Text Available Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks. Our plan was to induct simulation in emergency medicine residency program in order to ameliorate our defects in clinical bedside training. Our residents believed that simulation could be effective in their real medical practice. They mentioned that facilitators’ expertise and good medical knowledge, was the strongest point of the program and lack of proper facilities was the weakest.
Kateeb, Elham; Warren, John; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim
The purpose of this study was to investigate the extent of clinical training on atraumatic restorative treatment (ART) among pediatric dentistry residency programs and assess program directors' attitudes toward ART. All U.S. Pediatric Dentistry residency programs' directors were asked to complete a web-based survey. Sixty-one of the 76 directors (80 percent) completed the survey, with no significant response bias. Eighty-nine percent of the responding programs provided clinical instruction on ART. Of these, 30 percent provided ART training often/very often. ART was used mostly in single-surface cavities (43 percent) and as an interim treatment in primary teeth (57 percent). Factors associated with ART clinical training included not placing amalgams in primary teeth (Ppediatric dentistry residency programs in the United States. Residency directors' attitudes were highly predictive of the amount of clinical training provided, suggesting that directors need to be better informed about the use of ART.
Meagher, Ashley D; Beadles, Christopher A; Sheldon, George F; Charles, Anthony G
To estimate the capacity for supporting new general surgery residency programs among U.S. hospitals that currently do not have such programs. The authors compiled 2011 American Hospital Association data regarding the characteristics of hospitals with and without a general surgery residency program and 2012 Accreditation Council for Graduate Medical Education data regarding existing general surgery residencies. They performed an ordinary least squares regression to model the number of residents who could be trained at existing programs on the basis of residency program-level variables. They identified candidate hospitals on the basis of a priori defined criteria for new general surgery residency programs and an out-of-sample prediction of resident capacity among the candidate hospitals. The authors found that 153 hospitals in 39 states could support a general surgery residency program. The characteristics of these hospitals closely resembled the characteristics of hospitals with existing programs. They identified 435 new residency positions: 40 hospitals could support 2 residents per year, 99 hospitals could support 3 residents, 12 hospitals could support 4 residents, and 2 hospitals could support 5 residents. Accounting for progressive specialization, new residency programs could add 287 additional general surgeons to the workforce annually (after an initial five- to seven-year lead time). By creating new general surgery residency programs, hospitals could increase the number of general surgeons entering the workforce each year by 25%. A challenge to achieving this growth remains finding new funding mechanisms within and outside Medicare. Such changes are needed to mitigate projected workforce shortages.
Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha
In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.
Griswold, Todd; Bullock, Christopher; Gaufberg, Elizabeth; Albanese, Mark; Bonilla, Pedro; Dvorak, Ramona; Epelbaum, Claudia; Givon, Lior; Kueppenbender, Karsten; Joseph, Robert; Boyd, J. Wesley; Shtasel, Derri
Objective: The authors present what is to their knowledge the first description of a model for longitudinal third-year medical student psychiatry education. Method: A longitudinal, integrated psychiatric curriculum was developed, implemented, and sustained within the Harvard Medical School-Cambridge Integrated Clerkship. Curriculum elements…
Tunson, Java; Boatright, Dowin; Oberfoell, Stephanie; Bakes, Katherine; Angerhofer, Christy; Lowenstein, Steven; Zane, Richard; King, Renee; Druck, Jeffrey
Much work remains to be done to align the diversity of the health care workforce with the changing racial and ethnic backgrounds of patients, especially in the field of emergency medicine. In academic year (AY) 2012-2013, to increase the number of underrepresented minority (URM) candidates who were interviewed and matched, the Denver Health Residency in Emergency Medicine program (DHREM) initiated a focused pilot intervention with three principal strategies: (1) a scholarship-based externship program, (2) a funded second-look event, and (3) increased involvement and visibility of URM faculty in the interview and recruitment process. One year after implementation of the pilot intervention, the percentage of URMs among all applicants invited to interview at the DHREM doubled (7.1% [20/282] in AY 2011-2012, 7.0% [24/344] in AY 2012-2013, and 14.8% [58/393] in AY 2013-2014) (95% confidence interval [CI] = 5-10, 4-11, and 11-19, respectively). Of all DHREM interviewees in AY 2013-2014, 17.6% (49/279) (95% CI = 12-23) were URMs, nearly a threefold increase from AY 2012-2013 (6.2% [14/226], 95% CI = 3-10). In AY 2013-2014, 23.5% (4/17) (95% CI = 7-50) of all new DHREM residents were URMs, compared with 5.9% (1/17) in AY 2011-2012 and 5.6% (1/18) in AY 2012-2013 (95% CI = 0-29 and 0-27, respectively). Additional studies are needed to determine whether these results are sustainable and generalizable to other residency programs in emergency medicine and other specialties.
Mace, K C; Holm, C E; Lipsky, M S; Bartscht, K G
On Match Day in 1991, Broadlawns Medical Center in Des Moines, Iowa, learned that no residents had matched for the family practice residency program. In the 1992 match, the medical center filled all its residency positions, and repeated the success in the 1993 and 1994 matches. Broadlawns affected this impressively rapid turnaround through a strong commitment to bring its program to a level competitive with leading family practice residency programs, substantive changes to the structure and curriculum of the program, and significant expenditures of time, resources and personal energy. The Broadlawns' case illustrates the need for family practice residency programs to position themselves as strong competitors in the residency market.
Assiri, Abdullah S; Al-Jarallah, Abdullah S; Al-Amari, Omar; Turnbull, Jeff
The aim of the study was to determine how Saudi medical trainees in Canada perceive their training programs with regards to educational, ethnic and socio-cultural issues, and if different factors such as the chosen field of training, place or level of training make any difference to this perception. All Saudi residents in training programs in Canada in the 1996/1997 academic year were surveyed using a written anonymous self-administered questionnaire, evaluating educational, ethnic and socio-cultural aspects of various training programs. The response rate was 72.5% (185/255). Most of the respondents were in the fourth year of training. Overall, the level of stress was rated as tolerable in 154 (83%), and 179 respondents (96.8%) described the educational aspects of their program positively. Furthermore, 154 (83%) of the respondents agreed that they were treated fairly in the distribution of job functions with regards to Canadian residents, and 133 (72%) did not face any major difficulty in practicing their religion. The sites of training, type of specialty and the level of training made significant impact on the perceived educational, social, religious and administrative aspects of training. The majority of Saudi medical trainees in Canada perceived the educational aspects of their training as a positive experience. Major problems faced were mainly related to administrative matters and to some extent, social adjustment. Issues that affect the training process need to be tackled by the concerned authorities to ensure the success of the training programs.
Grabovac, Andrea D; Ganesan, Soma
Mental health professionals are increasingly aware of the need to incorporate a patient's religious and spiritual beliefs into mental health assessments and treatment plans. Recent changes in assessment and treatment guidelines in the US have resulted in corresponding curricular changes, with at least 16 US psychiatric residency programs now offering formal training in religious and spiritual issues. We present a survey of training currently available to Canadian residents in psychiatry and propose a lecture series to enhance existing training. We surveyed all 16 psychiatry residency programs in Canada to determine the extent of currently available training in religion and spirituality as they pertain to psychiatry. We received responses from 14 programs. Of these, 4 had no formal training in this area. Another 4 had mandatory academic lectures dedicated to the interface of religion, spirituality, and psychiatry. Nine programs offered some degree of elective, case-based supervision. Currently, most Canadian programs offer minimal instruction on issues pertaining to the interface of religion, spirituality, and psychiatry. A lecture series focusing on religious and spiritual issues is needed to address this apparent gap in curricula across the country. Therefore, we propose a 10-session lecture series and outline its content. Including this lecture series in core curricula will introduce residents in psychiatry to religious and spiritual issues as they pertain to clinical practice.
Yamada, Kei; Slanetz, Priscilla J; Boiselle, Phillip M
It has been suggested that assigned mentoring relationships are less successful than those that develop by free choice. This study evaluates radiology residents' overall experience with a mentoring program and compares the responses of those who self-selected mentors with those who were assigned mentors. A voluntary Web-based survey was sent to 27 radiology residents in postgraduate years 3-5. Data collected included the following: year in residency, method of mentor assignment, duration of relationship, frequency and types of communication, perceived value of mentoring, overall satisfaction with the program, and the perceived impact of mentoring. Twenty-five of 27 residents (93%) responded, with 14 having self-selected mentors (56%) and 11 having assigned mentors (44%). Both groups unanimously agreed that mentoring is beneficial or critical to their training; however, those residents with self-selected mentors were significantly more satisfied with the mentoring program (4 vs 3.3; P = .04) and more likely to consider their mentor as their primary mentor compared with those with assigned mentors (11 [79%] vs 4 [36%]; P = .049). Although all residents perceived a benefit, residents with self-selected mentors rated almost all mentoring parameters more positively than those with assigned mentors, although most of these parameters did not reach statistical significance. Residents highly value the importance of mentoring. However, residents who self-select their mentors are more likely to be satisfied with a mentoring program. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.
Ketterer, Andrew R; Salzman, David H; Branzetti, Jeremy B; Gisondi, Michael A
Emergency medicine (EM) residency programs may be 36 or 48 months in length. The Residency Review Committee for EM requires that 48-month programs provide educational justification for the additional 12 months. We developed additional milestones that EM training programs might use to assess outcomes in domains that meet this accreditation requirement. This study aims to assess for content validity of these supplemental milestones using a similar methodology to that of the original EM Milestones validation study. A panel of EM program directors (PD) and content experts at two institutions identified domains of additional training not covered by the existing EM Milestones. This led to the development of six novel subcompetencies: "Operations and Administration," "Critical Care," "Leadership and Management," "Research," "Teaching and Learning," and "Career Development." Subject-matter experts at other 48-month EM residency programs refined the milestones for these subcompetencies. PDs of all 48-month EM programs were then asked to order the proposed milestones using the Dreyfus model of skill acquisition for each subcompetency. Data analysis mirrored that used in the original EM Milestones validation study, leading to the final version of our supplemental milestones. Twenty of 33 subjects (58.8%) completed the study. No subcompetency or individual milestone met deletion criteria. Of the 97 proposed milestones, 67 (69.1%) required no further editing and remained at the same level as proposed by the study authors. Thirty milestones underwent level changes: 15 (15.5%) were moved one level up and 13 (13.4%) were moved one level down. One milestone (1.0%) in "Leadership and Management" was moved two levels up, and one milestone in "Operations and Administration" was moved two levels down. One milestone in "Research" was ranked by the survey respondents at one level higher than that proposed by the authors; however, this milestone was kept at its original level assignment
Ketterer, Andrew R
Full Text Available Emergency medicine (EM residency programs may be 36 or 48 months in length. The Residency Review Committee for EM requires that 48-month programs provide educational justification for the additional 12 months. We developed additional milestones that EM training programs might use to assess outcomes in domains that meet this accreditation requirement. This study aims to assess for content validity of these supplemental milestones using a similar methodology to that of the original EM Milestones validation study. A panel of EM program directors (PD and content experts at two institutions identified domains of additional training not covered by the existing EM Milestones. This led to the development of six novel subcompetencies: “Operations and Administration,” “Critical Care,” “Leadership and Management,” “Research,” “Teaching and Learning,” and “Career Development.” Subject-matter experts at other 48-month EM residency programs refined the milestones for these subcompetencies. PDs of all 48-month EM programs were then asked to order the proposed milestones using the Dreyfus model of skill acquisition for each subcompetency. Data analysis mirrored that used in the original EM Milestones validation study, leading to the final version of our supplemental milestones. Twenty of 33 subjects (58.8% completed the study. No subcompetency or individual milestone met deletion criteria. Of the 97 proposed milestones, 67 (69.1% required no further editing and remained at the same level as proposed by the study authors. Thirty milestones underwent level changes: 15 (15.5% were moved one level up and 13 (13.4% were moved one level down. One milestone (1.0% in “Leadership and Management” was moved two levels up, and one milestone in “Operations and Administration” was moved two levels down. One milestone in “Research” was ranked by the survey respondents at one level higher than that proposed by the authors; however, this
Mann, Keith J; Craig, Mark S; Moses, James M
The Accreditation Council for Graduate Medical Education requires residents to learn quality improvement (QI) methods to analyze, change, and improve their practice. Little is known about how pediatric residency programs design, implement, and evaluate QI curricula to achieve this goal. We sought to describe current QI educational practices, evaluation methods, and program director perceptions through a national survey. A survey of QI curricula was developed, pilot tested, approved by the Association of Pediatric Program Directors (APPD), and distributed to pediatric program directors. Descriptive statistics were used to analyze the data. The response rate was 53% (104 of 197). Most respondents reported presence of a QI curriculum (85%, 88 of 104), including didactic sessions (83%) and resident QI projects (88%). Continuous process improvement was the most common methodology addressed (65%). The most frequent topics taught were "Making a Case for QI" (68%), "PDSA [plan-do-study-act] Cycles" (66%), and "Measurement in QI" (60%). Projects were most frequently designed to improve clinical care (90%), hospital operations (65%), and the residency (61%). Only 35% evaluated patient outcomes, and 17% had no formal evaluation. Programs had a mean of 6 faculty members (standard deviation 4.4, range 2-20) involved in teaching residents QI. Programs with more faculty involved were more likely to have had a resident submit an abstract to a professional meeting about their QI project (9, 92%; P = .003). Barriers to teaching QI included time (66%), funding constraints (39%), and absent local QI expertise (33%). Most PPDs (65%) believed that resident input in hospital QI was important, but only 24% reported resident involvement. Critical factors for success included an experiential component (56%) and faculty with QI expertise (50%). QI curricular practices vary greatly across pediatric residency programs. Although pediatric residency programs commit a fair number of resources to
Gorouhi, Farzam; Alikhan, Ali; Rezaei, Arash; Fazel, Nasim
Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. PMID:24772165
Mutz, Alyssa B; Beyer, Jacob; Dickson, Whitney L; Gutman, Irina; Yucebay, Filiz; Lepkowsky, Marcie; Chan, Juliana; Carter, Kristen; Shaffer, Christopher L; Fuller, Patrick D
Purpose: To evaluate current residents' level of preparation by US colleges of pharmacy for postgraduate year 1 (PGY1) residency training from the perspective of residency program directors (RPDs). Methods: RPDs were asked in an electronic survey questionnaire to rate PGY1 pharmacy residents' abilities in 4 domains: communication, clinical knowledge, interpersonal/time-management skills, and professionalism/leadership. Results: One hundred ninety-seven RPDs of the American Society of Health-System Pharmacists (ASHP)-accredited PGY1 programs completed the survey. The majority of RPDs strongly agreed or agreed that residents were prepared as students to effectively communicate both verbally and nonverbally, were able to appropriately respond to drug inquiries using drug resources and literature searches, and consistently displayed professionalism. Respondents were more likely to disagree or give a neutral response when asked about residents' understanding of biostatistics and their ability to provide enteral and parenteral nutritional support for patients. Conclusion: Overall, RPDs agreed that residents were prepared to perform the majority of the tasks of each of the 4 domains assessed in this survey relating to PGY1 training. RPDs may use the results of this survey to provide additional support for their residents in the areas in which residents lack adequate preparation, while colleges of pharmacy may focus on incorporating more time in their curriculum for certain areas to better prepare their students for residency training.
Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry ... World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association of Community Psychiatrists American Association ...
Full Text Available ... general psychiatry training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry ... More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association of Community Psychiatrists ...
Full Text Available ... may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine ... American Association of Community Psychiatrists American Association for Geriatric Psychiatry Academy of Psychosomatic Medicine American Academy of ...
Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E
To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Boykan, Rachel; Jacobson, Robert M
The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.
Coverdale, John; Roberts, Laura Weiss; Balon, Richard; Beresin, Eugene V
Because there are no formal reviews, the authors set out to identify and describe programs that serve female patients with major mental disorders by integrating mental health care with services in obstetrics and gynecology and to describe the pedagogical implications of those programs. The authors searched PubMed for all articles describing a program in which psychiatry was formally integrated with obstetric or gynecological services, other than standard consultation-liaison programs, in the care of patients with major mental disorders. The search terms used included interdisciplinary, interprofessional, integrated, collaborative care, psychiatry, and obstetrics-gynecology or psychosomatic obstetrics-gynecology. The authors found six distinct integrated programs. These included family planning clinics that were integrated into inpatient psychiatry services; inpatient and outpatient psychiatry services for pregnant mentally ill women in close collaboration with obstetric services; a day hospital for pregnant women with psychiatric disorders in an obstetric setting; an interdisciplinary training site providing care for predominantly depressed, low-income, and minority women; a primary care HIV service for women integrated with departments of obstetrics-gynecology and psychiatry; and an obstetrics-gynecology clinic-based collaborative depression care intervention for socially disadvantaged women. Residents' involvement was described in four of the programs. These innovative and integrated programs potentially enhance the care of vulnerable and culturally diverse women with major mental disorders. The authors discuss how these programs may contribute to the education of residents in psychiatry and obstetrics-gynecology.
Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie
Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright Â© 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Katherine A. Moreau
Full Text Available Background: Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose: To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods: We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results: Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1 critically evaluating research literature, 2 writing a research proposal, 3 submitting an application for research funding, and 4 writing a manuscript. Discussion: This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway.
... identity. RECORD SOURCE CATEGORIES: This system contains records on residents, mentors, teachers, and... Privacy Act of 1974; System of Records--Evaluation of Teacher Residency Programs AGENCY: Institute of...) publishes this notice of a new system of records entitled ``Evaluation of Teacher Residency Programs'' (18...
Garakani, Amir; Abdullah, Hussain M; Chang, Christine M; Mendelsohn, Nathaniel; Lapidus, Kyle A B
Benzodiazepines are widely prescribed for a variety of symptoms and illnesses. There has been limited investigation on the training psychiatry residents receive regarding benzodiazepine prescribing. This study surveyed US psychiatric trainees about their didactic and clinical experience with benzodiazepines, investigating how experience with benzodiazepines may shape trainees' opinions and likelihood to prescribe. The 14-question online survey was distributed to residents and fellows at US training programs through an invitation from their training directors. Of 466 programs contacted, with an estimated 1345 trainees, a total of 97 programs (20.8%) and 424 trainees (31.5%) responded. The analyses focused only on the 342 general psychiatry trainees who responded. Most trainees reported having formal didactics on benzodiazepines, and earlier training was correlated with higher trainee quality of instruction assessments (p general. The survey indicated that psychiatry trainees generally feel adequately trained through didactic and clinical experience with benzodiazepines. Trainees perceived pressure by patients to prescribe benzodiazepines, but generally felt comfortable in managing benzodiazepine usage. Psychiatry attendings' opinions on benzodiazepines most impacted trainees. Influences on trainees' prescribing patterns are important variables that can impact future benzodiazepine prescribing.
Full Text Available Objective Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents’ perspective on the current residency program in Israel and propose changes in it. Methods A web-based survey was distributed among urology residents. Results 61 residents completed the survey out of 95 to whom it was sent (64% compliance. A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training “hands-on.” Most non-junior residents (post-graduate year 3 and beyond reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship. Conclusion Given the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center, greater out-patient urology clinic exposure, and possible changes in the basic science
Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J
This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.
Bergl, Paul A; Narang, Akhil; Arora, Vineet M
Residency programs face many challenges in educating learners. The millennial generation's learning preferences also force us to reconsider how to reach physicians in training. Social media is emerging as a viable tool for advancing curricula in graduate medical education. The authors sought to understand how social media enhances a residency program's educational mission. While chief residents in the 2013-2014 academic year, two of the authors (PB, AN) maintained a Twitter feed for their academic internal medicine residency program. Participants included the chief residents and categorical internal medicine house staff. At the year's end, the authors surveyed residents about uses and attitudes toward this initiative. Residents generally found the chief residents' tweets informative, and most residents (42/61, 69%) agreed that Twitter enhanced their overall education in residency. Data from this single-site intervention corroborate that Twitter can strengthen a residency program's educational mission. The program's robust following on Twitter outside of the home program also suggests a need for wider adoption of social media in graduate medical education. Improved use of data analytics and dissemination of these practices to other programs would lend additional insight into social media's role in improving residents' educational experiences.
Jarrett, Jennie B; Sairenji, Tomoko; Klatt, Patricia M; Wilson, Stephen A
The impact of an interprofessional faculty development fellowship (FDF) on pharmacy graduates' careers is described. The FDF instructional approach is a longitudinal acquisition and application of knowledge, skills, and attitudes fostered by clinical care delivery, teaching experiences, structured reflection, the giving and receiving of feedback, research and scholarly projects, and leadership development and exercises. Interprofessional FDF fellows teach, learn, and provide care together in both inpatient and outpatient clinical settings as a part of the evidence-based medicine curriculum, providing educational sessions for medical students, pharmacy students, medical residents, attending family medicine physicians, and clinical pharmacy faculty throughout the year. Twenty-seven of the 30 pharmacist graduates of the fellowship (90% response rate) responded to an electronic survey about the influence of the FDF on their careers. Overall, pharmacy graduates were very satisfied with the fellowship. The fellowship fostered a clear pattern of continued, collaborative learning. While additional training beyond a pharmacy residency program is not necessary for a successful clinical career, 41% of graduates pursued additional training after completing the fellowship. Open-ended responses for motivations for completing the FDF and influences the FDF had on their careers fell unforced into the FDF curriculum domains, which reinforced the belief that these are the right areas to target for development. Pharmacy residents participated in a broad, interprofessional faculty development curriculum, which fostered teaching, scholarship, leadership, professional development, and clinical skills. Pharmacist graduates indicated that the experience significantly influenced their careers and professional development. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Isaak, Robert S; Chen, Fei; Arora, Harendra; Martinelli, Susan M; Zvara, David A; Stiegler, Marjorie P
Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, including faculty time, expertise, and funding, as are currently needed for structured oral examination (SOE) preparation. This survey analyzed the current state of US-based anesthesiology residency programs regarding simulation-based educational programming for SOE and OSCE preparation. An online survey was distributed to every anesthesiology residency program director in the United States. The survey included 15 to 46 questions, depending on each respondent's answers. The survey queried current practices and future plans regarding resident preparation specifically for the ABA APPLIED examination, with emphasis on the OSCE. Descriptive statistics were summarized. χ and Fisher exact tests were used to test the differences in proportions across groups. Spearman rank correlation was used to examine the association between ordinal variables. The responding 66 programs (49%) were a representative sample of all anesthesiology residencies (N = 136) in terms of geographical location (χ P = .58). There was a low response rate from small programs that have 12 or fewer clinical anesthesia residents. Ninety-one percent (95% confidence interval [CI], 84%-95%) of responders agreed that it is the responsibility of the program to specifically prepare residents for primary certification, and most agreed that it is important to practice SOEs (94%; 95% CI, 88%-97%) and OSCEs (89%; 95% CI, 83%-94%). While 100% of respondents reported providing mock SOEs, only 31% (95% CI, 24%-40%) of respondents provided mock OSCE experiences. Of those without an OSCE program, 75% (95% CI, 64%-83%) reported plans to start one. The most common reasons for not having an OSCE program already in place
Full Text Available ... of Community Psychiatrists American Association for Geriatric Psychiatry Academy of Psychosomatic Medicine American Academy of Addiction Psychiatry American Association for Emergency Psychiatry ...
Lin, Patrice S; Viscardi, Molly Kreider; McHugh, Matthew D
Nurse residency programs are designed to increase competence and skill, and ease the transition from student to new graduate nurse. These programs also offer the possibility to positively influence the job satisfaction of new graduate nurses, which could decrease poor nursing outcomes. However, little is known about the impact of participation in a nurse residency program on new graduate nurses' satisfaction. This review examines factors that influence job satisfaction of nurse residency program participants. Eleven studies were selected for inclusion, and seven domains influencing new graduate nurses' satisfaction during participation in nurse residency programs were identified: extrinsic rewards, scheduling, interactions and support, praise and recognition, professional opportunities, work environment, and hospital system. Within these domains, the evidence for improved satisfaction with nurse residency program participation was mixed. Further research is necessary to understand how nurse residency programs can be designed to improve satisfaction and increase positive nurse outcomes. Copyright 2014, SLACK Incorporated.
Day, Isaiah; Lin, Andrew
In the past few years, quality assurance has become an increasingly important part of medical education for both Canadian and American training programs. Since this emphasis on quality assurance in residency programs is recent, most faculty members involved in teaching residents in dermatology training programs would not themselves have had experience with quality assurance. As a result, satisfying this requirement may be a challenge. In this article, we review published reports in which various residency training programs have satisfied this requirement and propose projects in which dermatology residency training programs may satisfy quality assurance requirements. Using the key words residency, training, project, quality, assurance, improvement, medical errors, and safety, a literature search was conducted of English-language articles published after January 1990. There are many innovative and effective ways program directors in dermatology training programs should be able to develop projects that improve patient care, enhance resident education, and fulfill accreditation requirements.
Full Text Available Although ethics training is one of the core components of psychiatric education, it is not sufficiently addressed in the curricula of many educational institutions. It is shown that many of the psychiatry residents received no ethics training in both residency and medical school. Predictably, over half of the psychiatry residents had faced an ethical dilemma that they felt unprepared to meet, and nearly all of them indicated ethics education would have helped them to solve this dilemma. In addition to learning about the fundamental topics of ethics like confidentiality, boundary violations, justice, benefience and nonmaleficence, psychiatrists must also learn to deal with other hidden ethical dilemmas which are mostly due to the changing world order. It is obvious that residency training should include a well developed ethics curriculum. However, some still believe that ethical principles cannot be taught and are formed in one’s early moral development. Accepting the fact that teaching ethics is difficult, we believe that it is getting easier with the new methods for teaching in medicine. These methods are clinical supervisions, rol-models, case studies, role playing, small group discussions, team based learning and “let’s talking medicine” groups which is a useful methods for discussing ethics dilemmas on daily practice and C.A.R.E (Core Beliefs, Actions, Reasons, Experience which is a special training method for teaching ethics. In this review, the need of ethics training in residency curriculum will be discussed and new methods for teaching ethics will be proposed.
Paola BA Andreoli
Full Text Available OBJECTIVE: To investigate the relevance of subjective criteria adopted by a psychiatry and psychology consultation-liaison service, and their suitability in the evaluation of case registries and objective results. METHODS: Semi-structured interviews were conducted and all supervisors of the university hospital service were interviewed. Routinely collected case registries were also reviewed. Standardized assessment with content analysis for each category was carried out. RESULTS: The results showed distortions in the adopted service focus (doctor-patient relationship and consultant requests. This focus is more on consulting physician-oriented interventions than on patients. DISCUSSION: Evaluation of the relevance of service criteria could help promoting quality assessment of the services provided, mainly when objective criteria have not yet been established to assure their suitability.
Andreoli Paola BA
Full Text Available OBJECTIVE: To investigate the relevance of subjective criteria adopted by a psychiatry and psychology consultation-liaison service, and their suitability in the evaluation of case registries and objective results. METHODS: Semi-structured interviews were conducted and all supervisors of the university hospital service were interviewed. Routinely collected case registries were also reviewed. Standardized assessment with content analysis for each category was carried out. RESULTS: The results showed distortions in the adopted service focus (doctor-patient relationship and consultant requests. This focus is more on consulting physician-oriented interventions than on patients. DISCUSSION: Evaluation of the relevance of service criteria could help promoting quality assessment of the services provided, mainly when objective criteria have not yet been established to assure their suitability.
Margaret K Sande
Full Text Available Introduction: There is currently no standard forensic medicine training program for emergency medicine residents. In the advent of sexual assault nurse examiner (SANE programs aimed at improving the quality of care for sexual assault victims, it is also unclear how these programs impact emergency medicine (EM resident forensic medicine training. The purpose of this study was togather information on EM residency programs’ training in the care of sexual assault patients and determine what impact SANE programs may have on the experience of EM resident training from the perspective of residency program directors (PDs.Methods: This was a cross-sectional survey. The study cohort was all residency PDs from approved EM residency training programs who completed a closed-response self-administered survey electronically.Results: We sent surveys to 152 PDs, and 71 responded for an overall response rate of 47%. Twenty-two PDs (31% reported that their residency does not require procedural competency for the sexual assault exam, and 29 (41% reported their residents are required only to observe sexual assault exam completion to demonstrate competency. Residency PDs were asked how their programs established resident requirements for sexual assault exams. Thirty-seven PDs (52% did not know how their sexual assault exam requirement was established.Conclusion: More than half of residency PDs did not know how their sexual assault guidelines were established, and few were based upon recommendations from the literature. There is no clear consensus as to how PDs view the effect of SANE programs on resident competency with the sexual assault exam. This study highlights both a need for increased awareness of EM resident sexual assault education nationally and also a possible need for a training curriculum defining guidelines forEM residents performing sexual assault exams. [West J Emerg Med. 2013;14(5:461–466.
Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some ...
Full Text Available ... certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind ... has an advanced degree, most commonly in clinical psychology, and often has extensive training in research or ...
Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some psychiatrists choose additional training in psychoanalysis ...
Full Text Available ... seem to lift or problems functioning, causing everyday life to feel distorted or out of control. Diagnosing ... general psychiatry training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry ...
Full Text Available ... general psychiatry training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry ... maintain private practices and many psychiatrists work in multiple settings. There are about 45,000 psychiatrists in ...
Journal and Dental Education, 1979
The manual for the development of general practice residency programs in dentistry is designed to be used in three regional workshops to train individuals representing institutions who wish to develop such programs. The first of three major sections in the manual reviews the historical background of general practice residency programs. In the…
Vemulakonda, Vijaya M; Sorensen, Mathew D; Joyner, Byron D
The American population continues to increase in ethnic diversity. However, the medical work force has lagged behind these population trends. We evaluated the extent of diversity and perceived barriers to multicultural training in American urology programs. A 25-question nonvalidated diversity questionnaire was distributed electronically to 112 American urology residency program directors. A total of 62 program directors (55%) responded, representing all American Urological Association geographic regions nationwide. Of the respondents 92% were male and 90% were older than 40 years. During their residency 44% of respondents reported no female co-residents and 51% reported no co-residents of color. As faculty, 40% of respondents reported no female colleagues and 49% reported no colleagues of color. Of the respondents 75% identified no formal process to recruit faculty of color. With regard to current residency training 36% of respondents reported 1 or fewer female residents, 66% reported at least 1 black resident and 42% reported at least 1 Hispanic resident in their program. Of the respondents 75% stated that multicultural training is important for residents and 46% reported no barriers to multicultural training. However, 75% of program directors reported no formal multicultural program training. Most urology program directors trained with few minority or female co-residents. This paucity of diversity has continued with current faculty members. Residents are increasingly diverse but few urology residency programs have a formal curriculum or mentors to address diversity issues. Therefore, current residency training may not encourage diversity at academic centers or adequately prepare residents to serve an increasingly diverse patient population.
Luis, E Jaramillo G; Elena, Martín C
The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Hempstead, Laura K; Shaffer, Todd D; Williams, Karen B; Arnold, Lt Col James
Between 2015 and 2020, residency programs accredited through the American Osteopathic Association (AOA) are preparing the single graduate medical education (GME) system through the Accreditation Council for Graduate Medical Education (ACGME). (1) To assess the attitudes of family medicine program directors in programs accredited dually by the AOA and ACGME (AOA/ACGME) or ACGME only toward the clinical and academic preparedness of osteopathic residency candidates and (2) to determine program director attitudes toward the perceived value of osteopathic-focused education, including osteopathic manipulative treatment (OMT) curricula. A survey was sent to program directors of AOA/ACGME and ACGME-only accredited family medicine residency programs. Items concerned program directors' perception of the academic and clinical strength of osteopathic residents at the onset of residency, the presence of osteopathic faculty and residents currently in the program, and the presence of formal curricula for teaching OMT. The perceived value of osteopathic focus was obtained through a composite score of 5 items. A total of 38 AOA/ACGME family medicine residency program directors (17%) and 211 ACGME family medicine residency program directors (45.6%) completed the survey (N=249). No difference was found in the ranking of the perceived clinical preparation of osteopathic residents vs allopathic residents in programs with and without OMT curricula (P=.054). Directors of programs with OMT curricula perceived the academic preparation of their osteopathic residents vs allopathic residents more highly than those without OMT curricula (P=.039). Directors of AOA/ACGME programs perceived both the academic preparation and clinical preparation of their osteopathic residents more highly than those at ACGME-only programs (P=.004 and P=.002, respectively). Directors of AOA/ACGME programs, as well as those whose programs have an osteopathic focus in curricular offerings, were more likely to rank the
Menzin, Andrew W; Spitzer, Mark
To assess current efforts to teach operative dictation in obstetrics and gynecology residency programs. A survey detailing the didactics of operative dictation was distributed in a single mailing to all program directors listed in the roster of the Council on Residency Education in Obstetrics and Gynecology. Of 274 surveys distributed, 115 (42%) were returned. Ten percent of program directors reported defined curricula related to operative dictation. Using a combination of lectures, personal instruction and review of previous notes, attendings and senior residents share the responsibility for teaching operative dictation in the majority (78%) of programs. Sixty percent of program directors were in favor of more formal guidelines for residency education in the technique of operative dictation, 34% were opposed, and 6% offered no opinion. Obstetrics and gynecology residency programs rarely have a structured curriculum for teaching operative dictation, and the majority of program directors support the institution of more formal guidelines.
Singer, Jennifer S; Cheng, Eric M; Baldwin, Kevin; Pfeffer, Michael A
Few opportunities exist for physician trainees to gain exposure to, and training in, the field of clinical informatics, an Accreditation Council for Graduate Medical Education-accredited, recently board-certified specialty. Currently, 21 approved programs exist nationwide for the formal training of fellows interested in pursuing careers in this discipline. Residents and fellows training in medical and surgical fields, however, have few avenues available to gain experience in clinical informatics. An early introduction to clinical informatics brings an opportunity to generate interest for future career trajectories. At University of California Los Angeles (UCLA) Health, we have developed a novel, successful, and sustainable program, the Resident Informaticist Program, with the goals of exposing physician trainees to the field of clinical informatics and its academic nature and providing opportunities to expand the clinical informatics workforce. Herein, we provide an overview of the development, implementation, and current state of the UCLA Health Resident Informaticist Program, with a blueprint for development of similar programs. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Parikshit Madhav Gogate
Full Text Available Purpose: To know the perception of young ophthalmologists about their dissertation and academics during residency training in order to improve the research output during present residency programs in India. Methods: A survey was conducted by Academic and Research Committee of the All India Ophthalmological Society, the world's second largest ophthalmic professional's organization, in 2014–2016 of young ophthalmologists (those who completed residency between 2005 and 2012 to gauge usefulness of dissertation or thesis during postgraduate residency. Results: There were 1005 respondents, of whom 531 fulfilled inclusion criteria. On a scale of 0–10, residents rated level of supervision of their dissertation as adequate (mean 5.9/10, standard deviation [SD] = 3.1, median = 6. The level of infrastructure available was for dissertation rated as 5.9/10 (median = 7, SD = 3.1, and 6.2/10 was the score that residents said about value added by the dissertation (median = 7. The dissertation was presented at local (33.5%, state (28.1%, national (15.4%, and international (4% levels. Students, not supervisors, did most of the local and state level presentations. It was published in some forms at local 210 (39.5%, state (140, 26.4%, national (94, 17.7%, and international (39, 7.3% levels. On a scale of 0–4, seminars (3/4 and case presentations were (3/4 rated higher than didactic lectures (2.2/4, journal clubs (2.2/4, and wet laboratory (1.1/4. Conclusion: Peer-reviewed publications from Indian residency training dissertations were few. Residents felt dissertation added value to their training, but there was a huge range among the responses. Journal clubs and wet laboratories were not graded high in academic programs, unlike seminars and case presentations.
Shaw, Jon A.; Lewis, John E.; Katyal, Shalini
Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…
Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W
Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.
Goyal, Kavita; Nguyen, Michael O; Reynolds, Rachel V; Mostaghimi, Arash; Joyce, Cara; Cohen, Jeffrey M; Buzney, Elizabeth A
Phototherapy utilization has declined over the last 20 years despite its efficacy and cost-effectiveness. Adequacy of phototherapy training in residency may be a contributing factor. The purpose of this study was to evaluate perceptions of U.S. dermatology residency program directors (PDs) regarding the effectiveness of their programs' phototherapy training and what constitutes adequate phototherapy education. A questionnaire was sent to PDs to assess phototherapy training within their program; aspects such as dedicated time, exposure to different modalities, and barriers to resident education were surveyed. We assessed the statistical association between these aspects and the perception by PDs that a program's training was adequate. Statistical testing was reported using Fisher's exact tests. A total of 42 PDs responded. Residency training in oral psoralen and ultraviolet A therapy (PUVA), home phototherapy, and excimer laser, respectively, is not provided in 19.0%, 31.0%, and 47.6% of programs. 38.1% of programs provide ≤5 hours of phototherapy training over 3 years of training. 59.5% of PDs cited lack of curriculum time as the most common barrier to phototherapy education. 19.0% of PDs reported completely adequate phototherapy training, which was significantly associated with inclusion of faculty-led didactics, assigned reading, or hands-on clinical training in the curriculum. There is a mismatch between the resources devoted to phototherapy education and the need for dedicated training reported by PDs. Limited time is allocated to phototherapy training during dermatology residency, and a large majority of PDs do not feel that the phototherapy training offered is completely adequate. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Toffoli, Sônia Ferreira Lopes; Ferreira Filho, Olavo Franco; Andrade, Dalton Francisco de
This paper proposes the unification of entrance exams to medical residency programs (MRP) in Brazil. Problems related to MRP and its interface with public health problems in Brazil are highlighted and how this proposal are able to help solving these problems. The proposal is to create a database to be applied in MRP unified exams. Some advantages of using the Item Response Theory (IRT) in this database are highlighted. The MRP entrance exams are developed and applied decentralized where each school is responsible for its examination. These exams quality are questionable. Reviews about items quality, validity and reliability of appliances are not common disclosed. Evaluation is important in every education system bringing on required changes and control of teaching and learning. The proposal of MRP entrance exams unification, besides offering high quality exams to institutions participants, could be as an extra source to rate medical school and cause improvements, provide studies with a database and allow a regional mobility. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.
Jarrett, Jennie B; Lounsbery, Jody L; D'Amico, Frank; Dickerson, Lori M; Franko, John; Nagle, John; Seehusen, Dean A; Wilson, Stephen A
The clinical pharmacist's role within family medicine residency programs (FMRPs) is well established. However, there is limited information regarding perceptions of program directors (PDs) about clinical pharmacy educators. The study objectives were (1) to estimate the prevalence of clinical pharmacists within FMRPs and (2) to determine barriers and motivations for incorporation of clinical pharmacists as educators. The Council of Academic Family Medicine Educational Research Alliance (CERA) distributed an electronic survey to PDs. Questions addressed formalized pharmacotherapy education, clinical pharmacists in educator roles, and barriers and benefits of clinical pharmacists in FMRPs. The overall response rate was 50% (224/451). Seventy-six percent (170/224) of the responding PDs reported that clinical pharmacists provide pharmacotherapy education in their FMRPs, and 57% (97/170) consider clinical pharmacists as faculty members. In programs with clinical pharmacists, 72% (83/116) of PDs reported having a systematic approach for teaching pharmacotherapy versus 22% (21/95) in programs without. In programs without clinical pharmacists, the top barrier to incorporation was limited ability to bill for clinical services 48% (43/89) versus 29% (32/112) in programs with clinical pharmacists. In both programs with and without clinical pharmacists, the top benefit of having clinical pharmacists was providing a collaborative approach to pharmacotherapy education for residents (35% and 36%, respectively). Less than half of FMRPs incorporate clinical pharmacists as faculty members. Despite providing collaborative approaches to pharmacotherapy education, their limited ability to bill for services is a major barrier.
Brahmi, Dalia; Dehlendorf, Christine; Engel, David; Grumbach, Kevin; Joffe, Carole; Gold, Marji
Access to abortion services in the United States is declining. While family physicians are well suited to provide this care, limited training in abortion occurs in family medicine residency programs. This study was designed to describe the structure of currently available training and the experience of residents participating in these programs. E-mail questionnaires were sent to key faculty members and third-year residents in nine programs that have required abortion training. These faculty members and a sample of residents also completed semi-structured interviews. Residency programs varied in the amount of time dedicated to the procedural aspects of abortion training, ranging from 2 to 8 days, and also in non-procedural aspects of training such as values clarification and didactics. Themes that emerged from interviews with residents included the benefit of training with respect to technical skills and continuity of care. In addition, residents valued discussion of the emotional aspects of abortion care and issues relating to performing abortions after graduation from residency. While the details of the curricula vary, residents in programs with required abortion training generally felt positively about their experiences and felt that abortion was an appropriate procedure for family physicians to provide. Residents emphasized the importance of both non-procedural and technical aspects of training.
Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F
The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Zeblisky, Kathy; Birr, Rebecca A; Sjursen Guerrero, Anne Marie
Librarians for the joint Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program were asked to assist on the Evidence-Based Medicine (EBM) Subcommittee for the program. Faculty was open to recommendations for revising and improving the curriculum and desired librarian assistance in completing the task. The annual program review and conference evaluations revealed a gap between the objectives of the EBM curriculum and the residents' perceived abilities to integrate knowledge into meaningful literature searches. This column demonstrates how librarians can collaborate with their residency programs to revise and improve processes to effect change in their program's EBM curriculum.
Cassidy, Robert E.
The currently used internal and external program evaluation processes for general practice residency and advanced education in general dentistry programs are discussed, noting accrediting and evaluation groups, criteria, and designs. A generalized evaluation plan is proposed. (MSE)
Wiese, Jeffrey G
A disaster such as Hurricane Katrina can result in extensive devastation to graduate medical education programs. While clinical services largely determine the recovery of each residency program, program director leadership is important. A qualitative survey of program directors was conducted to determine the leadership lessons most instrumental after a disaster. Gaining control, establishing communication, designing a vision for the recovery, maintaining physical accessibility, and identifying leaders within the program were identified as critical leadership attributes associated with a residency program's recovery. Understanding the logistics and finances of resident placement was also important. Preparing for a disaster is the best approach, but where a disaster policy is incomplete or inadequate, it will be the leadership skills of the program's director that will define the success of failure of the residency program.
Miloslavsky, Eli M; Sargsyan, Zaven; Heath, Janae K; Kohn, Rachel; Alba, George A; Gordon, James A; Currier, Paul F
Residency training is charged with improving resident teaching skills. Utilizing simulation in teacher training has unique advantages such as providing a controlled learning environment and opportunities for deliberate practice. We assessed the impact of a simulation-based resident-as-teacher (RaT) program. A RaT program was embedded in an existing 8-case simulation curriculum for 52 internal medicine (IM) interns. Residents participated in a workshop, then served as facilitators in the curriculum and received feedback from faculty. Residents' teaching and feed back skills were measured using a pre- and post-program self-assessment and post-session and post-curriculum evaluations by intern learners. Forty-one second- and third-year residents participated in the study August 2013 to October 2013 at a single center. Pre- and post-program teaching skills were assessed for 34 of 41 resident facilitators (83%) participating in 3.9 sessions on average. Partaking in the program led to improvements in resident facilitators' self-reported teaching and feedback skills across all domains. The most significant improvement was in teaching in a simulated environment (2.81 to 4.16, P model for the development of simulation curricula and RaT programs within IM residencies. © 2015 Society of Hospital Medicine.
Schwartz, Joseph S; Young, Meredith; Velly, Ana M; Nguyen, Lily H P
To examine the evolution of racial, ethnic, and gender diversity in US otolaryngology-head and neck surgery residency programs and compare these figures with other residency programs. Retrospective database review. US residency programs. Information concerning minority and female representation in US residency programs was obtained from annually published graduate medical education reports by the Journal of the American Medical Association from 1975 to 2010. Minority representation among US population and university students was obtained from the US Census Bureau. The racial, ethnic, and gender diversity of otolaryngology residents was then compared with other medical fields (general surgery, family medicine, and internal medicine). Underrepresentation in otolaryngology-head and neck surgery is particularly disconcerting for African Americans (-2.3%/y, P = .09) and Native Americans (1.5%/y, P = .11) given their nonsignificant annual growth rates. Hispanic representation (17.3%/y, P otolaryngology but is half the rate of growth of the Hispanic American population (32.8%/y, P otolaryngology residents. Despite increasing gender, ethnic, and racial diversity among medical residents in general, female and certain minority group representation in US otolaryngology residency programs is lagging. These findings are in contrast to rising trends of diversity within other residency programs including general surgery.
Eichholz, Amy C; Van Voorhis, Bradley J; Sorosky, Joel I; Smith, Brian J; Sood, Anil K
To determine the extent of formal education regarding operative dictation in U.S. Obstetrics and Gynecology residency programs and to prospectively evaluate the effectiveness of formal teaching regarding operative dictation. A 1-page questionnaire was mailed to all U.S. Obstetrics and Gynecology residency program directors (n = 270). The operative dictations of all Obstetrics and Gynecology residents at the University of Iowa before and after a 30-minute formal teaching session were evaluated using a scoring system developed by the authors of this study (scale 0-20). A 73% response rate (n = 198) was obtained from the surveys. The results from the survey demonstrated that only 23% of programs provide formal teaching regarding operative dictations; however, 83% of the residency program directors felt that it is an important skill to teach. All 16 obstetrics and gynecology residents at the University of Iowa attended a 30-minute teaching session on operative dictation. The mean scores for all residents improved from 9.06 to 18.56 after a formal teaching session (P dictation is uncommon in U.S. residency programs but felt to be important by most residency program directors. A brief teaching session is effective and may be useful during residency training. II-3
Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J
Nurse residency programs have been adopted by health care organizations to assist new graduate nurses with daily challenges such as intense working environments, increasing patient acuity, and complex technologies. Overall, nurse residency programs are proven beneficial in helping nurses transition from the student role to independent practitioners and bedside leaders. The purpose of this study was to assess the impact of residency programs on leadership skills of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. The study design was cross-sectional involving a convenience sample (n = 98) of new graduate nurses from three hospitals in Saudi Arabia. The Clinical Leadership Survey was used to measure the new graduate nurses' clinical leadership skills based on whether they completed a residency program or not. Descriptive statistics, correlation, and multiple linear regression analyses were conducted to examine leadership skills in this sample of new Saudi graduate nurses. A significant difference was found between residents and nonresidents in their leadership skills (t = 10.48, P = .000). Specifically, residents were significantly more likely to show higher levels of leadership skills compared to their counterparts. Attending a residency program was associated with a significant increase in clinical leadership skills. The findings of this study indicate that there is a need to implement more residency programs in hospitals of Saudi Arabia. It is imperative that nurse managers and policy makers in Saudi Arabia consider these findings to improve nurses' leadership skills, which will in turn improve patient care. Further research should examine how residency programs influence new graduate nurses' transition from student to practitioner with regard to clinical leadership skills in Saudi Arabia. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available The structure of the interview day affects applicant interactions with faculty and residents, which can influence the applicant’s rank list decision. We aimed to determine if there was a difference in matched residents between those interviewing on a day on which didactics were held and had increased resident and faculty presence (didactic day versus an interview day with less availability for applicant interactions with residents and faculty (non-didactic day. This was a retrospective study reviewing interview dates of matched residents from 2009-2015. Forty-two (61.8% matched residents interviewed on a didactic day with increased faculty and resident presence versus 26 (38.2% on a non-didactic interview day with less availability for applicant interactions (p = 0.04. There is an association between interviewing on a didactic day with increased faculty and resident presence and matching in our program.
Carek, Peter J; Anim, Tanya; Conry, Colleen; Cullison, Sam; Kozakowski, Stan; Ostergaard, Dan; Potts, Stacy; Pugno, Perry A
Residency programs have been integral to the development, expansion and progression of family medicine as a discipline. Three reports formed the foundation for graduate medical education in family medicine: Meeting the Challenge of Family Practice, The Graduate Education of Physicians, and Health is a Community Affair. In addition, the original core concepts of comprehensiveness, coordination, continuity, and patient centeredness continue to serve as the foundation for residency training in family medicine. While the Residency Review Committee for Family Medicine of the Accreditation Council for Graduate Medical Education has provided the requirements for training throughout the years, key organizations including the Society of Teachers of Family Medicine, the American Academy of Family Physicians, the Association of Family Medicine Residency Directors, and the American Board of Family Medicine have provided resources for and supported innovation in programs. Residency Program Solutions, National Institute for Program Director Development, and Family Medicine Residency Curriculum Resource are several of the resources developed by these organizations. The future of family medicine residency training should continue the emphasis on innovation and development of resources to enhance the training of residents. Areas for further development include leadership and health care systems training that allows residents to assume leadership of multidisciplinary health care teams and increase focus on the family medicine practice population as the main unit for resident education.
Williams, Laurel Lyn
Objective: This article explores the relevant data regarding teaching psychiatric residents practice management knowledge and skills. This article also introduces a unique program for teaching practice management to residents. Methods: A literature search was conducted through PubMed and "Academic Psychiatry". Additionally residents…
Phillips, Holly; Jasiak, Karalea D; Lindberg, Lance S; Ryzner, Kristi L
The training components and other characteristics of postgraduate year 1 (PGY1) pharmacy residency programs at a sample of academic medical centers were evaluated. A questionnaire was sent via e-mail to the directors of 98 PGY1 residency programs at academic medical centers in the University HealthSystem Consortium (UHC) to elicit benchmarking data on issues such as recruitment, learning experiences, resident staffing requirements, resident research projects and professional presentations, opportunities for resident participation in teaching activities, and requirements for faculty service as preceptors; 72 program directors responded to the survey. The residency programs represented in the survey reported an average of approximately 14 applicants for each available position in 2010 and an average of about five candidate interviews per available position. The survey results indicated wide variation in the learning experiences offered by PGY1 programs (the most commonly reported rotations were in administration, critical care, internal medicine, ambulatory care, and drug information), with a high degree of individualization of elective rotations. Almost all programs had a mandatory staffing component, typically requiring 4-10 hours of service weekly. Results of this survey indicate that there is a large amount of variation in the components of PGY1 pharmacy residency programs among UHC academic medical centers. The majority of respondents reported no change in the number of residency positions offered within the past two years, but they reported an increase in the number of applications from 2009 to 2010.
Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B
The development, implementation, and evaluation of a writing program with a formalized writing project as a component of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residencies are described. The writing program at Georgia Regents Medical Center/University of Georgia College of Pharmacy, a collaborative and jointly funded program, was initiated in the 2010-11 residency year. The goals of the program are to teach residents to communicate effectively, apply leadership skills, employ project management skills, and provide medication- and practice- related education and training. The program combines both writing experiences and mentorship. At the beginning of the residency year, trainees are presented with opportunities to participate in both research projects and writing projects. Specifically, opportunities within the writing program include involvement in review articles, case reports, drug information rounds, book chapters, letters to the editor, and high-quality medication-use evaluations for potential publication. The writing project is highly encouraged, and completion of a manuscript to be submitted for publication is expected by graduation. Nine papers were published by 8 of 18 PGY1 and PGY2 residents in the four years before program implementation. A total of 23 publications were published by 18 (72%) of the 25 PGY1 and PGY2 residents in the four years after implementation of the writing program. Implementation of a formal writing program increased the overall publication rate of residents. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Adams, Jennifer; Chacko, Karen; Guiton, Gretchen; Aagaard, Eva
The care of patients with HIV is increasingly focused on outpatient chronic disease management. It is not known to what extent internal medicine residents in the US are currently being trained in or encouraged to provide primary care for this population of patients. To survey internal medicine residency program directors about their attitudes regarding training in outpatient HIV care and current program practices. Program directors were surveyed first by email. Non-responding programs were mailed up to two copies of the survey. All internal medicine residency program directors in the US. Program director attitudes and residency descriptions. Of the 372 program directors surveyed, 230 responded (61.8 %). Forty-two percent of program directors agreed that it is important to train residents to be primary care providers for patients with HIV. Teaching outpatient-based HIV curricula was a priority for 45.1%, and 56.5% reported that exposing residents to outpatient HIV clinical care was a high priority. Only 46.5% of programs offer a dedicated rotation in outpatient HIV care, and 50.5% of programs have curricula in place to teach about outpatient HIV care. Only 18.8% of program directors believed their graduates had the skills to be primary providers for patients with HIV, and 70.6% reported that residents interested in providing care for patients with HIV pursued ID fellowships. The strongest reasons cited for limited HIV training during residency were beliefs that patients with HIV prefer to be seen and receive better care in ID clinics compared to general medicine clinics. With a looming HIV workforce shortage, we believe that internal medicine programs should create educational experiences that will provide their residents with the skills and knowledge necessary to meet the healthcare needs of this population.
Lombarts, Kiki M. J. M. H.; Heineman, Maas Jan; Scherpbier, Albert J. J. A.; Arah, Onyebuchi A.
To understand teaching performance of individual faculty, the climate in which residents' learning takes place, the learning climate, may be important. There is emerging evidence that specific climates do predict specific outcomes. Until now, the effect of learning climate on the performance of the
Wang, Xiao-Jing; Krystal, John H.
Psychiatric disorders such as autism and schizophrenia arise from abnormalities in brain systems that underlie cognitive, emotional and social functions. The brain is enormously complex and its abundant feedback loops on multiple scales preclude intuitive explication of circuit functions. In close interplay with experiments, theory and computational modeling are essential for understanding how, precisely, neural circuits generate flexible behaviors and their impairments give rise to psychiatric symptoms. This Perspective highlights recent progress in applying computational neuroscience to the study of mental disorders. We outline basic approaches, including identification of core deficits that cut across disease categories, biologically-realistic modeling bridging cellular and synaptic mechanisms with behavior, model-aided diagnosis. The need for new research strategies in psychiatry is urgent. Computational psychiatry potentially provides powerful tools for elucidating pathophysiology that may inform both diagnosis and treatment. To achieve this promise will require investment in cross-disciplinary training and research in this nascent field. PMID:25442941
Reiser, L W; Sledge, W H; Fenton, W; Leaf, P
The proportion of women in leadership positions in academic psychiatry has not kept pace with the increase in the number of women entering the field. This study examines differences in career activities between women and men who graduated from the Yale University psychiatric residency training program and explores whether these differences can be explained by preresidency expectations, residency experiences, or training immediately after residency. Departmental educational records of the Yale residency program were reviewed to determine professional interests expressed before psychiatric residency and training focus during residency for 355 residents in the 1970-1983 graduating classes. A 1984 follow-up study focused on their postresidency career activities. Differences in preresidency interests and experiences, training activities, and career paths between all female and male graduates and between women and men who chose academic careers were examined. After residency, the female graduates' marital status differed from men's--more had never married or were divorced. Women's professional activities diverged from men's; their practice pattern was different, they spent more hours teaching, and they had fewer publications in peer-reviewed journals. This divergence was not accounted for by differences in pretraining interests or in training focus during residency. The authors present possible explanations. Further research is indicated to determine the underlying causes of career differences between women and men in psychiatric practice and academia so that effective strategies for correcting the present inequality of women in senior faculty positions can be implemented.
Lacasse, Miriam; Ratnapalan, Savithiri
To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs' effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are
Adamson, Gregory T.; Draper, Lauren R.; Broom, Matthew A.
Background There is an ongoing effort to maximize educational material provided to residents who are in a time-constrained work environment. Mobile technology, principally smartphone applications and online modules, has shown educational promise. Intervention We developed a text-messaging program, Text4Peds, to assist residents with preparation for their pediatric board examinations. Goals were to assess (1) the feasibility of texting educational messages to residents, and (2) resident satisfaction and perceived usefulness of a texting program. Methods We conducted a prospective study of pediatrics and combined internal medicine-pediatrics residents. Messages derived from the most missed pediatric in-training examination questions were sent daily to residents. After 3 months, residents completed surveys that gauged their perception on the educational value of the text messages and the effect on their pediatric board preparation. Feasibility of the system was assessed as a total percentage of messages successfully received by residents. Results Of 55 residents, 35 (64%) participated in the program. Of 2534 messages sent out to participants, 2437 (96.2%) were delivered successfully. Positive comments cited the texting of board facts as a quick, helpful, daily study tool. Residents liked that messages were sent at 2:00 pm, and most felt that 1 to 5 messages per week was appropriate. Drawbacks included character restrictions of messages, content limitations, and the lack of a question-answer format. Conclusions An educational text message–based program was successfully implemented in our residency program. Messages were delivered with a high success rate, and residents found educational value in the messages. PMID:26140130
Lehmann, Susan W; Blazek, Mary C; Popeo, Dennis M
The aging of the US population and shortage of geriatric psychiatrists mean that all medical students must be prepared to evaluate psychiatric symptoms in older patients. The authors sought to describe current geriatric psychiatry teaching practices during the psychiatry clerkship. Psychiatry clerkship directors at 110 American medical schools were surveyed about didactic and clinical experiences of geriatric psychiatry. Sixty-two (56 %) of programs responded. One fifth of programs lacked specific instruction in geriatric psychiatry. Programs were more likely to include instruction on dementia than late-life depression. Increased geriatric psychiatry educational offerings were associated with the following: number of geriatric psychiatrists on faculty, presence of a geriatric psychiatrist on the medical education committee, and inclusion of geriatric psychiatry specific items in clerkship learning objectives. Current practices in some clerkships are inadequate to prepare medical students to care for older patients with psychiatric symptoms.
Britton, Kristina M; Stratman, Erik J
JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.
Gunay, Ilker; Agin, Hasan; Devrim, Ilker; Apa, Hursit; Tezel, Basak; Ozbas, Sema
The Neonatal Resuscitation Program (NRP) is an effective tool in decreasing mortality and morbidity due to birth asphyxia. The aim of the study was to assess the skill and knowledge level of pediatric residents in a teaching hospital and the effects of NRP training. Subjects consisted of pediatric residents of Dr Behcet Uz Hospital, Izmir, Turkey. They were assessed on practice exam scenarios and NRP provider course flow charts. Teams with two members were formed randomly. Each resident was evaluated on a 100 point scale covering all resuscitation steps and interventions. Exam scores were analyzed for two major parameters: resident participation in NRP training (never, within the last 6 months, and ≥6 months previously) and being a senior (>18 months residency). A total of 49 residents enrolled in the study (94.2% of the target group). Twenty-one residents had NRP training (42.9%). Junior residents comprised 46.9% of the study group. The mean skill score was 72.1, and it was significantly higher for senior residents and residents who attended the NRP course (P training significantly increases the resuscitation knowledge and skill of pediatric residents, although this can be achieved by being a senior. Residents should undergo training as soon as possible to achieve a higher level of quality in resuscitating babies. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.
Thombs, Dennis L.; Gonzalez, Jennifer M. Reingle; Osborn, Cynthia J.; Rossheim, Matthew E.; Suzuki, Sumihiro
In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training...
Das, Indra J; Moskvin, Vadim
The aim of this study was to compare the quality of medical physics education for radiation oncology medical residents. An independent survey regarding physics education was carried out using e-mail. The survey contained 12 questions addressing the duration, length, and quality of education. Responses were tabulated and compared with the recommended educational scheme. Nearly 56% of institutions participated in this survey. Educational patterns were found to be significantly variable among institutions. Some have minimum physics education (10 lectures), and some have 90 lectures per year. In general, two-thirds of the institutions require residents to attend classes up to the third year. Significant variability of physics education for radiation oncology medical residents was observed, contrary to the national recommendations. With advanced treatment techniques, physics education should be given more importance, and the number of lectures should be increased to accommodate every aspect of radiation oncology practice. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Ju, Melody [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Berman, Abigail T. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); LaMarra, Denise [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Baffic, Cordelia; Suneja, Gita [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vapiwala, Neha, E-mail: Neha.Vapiwala@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
Purpose: There is a lack of data for the structured development and evaluation of communication skills in radiation oncology residency training programs. Effective communication skills are increasingly emphasized by the Accreditation Council for Graduate Medical Education and are critical for a successful clinical practice. We present the design of a novel, pilot standardized patient (SP) program and the evaluation of communication skills among radiation oncology residents. Methods and Materials: Two case scenarios were developed to challenge residents in the delivery of “bad news” to patients: one scenario regarding treatment failure and the other regarding change in treatment plan. Eleven radiation oncology residents paired with 6 faculty participated in this pilot program. Each encounter was scored by the SPs, observing faculty, and residents themselves based on the Kalamazoo guidelines. Results: Overall resident performance ratings were “good” to “excellent,” with faculty assigning statistically significant higher scores and residents assigning lower scores. We found inconsistent inter rater agreement among faculty, residents, and SPs. SP feedback was also valuable in identifying areas of improvement, including more collaborative decision making and less use of medical jargon. Conclusions: The program was well received by residents and faculty and regarded as a valuable educational experience that could be used as an annual feedback tool. Poor inter rater agreement suggests a need for residents and faculty physicians to better calibrate their evaluations to true patient perceptions. High scores from faculty members substantiate the concern that resident evaluations are generally positive and nondiscriminating. Faculty should be encouraged to provide honest and critical feedback to hone residents' interpersonal skills.
Ju, Melody; Berman, Abigail T; Hwang, Wei-Ting; Lamarra, Denise; Baffic, Cordelia; Suneja, Gita; Vapiwala, Neha
There is a lack of data for the structured development and evaluation of communication skills in radiation oncology residency training programs. Effective communication skills are increasingly emphasized by the Accreditation Council for Graduate Medical Education and are critical for a successful clinical practice. We present the design of a novel, pilot standardized patient (SP) program and the evaluation of communication skills among radiation oncology residents. Two case scenarios were developed to challenge residents in the delivery of "bad news" to patients: one scenario regarding treatment failure and the other regarding change in treatment plan. Eleven radiation oncology residents paired with 6 faculty participated in this pilot program. Each encounter was scored by the SPs, observing faculty, and residents themselves based on the Kalamazoo guidelines. Overall resident performance ratings were "good" to "excellent," with faculty assigning statistically significant higher scores and residents assigning lower scores. We found inconsistent inter rater agreement among faculty, residents, and SPs. SP feedback was also valuable in identifying areas of improvement, including more collaborative decision making and less use of medical jargon. The program was well received by residents and faculty and regarded as a valuable educational experience that could be used as an annual feedback tool. Poor inter rater agreement suggests a need for residents and faculty physicians to better calibrate their evaluations to true patient perceptions. High scores from faculty members substantiate the concern that resident evaluations are generally positive and nondiscriminating. Faculty should be encouraged to provide honest and critical feedback to hone residents' interpersonal skills. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Rachel E Zigler,1 Jeffrey F Peipert,1,2 Qiuhong Zhao,1 Ragini Maddipati,1 Colleen McNicholas1 1Department of Obstetrics and Gynecology, Division of Clinical Research and Family Planning, Washington University School of Medicine in St. Louis, St. Louis, MO, 2Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA Background: The objective of the study was to estimate the personal usage of long-acting reversible contraception (LARC among obstetrics and gynecology (Ob/Gyn residents in the United States and compare usage between programs with and without a Ryan Residency Training Program (Ryan Program, an educational program implemented to enhance resident training in family planning. Materials and methods: We performed a web-based, cross-sectional survey to explore contraceptive use among Ob/Gyn residents between November and December 2014. Thirty-two Ob/Gyn programs were invited to participate, and 24 programs (75% agreed to participate. We divided respondents into two groups based on whether or not their program had a Ryan Program. We excluded male residents without a current female partner as well as residents who were currently pregnant or trying to conceive. We evaluated predictors of LARC use using bivariate analysis and multivariable Poisson regression. Results: Of the 638 residents surveyed, 384 (60.2% responded to our survey and 351 were eligible for analysis. Of those analyzed, 49.3% (95% confidence interval [CI]: 44.1%, 54.5% reported current LARC use: 70.0% of residents in Ryan Programs compared to 26.8% in non-Ryan Programs (RRadj 2.14, 95% CI 1.63–2.80. Residents reporting a religious affiliation were less likely to use LARC than those who described themselves as non-religious (RRadj 0.76, 95% CI 0.64–0.92. Of residents reporting LARC use, 91% were using the levonorgestrel intrauterine device. Conclusion: LARC use in this population of women’s health specialists is substantially
Full Text Available ... Depression Posttraumatic Stress Disorder (PTSD) More What Is Psychiatry? Back to Patients & Families All Topics What Is Psychiatry? Psychiatry is the branch of medicine focused on ...
Roberts, Gregory; Whelan, Paul; Kapoor, Anil
It is difficult to determine the effect of a residency program on the life of staff urologists. The objective of this study was to obtain subjective reports from urologists who have practiced before and after the implementation of a training program on how it affects their careers in 5 spheres: education, job-stress, free time, financial life and subjective quality of life. We asked urologists from McMaster University to complete a questionnaire to quantify how their current experiences have changed compared to the pre-residency program era on a balanced 7-point scale (4 = neutral). The response rate was 100% (9/9). Eight of the 9 urologists (89%) reported they would implement the program again if they could rewind the clock. Eight of 9 reported their overall career-related quality of life improved, with an average rating of 5.1 on the 7-point scale. The quality of continuing education was the most positive ranking at 5.4 followed by job stress at 5.2. The outcomes measured below 4 (neutral) were earning potential at 3.8 and ability to engage in pastimes at 3.4. Earning potential was clustered tightly around neutral, with 7 of the 9 respondents reporting no change. The largest standard deviation, corresponding to the most disagreement, was in their ability to engage in pastimes. Even with a mild decrease in earning potential and increased job stress, McMaster urologists feel their quality of life and continuing education have improved since the program's implementation; these urologists are almost uniformly happy they started a residency teaching program at their centre.
De Lange, G.; Rademaker, M.; Boks, Marco P M; Palmen, Saskia J M C
BACKGROUND: Human brain tissue is crucial to study the molecular and cellular basis of psychiatric disorders. However, the current availability of human brain tissue is inadequate. Therefore, the Netherlands Brain Bank initiated a program in which almost 4.000 participants of 15 large Dutch
de Lange, Geertje M.; Rademaker, Marleen; Boks, Marco P.; Palmen, Saskia J.M.C.
Background: Human brain tissue is crucial to study the molecular and cellular basis of psychiatric disorders. However, the current availability of human brain tissue is inadequate. Therefore, the Netherlands Brain Bank initiated a program in which almost 4.000 participants of 15 large Dutch
Young, Timothy P; Bailey, Caleb J; Guptill, Mindi; Thorp, Andrea W; Thomas, Tamara L
A "flipped classroom" educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. We evaluated residents' impression of the asynchronous video component and synchronous classroom component using four Likert items. We used open-ended questions to inquire about resident and faculty impressions of the advantages and disadvantages of the format. For the Likert items evaluating the video lectures, 33/35 residents (94%, 95% CI 80%-99%) responded that the video lecture added to their knowledge about the topic, and 33/35 residents felt that watching the video was a valuable use of their time. For items evaluating the flipped classroom format, 36/38 residents (95%, 95% CI 82%-99%) preferred the format to a traditional lecture on the topic, and 38/38 residents (100%, 95% CI 89%-100%) felt that the small group session was effective in helping them learn about the topic. Most residents preferred to see the format monthly in our curriculum and chose an ideal group size of 5.5 (first session) and 7 (second session). Residents cited the interactivity of the sessions and access to experts as advantages of the format. Faculty felt the ability to assess residents' understanding of concepts and provide feedback were advantages. Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents.
Aggarwal, Sonya [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Kusano, Aaron S. [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Carter, Justin Nathaniel; Gable, Laura [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Thomas, Charles R. [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Sciences University, Portland, Oregon (United States); Chang, Daniel T., E-mail: email@example.com [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States)
Purpose: To evaluate stressors among radiation oncology residency program directors (PDs) and determine the prevalence and indicators of burnout. Methods and Materials: An anonymous, online, cross-sectional survey was offered to PDs of US radiation oncology programs in the fall of 2014. Survey content examined individual and program demographics, perceptions surrounding the role of PD, and commonly encountered stressors. Burnout was assessed using the validated Maslach Burnout Inventory-Human Services Survey. Results: In total, 47 of 88 PDs (53%) responded to the survey. Although 78% of respondents reported feeling “satisfied” or “highly satisfied” with their current role, 85% planned to remain as PD for <5 years. The most commonly cited stressors were satisfying Accreditation Council for Graduate Medical Education/Residency Review Committee requirements (47%), administrative duties (30%) and resident morale (28%). Three-quarters of respondents were satisfied that they became PDs. Overall, 11% of respondents met criteria for low burnout, 83% for moderate burnout, and 6% for high burnout. Not having served as a PD at a prior institution correlated with high depersonalization (OR 6.75, P=.04) and overall burnout (odds ratio [OR], 15.6; P=.04). Having more years on faculty prior to becoming PD correlated with less emotional exhaustion (OR, 0.44, P=.05) and depersonalization (OR, 0.20, P=.04). Finally, having dedicated time for PD duties correlated with less emotional exhaustion (OR, 0.27, P=.04). Conclusions: Moderate levels of burnout are common in U.S. radiation oncology PDs with regulatory stressors being common. Despite this, many PDs are fulfilled with their role. Longitudinal studies assessing dynamic external factors and their influence on PD burnout would be beneficial.
Rait, Douglas; Glick, Ira
Objective: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. Methods: After reviewing recent trends in the field that…
Silk, Hugh; Shields, Sara
Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…
Four models of organizational structure for midwifery practices that are located in academic institutions with residency programs are described: parallel models, coexistence models, fully integrated models, and blended models. Examples of each of these models are presented along with advantages and disadvantages and overall effect on resident education.
Full Text Available ... takes place in in-patient, out-patient, and emergency room settings. After completing residency training, most psychiatrists ... nursing homes, industry, government, military settings, rehabilitation programs, emergency rooms, hospice programs, and many other places. About ...
Full Text Available During the last half of the century the researchers have placed a great deal of importance on brain behavior relations. This has brought upon a huge body of knowledge but unfortunately at the cost of culture - the true roots of much of our behaviour. This general disregard of cultural factors has not only led to false generalizations but has also blocked the understanding of the real forces that motivate and shape our perceptions, attitudes, and actions. This paper is therefore an attempt to highlight the trajectory of transcultural psychiatry, right from the conceptions of its idea, through flaws in methodology, assessment, treatment and to its future and its limitations.
Da Dalt, Liviana; Anselmi, Pasquale; Furlan, Sara; Carraro, Silvia; Baraldi, Eugenio; Robusto, Egidio; Perilongo, Giorgio
The way a postgraduate medical training program is organized and the capacity of faculty members to function as tutors and to organize effective professional experiences are among the elements that affect the quality of training. An evaluation system designed to target these elements has been implemented within the framework of the Pediatric Residency Program of the University of Padua (Italy). The aim of this report is to describe some aspects of the experience gained in the first 3 years of implementation of the system (2013-2015). Data were collected using four validated questionnaires: the "Resident Assessment Questionnaire", the "Tutor-Assessment Questionnaire", the "Rotation-Assessment Questionnaire", and the "Resident Affairs Committee-Assessment Questionnaire". The response rate was 72% for the "Resident Assessment Questionnaires"; 78% for the "Tutor-/Rotation-Assessment Questionnaires" and 84% for the "Resident Affair Committee-Assessment Questionnaires". The scores collected were validated by psychometric tests. The high rates of completed questionnaires returned and the psychometric validation of the results collected indicate that the evaluation system reported herein can be effectively implemented. Efforts should be made to refine this system and, more importantly, to document its impact in improving the Pediatric Residency Program. What is known: • The elements that influence the quality of postgraduate training programs and the knowledge, performance, and competences of residents must be regularly assessed. • Comprehensive evaluation systems for postgraduate residency programs are not universally implemented also because quite often common guidelines and rules, well-equipped infrastructures, and financial resources are missing. What is new: • We show the feasibility of implementing an evaluation system that targets some of the key elements of a postgraduate medical training program in Italy, a European country in which the regulations
Bauer, Bruce; Williams, Erin; Stratman, Erik J
The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic
Lee, Andrew G.; Beaver, Hilary A.; Greenlee, Emily; Oetting, Thomas A.; Boldt, H. Culver; Olson, Richard; Abramoff, Michael; Carter, Keith
The Accreditation Council for Graduate Medical Education (ACGME) has mandated that residency programs, including ophthalmology, teach and assess specific competencies, including systems-based learning. We review the pertinent literature on systems-based learning for ophthalmology and recommend
Brahmi, Dalia; Dehlendorf, Christine; Engel, David; Grumbach, Kevin; Joffe, Carole; Gold, Marji
Access to abortion services in the United States is declining. While family physicians are well suited to provide this care, limited training in abortion occurs in family medicine residency programs...
Brown, Jamie N; Tiemann, Kelsey A; Ostroff, Jared L
To provide a description of a pharmacy residency rotation dedicated to medical writing developed at a tertiary care academic medical center. Contribution to the medical literature is an important component of professional pharmacy practice, and there are many benefits seen by practitioners actively involved in scholarly activities. Residency programs have an opportunity to expand beyond the standard roles of postgraduate pharmacist training but rarely is there formal instruction on medical writing skills or are scholarship opportunities provided to residents. In order to address this deficiency, a residency program may consider the implementation of a formal Medical Writing rotation. This rotation is designed to introduce the resident to medical writing through active discussion on medical writing foundational topics, engage the resident in a collaborative review of a manuscript submitted to a peer-reviewed professional journal, and support the resident in the design and composition of manuscript of publishable quality. A structured Medical Writing rotation during a pharmacy resident's training can help develop the skills necessary to promote scholarly activities and foster resident interest in future pursuit of professional medical writing.
Jayagopal, Anita; Jaju, Rishita A; Tate, Anupama
The purpose of this study was to describe the current practice and perception of pain assessment in US accredited advanced pediatric dentistry residency programs, as reported by directors of these programs. A questionnaire was sent out to 68 accredited US pediatric dentistry residency programs. Responses were statistically analyzed to find significant correlations between the actual practice of pain assessment and the perceived usefulness of pain assessment. Forty-four surveys (65% response rate) were completed and returned. Sixty-eight percent of program directors stated that pain is assessed at all types of appointments. A statistically significant correlation exists between program directors who regard pain assessment scales as useful and those who teach the use of such resources in their programs (chi-square = 3.73, P = .05). A statistically significant correlation exists between program directors who regard preoperative pain assessment as clinically beneficial and those who report a need to place more emphasis on pain assessment (chi-square = 6.22, P = .01). Pediatric dentistry residency program directors generally regard pain assessment as clinically beneficial in patient treatment. Implementing increased pain assessment teaching in pediatric dentistry residency programs could improve the confidence and skills of residents in assessing the pain of young children and those with special health care needs.
Finding an academic program that caters to children's literature is hard. Many people consider children's literature no more sophisticated than its audience--an arena for those who cannot hack it either as writers or as teachers of adult literature. This author, however, found a new program--a "low residency program"--at Hamline…
MacMaster, Frank P; Swansburg, Rose; Rittenbach, Katherine
Bibliometrics play an increasingly critical role in the assessment of faculty for promotion and merit increases. Bibliometrics is the statistical analysis of publications, aimed at evaluating their impact. The objective of this study is to describe h-index and citation benchmarks in academic psychiatry. Faculty lists were acquired from online resources for all academic departments of psychiatry listed as having residency training programs in Canada (as of June 2016). Potential authors were then searched on Web of Science (Thomson Reuters) for their corresponding h-index and total number of citations. The sample included 1683 faculty members in academic psychiatry departments. Restricted to those with a rank of assistant, associate, or full professor resulted in 1601 faculty members (assistant = 911, associate = 387, full = 303). h-index and total citations differed significantly by academic rank. Both were highest in the full professor rank, followed by associate, then assistant. The range in each, however, was large. This study provides the initial benchmarks for the h-index and total citations in academic psychiatry. Regardless of any controversies or criticisms of bibliometrics, they are increasingly influencing promotion, merit increases, and grant support. As such, benchmarking by specialties is needed in order to provide needed context.
Honey, Brooke Lynn; Bray, Whitney M; Gomez, Michael R; Condren, Michelle
Medication errors are hazardous and costly. Children are at increased risk for medication errors because of weight-based dosing, limited FDA indications, and human calculation errors. The aim of this study is to determine the frequency and type of resident prescribing errors in a pediatric clinic and further compare error rates of residents in different training programs. Resident prescription error data from a pediatric clinic was collected for 5 months. Upon detection of an error, residents were notified/given feedback regarding the type of error, ways to remedy errors, and future prevention methods. Data were categorized based on medication involved, error type, and resident training program. The review included 2941 prescriptions, with the overall resident prescribing error rate being 5.88%. The pediatric resident error rate was 4%. Family medicine, internal medicine, and medicine/pediatrics had error rates of 11%, 8%, and 7%, respectively. The prescribing error rate showed a statistically significant difference with pediatrics compared with family medicine, internal medicine, and medicine/pediatrics (P medication error type was overdose, followed by unclear quantity. Among the medication classes, topical agents and antimicrobials were among the top prescribed. Numerous types of medication errors occur in a pediatric clinic. Prescribing errors take place among all medical trainees; however, medication error rates in the pediatric population may vary among resident specialty. Identifying the cause of prescribing errors will allow institutions to create educational programs tailored for safe medication use in children as well as systemwide changes for error reduction.
Kralewski, John E.; Wiggins, Carla
Three alternative program funding approaches used in other professions are examined: (1) the reorientation of selected dental schools toward graduate education, (2) emphasizing and marketing the service aspects of the programs, and (3) developing education programs as in-house training for large organizations. (MSE)
Moreno-Fernández, Jesús; Gutiérrez-Alcántara, Carmen; Palomares-Ortega, Rafael; García-Manzanares, Alvaro; Benito-López, Pedro
The current training program for resident physicians in endocrinology and nutrition (EN) organizes their medical learning. Program evaluation by physicians was assessed using a survey. The survey asked about demographic variables, EN training methods, working time and center, and opinion on training program contents. Fifty-one members of Sociedad Castellano-Manchega de Endocrinología, Nutrición y Diabetes, and Sociedad Andaluza de Endocrinología y Nutrición completed the survey. Forty-percent of them disagreed with the compulsory nature of internal medicine, cardiology, nephrology and, especially, neurology rotations (60%); a majority (>50%) were against several recommended rotations included in the program. The fourth year of residence was considered by 37.8% of respondents as the optimum time for outpatient and inpatient control and monitoring without direct supervision. The recommended monthly number of on-call duties was 3.8±1.2. We detected a positive opinion about extension of residence duration to 4.4±0.5 years. Doctoral thesis development during the residence period was not considered convenient by 66.7% of physicians. Finally, 97.8% of resident physicians would recommend residency in EN to other colleagues. Endocrinologists surveyed disagreed with different training program aspects such as the rotation system, skill acquisition timing, and on-call duties. Therefore, an adaptation of the current training program in EN would be required. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.
Baldor, R A; Luckmann, R
Declining hospitalization rates for children and an increased emphasis on ambulatory care may be affecting the way family practice residency programs train their residents in the care of children. We surveyed all US family practice residency program directors to determine the nature of the child care training that programs currently provide to residents. Responses were received from 78% of the programs. Residencies required a mean of 5.2 months of formal pediatric training (range: 1 to 11 months). Thirty percent of programs noted a declining inpatient census on inpatient pediatric teaching services, but since 1978, the mean duration of inpatient pediatric training increased by 0.4 months to a required mean of 2.7 months of general pediatric inpatient training (range: 0 to 6 months). The mean time devoted to structured outpatient pediatric training was only 1.6 months (range: 0 to 6 months). Nine percent of responding programs required no formal pediatric outpatient training other than family health center experience. Despite declining inpatient census and increased emphasis on comprehensive ambulatory care, family practice residencies require more formal inpatient pediatric training than formal outpatient training.
Bresolin, Linda; Bisset, George S; Hendee, William R; Kwakwa, Francis A
Over the past 2 years, ongoing efforts have been made to reevaluate and restructure the way physics education is provided to radiology residents. Program directors and faculty from North American radiology residency programs were surveyed about how physics is being taught and what resources are currently being used for their residents. Substantial needs were identified for additional educational resources in physics, better integration of physics into clinical training, and a standardized physics curriculum closely linked to the initial certification examination of the American Board of Radiology. (c) RSNA, 2008.
Stephen P Merry
Full Text Available Graduate medical education is an excellent means of building the capacity of health care systems in low and middle Income Countries (LMIC and a growing way for physicians in the U.S to get involved in integral mission – the proclamation and demonstration of the Gospel. This white paper purposes to provide a “best practices” recommendations on family and internal medicine (“medical” residency program development in majority world settings. An expert panel of residency educators convened in November 2015 at the Global Missions Health Conference (GMHC in Louisville, Kentucky and through an iterative process identified themes that were then further defined and clarified by medical residency faculty unable to be present. Participants largely agreed that integration and cooperation with the country’s Ministry of Health (MOH is essential for sustainable residency development. Recognition of family medicine as a specialty will enable graduates to succeed in the country’s physician job market and health systems leadership. Recognition by the national church of the unique needs of their mission hospitals’ educational programs to control their revenue in order to fund their programs’ growth and development exemplifies the common wisdom to provide authority and resources where responsibility for good outcomes is expected. Co-training of general surgeons and medical residents who can provide essential surgical call coverage may lead to on-going synergies. Teaching by medical and surgical subspecialists is essential in medical residencies to provide the depth of instruction residents need to develop as excellent clinicians. Dependable scheduling of their specialty instruction allows residency program directors to assure inclusion of their content in the residency curriculum. In summary, participants agreed that teaching in medical residency programs in LMIC present excellent opportunities for national and expat Christian physician educators
Simon R. Turner
Full Text Available Introduction. The preparation of medical students for clerkship has been criticized, both in terms of students’ ability to understand their new role as clinical trainees and in their ability to carry out that role. To begin to address this gap, this paper reports the experiences of students in a shadowing program aimed at enhancing the preparedness of medical students for clinical training. The study examined a novel program, the Resident-Medical Student Shadowing Program, in which first-year medical students at the University of Alberta shadowed a first-year resident during clinical duties over the course of eight months. Methods. A study was conducted to assess the experiences of 83 first-year medical student participants who shadowed a first-year resident intermittently for one year. Student and resident participants’ experiences were explored using semistructured interviews. Results. Students and residents experiences indicate that participation increased students’ understanding of the clinical environment and their role within it and introduced them to skills and knowledge needed to perform that role. Students reported that a close relationship with their resident enhanced their learning experience. Conclusion. This study demonstrates that a low-cost program in which first-year students shadow residents may be a useful tool for helping prepare students for clerkship.
O’Brien, Bridget C.; Brian Niehaus; Arianne Teherani; Young, John Q.
Objectives: To characterize junior residents' perspectives on the purpose, value, and potential improvement of the final year of medical school. Methods: Eighteen interviews were conducted with junior residents who graduated from nine different medical schools and who were in internal medicine, surgery, and psychiatry programs at one institution in the United States. Interview transcripts were coded and analyzed inductively for themes. Results: Participants' descriptions of the purpose of the...
Timothy P. Young
Full Text Available Introduction: A “flipped classroom” educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. Methods: We evaluated residents’ impression of the asynchronous video component and synchronous classroom component using four Likert items. We used open-ended questions to inquire about resident and faculty impressions of the advantages and disadvantages of the format. Results: For the Likert items evaluating the video lectures, 33/35 residents (94%, 95% CI 80%-99% responded that the video lecture added to their knowledge about the topic, and 33/35 residents felt that watching the video was a valuable use of their time. For items evaluating the flipped classroom format, 36/38 residents (95%, 95% CI 82%-99% preferred the format to a traditional lecture on the topic, and 38/38 residents (100%, 95% CI 89%-100% felt that the small group session was effective in helping them learn about the topic. Most residents preferred to see the format monthly in our curriculum and chose an ideal group size of 5.5 (first session and 7 (second session. Residents cited the interactivity of the sessions and access to experts as advantages of the format. Faculty felt the ability to assess residents’ understanding of concepts and provide feedback were advantages. Conclusion: Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents. [West J Emerg Med. 2014;15(7:-0.
Host, Brian D; Anderson, Michael J; Lucas, Paul D
The rationale for and logistics of the expansion of a postgraduate year 1 (PGY1) residency program in a community hospital are described. Baptist Health Lexington, a nonprofit community hospital in Lexington, Kentucky, sought to expand the PGY1 program by having residents perform second-shift decentralized pharmacist functions. Program expansion was predicated on aligning resident staffing functions with current hospitalwide initiatives involving medication reconciliation and patient education. The focus was to integrate residents into the workflow while allowing them more time to practice as pharmacists and contribute to departmental objectives. The staffing function would increase residents' overall knowledge of departmental operations and foster their sense of independence and ownership. The decentralized functions would include initiation of clinical pharmacokinetic consultations, admission medication reconciliation, discharge teaching for patients with heart failure, and order-entry support from decentralized locations. The program grew from three to five residents and established a staffing rotation for second-shift decentralized coverage. The increased time spent staffing did not detract from the time allotted to previously established learning experiences and enhanced overall continuity of the staffing experience. The change also emphasized to the residents the importance of integration of distributive and clinical functions within the department. Pharmacist participation in admission and discharge medication reconciliation activities has also increased patient satisfaction, evidenced by follow-up surveys conducted by the hospital. A PGY1 residency program was expanded through the provision of second-shift decentralized clinical services, which helped provide residents with increased patient exposure and enhanced staffing experience. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Rodenhauser, P; Smith, C J; Markert, R J
Sexism has been perceived at all levels of medical education. Although specialty training has been scrutinized from various perspectives, there have been few objective assessments of sexual discrimination in the selection of candidates. This study evaluates the responses of board-certified physicians to fictional residency applicants' personal statements, which were identical except for gender. Male and female physicians from six specialties in which women were overrepresented and six specialties in which women were underrepresented all favored female candidates. Female physicians in both groups rated male candidates as less hardworking than did male physicians. Implications of these and other findings are discussed.
Goroll, Allan H; Sirio, Carl; Duffy, F Daniel; LeBlond, Richard F; Alguire, Patrick; Blackwell, Thomas A; Rodak, William E; Nasca, Thomas
A renewed emphasis on clinical competence and its assessment has grown out of public concerns about the safety, efficacy, and accountability of health care in the United States. Medical schools and residency training programs are paying increased attention to teaching and evaluating basic clinical skills, stimulated in part by these concerns and the responding initiatives of accrediting, certifying, and licensing bodies. This paper, from the Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education, proposes a new outcomes-based accreditation strategy for residency training programs in internal medicine. It shifts residency program accreditation from external audit of educational process to continuous assessment and improvement of trainee clinical competence.
Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy
Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. This report summarizes the initial results of the regional geriatric medicine curriculum retreats for residency directors. The goals of the retreats were to build recognition among the residency directors of the skills that future family physicians will require to be successful providers of primary care to older adults and to allow the residency directors to identify and develop solutions to barriers to improving geriatric medicine training for residents. Forty-six program directors participated in the three retreats between February 2000 and February 2001. The participants represented 52 programs and rural tracks in all geographic regions, small and large programs, and urban and rural settings. The program directors developed a consensus on the geriatric medicine knowledge, skills, and attitudes that should be expected of all family practice residency graduates; developed a list of basic, required educational resources for each family practice residency program; and proposed solutions to common obstacles to successful curriculum development.
Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates
Full Text Available IntroductionThere are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application.BackgroundTo address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012. The mission of the program is to graduate advanced orthopedic practitioners who can lead their communities and local profession in the advancement of clinical care and education. Since its inception, six cohorts have been initiated for a total of 90 resident participants. In addition, six program graduates are being trained to continue the Residency program and are serving as teaching assistants for the on campus modules. This training will result in a self-sustaining program by 2020.DiscussionThe manual therapy Residency education model allowed for advancement of the participating physiotherapists professional development utilizing evidence-based practice. This was done without altering the current education system within the country, or accessing expensive equipment.Concluding remarksThe Residency program was developed and established with the cooperation of a local education institution and a non-profit corporation in the United States. This collaboration has facilitated the advancement of orthopedic clinical standards in the country and will, hopefully, one day serve an as a template for future programs.
Wen, Timothy; Huang, Brian; Mosley, Virgie; Afsar-Manesh, Nasim
In recent years, patient satisfaction has been integrated into residency training practices through core competency requirements as set forth by the Accreditation Council of Graduate Medical Education (ACGME). In 2006, the UCLA Health Systems established a program designed to obtain patient feedback and assess the communication abilities of resident physicians with a standard tool through the Assessing Residents' C-I-CARE (ARC) Program. This Program utilized a 17-item questionnaire, completed via a facilitator-administered interview, which employed polar, Likert and comment scale questions to assess physician trainees' interpersonal and communication skills. From 2006 to 2010, the ARC Program provided patient feedback data to more than six clinical departments while collecting 5,634 surveys for 323 trainees. Scores for resident recognition and performance increased from the first to second year of activity by an average of 22.5%, while attending recognition scores decreased 19% over the four years. Additionally, residents and attendings in surgical specialties received higher recognition rates than those in non-surgical specialties. The ARC Program provided a standard tool for attaining patient feedback through a facilitator-administered survey that assisted in the accreditation process of training programs. Furthermore, hospitals, health organizations and medical schools may find the ARC Program valuable in collecting information for quality control as well as providing an opportunity for students to become involved in the healthcare field.
Culley, Deborah J; Fahy, Brenda G; Xie, Zhongcong; Lekowski, Robert; Buetler, Sascha; Liu, Xiaoxia; Cohen, Neal H; Crosby, Gregory
Scholarly activity is expected of program directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs. Anesthesiology residency programs are cited more often than surgical programs for deficiencies in academic productivity. We hypothesized that this may in part reflect differences in scholarly activity between program directors of anesthesiology and surgical trainings programs. To test the hypothesis, we examined the career track record of current program directors of ACGME-accredited anesthesiology and surgical residency programs at the same institutions using PubMed citations and funding from the National Institutes of Health (NIH) as metrics of scholarly activity. Between November 1, 2011 and December 31, 2011, we obtained data from publicly available Web sites on program directors at 127 institutions that had ACGME-accredited programs in both anesthesiology and surgery. Information gathered on each individual included year of board certification, year first appointed program director, academic rank, history of NIH grant funding, and number of PubMed citations. We also calculated the h-index for a randomly selected subset of 25 institution-matched program directors. There were no differences between the groups in number of years since board certification (P = 0.42), academic rank (P = 0.38), or years as a program director (P = 0.22). However, program directors in anesthesiology had less prior or current NIH funding (P = 0.002), fewer total and education-related PubMed citations (both P < 0.001), and a lower h-index (P = 0.001) than surgery program directors. Multivariate analysis revealed that the publication rate for anesthesiology program directors was 43% (95% confidence interval, 0.31-0.58) that of the corresponding program directors of surgical residency programs, holding other variables constant. Program directors of anesthesiology residency programs have considerably less scholarly activity in terms of
Sidhu, Ravindar S.; Walker, G. Ross
Objectives To provide baseline data on resident continuity of care experience, to describe the effect of ambulatory centre surgery on continuity of care, to analyse continuity of care by level of resident training and to assess a resident-run preadmission clinic’s effect on continuity of care. Design Data were prospectively collected for 4 weeks. All patients who underwent a general surgical procedure were included if a resident was present at operation. Setting The Division of General Surgery, Queen’s University, Kingston, Ont. Outcome measures Preoperative, operative and inhospital postoperative involvement of each resident with each case was recorded. Results Residents assessed preoperatively (before entering the operating room) 52% of patients overall, 20% of patients at the ambulatory centre and 83% of patients who required emergency surgery. Of patients assessed by the chief resident, 94% were assessed preoperatively compared with 32% of patients assessed by other residents ( p 0.1). Conclusions This study serves as a reference for the continuity of care experience in Canadian surgical programs. Residents assessed only 52% of patients preoperatively, and only 40% of patients had complete continuity of care. Factors such as ambulatory surgery and junior level of training negatively affected continuity experience. Such factors must be taken into account in planning surgical education. PMID:10526519
Background: Beginning in 2012, the Government of Rwanda implemented the Human Resources for Health (HRH) program to enhance capacity building in the Rwandan health education sector. Through this program, surgical training at University of Rwanda (UR) has expanded. The aim of this presentation is to describe ...
Motov, Sergey M; Marshall, John P
Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs possess inadequate knowledge and lack formal training in acute pain management. The purpose of this article is to create a formal educational curriculum that would assist emergency medicine (EM) residents in proper assessment and treatment of acute pain, as well as in providing a solid theoretical and practical knowledge base for managing acute pain in the ED. The authors propose a series of lectures, case-oriented study groups, practical small group sessions, and class-specific didactics with the goal of enhancing the theoretical and practical knowledge of acute pain management in the ED. © 2011 by the Society for Academic Emergency Medicine.
Loertscher, Laura L; Halvorsen, Andrew J; Beasley, Brent W; Holmboe, Eric S; Kolars, Joseph C; McDonald, Furman S
Interactions with the pharmaceutical industry are known to affect the attitudes and behaviors of medical residents; however, to our knowledge, a nationally representative description of current practices has not been reported. The Association of Program Directors in Internal Medicine surveyed 381 US internal medicine residency program directors in 2006-2007 regarding pharmaceutical industry support to their training programs. The primary outcome measure was program director report of pharmaceutical financial support to their residency. Demographic and performance variables were analyzed with regard to these responses. In all, 236 program directors (61.9%) responded to the survey. Of these, 132 (55.9%) reported accepting support from the pharmaceutical industry. One hundred seventy of the 236 program directors (72.0%) expressed the opinion that pharmaceutical support is not desirable. Residency programs were less likely to receive pharmaceutical support when the program director held the opinion that industry support was not acceptable (odds ratio [OR], 0.07; 95% confidence interval [CI], 0.02-0.22). Programs located in the southern United States were more likely to accept pharmaceutical support (OR, 8.45; 95% CI, 1.95-36.57). The American Board of Internal Medicine pass rate was inversely associated with acceptance of industry support: each 1% decrease in the pass rate was associated with a 21% increase in the odds of accepting industry support (OR, 1.21; 95% CI, 1.07-1.36). Although most of the program directors did not find pharmaceutical support desirable, more than half reported acceptance of industry support. Acceptance of pharmaceutical industry support was less prevalent among residency programs with a program director who considered support unacceptable and those with higher American Board of Internal Medicine pass rates.
Zerby, Stephen A
The science fiction film Invaders From Mars is used to teach principles of child development; clinical features of separation anxiety and nightmares; and clinical interventions, including child psychotherapy, child protective issues, and crisis management. Commercial films have been used as teaching aids in child psychiatry seminars. In this child psychiatry seminar, Invaders From Mars is viewed, and relevant teaching points are discussed with child psychiatry residents. The response of child psychiatry residents has been positive, with high ratings. This film may serve as a useful tool for teaching child psychiatry residents principles of child development, clinical features of separation anxiety and nightmares, and basic clinical interventions.
Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius
Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), pcommunication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.
Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius
Background and Purpose Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Methods Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Results Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median = 92) compared to patients interacting with untrained residents (Median = 88) (p = .046). Second, trained residents used more assessment utterances (Relative Risk (RR) = 1.17; 95% Confidence intervals (95%CI) = 1.02–1.34; p = .023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR = 1.01; 95%CI = 1.01–1.02; p = .018) and supportive utterances (RR = 0.99; 95%CI = 0.98–1.00; p = .042) (respectively 1.15 (RR), 1.08–1.23 (95%CI), pcommunication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer. PMID:20865055
Investigated was the effect of the Scientist in Residence Program to inspire elementary school children with their personal enthusiasm for science. Describes changes in the students' image of scientists using the Draw-a-Scientist Test before and after the program. Discusses the results of written responses and feedback from scientists. (YP)
Terrell, Steven R.; Snyder, Martha M.; Dringus, Laurie P.; Maddrey, Elizabeth
Limited-residency and online doctoral programs have an attrition rate significantly higher than traditional programs. This grounded-theory study focused on issues pertaining to communication between students, their peers and faculty and how interpersonal communication may affect persistence. Data were collected from 17 students actively working on…
Farrokhyar, Forough; Amin, Nalin; Dath, Deepak; Bhandari, Mohit; Kelly, Stephan; Kolkin, Ann M; Gill-Pottruff, Catherine; Skot, Martina; Reid, Susan
To evaluate whether implementing the formal Surgical Research Methodology (SRM) Program in the surgical residency curriculum improved research productivity compared with the preceding informal Research Seminar Series (RSS). The SRM Program replaced the RSS in July 2009. In the SRM Program, the curriculum in Year-1 consisted of 12 teaching sessions on the principles of clinical epidemiology and biostatistics, whereas the focus in Year-2 was on the design, conduct, and presentation of a research project. The RSS consisted of 8 research methodology sessions repeated annually for 2 years along with the design, conduct, and presentation of a research project. Research productivity was measured as the number of peer-reviewed publications and the generation of studies with higher levels of evidence. Outcome measures were independently assessed by 2 authors to avoid bias. Student t test and chi-square test were used for the analysis. Frequencies, mean differences with 95% CI, and effect sizes have been reported. In this study, 81 SRM residents were compared with 126 RSS residents. The performance of the SRM residents was superior on all metrics in our evaluation. They were significantly more productive and published more articles than the RSS residents (mean difference = 1.0 [95% CI: 0.5-1.5], p research performance improved 11.0 grades (95% CI: 8.5%-13.5%, p research methodology is crucial to appropriately apply evidence-based findings in clinical practice. The SRM Program has significantly improved the research productivity and performance of the surgical residents from all disciplines. The implementation of a similar research methodology program is highly recommended for the benefit of residents' future careers and ultimately, evidence-based patient care. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Dallal y Castillo, E
In 1972, prepaid medical care for government employees provided by their social security institute, ISSSTE, was reorganized. A division of planning and technical standards was established, within which a Department of Psychiatry was included. Psychiatric care was restructured at three levels: psychiatric hospital, psychiatric OPD at clinic and hospital level and a pilot program in community psychiatry. A three-year psychiatric residency program was established, in addition to participation in other postgraduate, in-service training and monographic courses. Systematic research was started, as well as a publications program, working relationship with other institutions and societies were enhanced. A descriptive example is Child Psychiatry. Most frequent diagnoses are reviewed, and development of services is followed in relation to pediatric departments.
Burgin, Susan; Homayounfar, Gelareh; Newman, Lori R; Sullivan, Amy
Dermatology residents routinely teach junior co-residents and medical students. Despite the importance of teaching skills for a successful academic career, no formal teaching instruction programs for dermatology residents have been described to our knowledge, and the extent of teaching opportunities for dermatology residents is unknown. We sought to describe the range of teaching opportunities and instruction available to dermatology residents and to assess the need for additional teaching training from the perspective of dermatology residency program directors nationwide. A questionnaire was administered to 113 US dermatology residency program directors or their designees. Descriptive statistics were used to analyze questionnaire item responses. The response rate was 55% (62/113). All program directors reported that their residents teach; 59% (33/56) reported offering trainees teaching instruction; 11% (7/62) of programs offered a short-term series of formal sessions on teaching; and 7% (4/62) offered ongoing, longitudinal training. Most program directors (74%, 40/54) believed that their residents would benefit from more teaching instruction. Response rate and responder bias are potential limitations. Dermatology residents teach in a broad range of settings, over half receive some teaching instruction, and most dermatology residency program directors perceive a need for additional training for residents as teachers. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Background: The inability to attract medical graduates to specialize in psychiatry has always been a serious challenge to psychiatry training programs. Therefore, the aim of this study was to assess the attitude of medical students towards psychiatry. Methods: A comparative cross-sectional survey was conducted among 122 ...
Full Text Available Introduction. Mentoring is a recognized form of teaching learning strategy in postgraduate medical education. This paper describes the effectiveness of a formal mentorship program from the residents’ perspective after a year of implementation. Methods. The Aga Khan University Family Medicine Residency Program is the first program in Pakistan to our knowledge to implement formal mentorship for all four years of residency. A mentorship program was developed, implemented, and evaluated a year later using a rating scale. The 10-point Likert scale consisted of questions on academics, clinical work, research, administrative issues, and personal/social issues. Results. The response rate was 95% (. Eighty percent ( were women. Satisfaction level in seeking help was the highest for academics (75%. Residents scored mentorship as low in helping to tackle their personal problems (20%. Barriers reported in rapport building with mentor were time constraints and gender difference. The most useful attributes of the mentor which helped rapport building were accessibility, active listening, support for emotional needs, and trustworthiness. Conclusion. Mentoring has a role in trainees’ personal and professional growth especially when their needs are addressed. The effectiveness of the mentorship program in residency can improve if the residents are allowed to choose their own mentors.
Hau, Duncan K; Smart, Luke R; DiPace, Jennifer I; Peck, Robert N
Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. We searched PubMed from its earliest dates until October 2015. Articles included were survey results of U.S. program directors on global health training opportunities, and web-based searches of U.S. residency program websites on global health training opportunities. Data extracted included percentage of residency programs offering global health training within a specialty and challenges encountered. Studies were found for twelve U.S. residency specialties. Of the survey based studies, the specialties with the highest percentage of their residency programs offering global health training were preventive medicine (83%), emergency medicine (74%), and surgery (71%); and the lowest were orthopaedic surgery (26%), obstetrics and gynecology (28%), and plastic surgery (41%). Of the web-based studies, the specialties with the highest percentage of their residency programs offering global health training were emergency medicine (41%), pediatrics (33%), and family medicine (22%); and the lowest were psychiatry (9%), obstetrics and gynecology (17%), and surgery (18%). The most common challenges were lack of funding, lack of international partnerships, lack of supervision, and scheduling. Among U.S. residency specialties, there are wide disparities for global health training. In general, there are few opportunities in psychiatry and surgical residency specialties, and greater opportunities among medical residency specialties. Further emphasis should be made to scale-up opportunities for psychiatry and surgical residency specialties.
Tran, Elaine M; Scott, Ingrid U; Clark, Melissa A; Greenberg, Paul B
To report on the status of residency-based wellness initiatives in ophthalmic graduate medical education and identify strategies for promoting ophthalmology resident wellness by surveying US ophthalmology program directors (PDs). The PDs were each sent an e-mail containing a link to an anonymous online 15-question survey. The PDs also received a letter with the survey link and a $1 incentive. After 2 weeks, nonresponders received 2 weekly reminder e-mails and phone calls. Descriptive statistics were used to analyze the multiple choice responses and categorize the free response answers. National survey. All 111 US ophthalmology PDs were invited to participate. Of 111 PDs, 56 (50%) responded; 14 (26%) of 53 respondents reported that their programs faced an issue involving resident depression, burnout, or suicide within the last year; 25 (45%) of 56 reported that their department had a resident wellness program. Respondents without wellness programs reported a shortage of time (19/30; 63%) and lack of training and resources (19/30; 63%) as barriers to instituting these programs. Respondents reported that the Accreditation Council for Graduate Medical Education could better promote resident wellness by providing training resources for burnout and depression screening (35/53; 66%), resilience skills building (38/53; 72%), and wellness program development (36/53; 68%). This survey suggests that there is a substantial burden of burnout and depression among residents in ophthalmic graduate medical education and that this burden can be addressed by promoting the training of educators to recognize the signs of burnout and depression, and providing resources to develop and expand formal wellness programs. Published by Elsevier Inc.
Erik E. Langenau
Full Text Available Background: High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods: Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC were conducted to determine consistency across different specialties. Results: Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%, advanced cardiovascular life support (ACLS (91.1%, basic life support (BLS (90.0%, interpretation of electrocardiogram (89.4% and blood gas (88.7%. Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%, sterile technique (67.2%, BLS (68.9%, ACLS (65.9% and phlebotomy (63.5%. Discussion: Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the
Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.
Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first
Wittich, Christopher M; Agrawal, Anoop; Cook, David A; Halvorsen, Andrew J; Mandrekar, Jayawant N; Chaudhry, Saima; Dupras, Denise M; Oxentenko, Amy S; Beckman, Thomas J
E-learning-the use of Internet technologies to enhance knowledge and performance-has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs. Of the 368 PDs, 214 (58.2%) completed the e-learning survey. Use of synchronous e-learning at least sometimes, somewhat often, or very often was reported by 85 (39.7%); 153 programs (71.5%) use asynchronous e-learning at least sometimes, somewhat often, or very often. Most programs (168; 79%) do not have a budget to integrate e-learning. Mean (SD) scores for the PD perceptions of e-learning ranged from 3.01 (0.94) to 3.86 (0.72) on a 5-point scale. The odds of synchronous e-learning use were higher in programs with a budget for its implementation (odds ratio, 3.0 [95% CI, 1.04-8.7]; P = .04). Residency programs could be better resourced to integrate e-learning technologies. Asynchronous e-learning was used more than synchronous, which may be to accommodate busy resident schedules and duty-hour restrictions. PD perceptions of e-learning are relatively moderate and future research should determine whether PD reluctance to adopt e-learning is based on unawareness of the evidence, perceptions that e-learning is expensive, or judgments about value versus effectiveness.
Dodson, Guy; Pero, Vincent
The Shoshone-Paiute Tribes fish-stocking program was begun in 1988 and is intended to provide a subsistence fishery for the tribal members. The program stocks catchable and fingerling size trout in Mt. View and Sheep Creek Reservoirs. Rainbow trout are purchased from only certified disease-free facilities to be stocked in our reservoirs. This project will help restore a fishery for tribal members that historically depended on wild salmon and steelhead in the Owyhee and Bruneau Rivers and their tributaries for their culture as well as for subsistence. This project is partial substitution for loss of anadromous fish production due to construction and operation of hydroelectric dams on the Columbia and Snake Rivers. Until anadromous fish can be returned to the Owyhee and Bruneau Rivers this project will continue indefinitely. As part of this project the Shoshone-Paiute Tribes will also receive income in the form of fees from non-tribal members who come to fish these reservoirs. Regular monitoring and evaluation of the fishery will include sampling for length/weight/condition and for signs of disease. A detailed Monitoring and evaluation plan has been put in place for this project. However due to budget limitations on this project only the fishery surveys and limited water quality work can be completed. A creel survey was initiated in 1998 and we are following the monitoring and evaluation schedule for this program (as budget allows) as well as managing the budget and personnel. This program has been very successful in the past decade and has provided enjoyment and sustenance for both tribal and non-tribal members. All biological data and stocking rates will be including in the Annual reports to Bonneville Power Administration (BPA).
Richard, Raveesh Daniel; Deegan, Brian Francis; Klena, Joel Christian
To train surgeons effectively, it is important to understand how they are learning. The Kolb Learning Style Inventory (LSI) is based on the theory of experiential learning, which divides the learning cycle into 4 stages: active experimentation (AE), abstract conceptualization (AC), concrete experience, and reflective observation. The purpose of this investigation was to assess the learning styles of orthopedic residents, faculty, and applicants at an east-coast residency program. A total of 90 Kolb LSI, Version 3.1 surveys, and demographic questionnaires were distributed to all residency applicants, residents, and faculty at an academic program. Data collected included age, sex, type of medical school (MD or DO), foreign medical graduate status, and either year since college graduation, postgraduate year level (residents only), or years since completion of residency (faculty only). Seventy-one completed Kolb LSI surveys (14 residents, 14 faculty members, and 43 applicants) were recorded and analyzed for statistical significance. The most prevalent learning style among all participants was converging (53.5%), followed by accommodating (18.3%), diverging (18.3%), and assimilating (9.9%) (p = 0.13). The applicant and resident groups demonstrated a high tendency toward AE followed by AC. The faculty group demonstrated a high tendency toward AC followed by AE. None of the 24 subjects who were 26 years or under had assimilating learning styles, in significant contrast to the 12% of 27- to 30-year-olds and 18% of 31 and older group (p learning style involves problem solving and decision making, with the practical application of ideas and the use of hypothetical-deductive reasoning. Learning through AE decreased with age, whereas learning through AC increased. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Nawaz, Haq; Petraro, Paul V; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M
The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.
Wasnick, John D; Chang, Laura; Russell, Cortessa; Gadsden, Jeff
To determine the degree of knowledge that medical students applying to the St. Luke's-Roosevelt Hospital Center anesthesiology residency program had regarding the core physician competencies mandated by the Accreditation Council for Graduate Medical Education. As a part of the department's annual resident-selection process, in the fall of 2008, 193 interviewed fourth-year U.S. MD-degree medical students applying to the St. Luke's-Roosevelt Hospital Center anesthesiology program were given a brief, written questionnaire to determine their knowledge of the six core physician competencies. The instructions for completing the instrument were standardized and delivered to the applicants by one of the program directors. A total of 193 applicants completed the interview questionnaire. Seventy-six had no knowledge of any of the physician competencies, and only three were able to correctly identify all six. While this research is an observation of only one set of applicants to one residency program, if the findings are applicable to other programs and specialties, that suggests that medical schools and residency program directors should develop methods for increasing competency awareness among medical students.
Khan, Rao F H; Dunscombe, Peter B
Over the last two decades, there has been a concerted effort in North America to organize medical physicists' clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety-conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two-year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%-10% is spent in obtaining formal training in nontechnical "soft skills".
Kapoor, Neena; Smith, Stacy E
Data are limited on how radiology curricula vary across US medical schools and the association between characteristics of these curricula and application rates to radiology residency programs. The purpose of this study was to gather more information about medical school radiology curricula and to determine the association between radiology education and application rates to radiology residency programs. An anonymous web-based survey was e-mailed to residency program directors affiliated with 129 accredited US medical schools. Residency program directors were instructed to forward the survey to a radiology clerkship director or complete the survey themselves. Electronic Residency Application Service data were also obtained for 122 participating medical schools. Fifty-five of 122 schools responded, a response rate of 45%. The majority of medical schools (76%) had a dedicated radiology curriculum, which was most often offered in the third and fourth years. The majority (87%) of schools integrated radiology education into other courses throughout all 4 years. The application data revealed that application rates were similar across schools, ranging from 6% to 8%. Applications rates did not significantly vary across several characteristics of educational curricula. Although schools vary in the characteristics of radiology education, application rates to radiology residency programs are similar across schools and are not associated with specific characteristics of these educational programs. This lack of an association may be explained by universal exposure of medical students to radiology curricula and the fact that a career choice is a complex process that involves multiple factors. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Full Text Available Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions.
control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. 1. REPORT DATE (DD-MM-YYYY) 25-11-2014 2. REPORT TYPE Final...the contract Statement of Work. These functions included stipend payments, management of a major medical benefits insurance program, and...United States Echchgadda, Ibtissam Wilmink, Gerald J 7/1/2011-6/30/2013 Morocco Greer, Kimberly Ann Wilmink, Gerald J 7/30/2012-7/29/2013
Brown, D; Mundt, A; Einck, J; Pawlicki, T [University of California, San Diego, La Jolla, CA (United States)
Purpose: The purpose of this educational program is to motivate talented, intelligent individuals to become stakeholders in the global effort to improve access to radiotherapy. Methods: The need to improve global access to radiotherapy has been clearly established and several organizations are making substantial progress in securing funding and developing plans to achieve this worthwhile goal. The incorporation of elective international rotations in residency programs may provide one possible mechanism to promote and support this future investment. We recently incorporated an elective 1-month international rotation into our CAMPEP accredited Medical Physics residency program, with our first rotation taking place in Vietnam. A unique aspect of this rotation was that it was scheduled collaboratively with our Radiation Oncology residency program such that Radiation Oncology and Medical Physics residents traveled to the same clinic at the same time. Results: We believe the international rotation substantially enhances the educational experience, providing additional benefits to residents by increasing cross-disciplinary learning and offering a shared learning experience. The combined international rotation may also increase benefit to the host institution by modeling positive multidisciplinary working relationships between Radiation Oncologists and Medical Physicists. Our first resident returned with several ideas designed to improve radiotherapy in resource-limited settings – one of which is currently being pursued in collaboration with a vendor. Conclusion: The elective international rotation provides a unique learning experience that has the potential to motivate residents to become stakeholders in the global effort to improve access to radiotherapy. What better way to prepare the next generation of Medical Physicists to meet the challenges of improving global access to radiotherapy than to provide them with training experiences that motivate them to be socially
Lombroso, Paul; Eng, Lenny
Describes the process by which a department of psychiatry computerized its clinical services under a single communication network. Presents the program in detail, demonstrating the recording of various clinical, administrative and demographic data. Emphasizes the value of such information for returning patients, immediate updating of information,…
Mehaffey, J Hunter; Michaels, Alex D; Mullen, Matthew G; Yount, Kenan W; Meneveau, Max O; Smith, Philip W; Friel, Charles M; Schirmer, Bruce D
Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified. The effect of robotic surgery on laparoscopic case volume was assessed with linear regression analysis. Resident participation, operative time, hospital costs, and patient charges were also evaluated. We identified 2260 laparoscopic and 139 robotic operations. As the volume of robotic cases increased, the number of laparoscopic cases steadily decreased. Residents participated in all laparoscopic cases and 70% of robotic cases but operated from the robot console in only 21% of cases. Mean operative time was increased for robotic cholecystectomy (+22%), IHR (+55%), and VHR (+61%). Financial analysis revealed higher median hospital costs per case for robotic cholecystectomy (+$411), IHR (+$887), and VHR (+$1124) as well as substantial associated fixed costs. Introduction of robotic surgery had considerable negative impact on laparoscopic case volume and significantly decreased resident participation. Increased operative time and hospital costs are substantial. An institution must be cognizant of these effects when considering implementing robotics in departments with a general surgery residency program. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Background: The Accreditation Council for Graduate Medical Education requires residency programs to expose residents to research opportunities. Objective: The purpose of this study was to assess the impact of a series of iterative interventions to increase scholarly activity in one internal medicine residency. Methods: Retrospective analysis of the effectiveness of a series of interventions to increase resident and faculty scholarly productivity over a 14-year period was performed using quality improvement methodology. Outcomes measured were accepted regional and national abstracts and PubMed indexed manuscripts of residents and faculty. Results: Initially, regional meeting abstracts increased and then were supplanted by national meeting abstracts. Sustained gains in manuscript productivity occurred in the eighth year of interventions, increasing from a baseline of 0.01 publications/FTE/year to 1.57 publications/FTE/year in the final year measured. Run chart analysis indicated special cause variation associated with the interventions performed. Conclusions: Programs attempting to stimulate research production among faculty and residents can choose among many interventions cited in the literature. Since success of any group of interventions is likely additive and may take years to show benefit, measuring outcomes using quality improvement methodology may be an effective way to determine success.
Full Text Available BACKGROUND AND PURPOSE: Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. METHODS: Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm. Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. RESULTS: Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92 compared to patients interacting with untrained residents (Median=88 (p=.046. Second, trained residents used more assessment utterances (Relative Risk (RR=1.17; 95% Confidence intervals (95%CI=1.02-1.34; p=.023. Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018 and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042 (respectively 1.15 (RR, 1.08-1.23 (95%CI, p<.001 for empathy and 0.95 (RR, 0.92-0.99 (95%CI, p=.012 for reassurance was proportional to the number of hours of training attendance. CONCLUSION: The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on
Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene
Objective: The authors discuss journal writing in learning emergency psychiatry. Methods: The journal of a psychiatry intern rotating through an emergency department is used as sample material for analysis that could take place in supervision or a resident support group. A range of articles are reviewed that illuminate the relevance of journal…
Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel
Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Chamberlain, Lisa J; Wu, Susan; Lewis, Gena; Graff, Nancy; Javier, Joyce R; Park, Joseph S R; Johnson, Christine L; Woods, Steven D; Patel, Mona; Wong, Daphne; Blaschke, Gregory S; Lerner, Marc; Kuo, Anda K
Educational collaboratives offer a promising approach to disseminate educational resources and provide faculty development to advance residents' training, especially in areas of novel curricular content; however, their impact has not been clearly described. Advocacy training is a recently mandated requirement of the Accreditation Council for Graduate Medical Education that many programs struggle to meet.The authors describe the formation (in 2007) and impact (from 2008 to 2010) of 13 California pediatric residency programs working in an educational collaboration ("the Collaborative") to improve advocacy training. The Collaborative defined an overarching mission, assessed the needs of the programs, and mapped their strengths. The infrastructure required to build the collaboration among programs included a social networking site, frequent conference calls, and face-to-face semiannual meetings. An evaluation of the Collaborative's activities showed that programs demonstrated increased uptake of curricular components and an increase in advocacy activities. The themes extracted from semistructured interviews of lead faculty at each program revealed that the Collaborative (1) reduced faculty isolation, increased motivation, and strengthened faculty academic development, (2) enhanced identification of curricular areas of weakness and provided curricular development from new resources, (3) helped to address barriers of limited resident time and program resources, and (4) sustained the Collaborative's impact even after formal funding of the program had ceased through curricular enhancement, the need for further resources, and a shared desire to expand the collaborative network.
Background The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Methods Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Results Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. Conclusions These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents. PMID:23552445
Thabault, Paulette; Mylott, Laura; Patterson, Angela
Retail health clinics are an expanding health care delivery model and an emerging new practice site for nurse practitioners (NPs). Critical thinking skills, clinical competence, interprofessional collaboration, and business savvy are necessary for successful practice in this highly independent and autonomous setting. This article describes a pilot residency partnership program aimed at supporting new graduate NP transition to practice, reducing NP turnover, and promoting academic progression. Eight new graduate NPs were recruited to the pilot and paired with experienced clinical NP preceptors for a 12-month program that focused on increasing clinical and business competence in the retail health setting. The residency program utilized technology to facilitate case conferences and targeted Webinars to enhance learning and peer-to-peer sharing and support. An on-line doctoral-level academic course that focused on interprofessional collaboration in health care, population health, and business concepts was offered. Both NPs and preceptors were highly satisfied with the academic-service residency program between MinuteClinic and Northeastern University School of Nursing in Boston, MA. New NPs particularly valued the preceptor model, the clinical case conferences, and business Webinars. Because their priority was in gaining clinical experience and learning the business acumen relevant to managing the processes of care, they did not feel ready for the doctoral course and would have preferred to take later in their practice. The preceptors valued the academic course and felt that it enhanced their precepting and leadership skills. At the time of this article, 6 months post completion of the residency program, there has been no turnover. Our experience supports the benefits for residency programs for newly graduated NPs in retail settings. The model of partnering with academia by offering a course within a service organization's educational programs can enable academic
Varner, Catherine; Ovens, Howard; Letovsky, Eric; Borgundvaag, Bjug
To determine the practice settings of graduates of a residency program that leads to a Certificate of Special Competence in Emergency Medicine (CCFP[EM]). Web-based survey using standard Dillman methodology. Canada. All graduates of the CCFP(EM) residency training program at the University of Toronto (U of T) in Ontario between 1982 and 2009. Practice type and location, job satisfaction, and nonclinical EM activities of graduates of a CCFP(EM) residency program. Of 146 graduates surveyed, 88 responded (response rate of 60.3%). All of the respondents indicated that they had practised EM at some point after completing the CCFP(EM) program at U of T. At survey completion, 76.7% were practising EM. Of the EM-practising cohort, 93.9% worked in urban or suburban hospitals as opposed to rural settings. Those practising EM expressed high levels of job satisfaction, with 83.3% reporting a score of 8 or higher on a 10-point satisfaction scale. Most (57.0%) of the graduates of the CCFP(EM) residency program at U of T had participated in leadership activities in EM on local, provincial, or national levels. Most graduates of the CCFP(EM) residency program continue to practise EM, and most of them practise in urban and suburban environments. The low attrition rate of CCFP(EM) graduates should be regarded as a success of the CCFP(EM) program, and the geographic distribution of all physicians, including EM providers, warrants further study to help plan future physician resources in Canada.
Doty, Christopher I; Roppolo, Lynn P; Asher, Shellie; Seamon, Jason P; Bhat, Rahul; Taft, Stephanie; Graham, Autumn; Willis, James
The Accreditation Council for Graduate Medical Education (ACGME) recently has mandated the formation of a clinical competency committee (CCC) to evaluate residents across the newly defined milestone continuum. The ACGME has been nonproscriptive of how these CCCs are to be structured in order to provide flexibility to the programs. No best practices for the formation of CCCs currently exist. We seek to determine common structures of CCCs recently formed in the Council of Emergency Medicine Residency Directors (CORD) member programs and identify unique structures that have been developed. In this descriptive study, an 18-question survey was distributed via the CORD listserv in the late fall of 2013. Each member program was asked questions about the structure of its CCC. These responses were analyzed with simple descriptive statistics. A total of 116 of the 160 programs responded, giving a 73% response rate. Of responders, most (71.6%) CCCs are chaired by the associate or assistant program director, while a small number (14.7%) are chaired by a core faculty member. Program directors (PDs) chair 12.1% of CCCs. Most CCCs are attended by the PD (85.3%) and selected core faculty members (78.5%), leaving the remaining committees attended by any core faculty. Voting members of the CCC consist of the residency leadership either with the PD (53.9%) or without the PD (36.5%) as a voting member. CCCs have an average attendance of 7.4 members with a range of three to 15 members. Of respondents, 53.1% of CCCs meet quarterly while 37% meet monthly. The majority of programs (76.4%) report a system to match residents with a faculty mentor or advisor. Of respondents, 36% include the resident's faculty mentor or advisor to discuss a particular resident. Milestone summaries (determination of level for each milestone) are the primary focus of discussion (93.8%), utilizing multiple sources of information. The substantial variability and diversity found in our CORD survey of CCC structure
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Phillips, Donna; Egol, Kenneth A; Maculatis, Martine C; Roloff, Kathryn S; Friedman, Alan M; Levine, Brett; Garfin, Steven; Schwartz, Alexandra; Sterling, Robert; Kuivila, Thomas; Paragioudakis, Steve J; Zuckerman, Joseph D
To understand the personality factors associated with orthopedic surgery resident performance. A prospective, cross-sectional survey of orthopedic surgery faculty that assessed their perceptions of the personality traits most highly associated with resident performance. Residents also completed a survey to determine their specific personality characteristics. A subset of faculty members rated the performance of those residents within their respective program on 5 dimensions. Multiple regression models tested the relationship between the set of resident personality measures and each aspect of performance; relative weights analyses were then performed to quantify the contribution of the individual personality measures to the total variance explained in each performance domain. Independent samples t-tests were conducted to examine differences between the personality characteristics of residents and those faculty identified as relevant to successful resident performance. Data were collected from 12 orthopedic surgery residency programs1 throughout the United States. The level of clinical care provided by participating institutions varied. Data from 175 faculty members and 266 residents across 12 programs were analyzed. The personality features of residents were related to faculty evaluations of resident performance (for all, p performance. Particularly, the characteristics of agreeableness, neuroticism, and learning approach were found to be most important for explaining resident performance. Additionally, there were significant differences between the personality features that faculty members identified as important for resident performance and the personality features that residents possessed. Personality assessments can predict orthopedic surgery resident performance. However, results suggest the traits that faculty members value or reward among residents could be different from the traits associated with improved resident performance. Copyright © 2017 Association
Go, Pauline H; Klaassen, Zachary; Chamberlain, Ronald S
To determine whether residency program directors (PDs) of general surgery and surgical subspecialties review social networking (SN) websites during resident selection. A 16-question survey was distributed via e-mail (Survey Monkey, Palo Alto, California) to 641 PDs of general surgery and surgical subspecialty residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Institutions with ACGME-accredited general surgery and surgical subspecialty residency programs. PDs of ACGME-accredited general surgery and surgical subspecialty residency programs. Two hundred fifty (39%) PDs completed the survey. Seventeen percent (n = 43) of respondents reported visiting SN websites to gain more information about an applicant during the selection process, leading 14 PDs (33.3%) to rank an applicant lower after a review of their SN profile. PDs who use SN websites currently are likely to continue (69%), whereas those who do not use SN currently might do so in the future (yes 5.4%, undecided 44.6%). Online profiles displayed on SN websites provide surgery PDs with an additional avenue with which to evaluate highly competitive residency applicants. Applicants should be aware of the expansion of social media into the professional arena and the increasing use of these tools by PDs. SN profiles should reflect the professional standards to which physicians are held while highlighting an applicant's strengths and academic achievements. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Shah, Sandip; Desai, Nimisha; Shah, Saurabh; Pathare, Soumitra; Chauhan, Ajay; Sharma, Elavatsla
Dropout from an outpatient clinic is the loss of patient to the scheduled follow-up. Noncompliance in the form of treatment dropouts is a major problem across outpatient mental health settings and can range from 15% to 60%. Follow-up studies provide valuable insights into improving the quality of existing mental health facilities. Quality Rights Gujarat (QRG) is a step toward improving mental health facilities across various centers. This retrospective observational study aims to explore follow-up pattern, predictors and any change after QRG implementation. Pre intervention Group (A) attended psychiatry OPD for 6 months before implementation of QRG project and Post intervention Group (B) attended psychiatry OPD for 3 months after implementation of QRG project. Total 1632 Patients consulted in group A and 926 patients consulted Psychiatry OPD in group B. The most common Psychiatric disorder were Depression (A-19.55%, B-28.62%), Schizophrenia and related disorders (A-14.15%, B-15.01%), Neuropsychiatric disorders like headache and epilepsy (A-14.52%, B-18.68%), substance use disorder (A-15.26%, B-13.71%) and Bipolar disorder (A-11.76%, B-13.17%). 59.56% patients dropped out after the first visit in pre intervention group as compared to 51.94% patients in post intervention group. Significant reduction of about 8% in loss to follow up and 16% increase in follow-ups of initial visits after implementation of Quality Rights Gujarat project. Much can be done to improve attendance in most services. The initiative like QRG significantly has positive results on patient's follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.
Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E
The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.
Carek, P J; Abercrombie, S; Baughman, O; Buehler, J; Goforth, G; Hester, W; Lammie, J; Snape, P
The results of this study demonstrate several interesting characteristics of the graduates of the SC AHEC associated family medicine residency programs: 45 percent practice in South Carolina, 63 percent live further than 120 miles from their residency program, 96 percent are satisfied with their specialty choice, and 56 percent are involved in teaching medical students and residents. Furthermore, these graduates have the following tendencies: to practice in the traditional solo or group practice; to practice in a suburban community, town or rural community and a setting size less than a population of 100,000 persons; to care for the aging adult and geriatric population; to provide nursing home care; and to utilize house calls to provide patient care). As the current health care system continues to be redesigned, this information will be essential for assessment and planning purposes.
Cristiane Trivisiol da Silva
Full Text Available This research aims to identify the perception of professional members of a multi-professional residency program on Permanent Health Education. It is a case study research using a qualitative approach, with sixteen members of a multi-professional residency program. The data were collected from January to May 2012, through semi-structured interviews, document analysis and systematic observation, and analyzed according to Thematic Content Analysis. Two categories were identified: Permanent Health Education establishing collective spaces of reflection of practices and Permanent Health Education that promotes integration between disciplines. The members of the multiprofessional residency team were found to be aware that permanent education permeates their training and enables reflection on their clinical practices and multidisciplinary action as producers of health actions.
Rubin, Eugene H; Zorumski, Charles F
Psychiatry is facing a crisis fueled by a fragmented and inefficient system of care delivery and a disconnection between the state of research and the state of psychiatry education and practice. Many factors contribute to the current state of psychiatric care. Psychiatry is a shortage specialty, and this will become worse in the near future. In addition, financial pressures have led to decreases in psychiatric inpatient and outpatient services and to shorter lengths of hospitalization for even the sickest patients. This has resulted in fragmented care and an overreliance on polypharmacy. To reach the large number of patients needing psychiatric services, health care systems must change and take advantage of collaborative and integrative care models and new technologies. Psychiatrists must learn to partner more effectively with primary care providers to extend their expertise to the greatest number of patients. Currently, psychiatric diagnosis is based on a criteria-based system that was developed in the 1970s. Advances in systems and molecular neuroscience are beginning to elucidate specific brain systems that are dysfunctional in psychiatric illness. This has the potential to revolutionize psychiatric diagnosis and treatment in the future. However, psychiatry has not yet been successful in incorporating the language of this research into clinically meaningful terminology. If neuroscientific progress is to be translated into clinical advances, this must change. Residency programs must better prepare their graduates to keep up with a psychiatry literature that will increasingly use the language of neural circuits to describe psychiatric symptomatology and treatments.
The situation of present day psychiatry is described as being dominated by an empiricist perspective. The limitations of this perspective are analyzed and a rough sketch of the hermeneutical approach in psychiatry is offered. It is argued that a fully developed hermeneutical psychiatry implies a
Full Text Available Azad University medical school in Tehran was established in 1985 which followed by establishment of 13 medical schools in other cities. In 1992, the first group of medical graduates of Azad University medical schools found their way to residency programs. One of the indices that has been long interpreted as a basic medical education program success indicator is the proportion of medical graduates who enters residency program. As there has been no report on the proportion or exact number of Azad University medical graduates participating in residency program, we decided to provide a report on the medical graduates who entered residency program in 1992-9. The list of medical graduates from Tehran, Yazd, Najafabad, Kazeroon, Mashad, Tabriz, Ardebil, Quom, Shahrood, and Tonekabon medical schools of Azad University were provided through correspondence with each medical school. A list of Azad University medical graduates who entered residency program in 1992-9 was obtained from Ministry of Health and Medical Education and matched against the list of Azad University medical graduates and further confirmed by the respective medical schools. The students of Semman, Zahedan, Karaj, and Babol medical schools which were closed were included under transferred to Tehran. The 1992's graduates of Yazd and Tabriz medical school and the medical graduates of Najafabad till 1993 and the medical graduates of Quom and Mashad till 1994 are also included under transferred to Tehran. In 1992 Tehran medical school of Azad University graduated its first group of medical students. In 1992-9 Azad University medical schools graduated a total of 3830 medical students. Table 1, Figure 1 and Figure 2 give a general overview of Azad University medical graduates distribution through Azad University medical schools by year of graduation.
Hung, Kristin J.; Tsai, Alexander C.; Johnson, Timothy R.B.; MD, MPH, Rochelle P.; Bangsberg, David R.; Kerry, Vanessa B.
Objective To enumerate global health training activities in U.S. obstetrics and gynecology residency programs, and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. Methods Using a systematic, Web-based protocol, we searched for global health training opportunities at all U.S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life years due to maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman’s rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. Results Of the 243 accredited U.S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden due to maternal (Spearman’s ρ=0.37; 95% confidence interval [CI], 0.14-0.57) and perinatal conditions (ρ=0.34; 95% CI, 0.10-0.54) but not gynecologic cancers (ρ=−0.24; 95% CI, −0.46 to 0.01). Conclusions There are few global health training opportunities for U.S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease. PMID:24104785
Rozenshtein, Anna; Bauman-Fishkin, Olga; Fishkin, Igor; Homel, Peter
The purpose of this study was to develop objective measures of residency call frequency and difficulty, to establish mean values for the northeastern United States, and to test those values for correlation with program size. A survey questionnaire was sent to 104 radiology residency programs in the northeastern United States. The programs were classified according to number of residents, as small ( or = 31 residents). The call difficulty index was defined as the number of emergency examinations per resident per year. Call frequency indexes were defined as the numbers of evenings and of nights during the 4-year residency when residents were scheduled for call. The average call difficulty index and standard deviation for the respondent programs was 3,855 +/- 1,779. The average call frequency index and standard deviation for evenings was 140 +/- 53 and for nights was 120 +/- 59. A significant negative correlation was found between program size on one hand and call difficulty index (r = -0.36, P = .01), evening call frequency index (r = -0.29, P = .033), and night call frequency index (r = -0.51, P < .001) on the other. Residents in small programs could expect to be on call 192 evenings and 192 nights in the 4-year residency and to perform 4,866 emergency examinations per year, as opposed to the 110 evenings and 89 nights on call and the 3,213 emergency examinations that residents in very large programs could expect. In other words, the smaller the program, the more calls residents can expect to take, and the more emergency examinations they will interpret. The mean call difficulty and off-hours call frequency indexes established for residency programs of different size in the Northeast demonstrate increasing call difficulty and increasing off-hours call frequency with decreasing program size.
Imanuel-Noy, Dalia; Wagner, Tili
The research presents a Residency Math teacher education program that has been developed in Israel in search of transforming initial teacher preparation on the Clinical-Participatory continuum. It is a "multi-phase" mixed-method research aiming to present the clinical and participatory dimensions of the TMR: the way in which they are…
Massey, Christi Sporl; Raybould, Ted P; Skelton, Judith; Wrightson, A Stevens; Smith, Tim A
The oral health of children became a more prominent concern with the U.S. surgeon general's report on oral health in America in 2000. The purpose of our study was 1) to assess General Practice Residency (GPR) and Advanced Education in General Dentistry (AEGD) (here jointly referred to as advanced general dentistry [AGD] programs) directors' current behaviors with regard to pediatric training of residents and 2) to assess their attitudes about which components of pediatric oral health training should be included in AGD programs. A twenty-one item survey was mailed to all GPR and AEGD programs accessed through the American Dental Association website. Seventy percent of directors (N=187) completed and returned the survey. Responses indicated that AGD residents receive adequate clinical exposure to pediatric patients and provide much-needed services to uninsured, underinsured, and underserved people. Although clinical training in pediatric treatment was high, didactic hours focused on pediatric treatment did not seem commensurate with clinical activity. Program directors indicated strong attitudinal support for teaching residents many components of pediatric oral health care, although most directors have concerns over increasing didactic hours spent on pediatric oral health due to already crowded curricula. Approximately 88 percent of directors said that they would implement a pediatric oral health module in their curricula if they had access to one.
Gillham, John C.; Evans, Lesley Anne; Williams, Nicole V.
The purpose of this study was to learn if teachers believe their experience with the Resident Educator Program improved their ability to meet the Ohio Standards for the Teaching Profession and increased support and retention. The 189 participants completed a 33 question Likert-based survey and provided more than 406 comments. The findings indicate…
Michelle M Lee
Full Text Available Michelle M Lee1, Cameron J Camp2, Megan L Malone21Midwestern University, Department of Behavioral Medicine, Downers Grove, IL , USA; 2Myers Research Institute of Menorah Park Center for Senior Living, Beachwood, OH, USA Abstract: Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES. These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.Keywords: Montessori-based activities, intergenerational programming, engagement, dementia
Matheny, Pamela M.
Medical students apply for dermatology residency program acceptance and, after completing training, become eligible to take the American Board of Dermatology examination. Some recent dermatologist practice trends concern dermatology leaders in academia. Changing the workforce trends may begin with changing the workforce. Academic dermatology…
Rhodes, Allison; Wilson, Stephen
The purpose of this study was to determine various aspects of the research experiences in postgraduate and residency training programs in pediatric dentistry. A survey was developed and sent to all directors of postgraduate and residency training programs in pediatric dentistry. The survey consisted of 21 items on various topics related to research experiences of the postgraduate students and residents. The items varied in structure, but most contained response sets deemed appropriate for the intent of the question. The directors were asked to complete the survey and return the questionnaire in a self-addressed stamped envelope within a 3-week period. If a program did not respond within 6 weeks, a follow-up survey was sent. The response sets were collated and analyzed with descriptive and nonparametric statistics. Forty of 55 programs responded with usable data sets. All reporting programs indicated that research experiences occur for residents and all have access to statistical assistance. Eighty-seven percent devote clinical hours to student research and 50% of the students share data or protocols. Only a minority (7%) of programs has not published student research in the last 5 years. Interference with revenue-generating clinic times (45%), lack of faculty understanding/interest in research (40%), and lack of financial resources (32%) were the 3 major obstacles for postgraduate research. Despite research being accomplished in postgraduate programs in pediatric dentistry, variability in key factors (eg, devoted research time) is common among programs. The impact of this variability on the profession and its advancement of scientific endeavors are unknown.
Funminiyi A. Taylor
Full Text Available Problem Graduate medical education programs are expected to educate residents to be able to manage critically ill patients. Most obstetrics and gynecology (OB/GYN graduate medical education programs provide education primarily in a didactic format in a traditional face-to-face setting. Busy clinical responsibilities tend to limit resident engagement during these educational sessions. The revision of the training paradigm to a more learner-centered approach is suggested. Intervention A blended learning education program was designed and implemented to facilitate the teaching and learning of obstetric emergencies, specifically diabetic ketoacidosis and acute-onset severe hypertension in pregnancy. The program incorporated tools to foster a community of inquiry. Multimedia presentations were also utilized as the main modality to provide instruction. The blended learning course was designed in accordance with the cognitive theory of multimedia learning. Context This intervention was carried out in the Department of Obstetrics and Gynecology, Southern Illinois University. All 15 OB/GYN residents were enrolled in this course as part of their educational curriculum. First, face-to-face instructions were given in detail about the blended learning process, course content, and online website. The residents were then assigned tasks related to completing the online component of the course, including watching multimedia presentations, reading the resources placed online, and participating in online asynchronous discussions. The course culminated with a face-to-face session to clarify misconceptions. Pre- and postcourse quizzes were administered to the residents to assess their retention and understanding. Outcome Objective analysis demonstrated significant improvements in retention and understanding after participating in the course. The blended learning format was well received by the residents. Resident perception of social presence in the asynchronous
Sarkiss, Christopher A; Riley, Kyle J; Hernandez, Christopher M; Oermann, Eric K; Ladner, Travis R; Bederson, Joshua B; Shrivastava, Raj K
Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P productivity on both the resident and faculty level (average h-index 1.6, 1.9, 3.9 for 1, 2, and
The psychiatry of the 21st century will have to be different from the psychiatry of the 20th century. The latter began its journey in a socially, compartmentalized world in which sharp categories and boundaries for the definition of mental illness were assumed to be relevant. International psychiatry completed its hegemonic hold over the territory of mental health and illness with a commanding home-stretch run of success borne in the confidence and optimism of its neurobiologic and culture free program and agenda. The world in which psychiatry now exists, however is changing rapidly and will continue to change and so of necessity will the practice of psychiatry need to change. This issue offers a guidelines and a vision of the direction that should be followed. Migration and transnational communication and awareness of cultural differences are changing the character of communities around the world. These changes considered in the context of world wide political economic factors are bringing into close physical and symbolic juxtaposition persons from distinct nations and ethnic groups. Clashes in world views, attitudes, spiritual orientation, and general philosophic and moral outlook are becoming ever-present realities of urban centers around the world. In traditional contexts and among persons who do not physically migrate, the power of communications media manages to psychologically migrate them; that is, to challenge their local, native cultural traditions about mental health with the scientific perspectives about mental health and illness. Advances in the social and cultural sciences have underscored ways in which assumptions of reductionism and universalism need to be chastened with an appreciation of human differences and humane considerations as these relate to mental health problems. The science of psychiatry of the 21st century will have to accomodate to this new creolized world of ethnic pluralism, cultural differences, and clashing perspectives between
Gandhi, Manisha; Beasley, Anitra; Vinas, Emily; Sangi-Haghpeykar, Haleh; Ramin, Susan M; Kilpatrick, Charlie C
To evaluate the use of mobile technology to facilitate resident learning, assess clinical knowledge, and guide curricular development in a busy clinical environment. This was a cross-sectional study conducted in a large (N=48) urban obstetrics and gynecology residency program. Question sets were created in the following areas: office gynecology, general obstetrics, gynecologic surgery and urogynecology, maternal-fetal medicine and ultrasonography, reproductive endocrinology and pediatric gynecology, and gynecologic oncology. Using an educational mobile application (app), questions were sent monthly to resident smartphones with immediate feedback on answer accuracy along with answer explanation and references. Outcomes included app use, which was determined by how quickly participants answered questions (very active-active indicates questions answered within 7 days) and proficiency (mean percentage correct) calculated for individuals, resident class level, and by content area. All 48 residents participated and 77.4% were very active or active app users. On average, participants answered correctly 61.0% on the first attempt and improved to 78.3% on repeat attempt (P<.001). Proficiency was lowest for gynecologic surgery and highest for general obstetrics. A mobile app to support e-learning was successfully implemented in our program; its use was associated with knowledge retention and identification of low-proficiency topics to guide curriculum development.
N. Paul Ohori MD
Full Text Available The field of pathology has changed dramatically over the recent decades and has become more complex with emphasis toward subspecialization. These changes potentially influence resident training as programs and trainees search for cutting-edge skills in the evolving field. Over the last 20 years, our institution’s residency education was modified profoundly to emphasize subspecialty practice. Furthermore, efforts were made to search for and recruit candidates who desired such training. In this study, we examined a 20-year time period to determine how these changes may have influenced the characteristics of our resident graduates. For each trainee who graduated from our pathology residency program (1994-2013, the following parameters were evaluated: highest academic degree, gender, graduating medical school, type of training, number of publications during residency, enrollment in fellowships, and type of career position. The data collected were divided into 4 time periods. Fisher exact test and 2-tailed t test were used for statistical analyses comparing the first half (1994-2003 to the latter half (2004-2013 of the study. In the second half, there were more graduates who pursued single track pathology training—anatomic pathology or clinical pathology versus combined anatomic/clinical pathology training ( P = .035, more first author and total publications per graduate during residency ( P < .001, more graduates who enrolled in fellowships ( P < .001, and a greater tendency toward an academic career position than all other types combined ( P = .034. In parallel to the subspecialization trends in our department, we witnessed changes in the characteristics of our resident graduates whose interests and career choices have become more focused.
Rosser, J C; Rosser, L E; Savalgi, R S
Laparoscopic surgery adapts poorly to apprenticeship models for general surgical training. Standardized skill acquisition and validation programs, targeted performance goals, and a supervised, enforced, skill-based curriculum that readily can be shared between trainee and instructor must replace the observation and incremental skill-acquisition model used in an open surgical environment. The Yale Laparoscopic Skills and Suturing Program was used to develop a data bank for objective evaluation of dexterity and suturing skills for laparoscopic surgical training. The current study compares trainee and senior surgeon performance in this standardized training program. To compare objectively evaluated laparoscopic surgical skills and suturing capability of senior surgeons and of residents after they have completed the same standardized training regimen. Two hundred ninety-one trained surgeons performed 8730 standardized laparoscopic dexterity drills and 2910 intracorporeal suturing exercises in the Yale Laparoscopic Skills and Suturing Program. Their performance was supervised by an instructor who recorded performance and timing of the tasks in a 2 1/2-day program. Ninety-nine residents performed the same drills and exercises the same number of times and followed the same technique for intracorporeal suturing. Percentile graphs were prepared for each type of drill and suturing exercise to allow comparison of levels of achievement among different training groups. The performance of the residents was the same as that of trained surgeons for the rope pass drill and the suturing exercise. Residents in comparison with trained surgeons performed the triangle transfer drill faster and the new cup drop drill and old cup drop drill more slowly. There was no significant difference in performance between male and female residents. Basic skills relevant to laparoscopic performance can be acquired with a high level of competence in a brief course unrelated to prior surgical
Shin, Jennifer J; Cunningham, Michael J; Emerick, Kevin G; Gray, Stacey T
Surgical competency requires sound clinical judgment, a systematic diagnostic approach, and integration of a wide variety of nontechnical skills. This more complex aspect of clinician development has traditionally been difficult to measure through standard assessment methods. This study was conducted to use the Clinical Practice Instrument (CPI) to measure nontechnical diagnostic and management skills during otolaryngology residency training; to determine whether there is demonstrable change in these skills between residents who are in postgraduate years (PGYs) 2, 4, and 5; and to evaluate whether results vary according to subspecialty topic or method of administration. Prospective study using the CPI, an instrument with previously established internal consistency, reproducibility, interrater reliability, discriminant validity, and responsiveness to change, in an otolaryngology residency training program. The CPI was used to evaluate progression in residents' ability to evaluate, diagnose, and manage case-based clinical scenarios. A total of 248 evaluations were performed in 45 otolaryngology resident trainees at regular intervals. Analysis of variance with nesting and postestimation pairwise comparisons were used to evaluate total and domain scores according to training level, subspecialty topic, and method of administration. Longitudinal residency educational initiative. Assessment with the CPI during PGYs 2, 4, and 5 of residency. Among the 45 otolaryngology residents (248 CPI administrations), there were a mean (SD) of 5 (3) administrations (range, 1-4) during their training. Total scores were significantly different among PGY levels of training, with lower scores seen in the PGY-2 level (44 ) compared with the PGY-4 (64 ) or PGY-5 level (69 ) (P otolaryngology (mean [SD], 72 ) than in subspecialties (range, 55 , P = .003, to 56 , P < .001). Neither administering the examination with an electronic scoring system, rather than a
Full Text Available Background: The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating. Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective: To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods: Training included didactics (six sessions/year, distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs, self-assessments, and logs of personal health habits. Results: A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01. Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76% compared with plural for resident, preventive medicine residents (80%. However, this difference did not reach statistical significance (p=0.11. Conclusion: Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.
Chun, Maria B J; Deptula, Peter; Morihara, Sarah; Jackson, David S
Recent articles have documented the importance of cultural competency in surgery. Surgical residency programs have used the Objective Structured Clinical Examinations or cultural standardized patient examinations as a training tool. Past studies evaluating cultural competency have noted the importance of including an observational (control) arm, which would allow for a more objective assessment of a resident's competency in this area. The purpose of our article is to present the results of a follow-up study to a pilot cultural standardized patient examination for surgery residents. All first-year surgery residents were required to participate in the videotaped cultural SP examination as part of the general surgery residency curriculum. Two measures were used to assess resident performance. On the day of the examination, the Cross-Cultural Care Survey was administered. The examination was assessed by the residents themselves, faculty observers, and standardized patients, using a written checklist that was developed to evaluate residents on all 6 Accreditation Council for Graduate Medical Education competencies. The current study includes 20 first-year surgery residents from academic years 2011 to 2012 and 2012 to 2013. The examination of pretest differences in groups found that students born outside of the United States had significantly higher scores on attitude (t = -2.68, df = 18, p = 0.02), but no statistically significant differences were found in skillfulness or knowledge or in the overall rating scale. For the overall rating scale, change from pretest to posttest was statistically significant (t = -2.25, df = 18, p = 0.04). Further analysis revealed that students who were born in the United States demonstrated a significant increase in ratings (t = -3.08, df = 10, p = 0.01) whereas students who were not born in the United States showed little change (t = -0.35, df = 7, p = 0.74). These results show that the means in attitude scales changed little for all
Full Text Available Joan C Lo,1–3 Thomas E Baudendistel,2,3 Abhay Dandekar,3,4 Phuoc V Le,5 Stanton Siu,2,3 Bruce Blumberg6 1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; 2Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Graduate Medical Education, Kaiser Permanente East Bay, Oakland, CA, USA; 4Department of Pediatrics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 5School of Public Health, University of California Berkeley, Berkeley, CA, USA; 6Graduate Medical Education, Kaiser Permanente Northern California, Oakland, CA, USA Abstract: Collaborative partnerships between community-based academic residency training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention. These residency-MPH programs draw on more than 50 years of clinical education, public health training, and health services research – creating an environment that sparks inquiry and added value by developing skills in patient-centered care through the lens of population-based outcomes. Keywords: graduate medical education, public health, master’s degree, internal medicine, pediatrics, residency training
Roze des Ordons, Amanda; Kassam, Aliya; Simon, Jessica
Residents are commonly involved in establishing goals of care for hospitalized patients. While education can improve the quality of these conversations, whether and how postgraduate training programs integrate such teaching into their curricula is not well established. The objective of this study was to characterize perceptions of current teaching and assessment of goals of care conversations, and program director interest in associated curricular integration. An electronic survey was sent to all postgraduate program directors at the University of Calgary. Quantitative data was analyzed using descriptive statistics and qualitative comments were analyzed using thematic analysis. The survey response rate was 34% (22/64). Formal goals of care conversation teaching is incorporated into 63% of responding programs, and most commonly involves lectures. Informal teaching occurs in 86% of programs, involving discussion, direct observation and role modeling in the clinical setting. Seventy-three percent of programs assess goals of care conversation skills, mostly in the clinical setting through feedback. Program directors believe that over two-thirds of clinical faculty are prepared to teach goals of care conversations, and are interested in resources to teach and assess goals of care conversations. Themes that emerged include 1) general perceptions, 2) need for teaching, 3) ideas for teaching, and 4) assessment of goals of care conversations. The majority of residency training programs at the University of Calgary incorporate some goals of care conversation teaching and assessment into their curricula. Program directors are interested in resources to improve teaching and assessment of goals of care conversations.
Kallert, Thomas Wilhelm
This paper highlights issues in the field of coercion in psychiatry which have gained importance in 2007. Reviews on 'involuntary hospital admission' demonstrated negative and positive consequences on various outcome domains. Papers on 'coercion and the law' identified cross-national differences of legal regulations, or addressed justice and equality issues. Studies on the 'patient's perspective', and 'family burden of coercion' showed that involuntariness is associated with feeling excluded from participation in the treatment. A review on 'outpatient commitment' recommended the evaluation of a range of outcomes if this specific legislation is introduced. 'Coercion in special (healthcare) settings and patient subgroups' needs to be assessed in detail. This refers to somatic hospitals, establishments for mentally retarded patients, prisons, forensic settings, and coercion mechanisms for addiction treatment, eating disorders, and minors. Empirical findings in other areas focused on attitudes towards involuntary treatment; decision variables for involuntary commitment; guidelines on the use of coercive measures; and intervention programs for staff victims of patient assaults. Coercion in psychiatry is an important area for future clinical and research initiatives. Because of the linkages with legal, human rights and ethical issues, a huge number of individual questions needs to be addressed.
The residency program for a specialist in orthopedics and trauma surgery is facing fundamental changes based on an initiative originating from the working group "medical training" of the German Medical Association (GMA). A survey indicated that 50 % of all trainees are dissatisfied with their current situation. It appears important to integrate the ideas and wishes of current orthopedic residents in a novel training concept. To assess this a survey was performed by the Young Forum of the German Society for Orthopedics und Trauma Surgery. The internet-based short survey was conducted in January 2013 among members of the professional societies (DGU, DGOU and DGOOC). 408 physicians participated. The majority of the participating physicians is interested in a career in orthopedics and trauma surgery with primarily operative contents. Accordingly the majority (62 %, n = 253) voted against a reduction of numbers of surgical interventions with 86 % (n = 351) confirming the necessity that these operations must be carried out by the trainee himself. The upcoming changes in residency program for orthopedics and trauma surgery offer the opportunity for a well structured and practical oriented residency program. It could be a further step in increasing satisfaction in this profession. Georg Thieme Verlag KG Stuttgart · New York.
Lee, Michelle M; Camp, Cameron J; Malone, Megan L
Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP) with 15 preschool children from the facility's on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose--the Myers Research Institute Engagement Scale (MRI-ES). These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented "lessons" to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.
Clapp, Justin T; Gordon, Emily K B; Baranov, Dimitry Y; Trey, Beulah; Tilin, Felice J; Fleisher, Lee A
While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm. In 2013-2016, the University of Penn sylvania's Department of Anesthesiology and Critical Care (DACC) carried out a leadership development program for residents, which included seminars focused on developing particular leadership skills and annual capstone sessions facilitating discussion between residents and attending physicians about topics chosen by residents. The capstone sessions proved to be most impactful, serving as forums for open conversation about how these groups interact when engaged in social behaviors such as giving/receiving feedback, offering support after an adverse event, and teaching/learning in the clinic. The success of the capstone sessions led to a 2016 DACC-wide initiative to facilitate transparency among all professional roles (faculty, residents, nurse anesthetists, administrative staff) and encourage widespread reflexive examination about how the manner in which these groups interact encourages or impedes leadership and teamwork. Further work is necessary to describe how leadership program formats can be diversified to better encourage reflexivity. There is also a need to develop mechanisms for assessing outcomes of leadership programs that expand outside the competency-based system.
Schmalbach, Cecelia E
Current otolaryngology literature and future scientific direction rely heavily on a rigorous peer review process. Just as manuscripts warrant thoughtful review with constructive feedback to the authors, the same can be said for critiques written by novice peer reviewers. Formal scientific peer review training programs are lacking. Recognizing this knowledge gap, Otolaryngology-Head and Neck Surgery is excited to offer its new Resident Reviewer Development Program. All otolaryngology residents who are postgraduate year 2 and above and in excellent academic standing are eligible to participate in this mentored program, during which they will conduct 6 manuscript reviews under the direction of a seasoned reviewer in his or her subspecialty area of interest. By completing reviews alongside a mentor, participants gain the required skills to master the peer review process-a first step that often leads to journal editorial board and associate editor invitations. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.
Bratt, Marilyn Meyer
Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.
Paul, Baldeep; Baranchuk, Adrian
Electrocardiography (ECG) interpretation is an essential skill for a family physician. Teaching and learning electrocardiography is a difficult task, in part due to the erosion of knowledge when interpretation is not part of a daily activity. The objective of this study was to assess the current status of electrocardiography teaching in Canadian family medicine residency programs. A national survey was designed to specifically address the status of the ECG teaching curricula. This national survey was electronically sent to the family medicine program directors of all 17 Canadian accredited medical schools. Approximately 75% of the schools responded to the survey. There was a great variance among Canadian family medicine residency programs with respect to the time allotment, ECG training location, training faculty, and teaching methods utilized. The goals of each respective program are also quite wide-ranging. Family medicine residency programs across Canada are quite diverse regarding ECG training curricula and its goals. The need for a homogeneous way of teaching and evaluating has been identified.
Morris, Deborah A; Galicia-Castillo, Marissa
To describe the CARES program, a model of palliative care for nursing home residents. Descriptive analysis of the Caring About Residents' Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred. 170 nursing home residents were seen by CARES Program between February 2013 to December 2015, 48% for skilled services, and 52% for long term care. Majority of referrals were for goals of care and concurrent symptom management. Following consultation, 67% of residents had a change in code status. Of residents desiring a palliative course 90% were never hospitalized. Overall, 53% of residents died; and those in long term care dying more often with hospice. The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.
Ishida, Yuichi; Hosoya, Yoshinori; Sata, Naohiro; Yasuda, Yoshikazu; Lefor, Alan T
Although studies have been conducted to identify factors that attract students to a career in surgery, the relative importance of factors that attract students to a particular training program remains unknown. Comparative data between countries may provide insights and ultimately provide guidance to program directors as they seek to attract the best applicants to their program. Blinded written survey, scored 1-5 on a list of 26 factors divided into 3 categories, including educational factors, lifestyle factors, and other. Jichi Medical University, Japan and the David Geffen School of Medicine at University of California-Los Angeles. Japan residents (N = 125), Japan Medical Students (N = 68), United States Residents (N = 99), and United States Students (N = 55). All 4 groups surveyed judged faculty quality among the most important factors, with educational program quality, clinical experience and perceptions of resident happiness also rated among the most important. A comparison of factors consistent with lifestyle and factors consistent with the educational program found significantly (p applicants are most interested in training program factors related to the quality of the educational program and the faculty. Issues such as salary, vacation, night call, location, or benefits are considered less important. The results in Japan and the United States were remarkably similar despite major differences in the educational system and debt load at the time of graduation. Program directors should communicate the value of those factors considered important by applicants as part of the recruitment process. Copyright Â© 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Wexner, Trevor; Rosales-Velderrain, Armando; Wexner, Steven D; Rosenthal, Raul J
Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. We analyzed all laparoscopic appendectomies (lap-ap), cholecystectomies (lap-chole), and inguinal hernia repairs (IHR) performed before and after implementing a GRSP. Operative time significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001) and IHR (p = 0.03). Time to close the incision significantly increased for lap-ap (p < 0.0001), lap-chole (p = 0.006) and IHR (p = 0.03). Length of stay only increased for lap-ap (p = 0.04). Complication rates did not increase for any procedure. However, charges significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001), and IHR (p = 0.03). Although a newly implemented GSRP caused increases in overall operative times, times to close incisions, and charges, it did not negatively impact patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
Bharwani, Govind; Parikh, Pratik J; Lawhorne, Larry W; VanVlymen, Eric; Bharwani, Meena
Person-centered, nonpharmacological interventions for managing Alzheimer's/dementia-related behavioral disturbances have received significant attention. However, such interventions are quite often of a single type limiting their benefits. We develop a comprehensive nonpharmacological intervention, the Behavior-Based Ergonomic Therapy (BBET), which consists of multiple therapies. This low-cost, 24/7 program uses learning, personality, and behavioral profiles and cognitive function of each resident to develop a set of individualized therapies. These therapies are made available through an accessible resource library of music and video items, games and puzzles, and memory props to provide comfort or stimulation depending on an individual resident's assessment. The quantitative and qualitative benefits of the BBET were evaluated at the dementia care unit in a not-for-profit continuing care retirement community in west central Ohio. The 6-month pilot study reduced falls by 32.5% and markedly reduced agitation through increased resident engagement.
Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L
Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Napholz, L; Kelly, W H
Formal and structured training in medical risk assessment (MRA) has been a requirement in general practice residency (GPR) programs since their inception in 1972. Institutions offering GPR programs frequently differ in the levels and types of available resources necessary to implement this training. Program directors have expressed significant concerns that this training is difficult to provide, especially in the area of physical examination. The literature has not yet established how or if programs have organized their curricula to conform to accreditation standards in MRA established by the American Dental Association's Commission on Dental Accreditation. The purpose of this study was to conduct a nationwide survey of all GPR programs to identify program characteristics and resources, didactic and clinical educational methods, and perceived achievement of ADA Standard Fourteen for MRA training. Recommendations for further research are also given. Results will be reported in this paper, the paper following in this issue, and an additional paper to be published in a forthcoming issue.
Full Text Available Abstract Background While family medicine is not well established as a discipline in Japan, a growing number of Japanese medical schools and training hospitals have recently started sougoushinryoubu (general medicine departments. Some of these departments are incorporating a family medicine approach to residency training. We sought to learn from family medicine pioneers of these programs lessons for developing residency training. Methods This qualitative project utilized a long interview research design. Questions focused on four topics: 1 circumstances when becoming chair/faculty member; 2 approach to starting the program; 3 how Western ideas of family medicine were incorporated; and 4 future directions. We analyzed the data using immersion/crystallization to identify recurring themes. From the transcribed data, we selected representative quotations to illustrate them. We verified the findings by emailing the participants and obtaining feedback. Results Participants included: five chairpersons, two program directors, and three faculty members. We identified five lessons: 1 few people understand the basic concepts of family medicine; 2 developing a core curriculum is difficult; 3 start with undergraduates; 4 emphasize clinical skills; and 5 train in the community. Conclusion While organizational change is difficult, the identified lessons suggest issues that merit consideration when developing a family medicine training program. Lessons from complexity science could inform application of these insights in other countries and settings newly developing residency training.
Robin, Nathaniel H; Reid Sutton, V; Caldwell, John; Jackson, James; Irons, Mira; Demmer, Laurie
In-service exams are a commonly used educational tool in postgraduate medical education. Although most specialties utilize such an exam, medical genetics did not. It was decided in the spring of 2009 at the inaugural Medical Genetics Residency Program Directors (PDs) Group meeting to develop and implement such a test. Using questions sent in from PDs, a 125-question exam was created, with 125 multiple-choice questions according to the format of the National Board of Medical Examiners. The exam covered genetics in the following areas: basic/molecular (~45 questions), cancer and adult (20), prenatal (20), biochemical (20), pediatric/dysmorphology (20). The exam was administered for the first time in February 2010, and again with modifications in 2011. In total, 174 trainees from 35 programs completed the exam in 2010; in 2011 the number increased to 214, representing 39 US programs, and 4 Canadian programs. For both years, most participants were medical genetics residents (106 in 2010; 127 in 2011), but a substantial number of clinical laboratory fellows also participated (68 in 2010; 85 in 2011). The development and implementation of this test were an overall success, in that in two years we were able to secure almost 100% participation from medical genetics residency programs, and that we created an infrastructure to develop and implement this exam on a yearly basis. There is need for improvement, notably in the relatively low mean score and relatively narrow spread of scores. However, we believe that, with efforts under way to improve the quality of the questions, the in-service exam will become a fundamental tool in medical genetics residency education.
Junod Perron, Noelle; Nendaz, Mathieu; Louis-Simonet, Martine; Sommer, Johanna; Gut, Anne; Baroffio, Anne; Dolmans, Diana; van der Vleuten, Cees
Teaching communication skills (CS) to residents during clinical practice remains problematic. Direct observation followed by feedback is a powerful way to teach CS in clinical practice. However, little is known about the effect of training on feedback skills in this field. Controlled studies are scarce as well as studies that go beyond self-reported data. The aim of the study was to develop and assess the effectiveness of a training program for clinical supervisors on how to give feedback on residents' CS in clinical practice. The authors designed a pretest-posttest controlled study in which clinical supervisors working in two different medical services were invited to attend a sequenced and multifaceted program in teaching CS over a period of 6-9 months. Outcome measures were self-perceived and observed feedback skills collected during questionnaires and three videotaped objective structured teaching encounters. The videotaped feedbacks made by the supervisors were analysed using a 20-item feedback rating instrument. Forty-eight clinical supervisors participated (28 in the intervention, 20 in the control group). After training, a higher percentage of trained participants self-reported and demonstrated statistically significant improvement in making residents more active by exploring residents' needs, stimulating self-assessment, and using role playing to test strategies and checking understanding, with effect sizes ranging from 0.93 to 4.94. A training program on how to give feedback on residents' communication skills was successful in improving clinical supervisors' feedback skills and in helping them operate a shift from a teacher-centered to a more learner-centered approach.
Edwards, Asher; Nam, Samuel
As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training. In this study, we surveyed 338 Accreditation Council for Graduate Medical Education-accredited internal medicine program directors. We queried how palliative care was integrated into their training programs. The vast majority of respondents felt that palliative care training was "very important" (87.5%) and 75.9% of respondents offered some kind of palliative care rotation, often with a multidisciplinary approach. Moving forward, we are hopeful that the data provided from our survey will act as a launching point for more formal investigations into palliative care education for internal medicine residents. Concurrently, policy makers should aid in palliative care instruction by formalizing required palliative care training for internal medicine residents.
Rakesh Kumar Chadda
Full Text Available Preventive psychiatry is one of the most ignored subdiscipline of psychiatry, which has got important role to play in the contemporary psychiatry. Mental disorders are very common with lifetime prevalence of about 25%, and tend to be chronic. Due to the stigma associated with mental disorders, lack of awareness, and also lack of adequate mental health resources, nearly 60%–80% of the persons suffering from mental disorders do not access mental health care services. Mental and substance use disorders have been identified as one of the major contributors to the disease-related burden and disability-adjusted life years. In this background, preventive psychiatry has an important role to play in public health sector. Since etiology of most of the mental disorders is not known, it is not possible to follow here the standard model of primary, secondary, and tertiary prevention of public health. A concept of universal, selective, and indicated prevention has been proposed in primary prevention. Preventive approaches in psychiatry focus on evidence-based risk and protective factors, promoting quality of life, reducing stressors, and improving resilience. Such interventions, when planned targeting at specific mental disorders, have a potential to prevent mental disorders. Thus, preventive psychiatry has a crucial role to play in mental health, considering the high prevalence of mental disorders, the associated disability and burden, and a great drain on human resources.
Finkelstein, Julia B; Van Batavia, Jason P; Rosoff, James S
To evaluate the effect of a dedicated research year on academic productivity in a heterogeneous group of urology programs. We obtained information on publication output for the past 5 years, from 2009 to 2013, of urology graduates from all 15 New York Section residency programs (n = 148). We recorded resident sex; whether the program has a dedicated year of research; number of residents per year; total number of publications per resident noting first, second, and third or greater authorship; and whether residents pursued fellowship training. Overall, the median number of total publications was 3 for residents in 5-year programs compared with 7 in 6-year programs (P = .0007). This difference remained significant when evaluating the number of publications per year as well as the number of first and third or greater authorship. Programs with 3 residents per year had significantly more publications than those with 1 or 2, regardless of research time. Graduates of 5-year programs were less likely than their 6-year counterparts to pursue fellowship training. There was a significantly higher publication output for those residents who went on to fellowship training. On multivariate analysis, 5- or 6-year program, the number of residents per year and pursuit of fellowship training remained statistically significant predictors of total publication number. Urology residents with a dedicated year of research produce more than 2 times the number of publications than their counterparts in 5-year programs. This dedicated research time and greater publication output were both indicative of the pursuit of fellowship training. Copyright © 2015 Elsevier Inc. All rights reserved.
Chen, Qingsha; Wang, Feng; Li, Xiaozhen; Yang, Jian; Yu, Shouyi; Hu, Jun
To provide an easy computational tool for evaluating the health condition of local residents. An abridged life table was programmed by applying mathematical functions and formula in Excel program and tested with the real study data to evaluate the results computed. The Excel was capable of computing group death probability of age in the life table ((n)q(x)), number of survivors (l(x)), number of death ((n)d(x)), survival per person-year ((n)L(x)), survival total per person-year (T(x)) and life expectancy (e(x)). The calculated results were consistent with those by SAS. The abridged life table constructed using Microsoft Excel can conveniently and accurately calculate the relevant indices for evaluating the health condition of the residents.
Amoako, Adae O; Amoako, Agyenim B; Pujalte, George Ga
Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7%) compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8%) respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively). Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, sports medicine contribute to residents' knowledge and comfort level in treatment of common sports injuries.
Bratt, Marilyn Meyer; Felzer, Holly M
Retaining newly graduated nurses is critical for organizations because of the significant cost of turnover. Since commitment to an organization is associated with decreased turnover intent, understanding factors that influence new graduates' organizational commitment is important. In a sample of nurse residency program participants, predictors of organizational commitment over time were explored. Perceptions of the work environment, particularly job satisfaction and job stress, were found to be most influential.
Joshua Smith, Jesse; Patel, Ravi K; Chen, Xi; Tarpley, Margaret J; Terhune, Kyla P
Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic
Panda, Mukta; Desbiens, Norman A
Lifelong learning is an integral component of practice-based learning and improvement. Physicians need to be lifelong learners to provide timely, efficient, and state-of-the-art patient care in an environment where knowledge, technology, and social requirements are rapidly changing. To assess graduates' self-reported perception of the usefulness of a residency program requirement to submit a narrative report describing their planned educational modalities for their future continued medical learning ("Education for Life" requirement), and to compare the modalities residents intended to use with their reported educational activities. Data was compiled from the Education for Life reports submitted by internal medicine residents at the University of Tennessee College of Medicine Chattanooga from 1998 to 2000, and from a survey sent to the same 27 graduates 2 to 4 years later from 2000 to 2004. Twenty-four surveys (89%) were returned. Of the responding graduates, 58% (14/24) found the Education for Life requirement useful for their future continued medical learning. Graduates intended to keep up with a mean of 3.4 educational modalities, and they reported keeping up with 4.2. In a multivariable analysis, the number of modalities graduates used was significantly associated with the number they had planned to use before graduation (P = .04) but not with their career choice of subspecialization. The majority of residents found the Education for Life requirement useful for their future continued medical learning. Graduates, regardless of specialty, reported using more modalities for continuing their medical education than they thought they would as residents. Considering lifelong learning early in training and then requiring residents to identify ways to practice lifelong learning as a requirement for graduation may be dispositive.
Kanas, N.; Manzey, D.
This book deals with psychological, psychiatric, and psychosocial issues that affect people who live and work in space. Unlike other books that focus on anecdotal reports and ground-based simulation studies, this book emphasizes the findings from psychological research conducted during actual space missions. Both authors have been active in such research. What is presented in this readable text has previously been found only in scientific journal articles. Topics that are discussed include: behavioral adaptation to space; human performance and cognitive effects; crewmember interactions; psychiatric responses; psychological counter-measures related to habitability factors, work-design, selection, training, and in-flight monitoring and support; and the impact of expeditionary missions to Mars and beyond. People finding this book of interest will include: psychology and social science students and professors in universities; medical students and residents in psychiatry and aerospace medicine; human factors workers in space and aviation professions; individuals involved with isolated environments on Earth (e.g., the Antarctic, submarines); aerospace workers in businesses and space agencies such as NASA and ESA; and anyone who is interested in learning the facts about the human side of long-duration space missions. Link: http://www.wkap.nl/prod/b/1-4020-1341-8
Spear, Shawn; Sim, Vasiliy; Moore, Frederick A; Todd, S Rob
In 2009, the Society of Critical Care Medicine (SCCM)/American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) published "Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient." To improve our surgery residents' understanding of intensive care unit (ICU) nutrition, we developed a nutrition education program based on these guidelines. The purpose of this pilot study was to assess its effectiveness. We hypothesized that our nutrition education program would improve our residents' knowledge of ICU nutrition. This was a prospective observational pilot study performed in the surgical ICU of an academic medical center. Based on the SCCM/A.S.P.E.N. nutrition guidelines, we developed a nutrition education program (lectures covering selected guidelines and interactive case studies). Pre- and posttesting were performed to assess short-term comprehension. Long-term retention was assessed 3 months after the initial education program. The primary outcome measure was the change in ICU nutrition knowledge. Significance was set at P nutrition education program. Their mean age was 27.8 ± 1.2 years, and 50% were male. The mean test scores were as follows: pretest, 45% ± 9%; posttest, 81% ± 5%; and 3-month test, 65% ± 8%. The differences between the pretest and both posttest scores were significant (P nutrition. This is confirmed by the pretest results of the current study. Our nutrition education program improved both short-term and long-term ICU nutrition knowledge of our surgery residents. Future studies should evaluate the effect such education has on the clinical outcomes of ICU patients.
Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro
In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.
Duquette, Stephen P.; Valsangkar, Nakul P.; Sood, Rajiv; Socas, Juan; Zimmers, Teresa A.
Background: The aim of this study was to evaluate the effect of different surgical training pathways on the academic performance of plastic surgical divisions. Methods: Eighty-two academic parameters for 338 plastic surgeons (PS), 1737 general surgeons (GS), and 1689 specialist surgeons (SS) from the top 55 National Institutes of Health (NIH)-funded academic departments of surgery were examined using data gathered from websites, SCOPUS, and NIH Research Portfolio Online Reporting Tools. Results: The median size of a PS division was 7 faculty members. PS faculty had lower median publications (P)/citations (C) (ie, P/C) than GS and SS (PS: 25/328, GS: 35/607, and SS: 40/713, P < 0.05). Publication and citation differences were observed at all ranks: assistant professor (PS: 11/101, GS: 13/169, and SS: 19/249), associate professor (PS: 33/342, GS: 40/691, and SS: 44/780), and professor (PS: 57/968, GS: 97/2451, and SS: 101/2376). PS had a lower percentage of faculty with current/former NIH funding (PS: 13.5%, GS: 22.8%, and SS: 25.1%, P < 0.05). Academic productivity for PS faculty was improved in integrated programs. P/C for PS faculty from divisions with traditional 3-year fellowships was 19/153, integrated 6-year residency was 25/329, and both traditional and 6-year programs were 27/344, P < 0.05. Craniofacial and hand fellowships increased productivity within the integrated residency programs. P/C for programs with a craniofacial fellowship were 32/364 and for those that additionally had a hand fellowship were 45/536. PS faculty at divisions with integrated training programs also had a higher frequency of NIH funding. Conclusions: PS divisions vary in degree of academic productivity. Dramatically improved scholarly output is observed with integrated residency training programs and advanced specialty fellowships. PMID:27014543
Gordon, P R; Hale, F
Access to quality primary health care for our country's underserved populations is a challenge for both the government and physicians. The Division of Medicine, through funding priorities and other initiatives, is encouraging family practice educators to train residents and students for work in community and migrant health centers (C/MHCs) in underserved areas. The objective of this research was to study linkages between family practice residency programs and C/MHCs and determine the reasons for affiliation, disadvantages and advantages, predictors of successful linkages, and common errors in the linkage agreement. We conducted in-depth telephone interviews with the directors of 13 of the 19 family practice residency programs identified as having linkages with C/MHCs. All interviewees at residency programs indicated that their programs had a mission to serve underserved patients. The most commonly cited constraining factor cited by both residency programs and C/MHCs was financial support for residents, on-site faculty, and support staff. Many programs reported that residents training at the C/MHC were able to gain a community health perspective and practice community-oriented primary care. Finally, financing the relationship involved many different approaches, ranging from the residency paying all of the salaries, to a sharing of salaries by the residency, state, and/or hospital, to C/MHC paying the salaries either through its own funds or through grant support. These data provide an assessment of the current issues that family practice residencies must address to implement service-education linkages. They provide an empirical basis to outline the steps involved in forming a linkage between a residency and a C/MHC.
Keyes, C; Rodríguez-Gomez, G; Quesada-Rodriguez, D; Waller, J
A program of physician training in the specialty of emergency medicine was developed in Costa R