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Sample records for reside electronic reserve

  1. The Role of Electronic Reserves in Serving and Shaping New Teaching and Learning Environments in UK Universities.

    Science.gov (United States)

    Dugdale, Christine

    1999-01-01

    Describes the ResIDe Electronic Reserve at the University of the West of England (UWE), Bristol, an example of an electronic reserve that has been addressing many access problems and supporting different teaching/learning initiatives. Discusses new roles for the ResIDe electronic library, electronic information management, new librarian roles, and…

  2. The electronic residency application service application can predict accreditation council for graduate medical education competency-based surgical resident performance.

    Science.gov (United States)

    Tolan, Amy M; Kaji, Amy H; Quach, Chi; Hines, O Joe; de Virgilio, Christian

    2010-01-01

    Program directors often struggle to determine which factors in the Electronic Residency Application Service (ERAS) application are important in the residency selection process. With the establishment of the Accreditation Council for Graduate Medical Education (ACGME) competencies, it would be important to know whether information available in the ERAS application can predict subsequent competency-based performance of general surgery residents. This study is a retrospective correlation of data points found in the ERAS application with core competency-based clinical rotation evaluations. ACGME competency-based evaluations as well as technical skills assessment from all rotations during residency were collected. The overall competency score was defined as an average of all 6 competencies and technical skills. A total of77 residents from two (one university and one community based university-affiliate) general surgery residency programs were included in the analysis. Receiving honors for many of the third year clerkships and AOA membership were associated with a number of the individual competencies. USMLE scores were predictive only of Medical Knowledge (p = 0.004). Factors associated with higher overall competency were female gender (p = 0.02), AOA (p = 0.06), overall number of honors received (p = 0.04), and honors in Ob/Gyn (p = 0.03) and Pediatrics (p = 0.05). Multivariable analysis showed honors in Ob/Gyn, female gender, older age, and total number of honors to be predictive of a number of individual core competencies. USMLE scores were only predictive of Medical Knowledge. The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

  3. Electronic collaboration in dermatology resident training through social networking.

    Science.gov (United States)

    Meeks, Natalie M; McGuire, April L; Carroll, Bryan T

    2017-04-01

    The use of online educational resources and professional social networking sites is increasing. The field of dermatology is currently under-utilizing online social networking as a means of professional collaboration and sharing of training materials. In this study, we sought to assess the current structure of and satisfaction with dermatology resident education and gauge interest for a professional social networking site for educational collaboration. Two surveys-one for residents and one for faculty-were electronically distributed via the American Society for Dermatologic Surgery and Association of Professors of Dermatology (APD) listserves. The surveys confirmed that there is interest among dermatology residents and faculty in a dermatology professional networking site with the goal to enhance educational collaboration.

  4. Residency and movement patterns of an apex predatory shark (Galeocerdo cuvier) at the Galapagos Marine Reserve.

    Science.gov (United States)

    Acuña-Marrero, David; Smith, Adam N H; Hammerschlag, Neil; Hearn, Alex; Anderson, Marti J; Calich, Hannah; Pawley, Matthew D M; Fischer, Chris; Salinas-de-León, Pelayo

    2017-01-01

    The potential effectiveness of marine protected areas (MPAs) as a conservation tool for large sharks has been questioned due to the limited spatial extent of most MPAs in contrast to the complex life history and high mobility of many sharks. Here we evaluated the movement dynamics of a highly migratory apex predatory shark (tiger shark Galeocerdo cuvier) at the Galapagos Marine Reserve (GMR). Using data from satellite tracking passive acoustic telemetry, and stereo baited remote underwater video, we estimated residency, activity spaces, site fidelity, distributional abundances and migration patterns from the GMR and in relation to nesting beaches of green sea turtles (Chelonia mydas), a seasonally abundant and predictable prey source for large tiger sharks. Tiger sharks exhibited a high degree of philopatry, with 93% of the total satellite-tracked time across all individuals occurring within the GMR. Large sharks (> 200 cm TL) concentrated their movements in front of the two most important green sea turtle-nesting beaches in the GMR, visiting them on a daily basis during nocturnal hours. In contrast, small sharks (< 200 cm TL) rarely visited turtle-nesting areas and displayed diurnal presence at a third location where only immature sharks were found. Small and some large individuals remained in the three study areas even outside of the turtle-nesting season. Only two sharks were satellite-tracked outside of the GMR, and following long-distance migrations, both individuals returned to turtle-nesting beaches at the subsequent turtle-nesting season. The spatial patterns of residency and site fidelity of tiger sharks suggest that the presence of a predictable source of prey and suitable habitats might reduce the spatial extent of this large shark that is highly migratory in other parts of its range. This highly philopatric behaviour enhances the potential effectiveness of the GMR for their protection.

  5. Residency and movement patterns of an apex predatory shark (Galeocerdo cuvier at the Galapagos Marine Reserve.

    Directory of Open Access Journals (Sweden)

    David Acuña-Marrero

    Full Text Available The potential effectiveness of marine protected areas (MPAs as a conservation tool for large sharks has been questioned due to the limited spatial extent of most MPAs in contrast to the complex life history and high mobility of many sharks. Here we evaluated the movement dynamics of a highly migratory apex predatory shark (tiger shark Galeocerdo cuvier at the Galapagos Marine Reserve (GMR. Using data from satellite tracking passive acoustic telemetry, and stereo baited remote underwater video, we estimated residency, activity spaces, site fidelity, distributional abundances and migration patterns from the GMR and in relation to nesting beaches of green sea turtles (Chelonia mydas, a seasonally abundant and predictable prey source for large tiger sharks. Tiger sharks exhibited a high degree of philopatry, with 93% of the total satellite-tracked time across all individuals occurring within the GMR. Large sharks (> 200 cm TL concentrated their movements in front of the two most important green sea turtle-nesting beaches in the GMR, visiting them on a daily basis during nocturnal hours. In contrast, small sharks (< 200 cm TL rarely visited turtle-nesting areas and displayed diurnal presence at a third location where only immature sharks were found. Small and some large individuals remained in the three study areas even outside of the turtle-nesting season. Only two sharks were satellite-tracked outside of the GMR, and following long-distance migrations, both individuals returned to turtle-nesting beaches at the subsequent turtle-nesting season. The spatial patterns of residency and site fidelity of tiger sharks suggest that the presence of a predictable source of prey and suitable habitats might reduce the spatial extent of this large shark that is highly migratory in other parts of its range. This highly philopatric behaviour enhances the potential effectiveness of the GMR for their protection.

  6. Effects of electronic health information technology implementation on nursing home resident outcomes.

    Science.gov (United States)

    Pillemer, Karl; Meador, Rhoda H; Teresi, Jeanne A; Chen, Emily K; Henderson, Charles R; Lachs, Mark S; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P

    2012-02-01

    To examine the effects of electronic health information technology (HIT) on nursing home residents. The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior. © The Author(s) 2012

  7. A novel use of the discrete templated notes within an electronic health record software to monitor resident supervision.

    Science.gov (United States)

    Ban, Vin Shen; Madden, Christopher J; Browning, Travis; O'Connell, Ellen; Marple, Bradley F; Moran, Brett

    2017-04-01

    Monitoring the supervision of residents can be a challenging task. We describe our experience with the implementation of a templated note system for documenting procedures with the aim of enabling automated, discrete, and standardized capture of documentation of supervision of residents performing floor-based procedures, with minimal extra effort from the residents. Procedural note templates were designed using the standard existing template within a commercial electronic health record software. Templates for common procedures were created such that residents could document every procedure performed outside of the formal procedural areas. Automated reports were generated and letters were sent to noncompliers. A total of 27 045 inpatient non-formal procedural area procedures were recorded from August 2012 to June 2014. Compliance with NoteWriter template usage averaged 86% in the first year and increased to 94.6% in the second year ( P  = .0055). Initially, only 12.5% of residents documented supervision of any form. By the end of the first year, this was above 80%, with the gains maintained into the second year and beyond. Direct supervision was documented to have occurred where required in 62.8% in the first year and increased to 99.8% in the second year ( P  = .0001) after the addition of hard stops. Notification of attendings prior to procedures was documented 100% of the time by September 2013. Letters sent to errant residents decreased from 3.6 to 0.83 per 100 residents per week. The templated procedure note system with hard stops and integrated reporting can successfully be used to improve monitoring of resident supervision. This has potential impact on resident education and patient safety. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  8. Evaluation of the training capacity of the Spanish Resident Book of Otolaryngology (FORMIR) as an electronic portfolio.

    Science.gov (United States)

    Maza Solano, Juan Manuel; Benavente Bermudo, Gustavo; Estrada Molina, Francisco José; Ambrosiani Fernández, Jesús; Sánchez Gómez, Serafín

    2017-08-10

    and objectives We have evaluated the training capacity of the Spanish resident training book as an electronic portfolio to achieve the learning objectives of otorhinolaryngology (ENT) residents. A multi-method qualitative investigation with transversal characteristics, temporal and retrospective guidance was performed on Spanish ENT residents using a structured questionnaire, a semi-structured interview, and a computer application on the FORMIR website. A 56.5% of ENT-residents specialising in one of the 63 accredited Spanish hospitals between 2009-2012 participated in the study. The results obtained show that the ENT residents who used the e-portfolio were better able to implement self-guided study, were more aware of their learning objectives, fulfilled the training programme more efficiently, identified the causes of learning gaps more clearly, and considered FORMIR in e-portfolio format to be an ideal training tool to replace the resident training book in paper format. The ENT residents greatly appreciated the training benefits of FORMIR as an e-portfolio, especially its simple and intuitive interface, the ease and comfort with which they could record their activities, the automatic and numeric feedback on the acquisition of their competencies (which facilitates self-guided learning), its storage capacity for evidence, and its ability to be used as UEMS logbook as well as a standard curriculum vitae. All these features make FORMIR a training and evaluation tool that outperforms similar instruments available to ENT residents. They do not hesitate to identify it as the ideal resident training book for facilitating their specialised training. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  9. The effect of mature elephant bull introductions on ranging patterns of resident bulls: Phinda Private Game Reserve, South Africa

    Directory of Open Access Journals (Sweden)

    Heleen Druce

    2006-12-01

    Full Text Available Increasing popularity of wildlife viewing has resulted in a rapid increase in small, enclosed reserves in South Africa. The African elephant is one of the many species that has been reintroduced into these reserves for eco-tourism. These elephant populations were established as young (smaller that 10 years old orphans from prior Kruger National Park culling operations. Consequently, this abnormal sex and age structure of these introduced populations has influenced their behavioural and spatial ecology. In Pilanesberg National Park, this abnormal behaviour was corrected by introducing older bulls and culling certain problem elephants. In July 2003, three older bulls (29–41 years old were introduced into Phinda Private Game Reserve, KwaZulu-Natal, South Africa in order to normalise the bull age structure. These introduced bulls were monitored intensively after release, as was the resident bull population, both before and after introduction of the older bulls. The introduced bulls settled into restricted ranges separate from the family groups. All the resident bulls decreased their home ranges at first, with most increasing their home ranges a year later. The resident bulls’ change in ranging patterns was due more to ecological factors than to the influence of the mature bull introduction. This study indicates that the introduction of older male elephants into small populations does not pose major risks or animal welfare concerns.

  10. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home.

    Science.gov (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith

    2012-02-01

    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

  11. Modeling sediment transport processes and residence times in the shallow coastal bay complex of the Virginia Coast Reserve

    Science.gov (United States)

    Safak, I.; Wiberg, P. L.

    2011-12-01

    Patterns of sediment transport and particle residence times influence the morphology and ecology of shallow coastal bays in important ways. The Virginia Coast Reserve (VCR), a barrier island-lagoon-marsh system on the Eastern Shore of Virginia, is typical of many shallow coastal bay complexes that lack a significant fluvial source of freshwater and sediment. Sediment redistribution within the bays in response to storms and sea-level rise, together with the dynamics of marsh and lagoon-bottom plants, largely governs the morphological evolution of this system. There are also important feedbacks between sediment and ecosystem dynamics. This is particularly true in the VCR, which is relatively unaffected by human activities. As a step towards evaluating the impact of hydrodynamics on sediment and ecological processes in the VCR, a single unified model that accounts for circulation, surface waves, wave-current interaction, and sediment processes is employed. This three-dimensional unstructured grid finite-volume coastal ocean model (FVCOM) is validated with field observations of wind- and tide-induced water flow (water level and current velocities) in Hog Island Bay, centrally located within the VCR. Here, the resulting patterns of sediment transport and particle residence times over event and seasonal time scales are presented. Water and particle exchange within the VCR and between the VCR and the ocean is examined with the Lagrangian particle-tracking module in FVCOM. We focus on three bays with strongly varying bathymetry and coastline geometry, which are also located along a gradient of nitrogen input to the system. The results indicate that residence time of particles within the system vary greatly depending on the location of particle release, bay morphology, and wind conditions. The implications for morphologic evolution and ecosystem response to climate and land-use changes are evaluated.

  12. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Directory of Open Access Journals (Sweden)

    Yasaira Rodriguez Torres

    Full Text Available This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p 90% in 13 elements while Electronic Health Record B had high compliance (>90% in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  13. Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning.

    Science.gov (United States)

    Hards, Andrea; Davies, Sharon; Salman, Aliya; Erik-Soussi, Magda; Balki, Mrinalini

    2012-09-01

    Successful resuscitation of a pregnant woman undergoing cardiac arrest and survival of the fetus require prompt, high-quality cardiopulmonary resuscitation. The objective of this observational study was to assess management of maternal cardiac arrest by anesthesia residents using high-fidelity simulation and compare subsequent performance following either didactic teaching or electronic learning (e-learning). Twenty anesthesia residents were randomized to receive either didactic teaching (Didactic group, n = 10) or e-learning (Electronic group, n = 10) on maternal cardiac arrest. Baseline management skills were tested using high-fidelity simulation, with repeat simulation testing one month after their teaching intervention. The time from cardiac arrest to start of perimortem Cesarean delivery (PMCD) was measured, and the technical and nontechnical skills scores between the two teaching groups were compared. The median [interquartile range] time to PMCD decreased after teaching, from 4.5 min [3.4 to 5.1 min] to 3.5 min [2.5 to 4.0 min] (P = 0.03), although the change within each group was not statistically significant (Didactic group 4.9 to 3.8 min, P = 0.2; Electronic group 3.9 to 2.5 min, P = 0.07; Didactic group vs Electronic group, P = 1.0). Even after teaching, only 65% of participants started PMCD within four minutes. Technical and nontechnical skills scores improved after teaching in both groups, and there were no differences between the groups. There are gaps in the knowledge and implementation of resuscitation protocols and the recommended modifications for pregnancy among residents. Teaching can improve performance during management of maternal cardiac arrest. Electronic learning and didactic teaching offer similar benefits.

  14. Dietary intake of PBDEs of residents at two major electronic waste recycling sites in China

    Energy Technology Data Exchange (ETDEWEB)

    Chan, J.K.Y. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong (China); Man, Y.B. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); Wu, S.C. [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China); State Key Laboratory in Marine Pollution, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong (China); Wong, M.H., E-mail: mhwong@hkbu.edu.hk [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong (China)

    2013-10-01

    The dietary intake of polybrominated diphenyl ether (PBDE) of local residents from 2 major electronic waste (e-waste) processing sites (Guiyu, Guangdong Province and Taizhou, Zhejiang Province) in China was investigated. Seventy-four food items were collected from these sites, divided into 9 food groups (freshwater fish, marine fish, shellfish, pork, poultry, chicken offal, egg, vegetables and cereals), and examined for residual PBDE concentrations. Out of all food items examined, the freshwater bighead carp (Aristichthys nobilis) contained extremely high (11,400 ± 254 ng/g wet wt.) concentrations of PBDE, the highest concentrations amongst published data concerning PBDE detected in freshwater fish. Food consumption data obtained through semi-quantitative food intake questionnaires showed that Guiyu residents had a PBDE dietary intake of 931 ± 772 ng/kg bw/day, of which BDE-47 (584 ng/kg bw/day) exceeded the US EPA's reference dose (100 ng/kg/day). Taizhou (44.7 ± 26.3 ng/kg bw/day) and Lin'an (1.94 ± 0.86 ng/kg bw/day) residents exhibited lower readings. The main dietary source of PBDEs in Guiyu and Taizhou residents was seafood (88–98%) and pork (41%) in Lin'an. The present results indicated that health risks arising from PBDE dietary exposure are of significance in terms of public health and food safety to local residents of e-waste processing sites. - Highlights: ► Food basket analysis was conducted in 2 major e-waste processing sites in China. ► Different food items were contaminated by PBDE contained in e-waste sites in China. ► Guiyu residents had an potential unsafe level of PBDE dietary exposure.

  15. Business process improvement: an electronic system to monitor compliance with medical resident work hours.

    Science.gov (United States)

    Landesman, Linda Young; Markowitz, Forest; Conde, Nelson

    2010-01-01

    The limitation of medical intern and resident work hours, known as the Bell 405 regulations, was initiated in New York State in 1989 with a modification to the state hospital code. The Bell 405 regulations were strengthened in 2000, and facilities would now be fined for noncompliance. Monitoring systems in place at that time were insufficient to provide an adequate level of review for the New York City Health and Hospitals Corporation (HHC) with more than 7,000 medical residents whose training is based at or who rotate through these public hospitals. A "simple to use," yet comprehensive, method of monitoring compliance needed to be developed to ensure that residents and interns complied with laws regulating working hours. The subsequent development of national accreditation standards increased the stakes for reliable scrutiny. HHC developed and implemented a Web-based Structured Query Language (SQL) application that facilitated easy access to work hour surveys captured through electronic time sheets. The time sheet data automatically entered a database that provided instant analysis of conformance to state law. The development of an electronic on-line application accessible from anywhere allowed HHC to efficiently identify nonconformance and pinpoint corrective action. Since the inception of the application and its expansion allowing access through the intranet, 26,000 individual time sheets have been submitted for evaluation. With the national movement regulating work hours, other hospitals still at the pencil and manual computation stage would greatly benefit by developing a similar application.

  16. Electronic mail was not better than postal mail for surveying residents and faculty.

    Science.gov (United States)

    Akl, Elie A; Maroun, Nancy; Klocke, Robert A; Montori, Victor; Schünemann, Holger J

    2005-04-01

    To compare response rate, time to response, and data quality of electronic and postal surveys in the setting of postgraduate medical education. A randomized controlled trial in a university-based internal medicine residency program. We randomized 119 residents and 83 faculty to an electronic versus a postal survey with up to two reminders and measured response rate, time to response, and data quality. For residents, the e-survey resulted in a lower response rate than the postal survey (63.3% versus 79.7%; difference -16.3%, 95% confidence interval (95% CI) -32.3% to -0.4%%; P=.049), but a shorter mean response time, by 3.8 days (95% CI 0.2-7.4; P=.042). For faculty, the e-survey did not result in a significantly lower response rate than the postal survey (85.4% vs. 81.0%; difference 4.4%, 95% CI -11.7 to 20.5%; P=.591), but resulted in a shorter average response time, by 8.4 days (95% CI 4.4 to 12.4; P < 0.001). There were no differences in the quality of data or responses to the survey between the two methods. E-surveys were not superior to postal surveys in terms of response rate, but resulted in shorter time to response and equivalent data quality.

  17. Emergency medicine resident physicians' perceptions of electronic documentation and workflow: a mixed methods study.

    Science.gov (United States)

    Neri, P M; Redden, L; Poole, S; Pozner, C N; Horsky, J; Raja, A S; Poon, E; Schiff, G; Landman, A

    2015-01-01

    To understand emergency department (ED) physicians' use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving

  18. Whale shark (Rhincodon typus seasonal presence, residence time and habitat use at darwin island, galapagos marine reserve.

    Directory of Open Access Journals (Sweden)

    David Acuña-Marrero

    Full Text Available The life history of the whale shark (Rhincodon typus, including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST, with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL. Size distribution was bimodal, with a great majority (91.5% of adult female individuals averaging 11.35 m±0.12 m (TL±SE, all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20-30 m with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24-25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species.

  19. Whale Shark (Rhincodon typus) Seasonal Presence, Residence Time and Habitat Use at Darwin Island, Galapagos Marine Reserve

    Science.gov (United States)

    Acuña-Marrero, David; Jiménez, Jesús; Smith, Franz; Doherty, Paul F.; Hearn, Alex; Green, Jonathan R.; Paredes-Jarrín, Jules; Salinas-de-León, Pelayo

    2014-01-01

    The life history of the whale shark (Rhincodon typus), including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST), with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL). Size distribution was bimodal, with a great majority (91.5%) of adult female individuals averaging 11.35 m±0.12 m (TL±SE), all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE) sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE) days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20–30 m) with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24–25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species. PMID:25551553

  20. Whale shark (Rhincodon typus) seasonal presence, residence time and habitat use at darwin island, galapagos marine reserve.

    Science.gov (United States)

    Acuña-Marrero, David; Jiménez, Jesús; Smith, Franz; Doherty, Paul F; Hearn, Alex; Green, Jonathan R; Paredes-Jarrín, Jules; Salinas-de-León, Pelayo

    2014-01-01

    The life history of the whale shark (Rhincodon typus), including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST), with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL). Size distribution was bimodal, with a great majority (91.5%) of adult female individuals averaging 11.35 m±0.12 m (TL±SE), all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE) sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE) days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20-30 m) with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24-25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species.

  1. Electronic portfolio use in pediatric residency and perceived efficacy as a tool for teaching lifelong learning.

    Science.gov (United States)

    Frank, Annabel; Gifford, Kimberly

    2017-11-10

    Residency programs use electronic portfolios (efolios) to organize data, track resident performance, and sometimes teach and assess lifelong learning (LLL) skills. Published studies on efolios in graduate medical education are mostly descriptions of implementation at individual institutions. An anonymous online survey was sent to 199 pediatric residency program directors across the United States. Efolio usage patterns were described and compared between program directors that perceived efolios effective at fostering LLL and those that did not. Surveys were completed by 82 of 199 program directors (41%), and 55% used efolios. The 20% (9 of 45) of program directors that believed efolios were effective at teaching LLL more often used self-assessment (88% vs. 50%, p = 0.05) and goal-setting (75% vs. 40%, p = 0.03) functionalities. Common efolio challenges included limited usability and difficulty integrating data. Most non-users (65%) would like to invest in efolios. Respondents reported technical and convenience-related challenges to efolio use, which need to be addressed for efolios to meet their potential as valuable learning tools. The use of self-assessments and goal-setting features was associated with program directors' perceptions that efolios were effective at fostering LLL.

  2. Electronic portfolio use in pediatric residency and perceived efficacy as a tool for teaching lifelong learning

    Directory of Open Access Journals (Sweden)

    Annabel Frank

    2017-11-01

    Full Text Available Abstract Background Residency programs use electronic portfolios (efolios to organize data, track resident performance, and sometimes teach and assess lifelong learning (LLL skills. Published studies on efolios in graduate medical education are mostly descriptions of implementation at individual institutions. Methods An anonymous online survey was sent to 199 pediatric residency program directors across the United States. Efolio usage patterns were described and compared between program directors that perceived efolios effective at fostering LLL and those that did not. Results Surveys were completed by 82 of 199 program directors (41%, and 55% used efolios. The 20% (9 of 45 of program directors that believed efolios were effective at teaching LLL more often used self-assessment (88% vs. 50%, p = 0.05 and goal-setting (75% vs. 40%, p = 0.03 functionalities. Common efolio challenges included limited usability and difficulty integrating data. Most non-users (65% would like to invest in efolios. Conclusions Respondents reported technical and convenience-related challenges to efolio use, which need to be addressed for efolios to meet their potential as valuable learning tools. The use of self-assessments and goal-setting features was associated with program directors’ perceptions that efolios were effective at fostering LLL.

  3. Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study.

    Science.gov (United States)

    Lee, Wei Wei; Alkureishi, Maria A; Ukabiala, Obioma; Venable, Laura Ruth; Ngooi, Samantha S; Staisiunas, Daina D; Wroblewski, Kristen E; Arora, Vineet M

    2016-11-01

    While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. This was a prospective mixed-methods study. Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the "Clinical Care" subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the "Communication Functions" theme, and the majority of those related to the "Physical Focus" subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive

  4. Multivariate family factors in lifetime and current marijuana use among American Indian and white adolescents residing on or near reservations.

    Science.gov (United States)

    Swaim, Randall C; Stanley, Linda R

    2016-12-01

    Rates of marijuana use are consistently high among reservation-based American Indian adolescents. The roles of family are unique in this ethnic group and can serve as sources of both risk and protection for substance use. To assess the relationships between distal and proximal family factors and lifetime and current marijuana use among American Indian and white middle and high school students who attend the same schools on or near reservations. In-school surveys were administered to 3380 American Indian and 1562 white students from 35 middle schools and 17 high schools regarding levels of marijuana use and family characteristics. Three logistic regression models (Control, Control+Distal; Control+Distral+Proximal) estimated effects of multiple family variables on lifetime and current marijuana use. Strong effects were found for family structure, parental monitoring, family conflict, and family sanctions against marijuana use. Weaker effects were found for family participation in school events, and no relationship was found for family communication about marijuana. Anumber of similar results were found across ethnicity and middle and high school students. Family variables exert strong and largely consistent effects across reservation-based American Indian and white youth on lifetime and current marijuana use. Interventions that include a broad range of targeted family components may serve to both limit uptake and forestall increases in adolescent marijuana use in these two groups. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Attending Physician Remote Access of the Electronic Health Record and Implications for Resident Supervision: A Mixed Methods Study.

    Science.gov (United States)

    Martin, Shannon K; Tulla, Kiara; Meltzer, David O; Arora, Vineet M; Farnan, Jeanne M

    2017-12-01

    Advances in information technology have increased remote access to the electronic health record (EHR). Concurrently, standards defining appropriate resident supervision have evolved. How often and under what circumstances inpatient attending physicians remotely access the EHR for resident supervision is unknown. We described a model of attending remote EHR use for resident supervision, and quantified the frequency and magnitude of use. Using a mixed methods approach, general medicine inpatient attendings were surveyed and interviewed about their remote EHR use. Frequency of use and supervisory actions were quantitatively examined via survey. Transcripts from semistructured interviews were analyzed using grounded theory to identify codes and themes. A total of 83% (59 of 71) of attendings participated. Fifty-seven (97%) reported using the EHR remotely, with 54 (92%) reporting they discovered new clinical information not relayed by residents via remote EHR use. A majority (93%, 55 of 59) reported that this resulted in management changes, and 54% (32 of 59) reported making immediate changes by contacting cross-covering teams. Six major factors around remote EHR use emerged: resident, clinical, educational, personal, technical, and administrative. Attendings described resident and clinical factors as facilitating "backstage" supervision via remote EHR use. In our study to assess attending remote EHR use for resident supervision, attendings reported frequent remote use with resulting supervisory actions, describing a previously uncharacterized form of "backstage" oversight supervision. Future work should explore best practices in remote EHR use to provide effective supervision and ultimately improve patient safety.

  6. "How To" Videos Improve Residents Performance of Essential Perioperative Electronic Medical Records and Clinical Tasks.

    Science.gov (United States)

    Zoghbi, Veronica; Caskey, Robert C; Dumon, Kristoffel R; Soegaard Ballester, Jacqueline M; Brooks, Ari D; Morris, Jon B; Dempsey, Daniel T

    The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs. Additionally, we used "Cutting Insights"-a locally developed responsive mobile application for surgical trainee education-as a platform for providing interns with easy access to these videos. We hypothesized that exposure to these videos would lead to increased resident efficiency and confidence in performing essential perioperative tasks, ultimately leading to improved clinical performance. Eleven surgery interns participated in this initiative. Before watching the "how to" videos, each intern was timed performing the aforementioned 7 key perioperative EMR tasks. They also underwent a simulated perioperative emergency requiring the performance of 3 of these EMR tasks in conjunction with 5 other required interventions (including notifying the chief resident, the anesthesia team, and the OR coordinator; and ordering fluid boluses, appropriate laboratories, and blood products). These simulations were scored on a scale from 0 to 8. The interns were then directed to watch the videos. Two days later, their times for performing the 7 tasks and their scores for a similar perioperative emergency simulation were once again recorded. Before and after watching the videos, participants were surveyed to assess their confidence in performing each EMR task using a 5-point Likert scale. We also elicited their opinions of the videos and web-based mobile application using a 5-point scale. Statistical analyses to assess for

  7. Knowledge and prevalence of Human African Trypanosomiasis among residents of Kachia grazing reserve, Kachia local government area, Kaduna state, Nigeria, 2012.

    Science.gov (United States)

    Uba, Belinda Vernyuy; Aliyu, Ahmad; Abubakar, Aisha; Uba, Sabo Ado; Gidado, Saheed; Edukugho, Aboyowa; Anagbogu, Ifeoma; Kalejaiye, John; Nguku, Patrick

    2016-01-01

    Human African Trypanosomiasis (HAT) is a vector borne parasitic disease transmitted to humans by infected tse-tse flies cause morbidity including delayed child mental development. Reports of nuisance and bites from tse-tse flies by residents of Kachia grazing led to the study to determine the knowledge, practices and prevalence of HAT among residents of the grazing reserve. We conducted active case search in a cross-sectional study using multi-stage sampling with probability proportionate to size. We administered structured questionnaire on Knowledge, practices relating to HAT prevention and screened for HAT using card agglutination test for Trypanosomiasis (CATT). Knowledge of HAT was scored 0-5 and categorized good (3-5) and poor (0-2) based on score, predisposition to risk of HAT as exposure to ≥two risk factors and, a case of HAT as any respondent that tested positive on CATT. We analysed data using Epi-info and MS-excel. Of the 300 respondents, mean age 39(±17years) interviewed, 56.3% were males, 12.0% had good knowledge of HAT and 76.3% were exposed to HAT risk factors. Prevention practices included clearing of overgrown bushes around houses (99%), use of insecticidal treated nets (75.7%) and protective clothing (41.0%). Males {Odds Ratio [OR] 5.0; 95% Confidence Interval (CI) 1.8 - 13.6}, age above 40 years {OR 5.0; 95% CI 1.1 - 24.4} and family history of HAT {OR 8.7; 95% CI 2.4 - 32.1} were significantly associated with HAT knowledge. None tested positive on CATT. Despite poor knowledge of HAT, residents practiced HAT preventive measures and zero HAT prevalence was recorded.

  8. Resident use of the Internet, e-mail, and personal electronics in the care of surgical patients.

    Science.gov (United States)

    Plant, Mathew A; Fish, Joel S

    2015-01-01

    The use of smartphones, e-mail, and the Internet has affected virtually all areas of patient care. Current university and hospital policies concerning the use of devices may be incongruent with day-to-day patient care. The goal was to assess the current usage patterns of the Internet, e-mail, and personal electronics for clinical purposes by surgical residents as well as their communication habits and preferences. Also assessed was residents' knowledge regarding the institutional policies surrounding these issues. Surgical residents (n = 294) at a large teaching institution were surveyed regarding their knowledge of university policies as well as daily use of various communication technologies. Communication preferences were determined using theoretical clinical scenarios. Our survey with a response rate of 54.7% (n = 161) revealed that 93.8% of participants indicated daily Internet use for clinical duties. Most respondents (72%) were either completely unaware of the existence of guidelines for its use or aware but had no familiarity with their content. Use of e-mail for clinical duties was common (85%), and 74% of the respondents rated e-mail as "very important" or "extremely important" for patient care. Everyone who responded had a mobile phone with 98.7% being "smartphones," which the majority (82.9%) stated was "very important" or "extremely important" for patient care. Text messaging was the primary communication method for 57.8% of respondents. The traditional paging system was the primary communication method for only 1.3% of respondents and the preferred method for none. Daily use of technology is the norm among residents; however, knowledge of university guidelines was exceedingly low. Residents need better education regarding current guidelines. Current guidelines do not reflect current clinical practice. Hospitals should consider abandoning the traditional paging system and consider facilitating better use of residents' mobile phones.

  9. Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States.

    Science.gov (United States)

    Greenberg, Alexandra J; Haney, Danielle; Blake, Kelly D; Moser, Richard P; Hesse, Bradford W

    2018-02-01

    The increase in use of health information technologies (HIT) presents new opportunities for patient engagement and self-management. Patients in rural areas stand to benefit especially from increased access to health care tools and electronic communication with providers. We assessed the adoption of 4 HIT tools over time by rural or urban residency. Analyses were conducted using data from 7 iterations of the National Cancer Institute's Health Information National Trends Survey (HINTS; 2003-2014). Rural/urban residency was based on the USDA's 2003 Rural-Urban Continuum Codes. Outcomes of interest included managing personal health information online; whether providers maintain electronic health records (EHRs); e-mailing health care providers; and purchasing medicine online. Bivariate analyses and logistic regression were used to assess relationships between geography and outcomes, controlling for sociodemographic characteristics. In total, 6,043 (17.6%, weighted) of the 33,749 respondents across the 7 administrations of HINTS lived in rural areas. Rural participants were less likely to report regular access to Internet (OR = 0.70, 95% CI = 0.61-0.80). Rural respondents were neither more nor less likely to report that their health care providers maintained EHRs than were urban respondents; however, they had decreased odds of managing personal health information online (OR = 0.59, 95% CI = 0.40-0.78) and e-mailing health care providers (OR = 0.62, 95% CI = 0.49-0.77). The digital divide between rural and urban residents extends to HIT. Additional investigation is needed to determine whether the decreased use of HIT may be due to lack of Internet connectivity or awareness of these tools. © 2016 National Rural Health Association.

  10. Behavior of urban residents toward the discarding of waste electrical and electronic equipment: a case study in Baoding, China.

    Science.gov (United States)

    Li, Jinhui; Liu, Lili; Ren, Junshu; Duan, Huabo; Zheng, Lixia

    2012-11-01

    The volume of waste electrical and electronic equipment (WEEE) is growing rapidly worldwide, making its management difficult; therefore, this should be improved as a matter of urgency. WEEE includes both essential household appliances [including televisions, refrigerators, and washing machines; but not air conditioners, where the consumption mode is more like information, communication and technology (ICT)] ICT equipment (also called high-tech household appliances). In the present study, Baoding, a medium-sized, prefecture-level city in north central China with a population of 11 million, including 1.1 million urban residents, was selected as a representative city for an investigation of recycling behaviors. A valid sample size of 346 households in Baoding was investigated, and categorized into various income and educational levels. The results showed that the major reason for discarding WEEE was malfunction of the appliance, accounting for 52% of disposals. Surveyed households with either high income or good education were more likely to consume high-tech household appliances, attracted by advanced technology, versatile functions or flexibility of use. Personal computer ownership rates were highest in households with a high income and good education-1.2 and 0.9 per home respectively. WEEE was most often sold to peddlers or hawkers from where the WEEE flowed into the second-hand market to be refurbished or repaired, and then re-sold. However, 56.3% of residents in the college community were in support of charging consumers for disposal and 61.7% were in support of including a disposal surcharge in the purchase price of new products-a percentage approximately three times that for high-income residents. Thus, high educational level appears to be currently the most important factor in raising the potential of a household's willingness to pay for WEEE treatment cost. The findings of this study can be used to develop sound recycling systems for WEEE in mainland China.

  11. Communication dated 13 March 2009 received from the Resident Representative of the Russian Federation to the IAEA on the Russian initiative to establish a guaranteed reserve of low enriched uranium

    International Nuclear Information System (INIS)

    2009-01-01

    The Secretariat has received a communication dated 13 March 2009 from the Resident Representative of the Russian Federation, forwarding a statement delivered on 5 March 2009 by the Governor for the Russian Federation on the Board of Governors, Ambassador G.V. Berdennikov concerning the Russian initiative to establish a guaranteed reserve of low enriched uranium. As requested in that communication, the statement is circulated herewith for the information of Member States

  12. Effects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study.

    Science.gov (United States)

    Taft, Teresa; Lenert, Leslie; Sakaguchi, Farrant; Stoddard, Gregory; Milne, Caroline

    2015-01-01

    The effects of electronic health records (EHRs) on doctor-patient communication are unclear. To evaluate the effects of EHR use compared with paper chart use, on novice physicians' communication skills. Within-subjects randomized controlled trial using observed structured clinical examination methods to assess the impact of use of an EHR on communication. A large academic internal medicine training program. First-year internal medicine residents. Residents interviewed, diagnosed, and initiated treatment of simulated patients using a paper chart or an EHR on a laptop computer. Video recordings of interviews were rated by three trained observers using the Four Habits scale. Thirty-two residents completed the study and had data available for review (61.5% of those enrolled in the residency program). In most skill areas in the Four Habits model, residents performed at least as well using the EHR and were statistically better in six of 23 skills areas (pcommunication score was better when using an EHR: mean difference 0.254 (95% CI 0.05 to 0.45), p = 0.012, Cohen's d of 0.47 (a moderate effect). Residents scoring poorly (>3 average score) with paper methods (n = 8) had clinically important improvement when using the EHR. This study was conducted in first-year residents in a training environment using simulated patients at a single institution. Use of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  13. The Efficacy of an American Indian Culturally-Based Risk Prevention Program for Upper Elementary School Youth Residing on the Northern Plains Reservations.

    Science.gov (United States)

    Usera, John J

    2017-04-01

    Culturally-based risk behavior prevention programs for American Indian elementary school children are sparse. Thus a group of American Indian educators collaborated in the creation of a program that helps children make healthy decisions based on their cultural and traditional value system. In this paper the effectiveness of Lakota Circles of Hope (LCH), an elementary school culturally-based prevention program was studied and evaluated. Three cohorts of fourth and fifth graders participated in a mixed methods quasi-experimental evaluative research design that included focus groups and surveys prior to and following the intervention. Five research questions regarding the program's impact on students' self-esteem and self-efficacy, Lakota identity, communication, conflict resolution and risk behaviors were addressed in this study. Participants were compared to non-participants in three American Indian reservation school sites. Educators completed a survey to record their observations and feedback regarding the implementation of the program within their respective school sites. The study provides preliminary evidence that, when delivered with fidelity, LCH contributes to statistically significant changes in risk behaviors, Lakota identity, respect for others, and adult and parent communication. A two-way multivariate analysis of variance with post hoc analysis of data collected from the LCH participants (N = 1392) were used to substantiate a significant increase in respect for others and a decrease in risk behaviors which included alcohol, tobacco, and substance use at the 0.10 alpha level. Significant positive improvements in parent and adult communication and an increased Lakota identity at the 0.01 alpha level were obtained. There were no significant differences in self-esteem and conflict resolution from pre to post intervention and in comparison with non LCH participating students.

  14. Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi Method.

    Science.gov (United States)

    Hollaar, Vanessa; van der Maarel-Wierink, Claar; van der Putten, Gert-Jan; van der Sanden, Wil; de Swart, Bert; de Baat, Cees

    2016-03-07

    In nursing home residents, it is not possible to distinguish pneumonia and aspiration pneumonia clinically. International literature reveals no consensus on which and how many characteristics and risk indicators must be present to diagnose (nursing home-acquired) pneumonia and aspiration pneumonia. The aim of this survey was to reach consensus among a panel of clinical medical experts in geriatrics and pulmonology about the characteristics required for diagnosing pneumonia, and about the risk indicators needed to consider the diagnosis aspiration pneumonia in nursing home residents with pneumonia. Literature review and three expert-rating iterations using the electronically-modified Delphi Method were carried out. After each expert rating iteration, data analysis was performed. Qualitative responses and additional (nursing home-acquired) pneumonia characteristics which were mentioned in reply to structured open-ended questions were summarised, whilst similar responses were combined and these combinations were ordered by frequency in order to use them in the next iteration. Characteristics which failed to reach consensus were considered as inconclusive and eliminated. Consensus was reached when at least 70 % of the participants agreed. Literature review revealed 16 currently used common characteristics for diagnosing (nursing home-acquired) pneumonia. No consensus was reached about characteristics and the number of characteristics required for diagnosing (nursing home-acquired) pneumonia. However, 57 % agreed that dyspnea, fever, deterioration of general functioning, tachypnea and crepitation with auscultation are the most important characteristics and the responses by the participants suggested that two or three characteristics should be present. Subsequently, 80 % of the participants agreed on the risk indicators dysphagia, choking incident, (history of) tube feeding, neurological disease and cognitive impairment for considering the diagnosis aspiration pneumonia

  15. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  16. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States.

    Science.gov (United States)

    Nabavizadeh, Nima; Burt, Lindsay M; Mancini, Brandon R; Morris, Zachary S; Walker, Amanda J; Miller, Seth M; Bhavsar, Shripal; Mohindra, Pranshu; Kim, Miranda B; Kharofa, Jordan

    2016-02-01

    The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This analysis may serve as a valuable tool for those seeking to

  17. The "hidden curriculum" and residents' attitudes about medical error disclosure: comparison of surgical and nonsurgical residents.

    Science.gov (United States)

    Martinez, William; Lehmann, Lisa Soleymani

    2013-12-01

    The "hidden curriculum" and role models for responding to medical errors might play a central role in influencing residents' attitudes about disclosure. We sought to compare surgical and nonsurgical residents' exposure to role modeling for responding to medical errors and their attitudes about error disclosure. We conducted a cross-sectional, electronic survey of surgical and nonsurgical residents at 2 large academic medical centers. The questionnaire asked respondents about personal experience with medical errors; training for responding to errors; frequency of exposure to role modeling related to disclosure; and attitudes about disclosure. Descriptive statistics were used to describe frequencies. Chi-square and Fisher's exact test were used to compare proportions between surgical and nonsurgical trainees. The response rate was 58% (253 of 435). Surgical residents reported more frequently observing a colleague be treated harshly (eg, humiliated or verbally abused) for an error than nonsurgical residents (sometimes or often, 39% [26 of 66] vs 20% [37 of 187]; p = 0.002). Surgical residents were more likely than nonsurgical residents to believe they would be treated harshly by others if they acknowledged making a medical error (35% [23 of 66] vs 12% [23 of 187]; p medical errors at their institution (11% [7 of 66] vs 2% [4 of 187]; p = 0.008). Surgical residents were less likely than nonsurgical residents to feel free to express concerns to other members of the team about medical errors in patient care (70% [46 of 66] vs 83% [115 of 187]; p = 0.02). The punitive response to error by senior members of the health care team might be an impediment to the transparent disclosure of errors among residents that might disproportionally affect surgical training programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  20. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  1. Education Research: Neurology resident education

    Science.gov (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

    2016-01-01

    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  2. Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi Method.

    NARCIS (Netherlands)

    Hollaar, V.; Maarel-Wierink, C. van der; Putten, G.J. van der; Sanden, W. van der; Swart, B.J. de; Baat, C. de

    2016-01-01

    BACKGROUND: In nursing home residents, it is not possible to distinguish pneumonia and aspiration pneumonia clinically. International literature reveals no consensus on which and how many characteristics and risk indicators must be present to diagnose (nursing home-acquired) pneumonia and aspiration

  3. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    Abstract. Background: There is a phobia among doctors for the residency training program, since the establishment of ... Materials and Methods: Structured questionnaires were administered to residents at 3 training institutions in Nigeria. Results: ... Keywords: Decentralization, motivation, perception, remuneration, residents.

  4. Evolving Perceptions of the Plastic Surgery Integrated Residency Training Program.

    Science.gov (United States)

    Pace, Elizabeth; Mast, Bruce; Pierson, Justine M; Leavitt, Adam; Reintgen, Christian

    2016-01-01

    In recent years, there has been a transition in plastic surgery residency training. Many programs across the country are now using integrated training modalities vs. independent training programs. This change in residency training has brought into question the effectiveness of integrated residency programs, in which medical students immediately enter the plastic surgery specialty upon graduation. This study assessed plastic surgery residency program directors and faculty members׳ viewpoints on the transition to integrated training programs and the effect this transition has had on the training of plastic surgery residents. An anonymous 13-question survey was formulated using a pilot survey sent to members of the plastic surgery department at the University of Florida. The final survey was then electronically sent via SurveyMonkey.com to 92 current plastic surgery residency program directors. Program directors were identified via program lists provided by the American Council of Academic Surgeons. Program directors were then asked to forward the survey to faculty members of their respective institutions. Responses collected were analyzed via SurveyMonkey.com and Microsoft Excel. University of Florida College of Medicine, Department of Plastic Surgery. Plastic surgery residency program directors as identified by the American Council of Academic Surgeons. A response rate of 40.2% was achieved via 37 of the 92 plastic surgery program directors responding to the electronic survey. An additional 6 anonymous faculty members also responded to the survey, 13.9% of all responses. Institutions indicated that the majority was using integrated residency programs, with some institutions using both integrated and independent training programs simultaneously. Most respondents indicated that they supported the transition to the integrated residency program at their respective institutions. Respondents indicated several reasons as to why or why not programs have transitioned to the

  5. Contrast reaction training in US radiology residencies: a COARDRI study.

    Science.gov (United States)

    LeBedis, Christina A; Rosenkrantz, Andrew B; Otero, Hansel J; Decker, Summer J; Ward, Robert J

    To perform a survey-based assessment of current contrast reaction training in US diagnostic radiology residency programs. An electronic survey was distributed to radiology residency program directors from 9/2015-11/2015. 25.7% of programs responded. 95.7% of those who responded provide contrast reaction management training. 89.4% provide didactic lectures (occurring yearly in 71.4%). 37.8% provide hands-on simulation training (occurring yearly in 82.3%; attended by both faculty and trainees in 52.9%). Wide variability in contrast reaction education in US diagnostic radiology residency programs reveals an opportunity to develop and implement a national curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Early resident-to-resident physics education in diagnostic radiology.

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

    The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Trends in medical error education: are we failing our residents?

    Science.gov (United States)

    Bradley, Corey K; Fischer, Melissa A; Walsh, Kathleen E

    2013-01-01

    The Institute of Medicine has called for physician education as a key step in medical error prevention. In our 2002 national survey, pediatric resident education about medical error prevention was sporadic. We sought to describe the amount and type of pediatric resident training about medical errors and to assess the change in training since 2002. We surveyed a national sample of 50 pediatric chief residents randomly selected from the 198 Accreditation Council for Graduate Medical Education-accredited residency programs from August to November 2010. The 31-item telephone survey was developed from the 2002 survey, with the addition of 10 items about electronic learning and resident quality improvement projects. The survey included 4 domains: current patient safety curriculum, chief resident knowledge, learning from medical errors, and demographics. We phoned 55 chief residents and contacted 51. Fifty participated (90% participation rate). Ninety-four percent of chief residents stated that their program had a formalized curriculum to discuss medical errors, compared to only 50% (P medical error should be systemic change. The primary method for educating residents about medical error reported was informal teaching. Ninety-two percent reported never or rarely discussing medical error in an outpatient setting. Seventy-four percent of chief residents reported that they never or rarely learn from an error made by an attending physician, and 50% never or rarely learned from an error made by a fellow resident. Although resident education about medical errors has improved since 2002, opportunities to model learning from mistakes are frequently missed. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Template for success: using a resident-designed sign-out template in the handover of patient care.

    Science.gov (United States)

    Clark, Clancy J; Sindell, Sarah L; Koehler, Richard P

    2011-01-01

    Report our implementation of a standardized handover process in a general surgery residency program. The standardized handover process, sign-out template, method of implementation, and continuous quality improvement process were designed by general surgery residents with support of faculty and senior hospital administration using standard work principles and business models of the Virginia Mason Production System and the Toyota Production System. Nonprofit, tertiary referral teaching hospital. General surgery residents, residency faculty, patient care providers, and hospital administration. After instruction in quality improvement initiatives, a team of general surgery residents designed a sign-out process using an electronic template and standard procedures. The initial implementation phase resulted in 73% compliance. Using resident-driven continuous quality improvement processes, real-time feedback enabled residents to modify and improve this process, eventually attaining 100% compliance and acceptance by residents. The creation of a standardized template and protocol for patient handovers might eliminate communication failures. Encouraging residents to participate in this process can establish the groundwork for successful implementation of a standardized handover process. Integrating a continuous quality-improvement process into such an initiative can promote active participation of busy general surgery residents and lead to successful implementation of standard procedures. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Electronic health record and genome-wide genetic data in Generation Scotland participants [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Shona M. Kerr

    2017-09-01

    Full Text Available This article provides the first detailed demonstration of the research value of the Electronic Health Record (EHR linked to research data in Generation Scotland Scottish Family Health Study (GS:SFHS participants, together with how to access this data. The structured, coded variables in the routine biochemistry, prescribing and morbidity records, in particular, represent highly valuable phenotypic data for a genomics research resource. Access to a wealth of other specialized datasets, including cancer, mental health and maternity inpatient information, is also possible through the same straightforward and transparent application process. The EHR linked dataset is a key component of GS:SFHS, a biobank conceived in 1999 for the purpose of studying the genetics of health areas of current and projected public health importance. Over 24,000 adults were recruited from 2006 to 2011, with broad and enduring written informed consent for biomedical research. Consent was obtained from 23,603 participants for GS:SFHS study data to be linked to their Scottish National Health Service (NHS records, using their Community Health Index number. This identifying number is used for NHS Scotland procedures (registrations, attendances, samples, prescribing and investigations and allows healthcare records for individuals to be linked across time and location. Here, we describe the NHS EHR dataset on the sub-cohort of 20,032 GS:SFHS participants with consent and mechanism for record linkage plus extensive genetic data. Together with existing study phenotypes, including family history and environmental exposures, such as smoking, the EHR is a rich resource of real world data that can be used in research to characterise the health trajectory of participants, available at low cost and a high degree of timeliness, matched to DNA, urine and serum samples and genome-wide genetic information.

  10. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  11. Pediatric Program Leadership's Contribution Toward Resident Wellness.

    Science.gov (United States)

    Carson, Savanna L; Perkins, Kate; Reilly, Maura R; Sim, Myung-Shin; Li, Su-Ting T

    2018-02-27

    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.

  12. Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study.

    Science.gov (United States)

    Hollaar, Vanessa R Y; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D; Bronkhorst, Ewald M; de Swart, Bert J M; de Baat, Cees; Creugers, Nico H J

    Nursing home-acquired pneumonia (NHAP) is a common infection among nursing home residents. There is also a high prevalence of dysphagia in nursing home residents and they suffer more often from comorbidity and multimorbidity. This puts nursing home residents at higher risk of (mortality from) NHAP. Therefore it is important to gain more insight into the incidence of NHAP and the associated medical conditions in nursing home residents with dysphagia. To investigate possible associations between NHAP and dysphagia in nursing home residents and to search for a medical risk profile for NHAP. A retrospective cross-sectional study. Three nursing homes in The Netherlands. 416 electronic medical files of nursing home residents aged 65 or older living in 3 nursing homes. Data about age, gender, diagnosis of dysphagia and/or pneumonia, medical diagnosis and possible cause of death of the nursing home residents were extracted from electronic medical files. The data of 373 electronic medical files were analyzed. A significant difference in the prevalence of dysphagia was found between the nursing homes (p nursing homes. Statistically significant higher incidence of NHAP was found in residents with dysphagia (p = 0.046). Residents with dysphagia had statistically significantly more diseases compared to residents without dysphagia (p = 0.001). Logistic regression analyses revealed no statistically significant associations between NHAP and the number of diseases and the ICD-10 diseases. Dysphagia was found to be a risk factor for NHAP. Awareness of the signs of dysphagia by nurses and other care providers is important for early recognition and management of dysphagia and prevention of NHAP. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  13. General surgery resident rotations in surgical critical care, trauma, and burns: what is optimal for residency training?

    Science.gov (United States)

    Napolitano, Lena M; Biester, Thomas W; Jurkovich, Gregory J; Buyske, Jo; Malangoni, Mark A; Lewis, Frank R

    2016-10-01

    There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations. Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination. Duration (months) spent in SCC, trauma, and burn rotations, and postgraduate year (PGY) level were examined. The total months in SCC, trauma and burn rotations was mean 10.2 and median 10.0 (SD 3.9 months), representing approximately 16.7% (10 of 60 months) of a general surgery resident's training. However, there was great variability (range 0 to 29 months). SCC rotation duration was mean 3.1 and median 3.0 months (SD 2, min to max: 0 to 15), trauma rotation duration was mean 6.3 and median 6.0 months (SD 3.5, min to max: 0 to 24), and burn rotation duration was mean 0.8 and median 1.0 months (SD 1.0, min to max: 0 to 6). Of the total mean 10.2 months duration, the longest exposure was 2 months as PGY-1, 3.4 months as PGY-2, 1.9 months as PGY-3, 2.2 months as PGY-4 and 1.1 months as PGY-5. PGY-5 residents spent a mean of 1 month in SCC, trauma, and burn rotations. PGY-4/5 residents spent the majority of this total time in trauma rotations, whereas junior residents (PGY-1 to 3) in SCC and trauma rotations. There is significant variability in total duration of SCC, trauma, and burn rotations and PGY level in US general surgery residency programs, which may result in significant variability in the fund of knowledge and clinical experience of the trainee completing general surgery residency training. As acute care surgery programs have begun to integrate emergency general surgery with SCC, trauma, and burn rotations

  14. Association between postgraduate year 2 residency program characteristics and primary project publication.

    Science.gov (United States)

    Swanson, Joseph M; Shafeeq, Hira; Hammond, Drayton A; Li, Chenghui; Devlin, John W

    2018-03-15

    The association among residency program and research mentor characteristics, program director perceptions, and the publication of the primary research project for postgraduate year 2 (PGY2) graduates was assessed. Using a validated electronic survey, residency program directors (RPDs) of critical care PGY2 graduates were asked about primary research project publication success, program and research project mentor characteristics, and RPDs' perceptions surrounding project completion. All 55 RPDs surveyed responded; 44 (79%) reported being a research project mentor. PGY2 research project publications in 2011 and 2012 totaled 26 (37%) and 27 (35%), respectively. A significant relationship existed between research project publication and the number of residents in the program ( p project publication is important to their employer ( p projects versus no publications included the number of graduates in the PGY2 program (odds ratio [OR], 5.6; p project publication (OR, 10.2; p project versus no research projects was also independently associated with the RPD's perception that the employer valued research project publication (OR, 5.1; p = 0.04). A survey of RPDs of critical care PGY2 residents found that the number of PGY2 residents, the number of publications by the least experienced research mentor, and the perception that publishing the residents' research projects is important to the employer were independently associated with publication rates of residency research projects. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  15. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    This study was carried out to ascertain the perception of the residency ... the time of the study. Analysis of the respondents showed similar findings for both senior and junior levels of training. Discussion. The introduction of the residency training program .... Overseas training/ attachment should be re-introduced. 12. (10.1).

  16. 8 CFR 325.1 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false [Reserved] 325.1 Section 325.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS NATIONALS BUT NOT CITIZENS OF THE UNITED STATES; RESIDENCE WITHIN OUTLYING POSSESSIONS § 325.1 [Reserved] ...

  17. The surgical residency interview: a candidate-centered, working approach.

    Science.gov (United States)

    Seabott, Heather; Smith, Ryan K; Alseidi, Adnan; Thirlby, Richard C

    2012-01-01

    The interview process is a pivotal, differentiating component of the residency match. Our bias is toward a working interview, producing better fulfillment of the needs of both parties, and a more informed match selection for the candidates and program. We describe a "candidate-centered" approach for integrating applicant interviews into our daily work schedule. Applicants are informed upon accepting the interview of the working interview model. Our program offers 33 interview days over a 12-week period. A maximum of 5 applicants are hosted per day. Applicants are assigned to 1 of our general, thoracic, vascular, or plastic surgery teams. The interview day begins with the applicant changing into scrubs, attending a morning conference, and taking part in a program overview by a Chief Resident. Applicants join their host team where 4-8 hours are spent observing the operative team, on rounds and sharing lunch. The faculty and senior residents are responsible for interviewing and evaluating applicants though the Electronic Residency Application Service. A total of 13 surgeons are involved in the interview process resulting in broad-based evaluations. Each surgeon interviewed between 3 and 12 applicants. Faculty rate this interview approach highly because it allows them to maintain a rigorous operative schedule while interacting with applicants. Current residents are engaged in welcoming applicants to view the program. Faculty and residents believe cooperating in a real world manner aids their assessment of the applicant. Applicants routinely provide positive feedback, relaying this approach is informative, transparent, and should be the "standard." Applicants believe they are presented a realistic view of the program. Ultimately, this candidate-centered process may be attributable to our resident cohort who exhibit high satisfaction, excellent resident morale, and very low dropout rate. We present a candidate-centered, working interview approach used in the selection of

  18. Resident Characteristics Report

    Data.gov (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  19. Radiology residents as teachers: Current status of teaching skills training in United States residency programs.

    Science.gov (United States)

    Donovan, Andrea

    2010-07-01

    Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to determine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Residents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees. 2010 AUR. Published by Elsevier Inc. All rights reserved.

  20. Radiology resident teaching skills improvement: impact of a resident teacher training program.

    Science.gov (United States)

    Donovan, Andrea

    2011-04-01

    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

  1. Evaluating Dermatology Residency Program Websites.

    Science.gov (United States)

    Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

    2016-03-16

    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

  2. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  3. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  4. Child temperament and paternal transition to non-residence.

    Science.gov (United States)

    Flouri, Eirini; Malmberg, Lars-Erik

    2010-12-01

    Using the Millennium Cohort Study data this study showed that, even after adjustment, resident biological fathers of high-regularity children at 9 months were less likely than resident biological fathers of low-regularity children at 9 months to become non-resident by the time these children were 3 years old. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

    Science.gov (United States)

    Burrows, Jason; Coolen, Jillian

    2016-01-01

    The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  6. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

    Science.gov (United States)

    Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

    2018-04-17

    (permanent, grave disability or death) (p=0.05). Procedures involved were identified in 32% (36) of resident and 26% (188) of non-resident cases (p=0.17). The final diagnoses in resident cases were more often cardiac related 19% (21) vs 10% (71), pvs 3% (3), pvs 76% (p=0.24); communication 27% vs 30% (p=0.46); and documentation 20% vs 21% (p=0.95). Technical skills contributed to 20% (22) of resident versus 13% (96) of non-resident cases (p=0.07) but those procedures involving vascular access 2.7% (3) vs 0.1% (1) and spinal procedures 3.5% (4) vs 1.1% (8) were more prevalent in resident cases (p<0.05 for each). There are higher total incurred losses in non-resident cases. There are higher severity scores in resident cases. The overall case profiles, including allegation categories, final diagnoses and contributing factors between resident and non-resident cases are similar. Cases involving residents are more likely to involve certain technical skills, specifically vascular access and spinal procedures, which may have important implications regarding supervision. Clinical judgment, communication and documentation are the most prevalent contributing factors in all cases and should be targets for risk-reduction strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. A survey of dermatology resident education in cosmetic procedures.

    Science.gov (United States)

    Kirby, Joslyn S; Adgerson, Cheri N; Anderson, Bryan E

    2013-02-01

    The demands for cosmetic procedures are increasing. Dermatologists perform many of these procedures, therefore adequate education and training during residency is important. Surveys demonstrate dermatology residents desire more training even while faculty members believe this has already become a more prominent feature of resident education. We sought to assess the time and methods dedicated to education and training of cosmetic procedures in dermatology residency. A 26-question survey was developed and electronically distributed in May 2010 to dermatology program directors via the Association of Professors of Dermatology list-serve with their approval. Program directors were asked to forward the e-mail to their instructors of cosmetic/procedural dermatology, and chief residents. Responses were anonymous. A total of 86 responses were collected. In all, 67% (n = 54) of respondents had formal lectures focusing on cosmetic dermatology. Lecture topics reported by more than 50% of respondents included botulinum toxin injection, lasers, soft tissue augmentation, chemical peels, and sclerotherapy. Topics such as dermabrasion, liposuction, and scar revision were less commonly taught. The most commonly encountered and performed procedures were botulinum toxin injection and lasers (100%, n = 86); 98.8% (n = 85) encounter soft tissue augmentation and 95.4% (n = 82) encounter both chemical peels and sclerotherapy. Resident experience performing procedures as the first assistant or as the first surgeon varied widely. The limitations of this study are that the data were subjectively reported so results may differ from the true amount of time spent in any activity. The data may be biased by the population that responded as they may have strong opinions supporting or opposing training in cosmetic procedures. The data also may have been skewed by the small percentage of participants who were instructors of cosmetic dermatology (21%), chief residents (20%), and others respondents (8

  8. Residents' behaviors, attitudes, and willingness to pay for recycling e-waste in Macau.

    Science.gov (United States)

    Song, Qingbin; Wang, Zhishi; Li, Jinhui

    2012-09-15

    Large quantities of e-waste are presently being generated in Macau, but since recycling facilities and laws on e-waste still need to be developed, most e-waste cannot currently be properly treated. Moreover, little is known about residents' behaviors, attitudes, and their willingness to pay (WTP) for recycling e-waste. These issues are discussed in this study, based on a questionnaire survey on household electronic product usage. In 2010, "Life span completed" was the primary reason respondents abandoned their electronic products, accounting for about 37.97% of responses; the main disposal methods of e-waste in Macau were "Retailers retrieve from consumer" and "Sale to a recycling corporation." While having little understanding of e-waste disposal issues, most residents were still willing to hand their e-waste into the government for centralized collection. In addition, the respondents gave "telephone reservation" as their preferred collection method. Finally, the residents' WTP in Macau was estimated by the logistic regression method. It was found that education level, age and household income were the significant factors affecting residents' WTP. The monthly mean WTP was 20.03MOP (2.50 US dollar) per household, and the annual WTP was approximately 40,185,067 MOP (5,023,133 US dollar) for all of Macau. The results of our study can help managers develop more effective environmental management policies for e-waste disposal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Social networking profiles and professionalism issues in residency applicants: an original study-cohort study.

    Science.gov (United States)

    Ponce, Brent A; Determann, Jason R; Boohaker, Hikel A; Sheppard, Evan; McGwin, Gerald; Theiss, Steven

    2013-01-01

    To determine the frequency of social networking, the degree of information publicly disclosed, and whether unprofessional content was identified in applicants from the 2010 Residency Match. Medical professionalism is an essential competency for physicians to learn, and information found on social networking sites may be hazardous to the doctor-patient relationship and an institution's public perception. No study has analyzed the social network content of applicants applying for residency. Online review of social networking Facebook profiles of graduating medical students applying for a residency in orthopedic surgery. Evidence of unprofessional content was based upon Accreditation Council for Graduate Medical Education guidelines. Additional recorded applicant data included as follows: age, United States Medical Licensing Examination part I score, and residency composite score. Relationship between professionalism score and recorded data points was evaluated using an analysis of variance. Nearly half of all applicants, 46% (200/431), had a Facebook profile. The majority of profiles (85%) did not restrict online access to their profile. Unprofessional content was identified in 16% of resident applicant profiles. Variables associated with lower professionalism scores included unmarried relationship status and lower residency composite scores. It is critical for healthcare professionals to recognize both the benefits and risks present with electronic communication and to vigorously protect the content of material allowed to be publically accessed through the Internet. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Development and implementation of a residency project advisory board.

    Science.gov (United States)

    Dagam, Julie K; Iglar, Arlene; Kindsfater, Julie; Loeb, Al; Smith, Chad; Spexarth, Frank; Brierton, Dennis; Woller, Thomas

    2017-06-15

    The development and implementation of a residency project advisory board (RPAB) to manage multiple pharmacy residents' yearlong projects across several residency programs are described. Preceptor and resident feedback during our annual residency program review and strategic planning sessions suggested the implementation of a more-coordinated approach to the identification, selection, and oversight of all components of the residency project process. A panel of 7 department leaders actively engaged in residency training and performance improvement was formed to evaluate the residency project process and provide recommendations for change. These 7 individuals would eventually constitute the RPAB. The primary objective of the RPAB at Aurora Health Care is to provide oversight and a structured framework for the selection and execution of multiple residents' yearlong projects across all residency programs within our organization. Key roles of the RPAB include developing expectations, coordinating residency project ideas, and providing oversight and feedback. The development and implementation of the RPAB resulted in a significant overhaul of our entire yearlong resident project process. Trends toward success were realized after the first year of implementation, including consistent expectations, increased clarity and engagement in resident project ideas, and more projects meeting anticipated endpoints. The development and implementation of an RPAB have provided a framework to optimize the organization, progression, and outcomes of multiple pharmacy resident yearlong projects in all residency programs across our pharmacy enterprise. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  11. Emotional intelligence in orthopedic surgery residents

    Science.gov (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-01-01

    Background Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. Methods We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Results Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Conclusion Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing. PMID:24666445

  12. Emotional intelligence in orthopedic surgery residents.

    Science.gov (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-04-01

    Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing.

  13. [Burnout in nursing residents].

    Science.gov (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  14. Contemporary Trends in Radiation Oncology Resident Research.

    Science.gov (United States)

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A; Ojerholm, Eric

    2016-11-15

    radiation oncology, current residents, training programs, and prospective employers. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Anesthesiology resident personality type correlates with faculty assessment of resident performance.

    Science.gov (United States)

    Schell, Randall M; Dilorenzo, Amy N; Li, Hsin-Fang; Fragneto, Regina Y; Bowe, Edwin A; Hessel, Eugene A

    2012-11-01

    To study the association between anesthesiology residents' personality preference types, faculty evaluations of residents' performance, and knowledge. Convenience sample and prospective study. Academic department of anesthesiology. Consenting anesthesiology residents (n = 36). All participants completed the Myers Briggs Type Indicator® (MBTI®). All residents' 6-month summation of daily focal evaluations completed by faculty [daily performance score (DPS); 1 = unsatisfactory, 2 = needs improvement, 3 = meets expectations, 4 = exceeds expectations], as well as a global assessment of performance (GAP) score based on placement of each resident into perceived quartile compared with their peers (ie,1 = first, or top, quartile) by senior faculty (n = 7) who also completed the MBTI, were obtained. The resident MBTI personality preferences were compared with the DPS and GAP scores, the United States Medical Licensing Examination (USMLE) I and II scores, and faculty MBTI personality type. There was no association between personality preference type and performance on standardized examinations (USMLE I, II). The mean GAP score was better (higher quartile score) for Extraverts than Introverts (median 2.0 vs 2.6, P = 0.0047) and for Sensing versus Intuition (median 2.0 vs 2.6, P = 0.0206) preference. Faculty evaluator MBTI preference type did not influence the GAP scores they assigned residents. Like GAP, the DPS was better for residents with Sensing versus Intuition preference (median 3.5 vs 3.3, P = 0.0111). No difference in DPS was noted between Extraverts and Introverts. Personality preference type was not associated with resident performance on standardized examinations, but it was associated with faculty evaluations of resident performance. Residents with Sensing personality preference were evaluated more favorably on global and focal faculty evaluations than those residents who chose the Intuition preference. Extraverted residents were evaluated more favorably on

  16. Results of the 2012-2013 Association of Residents in Radiation Oncology (ARRO) job search and career planning survey of graduating residents in the United States.

    Science.gov (United States)

    Mattes, Malcolm D; Kharofa, Jordan; Zeidan, Youssef H; Tung, Kaity; Gondi, Vinai; Golden, Daniel W

    2014-01-01

    To determine the timeline used by postgraduate year (PGY)-5 radiation oncology residents during the job application process and the factors most important to them when deciding on a first job. In 2012 and 2013, the Association of Residents in Radiation Oncology conducted a nationwide electronic survey of PGY-5 radiation oncology residents in the United States during the final 2 months of their training. Descriptive statistics are reported. In addition, subgroup analysis was performed. Surveys were completed by 180 of 314 residents contacted. The median time to start networking for the purpose of employment was January PGY-4; to start contacting practices, complete and upload a curriculum vitae to a job search website, and use the American Society of Radiation Oncology Career Center was June PGY-4; to obtain letters of recommendation was July PGY-5; to start interviewing was August PGY-5; to finish interviewing was December PGY-5; and to accept a contract was January PGY-5. Those applying for a community position began interviewing at an earlier average time than did those applying for an academic position (P=.04). The most important factors to residents when they evaluated job offers included (in order from most to least important) a collegial environment, geographic location, emphasis on best patient care, quality of support staff and facility, and multidisciplinary approach to patient care. Factors that were rated significantly different between subgroups based on the type of position applied for included adequate mentoring, dedicated research time, access to clinical trials, amount of time it takes to become a partner, geographic location, size of group, starting salary, and amount of vacation and days off. The residents' perspective on the job application process over 2 years is documented to provide a resource for current and future residents and employers to use. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Pregnancy and the Plastic Surgery Resident.

    Science.gov (United States)

    Garza, Rebecca M; Weston, Jane S; Furnas, Heather J

    2017-01-01

    Combining pregnancy with plastic surgery residency has historically been difficult. Two decades ago, 36 percent of plastic surgery program directors surveyed actively discouraged pregnancy among residents, and 33 percent of women plastic surgeons suffered from infertility. Most alarmingly, 26 percent of plastic surgery trainees had had an elective abortion during residency. With increasing numbers of women training in plastic surgery, this historical lack of support for pregnancy deserves further attention. To explore the current accommodations made for the pregnant plastic surgery resident, an electronic survey was sent to 88 plastic surgery program directors in the United States. Fifty-four responded, for a response rate of 61.36 percent. On average, a director trained a total of 7.91 women among 17.28 residents trained over 8.19 years. Of the women residents, 1.43 were pregnant during a director's tenure, with 1.35 of those residents taking maternity leave. An average 1.75 male residents took paternity leave. Approximately one-third of programs had a formal maternity/paternity leave policy (36.54 percent) which, in most cases, was limited to defining allowed weeks of leave, time required to fulfill program requirements, and remuneration during leave. This survey of plastic surgery directors is a first step in defining the challenges training programs face in supporting the pregnant resident. Directors provided comments describing their challenges accommodating an absent resident in a small program and complying with the American Board of Plastic Surgery's required weeks of training per year. A discussion of these challenges is followed by suggested solutions.

  18. Facility Focus: Residence Halls.

    Science.gov (United States)

    College Planning & Management, 2003

    2003-01-01

    Describes four examples of residence hall design, one renovation and three new residence halls, that exemplify design principles that meet student and institutional requirements. The examples are at (1) the University of Illinois at Chicago; (2) Bowdoin College; (3) Muhlenberg College; and (4) Spring Arbor University. (SLD)

  19. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  20. Psychologic effects of residency.

    Science.gov (United States)

    Reuben, D B

    1983-03-01

    The intense situational and physiologic stresses that accompany postgraduate training may have serious psychosocial ramifications. Although only a small proportion of residents have overt psychiatric illness, virtually all display some psychologic impairment. Contributing factors include life-changes, stresses associated with providing patient care, loss of social support, long working hours, sleep deprivation, and underlying personality traits of residents. The manifestations of this impairment are variable and may be subtle. In response to these problems, residency programs have taken steps to provide psychosocial support. Unfortunately, most programs do not offer formal support groups or seminars to discuss difficulties that accompany residency. Further definition of the psychosocial effects of residency may prompt changes that make the training of physicians a more humane process.

  1. Problem neurology residents: a national survey.

    Science.gov (United States)

    Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

    2011-06-14

    Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

  2. Personal Therapy in Psychiatry Residency Training: A National Survey of Canadian Psychiatry Residents.

    Science.gov (United States)

    Hadjipavlou, George; Halli, Priyanka; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2016-02-01

    The authors collected nationally representative data on Canadian residents' experiences with and perspectives on personal psychotherapy in their psychiatric training. A 43-item questionnaire was distributed electronically to all current psychiatry residents in Canada (N = 839). Four hundred residents from every program across Canada returned the survey (response rate 47.7%). The prevalence of personal therapy at any time was 55.3%, with 42.8% receiving personal therapy during residency. Of residents who undertook personal psychotherapy, 59.3% engaged in weekly therapy, 74.1% received psychodynamic psychotherapy, and 81.5% participated in long-term therapy (>1 year). Personal growth, self-understanding, and professional development were the most common reasons for engaging in personal therapy; however, one-third of residents did so to alleviate symptoms of depression, anxiety, or other mental health concerns. Time was the most important factor impeding residents from personal therapy; only 8.8% found stigma to act as a barrier. The vast majority of residents rated their experience with personal therapy as having a positive or very positive impact on their personal life (84.8%) and overall development as psychiatrists (81.8%). For 64% of respondents, personal therapy had an important or very important role in psychiatry residency training. Residents who received personal therapy rated themselves as better able to understand what happens moment by moment during therapy sessions, detect and deal with patients' emotional reactions, and constructively use their personal reactions to patients. Interest in personal therapy remains strong among psychiatry trainees in Canada. Residents who engaged in psychotherapy endorsed greater confidence in psychotherapy and rated their psychotherapy skills more favorably than those who had never been in the patient role, supporting the view of personal therapy as an important adjunct to psychotherapy training during residency.

  3. Evaluation of stress experienced by pharmacy residents.

    Science.gov (United States)

    Le, Hung M; Young, Shardae D

    2017-04-15

    Results of a study of stress and negative affect levels in postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residents are presented. A cross-sectional approach was used. Pharmacy residency program directors received e-mailed invitation letters requesting that they ask their residents to participate in an online survey in 2011. The main study outcomes included evaluation of resident scores on the 10-item Perceived Stress Scale (PSS10) and the Multiple Affect Adjective Checklist-Revised (MAACL-R) anxiety, depression, hostility, and dysphoria subscales. Of the 524 pharmacy residents included in the study, 75.4% were female, 41.2% were under 26 years of age, and 41% reported working more than 60 hours per week. There were no significant differences between PGY1 and PGY2 residents in stress levels, as assessed with the PSS10 (mean ± S.D. score, 19.05 ± 5.96 versus 19.09 ± 5.77). MAACL-R scores for hostility were, on average, higher among PGY2 residents (mean ± S.D., 50.83 ± 10.02) than among PGY1 residents (48.62 ± 8.96), while there were no significant differences in anxiety, depression, and dysphoria levels. Relative to residents who worked 60 or fewer hours per week, those who worked more than 60 hours had higher perceived stress levels as well as higher depression, hostility, and dysphoria scores. Pharmacy residents exhibited high levels of perceived stress, especially those who worked more than 60 hours per week. Perceived stress was highly correlated to negative affect levels. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Use and utility of Web-based residency program information: a survey of residency applicants.

    Science.gov (United States)

    Embi, Peter J; Desai, Sima; Cooney, Thomas G

    2003-01-01

    The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty

  5. Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

    Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... such as the Scandinavian countries, where healthcare systems are slightly different. The aim of this study was to examine prevalence and characteristics of residents in difficulty in one out of three postgraduate medical training regions in Denmark, and to produce both a quantifiable overview and in-depth understanding...... of the topic. Methods We performed a mixed methods study. All regional residency program directors (N = 157) were invited to participate in an e-survey about residents in difficulty. Survey data were combined with database data on demographical characteristics of the background population (N = 2399...

  7. 38 CFR 51.110 - Resident assessment.

    Science.gov (United States)

    2010-07-01

    ... Medicaid Services (CMS) Resident Assessment Instrument Minimum Data Set, Version 2.0; and (ii) Describing... Set, Version 2.0 must be submitted electronically to VA at the IP address provided by VA to the State... information collection requirements in this section under control number 2900-0160) [65 FR 968, Jan. 6, 2000...

  8. General Surgery Resident Satisfaction on Cardiothoracic Rotations.

    Science.gov (United States)

    Lussiez, Alisha; Bevins, Jack; Plaska, Andrew; Rosin, Vadim; Reddy, Rishindra M

    2016-01-01

    General surgery residents' exposure to cardiothoracic (CT) surgery rotations has decreased, which may affect resident satisfaction. We surveyed general surgery graduates to assess the relationships among rotation satisfaction, CT disease exposure, rotation length, mentorship, and mistreatment. A survey assessing CT curriculum, exposure, mentorship, and satisfaction was forwarded to general surgery graduates from 17 residency programs. A Wilcoxon rank-sum test was used to assess statistical significance of ordinal level data. Statistical significance was defined as p surgery residency programs who graduated between the years of 1999 to 2014. A total of 94 responses were completed and received. Receiving adequate exposure to CT procedures and disease management was significantly associated with higher satisfaction ratings for all procedures, particularly thoracotomy incisions (p Surgery. Published by Elsevier Inc. All rights reserved.

  9. Drug target residence time: a misleading concept.

    Science.gov (United States)

    Folmer, Rutger H A

    2018-01-01

    Since the importance of drug target residence time was first highlighted more 10 years ago, slow binding kinetics has received much attention in the drug discovery literature, and indeed within pharmaceutical research. However, the residence concept as presented in most papers is supported by rather misleading simulations and arguments, and by examples where compounds are taken out of their pharmacokinetic context. Moreover, fast association is typically more desirable than slow, and advantages of long residence time, notably a potential disconnect between pharmacodynamics (PD) and pharmacokinetics (PK), would be partially or completely offset by slow on-rate. Therefore, plain potency is likely a better predictor of drug development success than is residence time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Global health education in emergency medicine residency programs.

    Science.gov (United States)

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid

    2014-06-01

    Interest in global health and international electives is growing among Emergency Medicine (EM) residents in the United States (US). The majority of EM residency programs offer opportunities for international electives. The degree of participation among residents and type of support provided by the residency program, however, remains unclear. To explore the current state of global health education among EM residents who participate in international electives. A 12-question survey was e-mailed to the program directors of the 192 EM residency programs in the US. The survey included questions about the number of residents participating in international electives and the types of preparation, project requirements, supervision, and feedback participating residents receive. The response rate was 53% with 102 responses. Seventy-five of 102 (74%) programs reported that at least one resident participated in an international elective in the 2010-2011 academic year. Forty-three programs (42%) report no available funding to support any resident on an international elective. Residents receive no preparation for international work in 41 programs (40%). Only 25 programs (26%) required their residents to conduct a project while abroad. Forty-nine programs (48%) reported no formal debriefing session, and no formal feedback was collected from returning residents in 57 of 102 (59%) programs. The majority of EM residencies have residents participating in international electives. However, the programs report variable preparation, requirements, and resident supervision. These results suggest a need for an expanded and more structured approach to international electives undertaken by EM residents. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Technology in Residence.

    Science.gov (United States)

    Fox, Jordan

    1999-01-01

    Discusses the necessity for incorporating current technology in today's college residence halls to meet the more diverse and continued activities of its students. Technology addressed covers data networking and telecommunications, heating and cooling systems, and fire-safety systems. (GR)

  12. Cognitive reserve in aging.

    Science.gov (United States)

    Tucker, A M; Stern, Y

    2011-06-01

    Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer's disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer's disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer's disease and other age-related problems.

  13. Text messaging among residents and faculty in a university general surgery residency program: prevalence, purpose, and patient care.

    Science.gov (United States)

    Shah, Dhruvil R; Galante, Joseph M; Bold, Richard J; Canter, Robert J; Martinez, Steve R

    2013-01-01

    There is little information about the use of text messaging (texting) devices among resident and faculty physicians for patient-related care (PRC). To determine the prevalence, frequency, purpose, and concerns regarding texting among resident and attending surgeons and to identify factors associated with PRC texting. E-mail survey. University medical center and its affiliated hospitals. Surgery resident and attending staff. Prevalence, frequency, purpose, and concerns regarding patient-related care text messaging. Overall, 73 (65%) surveyed physicians responded, including 45 resident (66%) and 28 attending surgeons (62%). All respondents owned a texting device. Majority of surgery residents (88%) and attendings (71%) texted residents, whereas only 59% of residents and 65% of attendings texted other faculty. Most resident to resident text occurred at a frequency of 3-5 times/d (43%) compared with most attending to resident texts, which occurred 1-2 times/d (33%). Most resident to attending (25%) and attending to attending (30%) texts occurred 1-2 times/d. Among those that texted, PRC was the most frequently reported purpose for resident to resident (46%), resident to attending (64%), attending to resident (82%), and attending to other attending staff (60%) texting. Texting was the most preferred method to communicate about routine PRC (47% of residents vs 44% of attendings). Age (OR: 0.86, 95% CI: 0.79-0.95; p = 0.003), but not sex, specialty/clinical rotation, academic rank, or postgraduate year (PGY) level predicted PRC texting. Most resident and attending staff surveyed utilize texting, mostly for PRC. Texting was preferred for communicating routine PRC information. Our data may facilitate the development of guidelines for the appropriate use of PRC texting. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Are neurology residents interested in headache?

    Science.gov (United States)

    Gago-Veiga, A B; Santos-Lasaosa, S; Viguera Romero, J; Pozo-Rosich, P

    The years of residency are the pillars of the subsequent practice in every medical specialty. The aim of our study is to evaluate the current situation, degree of involvement, main interests, and perceived quality of the training received by Spanish residents of neurology, specifically in the area of headache. A self-administered survey was designed by the Headache Study Group of the Spanish Society of Neurology (GECSEN) and was sent via e-mail to all residents who were members of the Society as of May 2015. Fifty-three residents completed the survey (N = 426, 12.4%): 6% were first year residents, 25.5% second year, 23.5% third year, and 45% fourth year residents, all from 13 different Spanish autonomous communities. The areas of greatest interest are, in this order: Vascular neurology, headache, and epilepsy. Of them, 85% believe that the area of headache is undervalued. More than half of residents (52.8%) do not rotate in specific Headache Units and only 35.8% complete their training dominating anaesthetic block and toxin infiltration techniques. Of them, 81.1% believe that research is scarce or absent; 69.8% have never made a poster/presentation, 79.3% have not published and only 15% collaborate on research projects in this area. Lastly, 40% believe that they have not received adequate training. Headache is among the areas that interest our residents the most; however, we believe that we must improve their training both at a patient healthcare level and as researchers. Thus, increasing the number of available courses, creating educational web pages, involving residents in research, and making a rotation in a specialised unit mandatory are among the fundamental objectives of the GECSEN. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Satisfaction among residents in ASHP-accredited pharmacy residency programs.

    Science.gov (United States)

    VanDenBerg, C; Murphy, J E

    1997-07-01

    The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

  16. Are oral and maxillofacial surgery residents being adequately trained to care for pediatric patients?

    Science.gov (United States)

    Abramowicz, Shelly; Kaban, Leonard B; Wurtzel, Andrew S; Roser, Steven M

    2017-09-01

    To evaluate whether current oral and maxillofacial surgery (OMS) residents are receiving adequate training and experience to perform specific surgical procedures and anesthesia for pediatric patients. A 17-question survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons. Descriptive data for individual surgeons, their associated residency programs, and the quantity of specific pediatric procedures they performed were collected. Resident case load for inpatient and outpatient procedures and overall experience in medical, surgical, and anesthetic management of pediatric OMS patients were explored. Surveys were sent to 110 active fellows; 64 completed the questionnaire (58%). There were 59 male fellows and 5 female fellows, with a mean age of 50.4 years. Of those, 68.8% practice in an academic setting. Specifically, 93.8% take after-hours emergency calls covering adult and pediatric patients and 98.4% have admitting privileges at a children's hospital or a pediatric unit in an adult hospital. Their affiliated residency programs include required rotations in pediatrics or pediatric subspecialties. In their opinion, >90% of graduating OMS residents have the appropriate skill set to perform dentoalveolar procedures, outpatient anesthesia, orthognathic procedures, and alveolar bone grafts. However, residents have limited ability to reconstruct pediatric ramus-condyle unit with a costochondral graft. Results of this study indicate that, in the opinion of the respondents, graduates of OMS residency programs have adequate training to perform dentoalveolar procedures, outpatient anesthesia, orthognathic surgery, and alveolar bone grafts in pediatric procedures, but have limited experience with reconstruction of pediatric ramus-condyle unit via costochondral graft. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. [The pharmaceutical industry and specialised medical training: Residents' perceptions in Madrid, Spain].

    Science.gov (United States)

    González-Rubio, Raquel; Escortell-Mayor, Esperanza; Del Cura González, Isabel

    2017-10-06

    To assess the frequency of exposure and attitudes to the pharmaceutical industry (PI) of residents in the Region of Madrid (RM), Spain, and to analyse the association with specialty, professional environment and training. Cross-sectional electronic survey in May and June 2015 of all medical residents in RM. We collected sociodemographic variables and those of interaction with the PI in four blocks: frequency of interactions, attitudes and perceptions, environment and regulatory framework, and skills; with the first two blocks we created a Synthetic PI Interaction Index (SPIII). Bivariate and multivariate analysis of logistic regression. 350 resident's responses (28% family and community medicine [FCM], 57% hospital, 15% others). Ninety-eight percent reported interacting with the PI. Twenty percent believed their prescribing was influenced by the PI and 48% believed it was influenced by other doctors. Sixty-five precent considered more training necessary. Ninety-six percent had received no information from their college of physicians, 80% did not know the regulations in their medical society and 50% were unaware of those of their institution. Hospital specialty residents showed more likelihood of SPIII ≥ percentile 75 than those of FCM (odds ratio [OR]: 3.96; 95% confidence interval [95%CI]: 1.88-8.35). Training in informal settings was associated with SPIII ≤ percentile 25 (OR: 2.83; 95%CI: 1.32-6.07). The medical residents in RM had a high level of interaction with the PI and believed its influence low. Hospital specialty residents showed more interaction with the PI. Regulations were not well known by residents and they consideredmore training necessary. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Are the French neurology residents satisfied with their training?

    Science.gov (United States)

    Codron, P; Roux, T; Le Guennec, L; Zuber, M

    2015-11-01

    There have been dramatic changes in neurology over the past decade; these advances require a constant adaptation of residents' theoretical and practical training. The French Association of Neurology Residents and the College of Neurology Teachers conducted a national survey to assess the French neurology residents' satisfaction about their training. A 16-item questionnaire was sent via e-mail to French neurology residents completing training in 2014. Data were collected and processed anonymously. Of eligible respondents, 126 returned the survey, representing approximately 40% of all the French neurology residents. Most residents (78%) rated their clinical training favorably. Seventy-two percent reported good to excellent quality teaching of neurology courses from their faculty. However, many residents (40%) felt insufficient their doctoral thesis supervision. All residents intended to enter fellowship training after their residency, and most of them (68%) planned to practice in a medical center. French neurology residents seemed satisfied with the structure and quality of their training program. However, efforts are required to improve management of the doctoral thesis and make private practice more attractive and accessible during the residency. In the future, similar surveys should be scheduled to regularly assess neurology residents' satisfaction and the impact of the forthcoming national and European reforms. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  20. Developing a curriculum for emergency medicine residency orientation programs.

    Science.gov (United States)

    Lucas, Raymond; Choudhri, Tina; Roche, Colleen; Ranniger, Claudia; Greenberg, Larrie

    2014-05-01

    New residents enter emergency medicine (EM) residency programs with varying EM experiences, which makes residency orientation programs challenging to design. There is a paucity of literature to support best practices. We report on a curriculum development project for EM residency orientation using the Kern Model. Components of the revised curriculum include administrative inculcation into the program; delivering skills and knowledge training to ensure an entering level of competence; setting expectations for learning in the overall residency curriculum; performing an introductory performance evaluation; and socialization into the program. Post-implementation resident surveys found the new curriculum to be helpful in preparing them for the first year of training. The Kern Model was a relevant and useful method for redesigning a new-resident orientation curriculum. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested

    2016-01-01

    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...

  2. Residents as teachers: survey of Canadian family medicine residents.

    Science.gov (United States)

    Ng, Victor K; Burke, Clarissa A; Narula, Archna

    2013-09-01

    To examine Canadian family medicine residents' perspectives surrounding teaching opportunities and mentorship in teaching. A 16-question online survey. Canadian family medicine residency programs. Between May and June 2011, all first- and second-year family medicine residents registered in 1 of the 17 Canadian residency programs as of September 2010 were invited to participate. A total of 568 of 2266 residents responded. Demographic characteristics, teaching opportunities during residency, and resident perceptions about teaching. A total of 77.7% of family medicine residents indicated that they were either interested or highly interested in teaching as part of their future careers, and 78.9% of family medicine residents had had opportunities to teach in various settings. However, only 60.1% of respondents were aware of programs within residency intended to support residents as teachers, and 33.0% of residents had been observed during teaching encounters. It appears that most Canadian family medicine residents have the opportunity to teach during their residency training. Many are interested in integrating teaching as part of their future career goals. Family medicine residencies should strongly consider programs to support and further develop resident teaching skills.

  3. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Informatics and Technology in Resident Education.

    Science.gov (United States)

    Niehaus, William

    2017-05-01

    Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education. How informatics can optimize communication for residents, promote information technology use, refine documentation techniques, reduce medical errors, and improve clinical decision making will be reviewed. It is hoped that this article will increase faculty and trainees' knowledge of the field of informatics, awareness of available technology, and will assist practitioners to maximize their ability to provide quality care to their patients. This article will also introduce the idea of incorporating informatics specialists into residency programs to help practitioners deliver more evidenced-based care and to further improve their efficiency. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  5. COGNITIVE RESERVE IN AGING

    Science.gov (United States)

    Tucker, Adrienne M.; Stern, Yaakov

    2011-01-01

    Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer’s disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer’s disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer’s disease and other age-related problems. PMID:21222591

  6. HYDROCARBONS RESERVES IN VENEZUELA

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Cruz, D.J.

    2007-07-01

    Venezuela is an important player in the energy world, because of its hydrocarbons reserves. The process for calculating oil and associated gas reserves is described bearing in mind that 90% of the gas reserves of Venezuela are associated to oil. Likewise, an analysis is made of the oil reserves figures from 1975 to 2003. Reference is also made to inconsistencies found by international experts and the explanations offered in this respect by the Ministry of Energy and Petroleum (MENPET) and Petroleos de Venezuela (PDVSA) regarding the changes that took place in the 1980s. In turn, Hubbert's Law is explained to determine peak production of conventional oil that a reservoir or field will reach, as well as its relationship with remaining reserves. Emphasis is placed on the interest of the United Nations on this topic. The reserves of associated gas are presented along with their relationship with the different crude oils that are produced and with injected gas, as well as with respect to the possible changes that would take place in the latter if oil reserves are revised. Some recommendations are submitted so that the MENPET starts preparing the pertinent policies ruling reserves. (auth)

  7. Ovarian reserve parameters

    DEFF Research Database (Denmark)

    Bentzen, J G; Forman, Julie Lyng; Pinborg, Anja

    2012-01-01

    2-5 of the menstrual cycle or during withdrawal bleeding, blood sampling and transvaginal sonography was performed. After adjusting for age, ovarian reserve parameters were lower among users than among non-users of hormonal contraception: serum AMH concentration by 29.8% (95% CI 19.9 to 38...... was observed between duration of hormonal-contraception use and ovarian reserve parameters. No dose-response relation was found between the dose of ethinyloestradiol and AMH or AFC. This study indicates that ovarian reserve markers are lower in women using sex steroids for contraception. Thus, AMH...... concentration and AFC may not retain their accuracy as predictors of ovarian reserve in women using hormonal contraception. Serum anti-Müllerian hormone (AMH) concentration is an indirect marker of the number of small follicles in the ovary and thereby the ovarian reserve. The AMH concentration is now widely...

  8. Global Health Imaging in Radiology Residency: A Survey of Canadian Radiology Residents.

    Science.gov (United States)

    Zener, Rebecca; Ross, Ian

    2017-11-01

    The study sought to determine Canadian radiology resident perception of and interest in global health imaging (GHI) and the barriers they encounter in pursuing GHI experiences during residency training. A peer-reviewed, online, anonymous, multiple-choice survey was distributed to Canadian radiology residents at English-language programs. Fifty residents responded to the survey (∼16% response rate); 72% of respondents perceived an unmet need for medical imaging in the developing world. A majority of residents (60%) would have been likely to participate in a GHI experience if one had been available during their residency; 65% planned on pursuing international outreach work as future radiologists, 81% of whom with on-site collaboration in education and training of local staff. However, 82% of respondents were uncertain or believed they would not be adequately prepared to help improve access and availability of medical imaging services in developing countries upon completion of residency. Overall, residents believed a GHI program would increase their knowledge of infectious diseases, increase their exposure to diseases at advanced stage presentation, enhance their knowledge of basic imaging modalities, and improve their cultural competence. Lack of information about opportunities, lack of funding, and lack of infrastructure were ranked as the most important barriers to participating in a radiology rotation in a developing country during residency. While many Canadian radiology residents are interested in participating in GHI, their preparation to do so may be inadequate. Formalizing international GHI rotations may alleviate barriers impeding their pursuit. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  9. 48 CFR 4.501 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false [Reserved] 4.501 Section 4.501 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 4.501 [Reserved...

  10. ultraLM and miniLM: Locator tools for smart tracking of fluorescent cells in correlative light and electron microscopy [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Elisabeth Brama

    2016-12-01

    Full Text Available In-resin fluorescence (IRF protocols preserve fluorescent proteins in resin-embedded cells and tissues for correlative light and electron microscopy, aiding interpretation of macromolecular function within the complex cellular landscape. Dual-contrast IRF samples can be imaged in separate fluorescence and electron microscopes, or in dual-modality integrated microscopes for high resolution correlation of fluorophore to organelle. IRF samples also offer a unique opportunity to automate correlative imaging workflows. Here we present two new locator tools for finding and following fluorescent cells in IRF blocks, enabling future automation of correlative imaging. The ultraLM is a fluorescence microscope that integrates with an ultramicrotome, which enables ‘smart collection’ of ultrathin sections containing fluorescent cells or tissues for subsequent transmission electron microscopy or array tomography. The miniLM is a fluorescence microscope that integrates with serial block face scanning electron microscopes, which enables ‘smart tracking’ of fluorescent structures during automated serial electron image acquisition from large cell and tissue volumes.

  11. Surgical resident learning styles: faculty and resident accuracy at identification of preferences and impact on ABSITE scores.

    Science.gov (United States)

    Kim, Roger H; Gilbert, Timothy; Ristig, Kyle; Chu, Quyen D

    2013-09-01

    accurately 41% of the time; more experienced faculty were better than less experienced ones (R(2) = 0.703, P = 0.018). Residents had similar accuracy to faculty in identifying their peers' learning styles. Chief residents were more accurate than junior residents (44% versus 28%, P = 0.009). Most general surgery residents have a multimodal learning preference. Faculty members are relatively inaccurate at identifying residents' preferred learning styles; however, there is a strong correlation between years of faculty experience and accuracy. Chief residents are more accurate than junior residents at learning style identification. Higher mean ABSITE scores may be a reflection of a dominant read/write learning style. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Skyline Reservation System

    Data.gov (United States)

    US Agency for International Development — Flight reservation application used for in-country flights by USAID and DoS staff in Afghanistan. The application is managed and maintained by the vendor and USAID...

  13. Formal training in vaccine safety to address parental concerns not routinely conducted in U.S. pediatric residency programs.

    Science.gov (United States)

    Williams, S Elizabeth; Swan, Rebecca

    2014-05-30

    To determine if U.S. pediatric residency programs provide formal training in vaccine safety to address parental vaccine concerns. An electronic survey was mailed to all members of the Association of Pediatric Program Directors (APPD) to assess (1) if U.S. pediatric residency programs were providing formal vaccine safety training, (2) the content and format of the training if provided, and (3) interest in a training module for programs without training. Two follow-up surveys were mailed at 2 week intervals. Responses to the survey were collected at 4 weeks following the last mailing and analyzed. Logistic regression was used to assess the impact of program size on the likelihood of vaccine safety training. Pearson's chi square was used to compare programs with and without formal vaccine safety training in 5 U.S. regions. The survey was sent to 199 APPD members; 92 completed the survey (response rate 46.2%). Thirty-eight respondents (41%) had formal training in vaccine safety for pediatric residents at their programs; 54 (59%) did not. Of those that did not, the majority (81.5%) were interested in formal vaccine safety training for their residents. Of all respondents, 78% agreed that training in vaccine safety was a high priority for resident education. Thirty-five percent of all respondents agreed that local parental attitudes about vaccines influenced the likelihood of formal vaccine safety training. Most pediatric residency programs surveyed do not include formal training on vaccine safety; yet, such training is supported by pediatric residency program directors as a priority for pediatric residents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. [Evaluation in medical residency training programs].

    Science.gov (United States)

    Kolokythas, O; Patzwahl, R; Straka, M; Binkert, C

    2016-01-01

    For resident doctors the acquisition of technical and professional competence is decisive for the successful practice of their activities. Competency and professional development of resident doctors benefit from regular self-reflection and assessment by peers. While often promoted and recommended by national educational authorities, the implementation of a robust evaluation process in the clinical routine is often counteracted by several factors. The aim of the study was to test a self-developed digital evaluation system for the assessment of radiology residents at our institute for practicality and impact with regard to the radiological training. The intranet-based evaluation system was implemented in January 2014, which allowed all Radiology consultants to submit a structured assessment of the Radiology residents according to standardized criteria. It included 7 areas of competency and 31 questions, as well as a self-assessment module, both of which were filled out electronically on a 3-month basis using a 10-point scale and the opportunity to make free text comments. The results of the mandatory self-evaluation by the residents were displayed beside the evaluation by the supervisor. Access to results was restricted and quarterly discussions with the residents were conducted confidentially and individually. The system was considered to be practical to use and stable in its functionality. The centrally conducted anonymous national survey of residents revealed a noticeable improvement of satisfaction with the institute assessment for the criterion "regular feedback"compared to the national average. Since its implementation the system has been further developed and extended and is now available for other institutions.

  15. Evaluation of otolaryngology residency program websites.

    Science.gov (United States)

    Svider, Peter F; Gupta, Amar; Johnson, Andrew P; Zuliani, Giancarlo; Shkoukani, Mahdi A; Eloy, Jean Anderson; Folbe, Adam J

    2014-10-01

    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

  16. Are there gender differences in the emotional intelligence of resident physicians?

    Science.gov (United States)

    McKinley, Sophia K; Petrusa, Emil R; Fiedeldey-Van Dijk, Carina; Mullen, John T; Smink, Douglas S; Scott-Vernaglia, Shannon E; Kent, Tara S; Black-Schaffer, W Stephen; Phitayakorn, Roy

    2014-01-01

    Because academic literature indicates that emotional intelligence (EI) is tied to work performance, job satisfaction, burnout, and client satisfaction, there is great interest in understanding physician EI. To determine whether gender differences in resident EI profiles mirror EI gender differences in the general population. A total of 325 residents in 3 types of residency programs (pathology, pediatrics, and general surgery) at 3 large academic institutions were invited electronically to complete the validated Trait Emotional Intelligence Questionnaire (TEIQue), a tool consisting of 153 items that cluster to 15 independent facets, 4 composite factors, and 1 global EI score. The response rate was 42.8% (n = 139, women = 84). Global EI was not significantly different between men and women resident physicians (p = 0.74). Women scored higher than men in the TEIQue facets impulse control (p = 0.004) and relationships (p = 0.004). Men scored higher than women in 2 facets, stress management (p = 0.008) and emotion management (p = 0.023). Within surgery (n = 85, women = 46), women scored higher than men in impulse control (p = 0.006), whereas men scored higher in stress management (p = 0.008). Men and women residents across 3 specialties demonstrated near-identical global EI scores. However, gender differences in specific TEIQue facets suggest that similar to the general population, men and women residents may benefit from specific training of different EI domains to enhance well-rounded development. The lack of significant gender differences within surgery may indicate that surgery attracts individuals with particular EI profiles regardless of gender. Future research should focus on the functional relationship between educational interventions that promote targeted EI development and enhanced clinical performance. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity

    Science.gov (United States)

    Tait, Glendon R.; Hodges, Brian D.

    2009-01-01

    Objective: The authors examined psychiatric residents' attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. Methods: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey…

  18. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  19. Handbook on loss reserving

    CERN Document Server

    Schmidt, Klaus; Schnaus, Anja

    2016-01-01

    This handbook presents the basic aspects of actuarial loss reserving. Besides the traditional methods, it also includes a description of more recent ones and a discussion of certain problems occurring in actuarial practice, like inflation, scarce data, large claims, slow loss development, the use of market statistics, the need for simulation techniques and the task of calculating best estimates and ranges of future losses. In property and casualty insurance the provisions for payment obligations from losses that have occurred but have not yet been settled usually constitute the largest item on the liabilities side of an insurer's balance sheet. For this reason, the determination and evaluation of these loss reserves is of considerable economic importance for every property and casualty insurer. Actuarial students, academics as well as practicing actuaries will benefit from this overview of the most important actuarial methods of loss reserving by developing an understanding of the underlying stochastic models...

  20. Lithium reserves and resources

    International Nuclear Information System (INIS)

    Evans, R.K.

    1978-01-01

    As a result of accelerating research efforts in the fields of secondary batteries and thermonuclear power generation, concern has been expressed in certain quarters regarding the availability, in sufficient quantities, of lithium. As part of a recent study by the National Research Council on behalf of the Energy Research and Development Administration, a subpanel was formed to consider the outlook for lithium. Principal areas of concern were reserves, resources and the 'surplus' available for energy applications after allowing for the growth in current lithium applications. Reserves and resources were categorized into four classes ranging from fully proved reserves to resources which are probably dependent upon the marketing of co-products to become economically attractive. Because of the proprietary nature of data on beneficiation and processing recoveries, the tonnages of available lithium are expressed in terms of plant feed. However, highly conservative assumptions have been made concerning mining recoveries and these go a considerable way to accounting for total losses. Western World reserves and resources of all classes are estimated at 10.6 million tonnes Li of which 3.5 million tonnes Li are located in the United States. Current United States capacity, virtually equivalent to Western World capacity, is 4700 tonnes Li and production in 1976 approximated to 3500 tonnes Li. Production for current applications is expected to grow to approx. 10,000 tonnes in year 2000 and 13,000 tonnes a decade later. The massive excess of reserves and resources over that necessary to support conventional requirements has limited the amount of justifiable exploration expenditures; on the last occasion, there was a a major increase in demand (by the USAEA) reserves and capacity were increased rapidly. There are no foreseeable reasons why this shouldn't happen again when the need is clear. (author)

  1. Bird checklist, Guánica Biosphere Reserve, Puerto Rico

    Science.gov (United States)

    Wayne J. Arendt; John Faaborg; Miguel Canals; Jerry Bauer

    2015-01-01

    This research note compiles 43 years of research and monitoring data to produce the first comprehensive checklist of the dry forest avian community found within the Guánica Biosphere Reserve. We provide an overview of the reserve along with sighting locales, a list of 185 birds with their resident status and abundance, and a list of the available bird habitats....

  2. SUIKERBOSRAND NATURE RESERVE

    African Journals Online (AJOL)

    Suikerbosrand Nature Reserve and fts educational facilities are run by the Transvaal. Division of. Nature Conservation. ... tion and the education facilities provided. The former are utilized mainly by the general public ... artist Paul Bosman (already reviewed in the EEASA newsletter). The co-founders of the Foundation are.

  3. Session 7: Reserve

    International Nuclear Information System (INIS)

    Bailey, R.; Crockford, G.

    2001-01-01

    The reserve session was devoted to some issues that came up through the workshop, which were grouped into three main areas: The Global Accelerator Network, Problems of stress and how to get organized to minimize them, What should an operations group be responsible for? This paper summarizes the discussions that took place. (author)

  4. School Shootings Stun Reservation

    Science.gov (United States)

    Borja, Rhea R.; Cavanagh, Sean

    2005-01-01

    This article deals with the impact brought by the school shootings at Red Lake Indian Reservation in Minnesota to the school community. A deeply troubled 16-year-old student shot and killed seven other people and himself at a high school. The nation's deadliest school attack since the 1999 slayings at Colorado's suburban Columbine High School took…

  5. SUIKERBOSRAND NATURE RESERVE

    African Journals Online (AJOL)

    reserve, the total length being 66 km with six overnight huts. There are also the BokmakiePie. Nature Troil. and the Cheetah Interpretive Troil. which can be used by day visitors. The former has two loops, one of 10 km and another of 17 km. The. Cheetah Troil. is much shorter and various points of interest are interpreted en ...

  6. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

    Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

  7. ELECTRON GUN

    Science.gov (United States)

    Christofilos, N.C.; Ehlers, K.W.

    1960-04-01

    A pulsed electron gun capable of delivering pulses at voltages of the order of 1 mv and currents of the order of 100 amperes is described. The principal novelty resides in a transformer construction which is disposed in the same vacuum housing as the electron source and accelerating electrode structure of the gun to supply the accelerating potential thereto. The transformer is provided by a plurality of magnetic cores disposed in circumferentially spaced relation and having a plurality of primary windings each inductively coupled to a different one of the cores, and a helical secondary winding which is disposed coaxially of the cores and passes therethrough in circumferential succession. Additional novelty resides in the disposition of the electron source cathode filament input leads interiorly of the transformer secondary winding which is hollow, as well as in the employment of a half-wave filament supply which is synchronously operated with the transformer supply such that the transformer is pulsed during the zero current portions of the half-wave cycle.

  8. Abortion training in Canadian obstetrics and gynecology residency programs.

    Science.gov (United States)

    Liauw, J; Dineley, B; Gerster, K; Hill, N; Costescu, D

    2016-11-01

    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.

  9. How Useful are Orthopedic Surgery Residency Web Pages?

    Science.gov (United States)

    Oladeji, Lasun O; Yu, Jonathan C; Oladeji, Afolayan K; Ponce, Brent A

    2015-01-01

    Medical students interested in orthopedic surgery residency positions frequently use the Internet as a modality to gather information about individual residency programs. Students often invest a painstaking amount of time and effort in determining programs that they are interested in, and the Internet is central to this process. Numerous studies have concluded that program websites are a valuable resource for residency and fellowship applicants. The purpose of the present study was to provide an update on the web pages of academic orthopedic surgery departments in the United States and to rate their utility in providing information on quality of education, faculty and resident information, environment, and applicant information. We reviewed existing websites for the 156 departments or divisions of orthopedic surgery that are currently accredited for resident education by the Accreditation Council for Graduate Medical Education. Each website was assessed for quality of information regarding quality of education, faculty and resident information, environment, and applicant information. We noted that 152 of the 156 departments (97%) had functioning websites that could be accessed. There was high variability regarding the comprehensiveness of orthopedic residency websites. Most of the orthopedic websites provided information on conference, didactics, and resident rotations. Less than 50% of programs provided information on resident call schedules, resident or faculty research and publications, resident hometowns, or resident salary. There is a lack of consistency regarding the content presented on orthopedic residency websites. As the competition for orthopedic websites continues to increase, applicants flock to the Internet to learn more about orthopedic websites in greater number. A well-constructed website has the potential to increase the caliber of students applying to a said program. Copyright © 2015 Association of Program Directors in Surgery. Published by

  10. [Assessment of a residency training program in endocrinology and nutrition: results of a resident survey].

    Science.gov (United States)

    Gutiérrez-Alcántara, Carmen; Moreno-Fernández, Jesús; Palomares-Ortega, Rafael; García-Manzanares, Alvaro; Benito-López, Pedro

    2011-12-01

    In 2006, a new training program was approved for resident physicians in endocrinology and nutrition (EN). A survey was conducted to EN residents to assess their training, their depth of knowledge, and compliance with the new program, as well as potential changes in training, and the results obtained were compared to those from previous surveys. A survey previously conducted in 2000 and 2005 was used for this study. The survey included demographic factors, questions about the different rotations, scientific and practical training, assessment of their training departments and other aspects. Results of the current survey were compared to those of the 2005 survey. The survey was completed by 40 residents. Mandatory rotations are mainly fulfilled, except for neurology. Some rotations removed from the program, such as radiology and nuclear medicine, still are frequently performed and popular among residents, who would include them back into the program. There was a low compliance with practical training in the endocrinology area. Forty percent of residents were not aware of the new program, but 60% thought that it was fulfilled. A total of 82.5% of residents thought that their departments fulfilled the training objectives. Few differences were found in rotations as compared to the data collected in 2005 despite changes in the training program, and there was still a lack of practical training. By contrast, rating of training received from departments and senior physicians was improved as compared to prior surveys. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

  11. The Strategic Petroleum Reserve

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The Strategic Petroleum Reserve program was set into motion by the 1975 Energy Policy and Conservation Act (EPCA). By 1990, 590 million barrels of oil had been placed in storage. Salt domes along the Gulf Coast offered ideal storage. Both sweet'' and sour'' crude oil have been acquired using various purchase options. Drawdown, sale, and distribution of the oil would proceed according to guidelines set by EPCA in the event of a severe energy supply disruption. (SM)

  12. [Hypertrophy and coronary reserve].

    Science.gov (United States)

    Motz, W; Scheler, S

    2008-12-01

    Left ventricular hypertrophy represents the structural mechanism of adaptation of the left ventricle as the answer of a chronic pressure overload in arterial hypertension. Initially an increment in left ventricular wall thickness occurs. In this stadium of "concentric hypertrophy" LV systolic wall stress, LV ejection fraction and myocardial oxygen consumption per weight unit myocardium remain unchanged. In the further time course of disease LV dilatation will be present. In this phase of "excentric hypertrophy" LV systolic wall stress and myocardial oxygen consumption per weight unit myocardium rise and LV ejection fraction decreases. Patients with arterial hypertension frequently complain of angina pectoris. Angina pectoris and the positive exercise tolerance test or the positive myocardial scintigraphy are the consequence of the impaired coronary flow reserve. The coronary flow reserve is diminished due to structural and functional changes of the coronary circulation. ACE-inhibitors and AT1-receptor blockers cause a significant improvement of coronary flow reserve and regression of both left ventricular hypertrophy and myocardial fibrosis.

  13. Opinions of Otorhinolaryngology Residents about Their Education Process.

    Science.gov (United States)

    Dokuzlar, Uğur; Miman, Murat Cem; Denizoğlu, İsmail İlter; Eğrilmez, Murat

    2015-09-01

    Our study was planned to get the views of residents about the Otorhinolaryngology (ORL) education process and to enlighten the studies to make this process more effective. A questionnaire was sent to the residents who were still in the residency program in all education clinics via "Google Drive". Seventy-four of 354 residents responded and the answers were evaluated electronically. Fifty residents (67.56%) gave an affirmative answer to the question about the use of "Resident Log Book" and no difference was seen among the clinics. While 9 residents (12.16%) were reporting that they did not read any scientific papers, 43 (58.1%) reported they read less than three per month. Forty-one residents thougt that they were having a good and sufficient education. Seventeen residents (51.51%) who thought they were not having a sufficient education reported that the education period should be longer. When they were wanted to evaluate the education process, while 66 of them (89.18%) said "Exhausting", 52 (70.27%) said "Stressful", it was seen that the ones who said "Instructive" and "Rewarding" were 26 (35.13%) and 17 (22.97%) respectively. Further, 43 of 48 residents (89.58%) who were over the third year of their residency program indicated that they were unable to perform at least one procedure listed in the questionnaire after finishing their education. This study is important because it is the first study about the opinion of ORL residents and will help determine the current status in Turkey. This study will be useful for the preparation of educational programs and guides in the future.

  14. Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance.

    Science.gov (United States)

    Ghareeb, Allen; Han, Heeyoung; Delfino, Kristin; Taylor, Funminiyi

    2016-01-01

    Effects of residents' blended learning on their clinical performance have rarely been reported. A blended learning pilot program was instituted at Southern Illinois University School of Medicine's Obstetrics and Gynecology program. One of the modules was chronic hypertension in pregnancy. We sought to evaluate if the resident blended learning was transferred to their clinical performance six months after the module. A review of patient charts demonstrated inadequate documentation of history, evaluation, and counseling of patients with chronic hypertension at the first prenatal visit by Obstetrics and Gynecology (OB/GYN) residents. A blended learning module on chronic hypertension in pregnancy was then provided to the residents. A retrospective chart review was then performed to assess behavioral changes in the OB/GYN residents. This intervention was carried out at the Department of Obstetrics and Gynecology, Southern Illinois University. All 16 OB/GYN residents were enrolled in this module as part of their educational curriculum. A query of all prenatal patients diagnosed with chronic hypertension presenting to the OB/GYN resident clinics four months prior to the implementation of the blended learning module (March 2015-June 2015) and six months after (July 20, 2015-February 2016) was performed. Data were collected from outpatient charts utilizing the electronic medical record. Data were abstracted from resident documentation at the first prenatal visit. The residents thought that the blended learning module was applicable to performance improvement in the real-world setting. Patients evaluated before ( n = 10) and after ( n = 7) the intervention were compared. After the intervention, there was an increase in assessment of baseline liver enzymes, referral for electrocardiogram, and early assessment for diabetes in the obese patients. More patients were provided a blood pressure cuff after the module (71.4% vs. 20%). Data were provided to the residents in an

  15. Assessing Residents' Confidence in the Context of Pharmacotherapy Competence.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Garlow, Steven J; Haroon, Ebrahim; Hermida, Adriana P; Young, John Q; Dunlop, Boadie W

    2017-06-01

    We aimed to determine whether residents' confidence initiating medications increased with the number of times they prescribed individual medications and to quantify the relationship between prescription frequency and gains in confidence. From July 2011 to June 2014, PGY-3 residents completed a survey of confidence levels at their psychopharmacology clinic orientation and then again 12 months later. The Emory Healthcare electronic medical record was used to identify all medications prescribed by each resident during their 12-month rotation and the frequency of these prescriptions. Confidence in initiating treatment with all medicines/medication classes increased over the 12-month period. For three of the medication classes for which residents indicated they were least confident at orientation, the number of prescriptions written during the year was significantly associated with an increase in confidence. Measuring resident confidence is a relevant and achievable outcome and provides data for educators regarding the amount of experience needed to increase confidence.

  16. Electrocardiographic interpretation skills of cardiology residents: are they competent?

    Science.gov (United States)

    Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

    2014-12-01

    Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  17. Fractional Reserve Banking

    OpenAIRE

    Andreasen, Niels; Bjerregaard, Mads; Lund, Jonas; Olsen, Ove Bitsch; Rasmussen, Andreas Dalgas

    2012-01-01

    Projektet er bygget op omkring kritisk realisme, som er det gennemgående videnskabelige fundament til undersøgelsen af hvilke strukturelle grunde der er til finansiel ustabilitet i Danmark. Projektet går i dybden med Fractional Reserve Banking og incitamentsstrukturen i banksystemet. Vi bevæger os både på det makro- og mikroøkonomiske niveau i analysen. På makro niveau bruger vi den østrigske skole om konjunktur teori (The Positive Theory of the Cycle). På mikro niveau arbejder vi med princip...

  18. Examination to assess the clinical examination and documentation of spine pathology among orthopedic residents.

    Science.gov (United States)

    Haglin, Jack M; Zeller, John L; Egol, Kenneth A; Phillips, Donna P

    2017-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) guidelines requires residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. To assess the progress of orthopedic interns' skills in performing a history, physical examination, and documentation of the encounter for a standardized patient with spinal stenosis, an objective structured clinical examination (OSCE) was conducted for 13 orthopedic intern residents, following a 1-month boot camp that included communications skills and curriculum in history and physical examination. Interns were objectively scored based on their performance of the physical examination, communication skills, completeness and accuracy of their electronic medical record (EMR), and their diagnostic conclusions gleaned from the patient encounter. The purpose of this study was to meaningfully assess the clinical skills of orthopedic post-graduate year (PGY)-1 interns. The findings can be used to develop a standardized curriculum for documenting patient encounters and highlight common areas of weakness among orthopedic interns with regard to the spine history and physical examination and conducting complete and accurate clinical documentation. A major orthopedic specialty hospital and academic medical center. Thirteen PGY-1 orthopedic residents participated in the OSCE with the same standardized patient presenting with symptoms and radiographs consistent with spinal stenosis. Videos of the encounters were independently viewed and objectively evaluated by one investigator in the study. This evaluation focused on the completeness of the history and the performance and completion of the physical examination. The standardized patient evaluated the communication skills of each intern with a separate objective evaluation. Interns completed these same scoring guides to evaluate their own performance in history, physical examination, and communications

  19. Older residents' perspectives on aged sexuality in institutionalized elderly care: a systematic literature review.

    Science.gov (United States)

    Mahieu, Lieslot; Gastmans, Chris

    2015-12-01

    The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential

  20. [Knowledge of health care ethics in paediatric residents].

    Science.gov (United States)

    Hernández González, A; Rodríguez Núñez, A; Cambra Lasaosa, F J; Quintero Otero, S; Ramil Fraga, C; García Palacios, M V; Hernández Rastrollo, R; Ruiz Extremera, M A

    2014-02-01

    Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured. To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates to the medical education during graduate and post-graduate training. A questionnaire with 20 multiple choice questions was designed to evaluate the knowledge in basic ethics with potential implications in clinical practice. We evaluated the education received during graduate and post-graduate training, and the main ethical conflicts faced. A total of 210 completed questionnaires were received from medical residents in paediatrics from 20 different Spanish hospitals, of whom 47 of these were first year residents (R1), 49 were second year residents (R2), 57 were third year residents (R3), and the remaining 57 were final year residents (R4). The mean number of correct answers was 16.8 out of 20. No differences were found between residents in different years of training, nor were there any differences between the group that had received specific training in bioethics versus those who had not. Residents were more likely to give wrong answers related with informed consent, the law on the freedom of the patient, principles of quality of life, the case analysis system, and the dimension of distributive justice. Limitation of therapeutic efforts was identified as the main ethical problem faced in clinical practice by Spanish residents in paediatrics. Most of the knowledge of bioethics is acquired during graduate training, and improved very little throughout the period of medical residence. Our results suggest that efforts are required in organising and structuring the education in bioethics during the training of residents in paediatrics. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. E-Mailed Conference Synopses as a Tool for Resident and Faculty Development.

    Science.gov (United States)

    LaSalle, Elizabeth E; Fitzgibbons, Shimae C; Chahine, A Alfred

    2017-12-18

    This study aims to investigate the utility and success of daily conference synopses emails ("Daily Dispatches") sent to surgical attending physicians, fellows, and residents to foster resident and faculty development. Emails were distributed by the surgical residency program director (PD), summarizing each day of a surgical conference. Two prospective electronic surveys were administered to surgical residents, fellows, and attending surgeons to evaluate the value of this Daily Dispatch method. Institutional; Medstar Georgetown University Hospital, Department of Surgery, Washington, DC. Email synopses were sent to surgical attendings, fellows and residents. Pilot survey was distributed to 60 participants, main survey sent to 74 participants. The response rate for the pilot survey was 41.6% (25/60). When asked about the mode of delivery, 96% of respondents wanted to maintain the email medium when compared to a lecture, paper handout, or the use of social media. The response rate for the main survey was 31.1% (23/74). Almost all (91%) respondents reported reading the emails. Within this group, 70% "agreed" or "strongly agreed" that the emails were useful. Furthermore, 90% reported learning "at least one new thing" and 80% confirmed these "emails provide meaningful content they would not otherwise obtain". Individualized daily synopsis emails highlighting relevant content provided meaningful information from conferences to non-attendees. The emails were well received and useful. Daily Dispatches meet an important need in dissemination of information traditionally gathered only by the rate-limiting step of conference attendance. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Google Internet searches on residency applicants do not facilitate the ranking process.

    Science.gov (United States)

    Shin, Nara C; Ramoska, Edward A; Garg, Manish; Rowh, Adam; Nyce, Drew; Deroos, Francis; Carter, Merle; Hall, Ronald V; Lopez, Bernard L

    2013-05-01

    Information used by program directors (PDs) to evaluate and rank residency applicants is largely limited to the Electronic Residency Application Service and the interview day. The Internet represents a potential source of additional data on applicants. Recent surveys reveal that up to 90% of United States (US) companies are already using the Internet to post jobs and to screen candidates. However, its use in residency applicant evaluation is not well studied. We hypothesize that the Internet, through the use of a Google search, will provide useful information to PDs in ranking applicants. This prospective observational study was completed by six Accreditation Council for Graduate Medical Education-accredited Emergency Medicine residency programs. After the interview process, programs formed their rank order list in their usual fashion. Then participating programs performed a Google search on applicants from their list. A standardized search was used and information reviewed was limited to the first two Google pages. The main outcome measure was change in an applicant's status on the rank order list. Change in status was based on the judgment of the individual program's PD. A total of 547 applicants were reviewed. The time for review of information was 4,386 min total and a mean of 7.2 min per resident. Position on the rank order list was changed for three applicants; two moved up on the list and one moved down. Four programs made no changes. No applicants were removed. The Internet, through the use of a Google search, did not appear to provide useful information in a time-effective manner to PDs in ranking applicants. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance

    Directory of Open Access Journals (Sweden)

    Allen Ghareeb

    2016-01-01

    Full Text Available Problem Effects of residents’ blended learning on their clinical performance have rarely been reported. A blended learning pilot program was instituted at Southern Illinois University School of Medicine's Obstetrics and Gynecology program. One of the modules was chronic hypertension in pregnancy. We sought to evaluate if the resident blended learning was transferred to their clinical performance six months after the module. Intervention A review of patient charts demonstrated inadequate documentation of history, evaluation, and counseling of patients with chronic hypertension at the first prenatal visit by Obstetrics and Gynecology (OB/GYN residents. A blended learning module on chronic hypertension in pregnancy was then provided to the residents. A retrospective chart review was then performed to assess behavioral changes in the OB/GYN residents. Context This intervention was carried out at the Department of Obstetrics and Gynecology, Southern Illinois University. All 16 OB/GYN residents were enrolled in this module as part of their educational curriculum. A query of all prenatal patients diagnosed with chronic hypertension presenting to the OB/GYN resident clinics four months prior to the implementation of the blended learning module (March 2015–June 2015 and six months after (July 20, 2015–February 2016 was performed. Data were collected from outpatient charts utilizing the electronic medical record. Data were abstracted from resident documentation at the first prenatal visit. Outcome The residents thought that the blended learning module was applicable to performance improvement in the real-world setting. Patients evaluated before ( n = 10 and after ( n = 7 the intervention were compared. After the intervention, there was an increase in assessment of baseline liver enzymes, referral for electrocardiogram, and early assessment for diabetes in the obese patients. More patients were provided a blood pressure cuff after the module (71

  4. [Regulations governing the training of diagnostic imaging residents: the residents' statute and the medical specialties law].

    Science.gov (United States)

    Morales Santos, A; del Cura Rodríguez, J L; Vieito Fuentes, X

    2010-01-01

    The current system for training medical specialists in Spain originated in 1963, and diagnostic radiology was one of the first specialties recognized. There are currently three types of regulations that govern the training of specialists: a) professional, The Health Professions Law; b) labor: The Residents' Statute; and c) educational, The New Medical Specialties Law and the Diagnostic Imaging Program This system consists of an exclusive contract with the training organization, a unified system of access, and a training program in accredited units that includes tutoring, evaluation, and progressive assignment of responsibilities. Residents have a right to be trained and evaluated, to participate in the teaching unit, and to their labor rights. In exchange, they must complete the tasks assigned in the program and abide by the institution's rules. Residents must be supervised directly in the first year and thereafter they should be given progressively more responsibility. Copyright 2009 SERAM. Published by Elsevier Espana. All rights reserved.

  5. Practical Interventions to Enhance Resident Ownership of Patient Care.

    Science.gov (United States)

    Soeprono, Thomas; Markman, Jesse; Grodesky, Michael; Cowley, Deborah

    2017-06-19

    In the modern training environment, some question whether trainees have the opportunity to develop ownership of patient care, which includes concepts such as advocacy, autonomy, commitment, communication, follow-through, knowledge about the patient, responsibility, and teamwork. Despite descriptions of what ownership is, there is little discussion of how to foster ownership during residency. The objective of this study was to solicit psychiatry resident and faculty perspectives on ways to enhance resident ownership in training. Twenty-nine of 74 (39.2%) residents and 31 of 68 (45.6%) faculty members surveyed provided narrative responses to a voluntary, anonymous, electronic survey asking two structured, open-ended questions about what factors make it more or less likely that a resident will take "ownership" of patient care. The coding process produced four overarching categories of themes (attending, resident, educational program, and environment) that reflect domains for possible interventions to increase ownership, with conceptual guidance from the Theory of Planned Behavior. From these factors, the authors propose a number of practical yet theory-based interventions which include setting expectations, modeling, promoting autonomy, countertransference supervision, changing residency culture, and longer rotations. These interventions address subjective norms, attitudes, perceived ability and control, environment, and actual resident abilities, all of which, according to the Theory of Planned Behavior, would be likely to influence patient care ownership. Future studies could develop curricula and examine the effectiveness of the interventions proposed here in reinforcing or developing ownership in physicians.

  6. Dynamic Flaps Electronic Scan Antenna

    National Research Council Canada - National Science Library

    Gonzalez, Daniel

    2000-01-01

    A dynamic FLAPS(TM) electronic scan antenna was the focus of this research. The novelty S of this SBIR resides in the use of plasma as the main component of this dynamic X-Band phased S array antenna...

  7. Meeting the needs of the resident trainee during an elective subspecialty rotation.

    Science.gov (United States)

    Hale, Andrew; Glassman, Rebecca; Fessler, David; Mukamal, Kenneth J; Stead, Wendy

    2016-04-10

    To examine and compare perceptions between resident-trainees and faculty-educators on goals and reasons why resident trainees choose certain subspecialty elective rotations. In June 2013 residents and faculty-educators at a large tertiary care academic medical center were surveyed regarding perceived resident goals for subspecialty electives. Each group was sent a different electronic survey of parallel questions assessing agreement on an ordered scale with statements about which factors impacted resident choice. The survey was sent to 154 residents and had 75 (49%) respondents, as well as 20 faculty-educators with 12 (60%) respondents. Residents and faculty did not differ in their responses that electives were chosen to fill perceived knowledge gaps (exact Cochran-Armitage p = .51). However, educators and residents significantly varied in the degree to which they thought resident choice was based on networking within the field (exact Cochran-Armitage p = .01), auditioning for fellowship (exact Cochran-Armitage p < .01), or exploring career options (exact Cochran-Armitage p = .01), with educators overestimating the degree to which these impacted resident choice. Resident trainees and faculty educators agree that subspecialty electives are most frequently chosen in order to meet resident educational goals, highlighting the importance of developing and delivering high quality subspecialty curricular content for the internal medicine resident learner during electives. Many residents choose electives for career development reasons, but faculty educators overestimate this motivation.

  8. Are uranium reserves adequate?

    International Nuclear Information System (INIS)

    Anon.

    2006-01-01

    Against a backdrop of growing concerns about global warming and geopolitical pressures on fossil energies, especially natural gas and oil, interest in nuclear power has revived considerably. Conscious of its addiction to oil and reeling from a series of gigantic blackouts, the United States, in the words of its president, must 'aggressively move forward with the construction of nuclear power plants'. Some European countries have approved new power plant construction (Finland and France), while the more reserved ones (Belgium, Germany and Sweden) have begun to show a change in attitude. Asia, meanwhile, is host to the planet's largest number of potential nuclear construction projects in this first half of the 21. century. All these signs point to a sharp rise in uranium consumption, the basic fuel for these plants. But are there enough resources to support a nuclear revival on a planetary scale? The publication of the Red Book on uranium in late May 2006 was an opportunity for Thierry Dujardin, Deputy Director of Science and Development at the OECD's Nuclear Energy Agency, to take stock of resources. He gives his opinion in this paper

  9. Pathology residency training: time for a new paradigm.

    Science.gov (United States)

    Domen, Ronald E; Baccon, Jennifer

    2014-06-01

    The exponential growth of the field of pathology over the past several decades has created challenges for residency training programs. These challenges include the ability to train competent pathologists in 4 years, an increased demand for fellowship training, and the structuring and completion of maintenance of certification. The authors feel that pathology residency training has reached a critical point and that a new paradigm for training is required. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Psychopathology and resident status - comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents.

    Science.gov (United States)

    Heeren, Martina; Wittmann, Lutz; Ehlert, Ulrike; Schnyder, Ulrich; Maier, Thomas; Müller, Julia

    2014-05-01

    This study aimed to describe, compare, and predict mental health outcomes of different migrant groups and native residents in Switzerland. Asylum seekers (n=65); refugees holding permanent protection visas (n=34); illegal migrants (n=21); labor migrants (n=26); and residents (n=56) completed an assessment by questionnaire. Main outcome variables were symptoms of posttraumatic stress, anxiety and depression. It was tested whether resident status predicted psychopathology over and above the influence of control variables including social desirability, traumatic event types and post-migration resources. Asylum seekers (54.0%) and refugees (41.4%) fulfilled criteria of PTSD most frequently. Clinically relevant symptoms of anxiety and depression were most frequently reported by asylum seekers (84.6% and 63.1%, resp.) and illegal migrants (both 47.6%). Resident status contributed to psychopathology over and above the influence of control variables. Overall, asylum seekers, refugees, and illegal migrants showed high psychiatric morbidity. Differences in resident status appear to be specifically associated with mental health outcomes. This association persists even when controlling for social desirability, post-migration resources and traumatic events. This emphasizes the importance of current socio-political living conditions for mental health, even with respect to the psychopathological sequelae of past traumatic experiences. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Exposure to and Attitudes Regarding Transgender Education Among Urology Residents.

    Science.gov (United States)

    Dy, Geolani W; Osbun, Nathan C; Morrison, Shane D; Grant, David W; Merguerian, Paul A

    2016-10-01

    Transgender individuals are underserved within the health care system but might increasingly seek urologic care as insurers expand coverage for medical and surgical gender transition. To evaluate urology residents' exposure to transgender patient care and their perceived importance of transgender surgical education. Urology residents from a representative sample of U.S. training programs were asked to complete a cross-sectional survey from January through March 2016. Respondents were queried regarding demographics, transgender curricular exposure (didactic vs clinical), and perceived importance of training opportunities in transgender patient care. In total, 289 urology residents completed the survey (72% response rate). Fifty-four percent of residents reported exposure to transgender patient care, with more residents from Western (74%) and North Central (72%) sections reporting exposure (P ≤ .01). Exposure occurred more frequently through direct patient interaction rather than through didactic education (psychiatric, 23% vs 7%, P importance on gender-confirming surgical training than did their male colleagues (91% vs 70%, P important. Most residents (77%) stated transgender-related surgical training should be offered in fellowships. Urology resident exposure to transgender patient care is regionally dependent. Perceived importance of gender-confirming surgical training varies by sex and geography. A gap exists between the direct transgender patient care urology residencies provide and the didactic transgender education they receive. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  12. Attitudes of Portuguese medical residents' towards clinical communication skills.

    Science.gov (United States)

    Loureiro, Elizabete; Severo, Milton; Ferreira, Maria Amélia

    2015-08-01

    To explore the attitudes and perceptions of Portuguese residents towards Clinical Communication Skills (CCS) and the need for complementary training. 78 medical residents responded to an on-line questionnaire which comprised demographic data, open-ended questions and a Portuguese version of the Communication Skills Attitude Scale (CSAS). Residents gave significantly higher scores (Pcommunication skills in general, compared to CSAS2 (attitudes towards the teaching/learning process of CCS). Residents doing their residency training in other parts of the country, other than the north, reveal a higher perception of insufficient training (72.7% vs. 38.7%, P=0.036). Residents showed more positive attitudes towards communication skills than towards the teaching/learning process. They admit to need more training in CCS in their residency year and highlight that the clinical cycle of undergraduate education should integrate these topics. Content analysis indicates that residents' perceptions are context-influenced. Integration of CCS in the undergraduate education, enhanced during post-graduate training. Training of clinical faculty and supervisors/tutors and the role that stakeholders have to play in order to promote continuous training in CCS; encourage patient-centeredness and reflective practice, as to facilitate transfer of acquired skills to clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Residence time modeling of hot melt extrusion processes.

    Science.gov (United States)

    Reitz, Elena; Podhaisky, Helmut; Ely, David; Thommes, Markus

    2013-11-01

    The hot melt extrusion process is a widespread technique to mix viscous melts. The residence time of material in the process frequently determines the product properties. An experimental setup and a corresponding mathematical model were developed to evaluate residence time and residence time distribution in twin screw extrusion processes. The extrusion process was modeled as the convolution of a mass transport process described by a Gaussian probability function, and a mixing process represented by an exponential function. The residence time of the extrusion process was determined by introducing a tracer at the extruder inlet and measuring the tracer concentration at the die. These concentrations were fitted to the residence time model, and an adequate correlation was found. Different parameters were derived to characterize the extrusion process including the dead time, the apparent mixing volume, and a transport related axial mixing. A 2(3) design of experiments was performed to evaluate the effect of powder feed rate, screw speed, and melt viscosity of the material on the residence time. All three parameters affect the residence time of material in the extruder. In conclusion, a residence time model was developed to interpret experimental data and to get insights into the hot melt extrusion process. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Factors Influencing Resident Choice of Prosthodontic Residency Program.

    Science.gov (United States)

    Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas

    2017-06-01

    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

  15. Cross analysis of knowledge and learning methods followed by French residents in cardiology.

    Science.gov (United States)

    Menet, Aymeric; Assez, Nathalie; Lacroix, Dominique

    2015-01-01

    No scientific assessment of the theoretical teaching of cardiology in France is available. To analyse the impact of the available teaching modalities on the theoretical knowledge of French residents in cardiology. Electronic questionnaires were returned by 283 residents. In the first part, an inventory of the teaching/learning methods was taken, using 21 questions (Yes/No format). The second part was a knowledge test, comprising 15 multiple-choice questions, exploring the core curriculum. Of the 21 variables tested, four emerged as independent predictors of the score obtained in the knowledge test: access to self-assessment (P=0.0093); access to teaching methods other than lectures (P=0.036); systematic discussion about clinical decisions (P=0.013); and the opportunity to prepare and give lectures (P=0.039). The fifth variable was seniority in residency (P=0.0003). Each item of the knowledge test was analysed independently: the score was higher when teaching the item was driven by reading guidelines and was lower if the item had not been covered by the programme (Plearning platform if available. It is necessary to rethink teaching in cardiology by involving students in the training, by using teaching methods other than lectures and by facilitating access to self-assessment. The use of digital tools may be a particularly effective approach. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Pathology Informatics Essentials for Residents

    Science.gov (United States)

    Karcher, Donald S.; Harrison, James H.; Sinard, John H.; Riben, Michael W.; Boyer, Philip J.; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

    2016-01-01

    Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:28725772

  17. Pathology Informatics Essentials for Residents

    Directory of Open Access Journals (Sweden)

    Walter H. Henricks MD

    2016-07-01

    Full Text Available Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016. Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  18. Incorporating resident research into the dermatology residency program

    Science.gov (United States)

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    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

  19. The Preferred Learning Styles of Neurosurgeons, Neurosurgery Residents, and Neurology Residents: Implications in the Neurosurgical Field.

    Science.gov (United States)

    Lai, Hung-Yi; Lee, Ching-Yi; Chiu, Angela; Lee, Shih-Tseng

    2014-01-01

    To delineate the learning style that best defines a successful practitioner in the field of neurosurgery by using a validated learning style inventory. The Kolb Learning Style Inventory, a validated assessment tool, was administered to all practicing neurosurgeons, neurosurgical residents, and neurology residents employed at Chang Gung Memorial Hospital, an institution that provides primary and tertiary clinical care in 3 locations, Linkou, Kaohsiung, and Chiayi. There were 81 participants who entered the study, and all completed the study. Neurosurgeons preferred the assimilating learning style (52%), followed by the diverging learning style (39%). Neurosurgery residents were slightly more evenly distributed across the learning styles; however, they still favored assimilating (32%) and diverging (41%). Neurology residents had the most clearly defined preferred learning style with assimilating (76%) obtaining the large majority and diverging (12%) being a distant second. The assimilating and diverging learning styles are the preferred learning styles among neurosurgeons, neurosurgery residents, and neurology residents. The assimilating learning style typically is the primary learning style for neurosurgeons and neurology residents. Neurosurgical residents start off with a diverging learning style and progress toward an assimilating learning style as they work toward becoming practicing neurosurgeons. The field of neurosurgery has limited opportunities for active experimentation, which may explain why individuals who prefer reflective observation are more likely to succeed in this field. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. A psychological profile of surgeons and surgical residents.

    Science.gov (United States)

    Foster, Kevin N; Neidert, Gregory P M; Brubaker-Rimmer, Ruth; Artalejo, Diana; Caruso, Daniel M

    2010-01-01

    surgeons. This tool also demonstrates differences in the interest and personality profiles between high and low performing surgical residents. It may be useful as an indicator of success in surgical residency and in surgery as a profession. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. A national resident survey about the current state of venous education in vascular surgery training programs.

    Science.gov (United States)

    Hicks, Caitlin W; Kernodle, Amber; Abularrage, Christopher J; Heller, Jennifer A

    2017-11-01

    The objective of this study was to characterize U.S. vascular surgery trainees' perceptions, case numbers, and attitudes toward venous disease education, as well as their intent to incorporate it into future practice. These data will provide us with a current snapshot of postgraduate venous education from a resident's perspective. Institutional Review Board approval was obtained. A 13-question survey was created and distributed to all vascular surgery residents in the United States by SurveyMonkey. Formal electronic distribution remained deidentified as the surveys were e-mailed to residents from the Association of Program Directors in Vascular Surgery. Of 464 vascular surgery trainees queried, 104 (22%) responded to the survey. The majority of responders (80%) were between 25 and 34 years of age, 60% were male, and 72% were white; 91% reported that they were in an academic training program, and 57% were enrolled in an integrated vascular surgery residency program. Postgraduate years (PGYs) of training among respondents were well represented: PGY 1, 14%; PGY 2, 8%; PGY 3, 14%; PGY 4, 12%; PGY 5, 9%; PGY 6, 18%; and PGY 7, 25%. Vascular resident training experience with venous disease revealed the following: 63% performed training. Experience with endothermal ablations was slightly better, with 74% of responders reporting having performed up to 20 cases. Case volumes for endothermal ablation, vein stripping/ligation, inferior vena cava stenting, and iliac stenting increased progressively by clinical training year among integrated vascular residents (P ≤ .02) but were relatively stable for classic 5 + 2 vascular fellows (P ≥ .67). Integrated residents reported having received more didactic venous education than the 5 + 2 vascular surgery fellows (P = .01). There were no differences in overall reported venous procedure volumes between groups (P ≥ .28). The majority of trainees (82%) acknowledged that treating venous disease is part of a standard vascular

  2. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest

  3. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  4. Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination.

    Science.gov (United States)

    Smeds, Matthew R; Thrush, Carol R; McDaniel, Faith K; Gill, Roop; Kimbrough, Mary K; Shames, Brian D; Sussman, Jeffrey J; Galante, Joseph M; Wittgen, Catherine M; Ansari, Parswa; Allen, Steven R; Nussbaum, Michael S; Hess, Donald T; Knight, David C; Bentley, Frederick R

    2017-09-01

    The American Board of Surgery In-Training Examination (ABSITE) is used by programs to evaluate the knowledge and readiness of trainees to sit for the general surgery qualifying examination. It is often used as a tool for resident promotion and may be used by fellowship programs to evaluate candidates. Burnout has been associated with job performance and satisfaction; however, its presence and effects on surgical trainees' performance are not well studied. We sought to understand factors including burnout and study habits that may contribute to performance on the ABSITE examination. Anonymous electronic surveys were distributed to all residents at 10 surgical residency programs (n = 326). Questions included demographics as well as study habits, career interests, residency characteristics, and burnout scores using the Oldenburg Burnout Inventory, which assesses burnout because of both exhaustion and disengagement. These surveys were then linked to the individual's 2016 ABSITE and United States Medical Licensing Examination (USMLE) step 1 and 2 scores provided by the programs to determine factors associated with successful ABSITE performance. In total, 48% (n = 157) of the residents completed the survey. Of those completing the survey, 48 (31%) scored in the highest ABSITE quartile (≥75th percentile) and 109 (69%) scored less than the 75th percentile. In univariate analyses, those in the highest ABSITE quartile had significantly higher USMLE step 1 and step 2 scores (P burnout scores (disengagement, P Burnout Inventory exhaustion (P = 0.02), and USMLE step 1 and 2 scores (P = 0.007 and 0.0001, respectively). Residents who perform higher on the ABSITE have a regular study schedule throughout the year, report less burnout because of exhaustion, study away from home, and have shown success in prior standardized tests. Further study is needed to determine the effects of burnout on clinical duties, career advancement, and satisfaction. Copyright © 2017

  5. Characterizing the Relationship Between Surgical Resident and Faculty Perceptions of Autonomy in the Operating Room.

    Science.gov (United States)

    Young, Katelyn A; Lane, Samantha M; Widger, John E; Neuhaus, Nina M; Dove, James T; Fluck, Marcus; Hunsinger, Marie A; Blansfield, Joseph A; Shabahang, Mohsen M

    Characterize the concordance among faculty and resident perceptions of surgical case complexity, resident technical performance, and autonomy in a diverse sample of general surgery procedures using case-specific evaluations. A prospective study was conducted in which a faculty surgeon and surgical resident independently completed a postoperative assessment examining case complexity, resident operative performance (Milestone assessment) and autonomy (Zwisch model). Pearson correlation coefficients (r) reaching statistical significance (p autonomy demonstrated a moderate correlation (r = 0.56, p autonomy and operative performance, respectively. General surgery residents generally demonstrated high correlations with faculty perceptions of case complexity, technical performance, and operative autonomy. This generalized accord supports the use of the Milestone and Zwisch assessments in residency programs. However, discordance among perceptions of midlevel resident autonomy and chief resident operative performance suggests that these trainees may need more direct communication from the faculty. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

    Science.gov (United States)

    Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

    2015-01-01

    Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

  7. [Career plans of French residents in Psychiatry: results of a National Survey].

    Science.gov (United States)

    Berger-Vergiat, A; Chauvelin, L; Van Effenterre, A

    2015-02-01

    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.

  8. Smoking cessation counseling by surgical and nonsurgical residents: opportunities for health promotion education.

    Science.gov (United States)

    Turner, Simon R; Lai, Hollis; Bédard, Eric L R

    2014-01-01

    aimed at improving resident competency in health promotion. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. A national survey on the current status of informatics residency education in pharmacy.

    Science.gov (United States)

    Blash, Anthony; Saltsman, Connie L; Steil, Condit

    2017-11-01

    Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Comorbidity and 1-year mortality risks in nursing home residents

    NARCIS (Netherlands)

    van Dijk, P.T.; Mehr, D.R.; Ooms, M.E.; Madsen, R.W.; Petroski, G.; Frijters, D.H.M.; Pot, A.M.; Ribbe, M.W.

    2005-01-01

    OBJECTIVES: To investigate the effect of chronic diseases and disease combinations on 1-year mortality in nursing home residents. DESIGN: Retrospective cohort study using electronically submitted Minimum Data Set (MDS) information and Missouri death certificate data. SETTING: Five hundred twenty-two

  11. E-conferencing for delivery of residency didactics.

    Science.gov (United States)

    Markova, Tsveti; Roth, Linda M

    2002-07-01

    While didactic conferences are an important component of residency training, delivering them efficiently is a challenge for many programs, especially when residents are located in multiple sites, as they are at Wayne State University School of Medicine in the Department of Family Medicine. Our residents find it difficult to travel from our hospitals or rotation sites to a centralized location for conferences. In order to overcome this barrier, we implemented distance learning and electronically delivered the conferences to the residents. We introduced an Internet-delivered, group-learning interactive conference model in which the lecturer is in one location with a group of residents and additional residents are in multiple locations. We launched the project in July 2001 using external company meeting services to schedule, coordinate, support, and archive the conferences. Equipment needed in each location consisted of a computer with an Internet connection, a telephone line, and a LCD projector (a computer monitor sufficed for small groups). We purposely chose simple distance-learning technology and used widely available equipment. Our e-conferencing had two components: (1) audio transmission via telephone connection and (2) visual transmission of PowerPoint presentations via the Internet. The telephone connection was open to all users, allowing residents to ask questions or make comments. Residents chose a conference location depending on geographic proximity to their rotation locations. Although we could accommodate up to 50 sites, we focused on a small number of locations in order to facilitate interaction among residents and faculty. Each conference session is archived and stored on the server for one week so those residents whose other residency-related responsibilities precluded attendance can view any conferences they have missed. E-conferencing proved to be an effective method of delivering didactics in our residency program. Its many advantages included

  12. Experimental determination of residence time distribution in continuous dry granulation.

    Science.gov (United States)

    Mangal, Haress; Kleinebudde, Peter

    2017-05-30

    With increasing importance of continuous manufacturing, the interest in integrating dry granulation into a continuous manufacturing line is growing. Residence time distribution measurements are of importance as they provide information about duration of materials within the process. These data enable traceability and are highly beneficial for developing control strategies. A digital image analysis system was used to determine the residence time distribution of two materials with different deformation behavior (brittle, plastic) in the milling unit of dry granulation systems. A colorant was added to the material (20%w/w iron oxide), which did not affect the material properties excessively, so the milling process could be mimicked well. Experimental designs were conducted to figure out which parameters effect the mean residence time strongly. Moreover, two types of dry granulation systems were contrasted. Longer mean residence times were obtained for the oscillating mill (OM) compared to the conical mill (CM). For co-processed microcrystalline cellulose residence times of 19.8-44.4s (OM) and 11.6-29.1s (CM) were measured, mainly influenced by the specific compaction force, the mill speed and roll speed. For dibasic calcium phosphate anhydrate residence times from 17.7-46.4 (OM) and 5.4-10.2s (CM) were measured, while here the specific compaction force, the mill speed and their interactions with the roll speed had an influence on the mean residence time. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. [Competency-based Neurosurgery Residency Programme].

    Science.gov (United States)

    Lobato, Ramiro D; Jiménez Roldan, Luis; Alen, José F; Castaño, Ana M; Munarriz, Pablo M; Cepeda, Santiago; Lagares, Alfonso

    2016-01-01

    assess the overall operation of the programme. Results of evaluations are registered, together with other relevant data, in the Resident's Book. The creation of a Programme Committee directly attached to the SENEC (National Commission) that, aside from generating a final version of the programme, monitors its implementation (level of adherence and operation in the different departments), assumes the creation of test banks and the centralized administration of knowledge tests (in the middle of the residency and/or at the end of it) and centralizes information collected by tutors that could be used for re-accreditation of the services, is proposed. Copyright © 2016 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  14. Resident training in a new robotic thoracic surgery program.

    Science.gov (United States)

    White, Yasmine N; Dedhia, Priya; Bergeron, Edward J; Lin, Jules; Chang, Andrew A; Reddy, Rishindra M

    2016-03-01

    The volume of robot-assisted operations has drastically increased over the past decade. New programs have focused on training surgeons, whereas resident training has lagged behind. The objective of this study was to evaluate our institutional experience with resident participation in thoracic robotic surgery cases since the initiation of our program. The first 100 robotic thoracic surgery cases at our institution were retrospectively reviewed and categorized into three sequential cohorts. Procedure type, patient and operative characteristics, level of resident participation (primary surgeon [PS] or assistant), and postoperative variables were evaluated. Of the first 100 cases, 38% were lung resections, 23% were esophageal operations, and 20% were sympathectomies. The distribution of cases changed over time with the proportion of pulmonary resections significantly increasing. Patient age (P robotics program. Operative time, estimated blood loss, and length of stay were similar regardless of level of resident participation. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Management training for pathology residents: a regional approach.

    Science.gov (United States)

    Horowitz, Richard E; Naritoku, Wesley; Wagar, Elizabeth A

    2004-01-01

    Success in the practice of pathology demands proficiency in management, but management training for pathology residents is generally inadequate, with little agreement on an appropriate curriculum or competency assessment. Most residency training programs do not have faculty members who are interested and have expertise in management and who are dedicated to and have time available for teaching. To develop a didactic management training program for the residents from 6 separate pathology residency programs in Southern California, with a comprehensive curriculum taught by experts in each area without undue burden on any single training program. Faculty from the University of California-Los Angeles and the University of Southern California reviewed the literature and the management needs of practicing pathologists and devised the curriculum. Pathologist and nonpathologist speakers were identified who were working in important management positions both regionally and nationally. Seminars were presented in alternate months during a 2-year period. Sessions were videotaped, and each session was evaluated by the attendees. The curriculum consisted of 12 major topics, and seminars were delivered by 15 presenters from 6 institutions. Attendance was highest for residents in postgraduate years 2 and 3. The overall evaluation scores were exceedingly high (4.66 of a possible 5.0), and residents reported a significant increase in subject knowledge. Videotaping of presentations provided flexibility for residents who were unable to attend the seminars. This program was effective and could serve as a template for other pathology residency training programs to establish curriculum content and develop resident competency. Teaching responsibilities were less burdensome when spread among several programs and when supplemented by nonpathology faculty. Electronic and audiovisual support enhanced flexibility and access to the program.

  16. Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures.

    Science.gov (United States)

    Reynolds, Kellin; Barnhill, Danny; Sias, Jamie; Young, Amy; Polite, Florencia Greer

    2014-12-01

    A portable electronic method of providing instructional feedback and recording an evaluation of resident competency immediately following surgical procedures has not previously been documented in obstetrics and gynecology. This report presents a unique electronic format that documents resident competency and encourages verbal communication between faculty and residents immediately following operative procedures. The Microsoft Tag system and SurveyMonkey platform were linked by a 2-D QR code using Microsoft QR code generator. Each resident was given a unique code (TAG) embedded onto an ID card. An evaluation form was attached to each resident's file in SurveyMonkey. Postoperatively, supervising faculty scanned the resident's TAG with a smartphone and completed the brief evaluation using the phone's screen. The evaluation was reviewed with the resident and automatically submitted to the resident's educational file. The evaluation system was quickly accepted by residents and faculty. Of 43 residents and faculty in the study, 38 (88%) responded to a survey 8 weeks after institution of the electronic evaluation system. Thirty (79%) of the 38 indicated it was superior to the previously used handwritten format. The electronic system demonstrated improved utilization compared with paper evaluations, with a mean of 23 electronic evaluations submitted per resident during a 6-month period versus 14 paper assessments per resident during an earlier period of 6 months. This streamlined portable electronic evaluation is an effective tool for direct, formative feedback for residents, and it creates a longitudinal record of resident progress. Satisfaction with, and use of, this evaluation system was high.

  17. Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program.

    Science.gov (United States)

    Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E

    2015-01-01

    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.

  18. Understanding the exercise habits of residents and attending physicians: a mixed methodology study.

    Science.gov (United States)

    Williams, Amy S; Williams, Casey D; Cronk, Nikole J; Kruse, Robin L; Ringdahl, Erika N; Koopman, Richelle J

    2015-02-01

    Although the benefits of exercise are well known, rates of exercise among residents are much lower than those of attendings or medical students. Little is known about the barriers that prevent residents from exercising regularly. This mixed methodology study identifies and compares these barriers for resident and attending physicians practicing in the same setting. We conducted three focus groups with first-year and senior residents and attending physicians in the University of Missouri Department of Family and Community Medicine from April to August 2013. We also administered a survey inquiring about exercise rates and habits to 110 resident and attending physicians in the same department using both paper and electronic versions. During both inpatient and non-inpatient rotations, residents reported exercising less than attending physicians. No residents exercised more than 150 minutes/week during inpatient rotations compared to 18.42% of attendings. Only 6.9% of residents exercised more than 150 minutes/week during non-inpatient rotations, compared to 25% of attendings. Residents and attendings reported different barriers to regular exercise. Residents reported lack of time for a traditional structured workout as a major barrier, which leads to an adversarial relationship between work and exercise. Residency programs can help residents overcome exercise barriers by reframing exercise expectations to include more frequent but brief periods of exercise during the workday and by developing a supportive exercise culture. Changing worksite environments to support physician exercise may improve physician wellness.

  19. Electronics and electronic systems

    CERN Document Server

    Olsen, George H

    1987-01-01

    Electronics and Electronic Systems explores the significant developments in the field of electronics and electronic devices. This book is organized into three parts encompassing 11 chapters that discuss the fundamental circuit theory and the principles of analog and digital electronics. This book deals first with the passive components of electronic systems, such as resistors, capacitors, and inductors. These topics are followed by a discussion on the analysis of electronic circuits, which involves three ways, namely, the actual circuit, graphical techniques, and rule of thumb. The remaining p

  20. Helping Residents Protect Water Sources

    Science.gov (United States)

    Building on the successful early engagement of the Plain Sect agricultural community, the Eastern Lancaster County Source Water Protection Collaborative is expanding its efforts to involve local residents in the work of protecting drinking water sources.

  1. Development of a Night Float Call Model for Obstetrics and Gynaecology Residency: The Process and Residents' Perceptions.

    Science.gov (United States)

    Sterling, Lynn; McCaffrey, Carmen; Secter, Michael; Rich, Rebecca; Green, Jessica; Shirreff, Lindsay; Steele, Donna

    2016-11-01

    The 2013 pan-Canadian consensus Report on Resident Duty Hours identified that traditional 24-hour duty periods pose risks to the well-being of residents and should be avoided. In anticipation of duty-hour restrictions, the Obstetrics and Gynaecology Residency Program at the University of Toronto developed and implemented a night float (NF) call model over a three-year span. Quarterly resident surveys have consistently shown that the NF system is preferred to traditional 24-hour call and has resulted in reduced fatigue and improved continuity of patient care. Through many iterations, the NF model achieved levels of resident morale, surgical experience, and impact on family relationships that are comparable to the 24-hour call system. We review here our process for developing an NF call model and the perceptions and experiences of residents, with the goal of providing insight for other residency programs that are considering or instituting NF call systems. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  2. the contribution of resident physicians

    OpenAIRE

    Trusch, Klaus

    2011-01-01

    A telephone survey of resident physicians to the basic conditions in which they work has been conducted in 14 of the 16 federal states. In the center of the survey stood the general medicine within the prisons. This limitation was necessary in order to achieve comparability to primary medical care outside of correctional services. There are 140 salaried and tenured resident pysicians and 97 contract doctors in the general medical care of approx. 70000 prisoners in 185 independent prisons ...

  3. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS Active Resident Report summarizes information for residents currently in nursing homes. The source of these counts is the residents MDS assessment record....

  4. Sleep Quality Among Psychiatry Residents.

    Science.gov (United States)

    Carvalho Aguiar Melo, Matias; das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth

    2016-01-01

    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.

  5. Selection criteria of residents for residency programs in Kuwait.

    Science.gov (United States)

    Marwan, Yousef; Ayed, Adel

    2013-01-19

    In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

  6. Surgical resident education in patient safety: where can we improve?

    Science.gov (United States)

    Putnam, Luke R; Levy, Shauna M; Kellagher, Caroline M; Etchegaray, Jason M; Thomas, Eric J; Kao, Lillian S; Lally, Kevin P; Tsao, KuoJen

    2015-12-01

    Effective communication and patient safety practices are paramount in health care. Surgical residents play an integral role in the perioperative team, yet their perceptions of patient safety remain unclear. We hypothesized that surgical residents perceive the perioperative environment as more unsafe than their faculty and operating room staff despite completing a required safety curriculum. Surgeons, anesthesiologists, and perioperative nurses in a large academic children's hospital participated in multifaceted, physician-led workshops aimed at enhancing communication and safety culture over a 3-y period. All general surgery residents from the same academic center completed a hospital-based online safety curriculum only. All groups subsequently completed the psychometrically validated safety attitudes questionnaire to evaluate three domains: safety culture, teamwork, and speaking up. Results reflect the percent of respondents who slightly or strongly agreed. Chi-square analysis was performed. Sixty-three of 84 perioperative personnel (75%) and 48 of 52 surgical residents (92%) completed the safety attitudes questionnaire. A higher percentage of perioperative personnel perceived a safer environment than the surgical residents in all three domains, which was significantly higher for safety culture (68% versus 46%, P = 0.03). When stratified into two groups, junior residents (postgraduate years 1-2) and senior residents (postgraduate years 3-5) had lower scores for all three domains, but the differences were not statistically significant. Surgical residents' perceptions of perioperative safety remain suboptimal. With an enhanced safety curriculum, perioperative staff demonstrated higher perceptions of safety compared with residents who participated in an online-only curriculum. Optimal surgical education on patient safety remains unknown but should require a dedicated, systematic approach. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Modeling Hourly Resident Productivity in the Emergency Department.

    Science.gov (United States)

    Joseph, Joshua W; Henning, Daniel J; Strouse, Connie S; Chiu, David T; Nathanson, Larry A; Sanchez, Leon D

    2017-08-01

    Resident productivity, defined as new patients per hour, carries important implications for emergency department operations. In high-volume academic centers, essential staffing decisions can be made on the assumption that residents see patients at a static rate. However, it is unclear whether this model mirrors reality; previous studies have not rigorously examined whether productivity changes over time. We examine residents' productivity across shifts to determine whether it remained consistent. This was a retrospective cohort study conducted in an urban academic hospital with a 3-year emergency medicine training program in which residents acquire patients ad libitum throughout their shift. Time stamps of all patient encounters were automatically logged. A linear mixed model was constructed to predict productivity per shift hour. A total of 14,364 8- and 9-hour shifts were worked by 75 residents between July 1, 2010, and June 20, 2015. This comprised 6,127 (42.7%) postgraduate year (PGY) 1 shifts, 7,236 (50.4%) PGY-2 shifts, and 998 (6.9%) PGY-3 nonsupervisory shifts (Table 1). Overall, residents treated a mean of 10.1 patients per shift (SD 3.2), with most patients at Emergency Severity Index level 3 or more acute (93.8%). In the initial hour, residents treated a mean of 2.14 patients (SD 1.2), and every subsequent hour was associated with a significant decrease, with the largest in the second, third, and final hours. Emergency medicine resident productivity during a single shift follows a reliable pattern that decreases significantly hourly, a pattern preserved across PGY years and types of shifts. This suggests that resident productivity is a dynamic process, which should be considered in staffing decisions and studied further. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  8. Money matters: a resident curriculum for financial management.

    Science.gov (United States)

    Mizell, Jason S; Berry, Katherine S; Kimbrough, Mary Katherine; Bentley, Frederick R; Clardy, James A; Turnage, Richard H

    2014-12-01

    A 2005 survey reported 87% of surgery program directors believed practice management training should occur during residency. However, only 8% of program directors believed residents received adequate training in practice management [1]. In addition to the gap in practice financial management knowledge, we recognized the need for training in personal finance among residents. A literature review and needs assessment led to the development of a novel curriculum for surgery residents combining principles of practice management and personal finance. An 18-h curriculum was administered over the 2012 academic year to 28 post graduate year 1-5 surgery residents and faculty. A self-assessment survey was given at the onset and conclusion of the curriculum [2]. Pre-tests and post-tests were given to objectively evaluate each twice monthly session's content. Self-perception of learning, interest, and acquired knowledge were analyzed using the Wilcoxon signed ranks test. Initial self-assessment data revealed high interest in practice management and personal finance principles but a deficiency in knowledge of and exposure to these topics. Throughout the curriculum, interest increased. Residents believed their knowledge of these topics increased after completing the curriculum, and objective data revealed various impacts on knowledge. Although surgery residents receive less exposure to these topics than residents in other specialties, their need to know is no less. We developed, implemented, and evaluated a curriculum that bridged this gap in surgery education. After the curriculum, residents reported an increase in interest, knowledge, and responsible behavior relating to personal and practice financial management. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The use of error analysis to assess resident performance.

    Science.gov (United States)

    D'Angelo, Anne-Lise D; Law, Katherine E; Cohen, Elaine R; Greenberg, Jacob A; Kwan, Calvin; Greenberg, Caprice; Wiegmann, Douglas A; Pugh, Carla M

    2015-11-01

    The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems. Residents committed 121 total errors on day 1 compared with 146 on day 2. One of 7 residents successfully completed the LVH repair on day 1 compared with all 7 residents on day 2 (P = .001). The majority of errors (85%) committed on day 2 were technical and occurred during the last 2 steps of the procedure. There were significant differences in error type (P ≤ .001) and level (P = .019) from day 1 to day 2. The proportion of omission errors decreased from day 1 (33%) to day 2 (14%). In addition, there were more technical and commission errors on day 2. The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Fractional Reserve in Banking System

    OpenAIRE

    Valkonen, Maria

    2016-01-01

    This thesis is aimed to provide understanding of the role of the fractional reserve in the mod-ern banking system worldwide and particularly in Finland. The fractional reserve banking is used worldwide, but the benefits of this system are very disputable. On the one hand, experts say that the fractional reserve is a necessary instrument for the normal business and profit making. On the other hand, sceptics openly criticize the fractional reserve system and blame it for fiat money (money n...

  11. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    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 © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  12. Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Non-Reservation

    Science.gov (United States)

    Hirchak, Katherine A.; Murphy, Sean M.

    2017-01-01

    Background Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substance-use-disorder therapy. Purpose Assess differences in the number of opioid agonist therapy (OAT) facilities and physicians with Drug Addiction Treatment Act (DATA) waivers for rural versus urban, and AI reservation/trust land versus non-AI reservation/trust land areas in Washington State. Methods The unit of analysis was the zip code. The dependent variables were the number of OAT facilities and DATA-waivered physicians in a region per 10,000 residents aged 18–64 in a zip code. A region was defined as a zip code and its contiguous zip codes. The independent variables were binary measures of whether a zip code was classified as rural versus urban, or AI reservation/trust land versus non-AI reservation/trust land. Zero-inflated negative binomial regressions with robust standard errors were estimated. Results The number of OAT clinics in a region per 10,000 zip-code residents was significantly lower in rural versus urban areas (P = .002). This did not differ significantly between AI reservation/trust land and non-AI reservation/trust land areas (P = .79). DATA-waivered physicians in a region per 10,000 zip-code residents was not significantly different between rural and urban (P = .08), or AI reservation/trust land versus non-AI reservation/trust land areas (P = .21). Conclusions It appears that the potential for Washington State residents of rural and AI reservation areas to receive OAT is similar to that of residents outside of those areas; however, difficulties in accessing therapy may remain, highlighting the importance of expanding health care insurance and providing support for DATA-waivered physicians. PMID:26987797

  13. Emergency Medicine Resident Orientation: How Training Programs Get their Residents Started

    Directory of Open Access Journals (Sweden)

    McGrath, Jillian

    2017-01-01

    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

  14. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

    Full Text Available Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

  15. Increasing faculty participation in resident education and providing cost-effective self-assessment module credit to faculty through resident-generated didactics.

    Science.gov (United States)

    Kim, Hyun; Malatesta, Theresa M; Anné, Pramila R; McAna, John; Bar-Ad, Voichita; Dicker, Adam P; Den, Robert B

    to purchasing SAM resources, increases faculty attendance, and may improve the quality of radiation oncology resident education. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  16. An International Collaboration for the Training of Medical Chief Residents in Rwanda.

    Science.gov (United States)

    Walker, Tim; Dusabejambo, Vincent; Ho, Janet J; Karigire, Claudine; Richards, Bradley; Sofair, Andre N

    The year-long position of chief medical resident is a time-honored tradition in the United States that serves to provide the trainee with an opportunity to gain further skills as a clinician, leader, teacher, liaison, and administrator. However, in most training programs in the developing world, this role does not exist. We sought to develop a collaborative program to train the first medical chief residents for the University of Rwanda and to assess the impact of the new chief residency on residency training, using questionnaires and qualitative interviews with Rwandan faculty, chief residents, and residents. The educational context and the process leading up to the appointment of Rwandan chief residents, including selection, job description, and necessary training (in the United States and Rwanda), are described. One year after implementation, we used a parallel, mixed methods approach to evaluate the new chief medical resident program through resident surveys as well as semistructured interviews with key informants, including site chief residents, chief residents, and faculty. We also observed chief residents and site chief residents at work and convened focus groups with postgraduate residents to yield additional qualitative information. Rwandan faculty and residents generally felt that the new position had improved the educational and administrative structure of the teaching program while providing a training ground for future academicians. A collaborative training program between developing and developed world academic institutions provides an efficient model for the development of a new chief residency program in the developing world. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  17. Workplace bullying of general surgery residents by nurses.

    Science.gov (United States)

    Schlitzkus, Lisa L; Vogt, Kelly N; Sullivan, Maura E; Schenarts, Kimberly D

    2014-01-01

    the toll on the resident's well-being and patient outcomes. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Complementary and integrative medicine attitudes and perceived knowledge in a large pediatric residency program.

    Science.gov (United States)

    Ziodeen, Kamilah A; Misra, Sanghamitra M

    2018-04-01

    There is limited formal complementary and alternative medicine (CAM)/integrative medicine (IM) training in most US pediatric residency programs. Not surprisingly, the AAP Fellows survey #49 demonstrated that pediatricians in residency training and those younger than 42 years old reported less knowledge of CAM than their counterparts. The purpose of this study was to assess pediatric residents' attitudes toward CAM and IM, personal use of CAM, perceived knowledge gaps, and preferred methods of delivery for IM education in a large pediatric residency program. A 20-question anonymous, voluntary electronic survey was sent to all categorical and combined program pediatric residents at a pediatric residency program in Texas. Eighty of 177 pediatric residents completed the survey. Eighty-three percent of respondents reported that patients have asked them about complementary and integrative medicine, and 88% reported that they would like to expand their knowledge on CAM/IM. Lack of knowledge was the top barrier to residents' incorporation of complementary and integrative medicine into their practice. Preferred methods of education delivery were reported as exposure to complementary and integrative medicine providers and noon conference lectures. Residents in this large pediatric residency program recognize their knowledge gaps and wish to improve their understanding of complementary and integrative medicine. A formal IM curriculum could bridge knowledge gaps and help residents feel more comfortable discussing IM with patients and their families. Copyright © 2018. Published by Elsevier Ltd.

  19. Biosphere reserves: Attributes for success.

    Science.gov (United States)

    Van Cuong, Chu; Dart, Peter; Hockings, Marc

    2017-03-01

    Biosphere reserves established under the UNESCO Man and the Biosphere Program aim to harmonise biodiversity conservation and sustainable development. Concerns over the extent to which the reserve network was living up to this ideal led to the development of a new strategy in 1995 (the Seville Strategy) to enhance the operation of the network of reserves. An evaluation of effectiveness of management of the biosphere reserve network was called for as part of this strategy. Expert opinion was assembled through a Delphi Process to identify successful and less successful reserves and investigate common factors influencing success or failure. Ninety biosphere reserves including sixty successful and thirty less successful reserves in 42 countries across all five Man and the Biosphere Program regions were identified. Most successful sites are the post-Seville generation while the majority of unsuccessful sites are pre-Seville that are managed as national parks and have not been amended to conform to the characteristics that are meant to define a biosphere reserve. Stakeholder participation and collaboration, governance, finance and resources, management, and awareness and communication are the most influential factors in the success or failure of the biosphere reserves. For success, the biosphere reserve concept needs to be clearly understood and applied through landscape zoning. Designated reserves then need a management system with inclusive good governance, strong participation and collaboration, adequate finance and human resource allocation and stable and responsible management and implementation. All rather obvious but it is difficult to achieve without commitment to the biosphere reserve concept by the governance authorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. A problem-oriented approach to resident performance ratings.

    Science.gov (United States)

    Williams, Reed G; Mellinger, John D; Dunnington, Gary L

    2016-10-01

    Global, end-of-rotation evaluations are often difficult to interpret due to their high level of abstraction (eg, excellent, good, poor) and the bias toward high ratings. This study documents the utility of and measurement characteristics of serious problem items, an alternative item format. This report is based on 4,234 faculty performance ratings for 105 general surgery residents. Faculty members reported whether each resident had a serious problem for each of 8 areas of clinical performance and 6 areas of professional behavior. A total of 263 serious problems were reported. The performance category with the most total serious problems noted was knowledge and that with the least problems noted was relations with patients and family members. Seven residents accounted for 86.9% of all serious problem reports. Each resident had serious problems in multiple performance areas. Problems were reported most frequently in knowledge, management, technical/procedural skills, ability to assume responsibility within level of competence, and problem identification. Citations of these serious problems were most common in year 3. Traditional ratings of global performance were not an adequate means for identifying residents with serious performance problems. Serious problem ratings can communicate faculty concerns about residents more directly and can be used as a complement to conventional global rating scales without substantially increasing faculty workload. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [French residents' training in instrumental deliveries: A national survey].

    Science.gov (United States)

    Saunier, C; Raimond, E; Dupont, A; Pelissier, A; Bonneau, S; Gabriel, R; Graesslin, O

    2016-11-01

    To evaluate French residents in Obstetrics and Gynaecology's training in instrumental deliveries in 2015. We conducted a national descriptive survey among 758 residents between December 2014 and January 2015. Respondents were invited by email to specify their University Hospital, their current university term, the number of instrumental deliveries performed by vacuum extractor, forceps or spatulas, and whether they made systematic ultrasound exams before performing the extraction. Response rate was 34.7 % (n=263). There were important differences between regions in terms of type of instruments used. Vacuum extractor was the most commonly used instrument for instrumental deliveries by French residents (56.9 %), more than forceps (25.2 %) and spatulas (17.9 %). At the end of the residency, all the residents had been trained in instrumental deliveries with at least two instruments. The training of difficult techniques as well as their perfect control is required for instrumental deliveries. Yet, we are forced to note that there are substantial differences in the French residents' training in instrumental deliveries depending on their region. So, teaching at least two techniques seems essential as well as improving the training capacities and standardizing practices. A greater systematization of the teaching of the mechanics and obstetric techniques might be a solution to be considered too. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. [Prevalence of burnout among obstetrics and gynecology residents].

    Science.gov (United States)

    Rua, C; Body, G; Marret, H; Ouldamer, L

    2015-01-01

    Prevalence assessment of burnout among obstetrics and gynecology residents and predisposing factors. Multicentric cross-sectional survey based on a questionnaire sent by email to the residents including demographics data and Maslach Burnout Inventory. Mean burnout scores were 19.67±10.19 for emotional exhaustion, 33.94±5.01 for personal accomplishment and 8.72±6.10 for depersonalization, corresponding to a moderate burnout for each category. High scores of burnout were seen on 19.45 % of residents for emotional exhaustion, 33.33 % for depersonalization and 11.11 % for personal accomplishment. 36.11 % of residents showed evidence of high burnout in emotional exhaustion or depersonalization, and 5.55 % in the three dimensions. The number of semesters is correlated with depersonalization (P=0.01). There is a strong personal accomplishment among obstetrics and gynecology residents; however, burnout and emotional exhaustion remains a reality during obstetrics and gynecology residency. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Residents' perception of skill decay during dedicated research time.

    Science.gov (United States)

    D'Angelo, Anne-Lise D; Ray, Rebecca D; Jenewein, Caitlin G; Jones, Grace F; Pugh, Carla M

    2015-11-01

    Surgery residents may take years away from clinical responsibilities for dedicated research time. As part of a longitudinal project, the study aim was to investigate residents' perceptions of clinical skill reduction during dedicated research time. Our hypothesis was that residents would perceive a greater potential reduction in skill during research time for procedures they were less confident in performing. Surgical residents engaged in dedicated research training at multiple training programs participated in four simulated procedures: urinary catheterization, subclavian central line, bowel anastomosis, and laparoscopic ventral hernia (LVH) repair. Using preprocedure and postprocedure surveys, participants rated procedures for confidence and difficulty. Residents also indicated the perceived level of skills reduction for the four procedures as a result of time in the laboratory. Thirty-eight residents (55% female) completed the four clinical simulators. Participants had between 0-36 mo in a laboratory (M = 9.29 mo, standard deviation = 9.38). Preprocedure surveys noted lower confidence and higher perceived difficulty for performing the LVH repair followed by bowel anastomosis, central line insertion, and urinary catheterization (P perception for urinary catheterization (P perception and may provide a mechanism for maintaining skills and keeping confidence grounded in experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Nuclear, uranium, reserves, sustainability, independence; Nucleaire, Uranium, reserves, durabilite, independance

    Energy Technology Data Exchange (ETDEWEB)

    Acket, C

    2007-06-15

    In order to evaluate the energy independence concerning the nuclear energy, the author takes the state of the art about the uranium. He details the fuel needs, the reserves on the base of the today available techniques, the reserves on the base of the future techniques and concludes positively on the energy independence for the nuclear. (A.L.B.)

  5. Plagiarism in residency application essays.

    Science.gov (United States)

    Segal, Scott; Gelfand, Brian J; Hurwitz, Shelley; Berkowitz, Lori; Ashley, Stanley W; Nadel, Eric S; Katz, Joel T

    2010-07-20

    Anecdotal reports suggest that some residency application essays contain plagiarized content. To determine the prevalence of plagiarism in a large cohort of residency application essays. Retrospective cohort study. 4975 application essays submitted to residency programs at a single large academic medical center between 1 September 2005 and 22 March 2007. Specialized software was used to compare residency application essays with a database of Internet pages, published works, and previously submitted essays and the percentage of the submission matching another source was calculated. A match of more than 10% to an existing work was defined as evidence of plagiarism. Evidence of plagiarism was found in 5.2% (95% CI, 4.6% to 5.9%) of essays. The essays of non-U.S. citizens were more likely to demonstrate evidence of plagiarism. Other characteristics associated with the prevalence of plagiarism included medical school location outside the United States and Canada; previous residency or fellowship; lack of research experience, volunteer experience, or publications; a low United States Medical Licensing Examination Step 1 score; and non-membership in the Alpha Omega Alpha Honor Medical Society. The software database is probably incomplete, the 10%-match threshold for defining plagiarism has not been statistically validated, and the study was confined to applicants to 1 institution. Evidence of matching content in an essay cannot be used to infer the applicant's intent and is not sensitive to variations in the cultural context of copying in some societies. Evidence of plagiarism in residency application essays is more common in international applicants but was found in those by applicants to all specialty programs, from all medical school types, and even among applicants with significant academic honors. No external funding.

  6. 38 CFR 51.70 - Resident rights.

    Science.gov (United States)

    2010-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a... legal representative. (5) Conveyance upon death. Upon the death of a resident with a personal fund...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must meet...

  7. Mentorship in orthopaedic and trauma residency training ...

    African Journals Online (AJOL)

    Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

  8. Surgery resident learning styles and academic achievement.

    Science.gov (United States)

    Contessa, Jack; Ciardiello, Kenneth A; Perlman, Stacie

    2005-01-01

    To determine if surgical residents share a preferred learning style as measured by Kolb's Learning Style Inventory (LSI) and if a relationship exists between resident learning style and achievement as measured by a standardized examination (AME). Also, core faculty learning styles were assessed to determine if faculty and residents share a preferred learning style. Kolb's LSI, Version 3, was administered to 16 surgical residents and the residency program's core faculty of 6 attending physicians. To measure academic achievement, the American Medical Education (AME) examination was administered to residents. The Hospital of Saint Raphael, General Surgery Residency Program, New Haven, Connecticut. Both instruments were administered to residents during protected core curriculum time. Core faculty were administered the LSI on an individual basis. Surgical residents of the Hospital of Saint Raphael's General Surgery Residency Program and 6 core faculty members Analysis of resident learning style preference revealed Converging as the most commonly occurring style for residents (7) followed by Accommodating (5), Assimilating (3), and Diverging (1). The predominant learning style for core faculty was also Converging (4) with 2 Divergers. The average score for the Convergers on the AME was 62.6 compared with 42 for the next most frequently occurring learning style, Accommodators. In this surgical residency program, a preferred learning style for residents seems to exist (Converging), which confirms what previous studies have found. Additionally, residents with this learning style attained a higher average achievement score as measured by the AME. Also, core faculty share the same preferential learning style as this subset of residents.

  9. The resident's view of residency training in Canada.

    Science.gov (United States)

    Fish, D G

    1966-04-09

    In the view of residents in their last year of specialty training, the Fellowship is now becoming the operative standard for obtaining hospital privileges in urban centres and they felt that this implied that the two standards, the Certificate and the Fellowship of the Royal College, were not achieving the purpose for which they were designed. Although 80% of the residents intended to write the Fellowship, few viewed a year in a basic science department or in research as of intrinsic value in terms of their future practice.The examinations of the Royal College were the subject of criticism, most residents feeling that the examinations did not test the knowledge and ability gained in training. Most expressed a desire for ongoing evaluation during the training period.Service responsibilities were generally regarded as too heavy.Despite the criticism of both training and examination, most residents felt that their training had provided them with the experience and background they needed to practise as specialists.

  10. Thoughts of Quitting General Surgery Residency: Factors in Canada.

    Science.gov (United States)

    Ginther, David Nathan; Dattani, Sheev; Miller, Sarah; Hayes, Paul

    2016-01-01

    Attrition rates in general surgery training are higher than other surgical disciplines. We sought to determine the prevalence with which Canadian general surgery residents consider leaving their training and the contributing factors. An anonymous survey was administered to all general surgery residents in Canada. Responses from residents who considered leaving their training were assessed for importance of contributing factors. The study was conducted at the Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, a tertiary academic center. The response rate was approximately 34.0%. A minority (32.0%) reported very seriously or somewhat seriously considering leaving their training, whereas 35.2% casually considered doing so. Poor work-life balance in residency (38.9%) was the single-most important factor, whereas concern about future unemployment (16.7%) and poor future quality of life (15.7%) were next. Enjoyment of work (41.7%) was the most frequent mitigating factor. Harassment and intimidation were reported factors in 16.7%. On analysis, only intention to practice in a nonacademic setting approached significant association with thoughts of leaving (odds ratio = 1.92, CI = 0.99-3.74, p = 0.052). There was no association with sex, program, postgraduate year, relationship status, or subspecialty interest. There was a nonsignificant trend toward more thoughts of leaving with older age. Canadian general surgery residents appear less likely to seriously consider quitting than their American counterparts. Poor work-life balance in residency, fear of future unemployment, and anticipated poor future quality of life are significant contributors to thoughts of quitting. Efforts to educate prospective residents about the reality of the surgical lifestyle, and to assist residents in securing employment, may improve completion rates. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Surgical residency market research-what are applicants looking for?

    Science.gov (United States)

    Parker, Anna M; Petroze, Robin T; Schirmer, Bruce D; Calland, James F

    2013-01-01

    We propose that one of the integral parts of building a stronger residency program is the ability to recruit top applicants. Little is known about the factors applicants use to evaluate residency programs. Given that the top applicants are likely to be ranked highly by multiple programs, we sought to determine which factors applicants themselves used to evaluate potential residency programs. An anonymous, voluntary survey was distributed to all interviewing applicants, asking them to rank 12 factors when choosing a residency. They were additionally asked about any prior research or international medical experience. Surveys were distributed at the beginning of the interview day and collected in sealed unmarked envelopes. All applicants interviewing for general surgery residency at the University of Virginia during the 2009-2010 and 2010-2011 seasons. Resident satisfaction was rated the highest, 8.7 out of 9. In descending order of importance, applicants ranked record of the chiefs (8.0), resident case volume (7.8), academic reputation (7.6), geography (7.4), research opportunities (7.3), laparoscopic laboratory (6.2), elective time (5.4), international opportunities (5.1), benefits (4.8), and vacation (4.7), respectively. No correlation was found between prior research experience and research ranking score. A significant positive correlation was found between those applicants with prior international experience and their ranking of international opportunities during residency (p < 0.0001). Applicants rated a program on a broad range of factors and commonly cited a "gut feeling" or "esprit de corps." The ability to pursue an identified area of special interest, in this case an international opportunity, proved to be an additional major selection factor for a subset of candidates. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Conversations with Holocaust survivor residents.

    Science.gov (United States)

    Hirst, Sandra P; LeNavenec, Carole Lynne; Aldiabat, Khaldoun

    2011-03-01

    Traumatic events in one's younger years can have an impact on how an individual copes with later life. One traumatic experience for Jewish individuals was the Holocaust. Some of these people are moving into long-term care facilities. It was within this context that the research question emerged: What are Holocaust survivor residents' perceptions of a life lived as they move into a long-term care facility? For this qualitative study, Holocaust survivors were individually interviewed. Findings emphasize that nursing care needs to ensure that Holocaust survivor residents participate in activities, receive timely health care, and receive recognition of their life experiences. Copyright 2011, SLACK Incorporated.

  13. Incorporating gross anatomy education into radiation oncology residency: a 2-year curriculum with evaluation of resident satisfaction.

    Science.gov (United States)

    Cabrera, Alvin R; Lee, W Robert; Madden, Richard; Sims, Ershela; Hoang, Jenny K; White, Leonard E; Marks, Lawrence B; Chino, Junzo P

    2011-05-01

    Radiation oncologists require a thorough understanding of anatomy, but gross anatomy is not part of the standard residency curriculum. "Oncoanatomy" is an educational program for radiation oncology residents at Duke University that integrates cadaver dissection into the instruction of oncologic anatomy, imaging, and treatment planning. In this report, the authors document their experience with a 2-year curriculum. Nineteen radiation oncology residents from Duke University and the University of North Carolina participated during academic years 2008-2009 and 2009-2010. Monthly modules, based on anatomic site, consisted of one or two clinically oriented hour-long lectures, followed by a 1-hour gross anatomy session. Clinical lectures were case based and focused on radiographic anatomy, image segmentation, and field design. Gross anatomy sessions centered on cadaver prosections, with small groups rotating through stations at which anatomists led cadaver exploration. Adjacent monitors featured radiologic imaging to facilitate synthesis of gross anatomy with imaging anatomy. Satisfaction was assessed on a 10-point scale via anonymous survey. Twenty modules were held over the 2-year period. Participants gave the course a median rating of 8 (interquartile range, 7-9), with 1 signifying "as effective as the worst educational activities" and 10 "as effective as the best educational activities." High resident satisfaction was seen with all module components. Incorporating a structured, 2-year gross anatomy-based curriculum into radiation oncology residency is feasible and associated with high resident satisfaction. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Oak Ridge Reservation environmental report for 1989

    International Nuclear Information System (INIS)

    Jacobs, V.A.; Wilson, A.R.

    1990-10-01

    This two-volume report, the Oak Ridge Reservation Environmental Report for 1989, is the nineteenth in an annual series that began in 1971. It reports the results of a comprehensive, year-round program to monitor the impact of operations at the three major US Department of Energy (DOE) production and research installations in Oak Ridge on the immediate areas' and surrounding region's groundwater and surface waters, soil, air quality, vegetation and wildlife, and through these multiple and varied pathways, the resident human population. Information is presented for the environmental monitoring Quality Assurance (QA) Program, audits and reviews, waste management activities, land special environmental studies. Data are included for the Oak Ridge Y-12 Plant, Oak Ridge National Laboratory (ORNL), and Oak Ridge Gaseous Diffusion Plant (ORGDP). Volume 1 presents narratives, summaries, and conclusions based on environmental monitoring at the three DOE installations and in the surrounding environs during calendar year (CY) 1989. Volume 1 is intended to be a ''stand-alone'' report about the Oak Ridge Reservation (ORR) for the reader who does not want an in-depth review of 1989 data. Volume 2 presents the detailed data from which these conclusions have been drawn and should be used in conjunction with Volume 1

  15. Oak Ridge Reservation environmental report for 1989

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, V.A.; Wilson, A.R. (eds.)

    1990-10-01

    This two-volume report, the Oak Ridge Reservation Environmental Report for 1989, is the nineteenth in an annual series that began in 1971. It reports the results of a comprehensive, year-round program to monitor the impact of operations at the three major US Department of Energy (DOE) production and research installations in Oak Ridge on the immediate areas' and surrounding region's groundwater and surface waters, soil, air quality, vegetation and wildlife, and through these multiple and varied pathways, the resident human population. Information is presented for the environmental monitoring Quality Assurance (QA) Program, audits and reviews, waste management activities, land special environmental studies. Data are included for the Oak Ridge Y-12 Plant, Oak Ridge National Laboratory (ORNL), and Oak Ridge Gaseous Diffusion Plant (ORGDP). Volume 1 presents narratives, summaries, and conclusions based on environmental monitoring at the three DOE installations and in the surrounding environs during calendar year (CY) 1989. Volume 1 is intended to be a stand-alone'' report about the Oak Ridge Reservation (ORR) for the reader who does not want an in-depth review of 1989 data. Volume 2 presents the detailed data from which these conclusions have been drawn and should be used in conjunction with Volume 1.

  16. Residency in urology and training in kidney transplantation. Results of a national survey.

    Science.gov (United States)

    Cabello-Benavente, R; González-Enguita, C

    2015-06-01

    To determine the current state of kidney transplantation (KT) training in a country that is leader in organ donation and transplantation. We conducted an online survey by e-mail to 138 urology residents. The survey contained 5 sections: affiliation, training in KT, interest in KT, residents of transplant centers and residents of nontransplant centers. Sixty-five residents responded, 47.1% of the urologists in training surveyed, representing 28 cities and 15 provinces. Fifty-five percent (n=36) of the respondents deemed the KT training offered during their residency as insufficient, and 85% (n=55) demanded more resources. More than half were not confident in their abilities to perform transplantation surgery over the course of their residency (n=35). Nineteen percent of the residents considered KT an important discipline in their residency, with a mean score of 56.2 (1-100). Among the residents of the transplant centers (69.2%, n=45), 73% (n=33) considered KT when choosing a center for their residency. Of the surveyed residents from nontransplant centers (30.7%, n=20), 45% (n=9) do not perform an external rotation in KT. The surveyed residents demand more training in KT. The most common situation is to end a residency without having performed a complete KT. KT is considered an asset when selecting a resident medical intern position and commonly they are part of the transplantation team. The majority of residents are trained in centers with less than 75 transplants/year. External rotations in KT are not the rule in centers where transplantation is not performed. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Assessing Resident Performance in Screening Mammography: Development of a Quantitative Algorithm.

    Science.gov (United States)

    Lewis, Petra J; Rooney, Timothy B; Frazee, Tracy E; Poplack, Steven P

    2018-01-20

    This study aims to provide objective performance data and feedback, including examination volumes, recall rates, and concordance with faculty interpretations, for residents performing independent interpretation of screening mammography examinations. Residents (r) and faculty (f) interpret screening mammograms separately and identify non-callbacks (NCBs) and callbacks (CBs). Residents review all discordant results. The number of concordant interpretations (fCB-rCB and fNCB-rNCB) and discordant interpretations (fCB-rNCB and fNCB-rCB) are entered into a macro-driven spreadsheet. These macros weigh the data dependent on the perceived clinical impact of the resident's decision. Weighted outcomes are combined with volumes to generate a weighted mammography performance score. Rotation-specific goals are assigned for the weighted score, screening volumes, recall rate relative to faculty, and concordance rates. Residents receive one point for achieving each goal. Between July 2013 and May 2017, 18,747 mammography examinations were reviewed by 31 residents, in 71 resident rotations, over 246 resident weeks. Mean resident recall rate was 9.9% and significantly decreased with resident level (R), R2 = 11.3% vs R3 = 9.4%, R4 = 9.2%. Mean resident-faculty discordance rate was 10% and significantly decreased from R2 = 12% to R4 = 9.6%. Weighted performance scores ranged from 1.1 to 2.0 (mean 1.6, standard deviation 0.17), but did not change with rotation experience. Residents had a mean goal achievement score of 2.6 (standard deviation 0.47). This method provides residents with easily accessible case-by-case individualized screening outcome data over the longitudinal period of their residency, and provides an objective method of assessing resident screening mammography performance. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  18. Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

    Science.gov (United States)

    Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

    2014-12-15

    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.

  19. What factors influence attending surgeon decisions about resident autonomy in the operating room?

    Science.gov (United States)

    Williams, Reed G; George, Brian C; Meyerson, Shari L; Bohnen, Jordan D; Dunnington, Gary L; Schuller, Mary C; Torbeck, Laura; Mullen, John T; Auyang, Edward; Chipman, Jeffrey G; Choi, Jennifer; Choti, Michael; Endean, Eric; Foley, Eugene F; Mandell, Samuel; Meier, Andreas; Smink, Douglas S; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Joseph B; Lillemoe, Keith D; Fryer, Jonathan P

    2017-12-01

    Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure. Predictor variables included resident performance on that case, supervising surgeon history with granting autonomy, resident training level, and case difficulty. Resident performance was the strongest predictor of autonomy granted. Typical autonomy by supervising surgeon was the second most important predictor. Each additional factor led to a smaller but still significant improvement in ability to predict the supervising surgeon's autonomy decision. The 4 factors together accounted for 54% of decision variance (r = 0.74). Residents' operative performance in each case was the strongest predictor of how much autonomy was allowed in that case. Typical autonomy granted by the supervising surgeon, the second most important predictor, is unrelated to resident proficiency and warrants efforts to ensure that residents perform each procedure with many different supervisors. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Using Quality Improvement in Resident Education to Improve Transition Care.

    Science.gov (United States)

    Volertas, Sofija D; Rossi-Foulkes, Rita

    2017-05-01

    The importance of a specific transition process is recognized by many health organizations. Got Transition, a cooperative endeavor aimed at improving the transition from pediatric to adult health care, developed Six Core Elements defining the basic components of health care transition support. In this article, we review the Six Core Elements by presenting a model that combines resident quality improvement and transition care training. In this Internal Medicine-Pediatrics residency program, ambulatory training for residents takes place in a combined adult and pediatric clinic. Aligned with the Six Core Elements, the program has crafted and disseminated a transition policy for the practice, designed a portable health summary template for the electronic medical record (EMR), created EMR tools for assessing transition readiness and setting transition goals, formed a registry of patients, and audited charts. [Pediatr Ann. 2017;46(5):e203-e206.]. Copyright 2017, SLACK Incorporated.

  1. Residency Surgical Training at an Independent Academic Medical Center.

    Science.gov (United States)

    Jones, Jeremiah; Sidwell, Richard A

    2016-02-01

    Independent academic medical centers have been training surgeons for more than a century; this environment is distinct from university or military programs. There are several advantages to training at a community program, including a supportive learning environment with camaraderie between residents and faculty, early and broad operative experience, and improved graduate confidence. Community programs also face challenges, such as resident recruitment and faculty engagement. With the workforce needs for general surgeons, independent training programs will continue to play an integral role. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Youth Problems on Indian Reservations.

    Science.gov (United States)

    Underhill, Ruth M., Ed.

    Juvenile delinquency was identified as the major problem affecting youth on Indian reservations. Causes for delinquency which were discussed included culture conflict, expectation of failure, unemployment, failure of homes and parents, discrimination, inadequate education, off-reservation schools, and alcoholism. Needs identified by tribal leaders…

  3. Can Creativity Predict Cognitive Reserve?

    Science.gov (United States)

    Palmiero, Massimiliano; Di Giacomo, Dina; Passafiume, Domenico

    2016-01-01

    Cognitive reserve relies on the ability to effectively cope with aging and brain damage by using alternate processes to approach tasks when standard approaches are no longer available. In this study, the issue if creativity can predict cognitive reserve has been explored. Forty participants (mean age: 61 years) filled out: the Cognitive Reserve…

  4. Opening Residents' Notes to Patients: A Qualitative Study of Resident and Faculty Physician Attitudes on Open Notes Implementation in Graduate Medical Education.

    Science.gov (United States)

    Crotty, Bradley H; Anselmo, Melissa; Clarke, Deserae N; Famiglio, Linda M; Flier, Lydia; Green, Jamie A; Leveille, Suzanne; Mejilla, Roanne; Stametz, Rebecca A; Thompson, Michelle; Walker, Jan; Bell, Sigall K

    2016-03-01

    OpenNotes is a growing national initiative inviting patients to read clinician progress notes (open notes) through a secure electronic portal. The goals of this study were to (1) identify resident and faculty preceptor attitudes about sharing notes with patients, and (2) assess specific educational needs, policy recommendations, and approaches to facilitate open notes implementation. This was a qualitative study using focus groups with residents and faculty physicians who supervise residents, representing primary care, general surgery, surgical and procedural specialties, and nonprocedural specialties, from Beth Israel Deaconess Medical Center and Geisinger Health System in spring 2013. Data were audio recorded and transcribed verbatim, then coded and organized into themes. Thirty-six clinicians (24 [66.7%] residents and 12 [33.3%] faculty physicians) participated. Four main themes emerged: (1) implications of full transparency, (2) note audiences and ideology, (3) trust between patients and doctors, and (4) time pressures. Residents and faculty discussed how open notes might yield more engaged patients and better notes but were concerned about the time needed to edit notes and respond to patient inquiries. Residents were uncertain how much detail they should share with patients and were concerned about the potential to harm the patient-doctor relationship. Residents and faculty offered several recommendations for open notes implementation. Overall, participants were ambivalent about resident participation in open notes. Residents and faculty identified clinical and educational benefits to open notes but were concerned about potential effects on the patient-doctor relationship, requirements for oversight, and increased workload and burnout.

  5. Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.

    Science.gov (United States)

    Li, Su-Ting T; Paterniti, Debora A; Tancredi, Daniel J; Burke, Ann E; Trimm, R Franklin; Guillot, Ann; Guralnick, Susan; Mahan, John D

    2015-01-01

    To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. Cross-sectional analysis of existing deidentified American Academy of Pediatrics' PediaLink individualized learning plan data for the academic year 2009-2010. Residents self-assessed competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas and wrote learning goals. Textual responses for goals were mapped to 6 ACGME competency areas, future practice, or personal attributes. Adjusted mean differences and associations were estimated using multiple linear and logistic regression. A total of 2254 residents reported 6078 goals. Residents self-assessed their systems-based practice (51.8) and medical knowledge (53.0) competencies lowest and professionalism (68.9) and interpersonal and communication skills (62.2) highest. Residents were most likely to identify goals involving medical knowledge (70.5%) and patient care (50.5%) and least likely to write goals on systems-based practice (11.0%) and professionalism (6.9%). In logistic regression analysis adjusting for postgraduate year (PGY), gender, and degree type (MD/DO), resident-reported goal area showed no association with the learner's relative self-assessment score for that competency area. In the conditional logistic regression analysis, with each learner serving as his or her own control, senior residents (PGY2/3+s) who rated themselves relatively lower in a competency area were more likely to write a learning goal in that area than were PGY1s. Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. Objective Assessment of General Surgery Residents Followed by Remediation.

    Science.gov (United States)

    Gas, Becca L; Buckarma, EeeLN H; Mohan, Monali; Pandian, T K; Farley, David R

    assess most GS trainees and offer opportunities to remediate if performance is poor. Our multifaceted remediation methodology allowed 18 residents to achieve good or stellar performance on each station after deliberate practice. Enticing chief residents to participate in remediation efforts in the spring of their final year of training remains a work in progress. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

    Science.gov (United States)

    Zeger, Scott L.; Kolars, Joseph C.

    2007-01-01

    BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p < .001). In the year before examination, comparable increases in IM-ITE score were associated with attendance at two curricular conferences per week, score increase of 3.9% (95%CI 2.1%, 5.7%; p < .001), or self-directed reading of an electronic knowledge resource 20 minutes each day, score increase of 4.5% (95%CI 1.2%, 7.8%; p = .008). Other factors significantly associated with IM-ITE performance included: age at start of residency, score decrease per year of increasing age, −0.2% (95%CI −0.36%, −0.042%; p = .01), and graduation from a US medical school, score decrease compared to international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

  8. Model Legislation on Student Residency.

    Science.gov (United States)

    Higher Education in the States, 1971

    1971-01-01

    Because of the radical variance in residency requirements from state to state and sometimes from institution to institution, and because of several court cases involving this issue, the Education Commission of the States appointed a Committee to develop (1) a statement of principles for consideration in drafting legislation in connection with…

  9. From Residency to Lifelong Learning.

    Science.gov (United States)

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement.

  10. Teaching Communication Skills to Radiology Residents.

    Science.gov (United States)

    Itri, Jason N; Yacob, Sammy; Mithqal, Ayman

    The transition of health care in the United States from volume to value requires a systems-based approach aligning clinical services across the continuum of care. The ability to communicate effectively and resolve conflict is a critical skill within the systems-based model. Recognizing the essential role of communication in medicine, the Accreditation Council of Graduate Medical Education has designated interpersonal and communication skills a core competency for all residents regardless of specialty. Yet, communication skills are often developed through on-the-job training or not at all. Traditional educational curricula use a predominantly didactic approach without opportunities for trainees to observe, actively experiment, or reflect on what is learned as a part of the learning process. In this article, we describe a 1-day experiential communication skills workshop customized for radiology residents that consists of Myers-Briggs Type Indicator and conflict management sessions designed to develop interpersonal, communication, and conflict management skills through group discussion, role-play, and simulation. The purpose of this educational initiative was to determine the perceived value of an experiential communication skills workshop designed for radiology trainees. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Do changes in residents' fear of crime impact their walking? Longitudinal results from RESIDE.

    Science.gov (United States)

    Foster, Sarah; Knuiman, Matthew; Hooper, Paula; Christian, Hayley; Giles-Corti, Billie

    2014-05-01

    To examine the influence of fear of crime on walking for participants in a longitudinal study of residents in new suburbs. Participants (n=485) in Perth, Australia, completed a questionnaire about three years after moving to their neighbourhood (2007-2008), and again four years later (2011-2012). Measures included fear of crime, neighbourhood perceptions and walking (min/week). Objective environmental measures were generated for each participant's neighbourhood, defined as the 1600 m road network distance from home, at each time-point. Linear regression models examined the impact of changes in fear of crime on changes in walking, with progressive adjustment for other changes in the built environment, neighbourhood perceptions and demographics. An increase in fear of crime was associated with a decrease in residents' walking inside the local neighbourhood. For each increase in fear of crime (i.e., one level on a five-point Likert scale) total walking decreased by 22 min/week (p=0.002), recreational walking by 13 min/week (p=0.031) and transport walking by 7 min/week (p=0.064). This study provides longitudinal evidence that changes in residents' fear of crime influence their walking behaviours. Interventions that reduce fear of crime are likely to increase walking and produce public health gains. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The impact of a head and neck microvascular fellowship program on otolaryngology resident training.

    Science.gov (United States)

    Zender, Chad A; Clancy, Kate; Melki, Sami; Li, Shawn; Fowler, Nicole

    2018-01-01

    To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience. Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey. A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship. An electronic survey was distributed to senior residents at all U.S. otolaryngology residency programs to determine residents' perceptions of a H&N fellow's impact on their surgical experience. An electronic survey was distributed to senior medical students applying to surgical residencies to explore the perceived impact that a fellowship has on the desirability of a residency program. The average number of each postgraduate year (PGY)5's H&N KIC before and after the addition of the fellowship were: parotidectomy, 19 versus 17.8; neck dissection, 33.2 versus 40.6; oral cavity resection, 15.3 versus 12.6; thyroid/parathyroid, 45.5 versus 45.6; and flaps/grafts, 56.7 versus 42. PGY5 participation as first assistant in free flaps dropped from 78% to 17%; however, residents still participated in some aspect of 45% of the cases. Seventy percent of senior residents reported a positive perception of the H&N fellow on their H&N operative experience. Eighty-nine percent of senior medical student respondents reported a nonnegative perception of a fellowship in their applied field. The addition of a H&N fellowship did not decrease senior residents' H&N KIC, and most senior residents at programs with fellowships report that the fellow has a positive impact on their H&N operative experience. 4. Laryngoscope, 128:52-56, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  13. EPR DOSIMETRY STUDY FOR POPULATION RESIDING IN THE VICINITY OF FALLOUT TRACE FOR NUCLEAR TEST ON 7 AUGUST 1962.

    Science.gov (United States)

    Zhumadilov, Kassym Sh; Ivannikov, Alexander I; Stepanenko, Valeriy F; Toyoda, Shin; Skvortsov, Valeriy G; Hoshi, Masaharu

    2016-12-01

    The method of electron paramagnetic resonance (EPR) dosimetry using extracted teeth has been applied to human tooth enamel to obtain individual absorbed doses of residents of settlements in the vicinity of the central axis of radioactive fallout trace from the contaminating surface nuclear test on 7 August 1962. Most of the settlements (Kurchatov, Akzhar, Begen, Buras, Grachi, Mayskoe, Semenovka) are located from 70 to 120 km to the North-East from the epicenter of the explosion at the Semipalatinsk Nuclear Test Site (SNTS). This region is basically an agricultural region. A total of 57 teeth samples were collected from these sites. Eight teeth from residents of the Kokpekty settlement, which was not subjected to any radioactive contamination and located 400 km to the Southeast from SNTS, were chosen as a control. The principal findings, using this method, were that the average excess dose obtained after subtraction of the natural background radiation was 13 mGy and ranged up to about 100 mGy all for residents in this region. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Influence of a systems-based approach to prescribing errors in a pediatric resident clinic.

    Science.gov (United States)

    Condren, Michelle; Honey, Brooke L; Carter, Sandra M; Ngo, Nelson; Landsaw, Jeremy; Bryant, Cheryl; Gillaspy, Stephen

    2014-01-01

    To measure the difference in prescribing error rates between 2 clinics, 1 with a system in place to reduce errors and 1 with no such system; to determine variables that affect the likelihood of prescription errors. This was a retrospective study at 2 university-based general pediatric clinics utilizing the same electronic medical record (EMR) system. Clinic 1 employed pharmacists who provided daily prescription review, provider feedback and education, and EMR customization to decrease errors. Clinic 2 had no systems in place for reducing prescribing errors. Prescriptions written by resident physicians over 2 months were identified and reviewed. A total of 1361 prescriptions were reviewed, 40.7% from clinic 1 and 59.3% from clinic 2. Errors were found in 201 prescriptions (14.8%). Clinics 1 and 2 had error rates of 11% and 17.5%, respectively (P = .0012). The odds of a prescription error at clinic 2 were 1.7 times the odds of a prescription error at clinic 1. Logistic regression identified clinic, nonpediatric resident, liquid dose forms, and younger patient age as significant predictors of prescription errors. Half of the errors could have been prevented with consistent use of a custom medication list within the EMR. We found 37% fewer prescribing errors in a clinic with systems in place for prescribing error detection and prevention. Pediatric clinics should explore systematic procedures for identifying, resolving, and providing education about prescribing errors to reduce patient risk. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. Student Expenses in Residency Interviewing.

    Science.gov (United States)

    Walling, Anne; Nilsen, Kari; Callaway, Paul; Grothusen, Jill; Gillenwater, Cole; King, Samantha; Unruh, Gregory

    2017-08-01

    The student costs of residency interviewing are of increasing concern but limited current information is available. Updated, more detailed information would assist students and residency programs in decisions about residency selection. The study objective was to measure the expenses and time spent in residency interviewing by the 2016 graduating class of the University of Kansas School of Medicine and assess the impact of gender, regional campus location, and primary care application. All 195 students who participated in the 2016 National Residency Matching Program (NRMP) received a 33 item questionnaire addressing interviewing activity, expenses incurred, time invested and related factors. Main measures were self-reported estimates of expenses and time spent interviewing. Descriptive analyses were applied to participant characteristics and responses. Multivariate analysis of variance (MANOVA) and chi-square tests compared students by gender, campus (main/regional), and primary care/other specialties. Analyses of variance (ANOVA) on the dependent variables provided follow-up tests on significant MANOVA results. A total of 163 students (84%) completed the survey. The average student reported 38 (1-124) applications, 16 (1-54) invitations, 11 (1-28) completed interviews, and spent $3,500 ($20-$12,000) and 26 (1-90) days interviewing. No significant differences were found by gender. After MANOVA and ANOVA analyses, non-primary care applicants reported significantly more applications, interviews, and expenditures, but less program financial support. Regional campus students reported significantly fewer invitations, interviews, and days interviewing, but equivalent costs when controlled for primary care application. Cost was a limiting factor in accepting interviews for 63% and time for 53% of study respondents. Students reported investing significant time and money in interviewing. After controlling for other variables, primary care was associated with significantly

  16. Heat Transfer in the LCCM Thermal Reserve Battery

    Science.gov (United States)

    2009-09-01

    CEDEX ALLEE SAINTE HELENE 18021 FRANCE 4 EAGLE PICHER TECHNOLOGIES, LLC ATTN C LAMB ATTN J FERRARO ATTN M STEELE ATTN R...Heat Transfer in the LCCM Thermal Reserve Battery by Frank C. Krieger and Michael Ding ARL-TR-4843 September 2009...Transfer in the LCCM Thermal Reserve Battery Frank C. Krieger and Michael Ding Sensors and Electron Devices Directorate, ARL

  17. "Ghost" publications among applicants to a general surgery residency program.

    Science.gov (United States)

    Kuo, Paul C; Schroeder, Rebecca A; Shah, Anand; Shah, Jatin; Jacobs, Danny O; Pietrobon, Ricardo

    2008-10-01

    To determine the incidence of potentially fraudulent (or "ghost") publications in applications to a general surgery residency program. Electronic Residency Application Services applications submitted in 2005 to the general surgery residency program were reviewed in an IRB-approved study. No identifiers were collected. Publications were checked against Medline, PubMed, ISI Web of Science, and Google. Nonverifiable publications were then submitted to the medical librarian for verification. Ghost publications were defined as journals, books, or meetings that cannot be verified; verified journals without the listed publication; or verified publications without an applicant author. Data analyses were performed using univariate and multivariate regression analysis for nonparametric data. A p value publications, including 30 abstracts, 359 journal articles, and 207 chapters. Thirty-three percent (196 of 596) of the publications could not be verified: 7 abstracts, 177 journal articles, and 12 chapters. The distribution of ghost publications was skewed toward the journals subgroup (p publications were age and foreign medical school. The sole negative predictor was enrollment in a top-10 US research medical school. A disturbingly substantial fraction of publications listed on Electronic Residency Application Services applications cannot be verified. This might indicate a need for greater mentorship and oversight for medical school applicants. It is unknown whether this behavior predicts lack of integrity in other professional settings.

  18. Mentorship Programs in Radiation Oncology Residency Training Programs: A Critical Unmet Need

    Energy Technology Data Exchange (ETDEWEB)

    Dhami, Gurleen; Gao, Wendy; Gensheimer, Michael F. [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Trister, Andrew D. [Sage Bionetworks, Seattle, Washington (United States); Kane, Gabrielle [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Zeng, Jing, E-mail: jzeng13@uw.edu [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States)

    2016-01-01

    Purpose: To conduct a nationwide survey to evaluate the current status of resident mentorship in radiation oncology. Methods and Materials: An anonymous electronic questionnaire was sent to all residents and recent graduates at US Accreditation Council for Graduate Medical Education–accredited radiation oncology residency programs, identified in the member directory of the Association of Residents in Radiation Oncology. Factors predictive of having a mentor and satisfaction with the mentorship experience were identified using univariate and multivariate analyses. Results: The survey response rate was 25%, with 85% of respondents reporting that mentorship plays a critical role in residency training, whereas only 53% had a current mentor. Larger programs (≥10 faculty, P=.004; and ≥10 residents, P<.001) were more likely to offer a formal mentorship program, which makes it more likely for residents to have an active mentor (88% vs 44%). Residents in a formal mentoring program reported being more satisfied with the overall mentorship experience (univariate odds ratio 8.77, P<.001; multivariate odds ratio 5, P<.001). On multivariate analysis, women were less likely to be satisfied with the mentorship experience. Conclusions: This is the first survey focusing on the status of residency mentorship in radiation oncology. Our survey highlights the unmet need for mentorship in residency programs.

  19. Variability of physics education in radiation oncology medical residency programs.

    Science.gov (United States)

    Das, Indra J; Moskvin, Vadim

    2012-11-01

    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.

  20. Teaching residents to write a research paper.

    Science.gov (United States)

    Coleridge, S T

    1993-09-01

    Medical writing and publications are important in developing a scholarly basis for residency programs and in providing a learning experience for both resident and faculty mentors. Residency directors must provide the stimulus and support for both faculty and residents' varied creative activities. This support manifests itself in a commitment to scholarly activity (including a dedicated research person), the procurement of available research materials, the establishment of a process or plan for beginning a research project, and the development of a method for rewarding or recognizing faculty and residents who produce scholarly works. Some osteopathic residency programs may need to train faculty in research skills at the same time that residents are learning to write. Trained faculty are better models and coaches for residents engaged in research. Beginning with a fundamental, but disciplined, writing program, both faculty and residents may learn methods for sharing new knowledge or acquiring those skills necessary to critically analyze the medical literature.

  1. Estimating Foreign Exchange Reserve Adequacy

    Directory of Open Access Journals (Sweden)

    Abdul Hakim

    2013-04-01

    Full Text Available Accumulating foreign exchange reserves, despite their cost and their impacts on other macroeconomics variables, provides some benefits. This paper models such foreign exchange reserves. To measure the adequacy of foreign exchange reserves for import, it uses total reserves-to-import ratio (TRM. The chosen independent variables are gross domestic product growth, exchange rates, opportunity cost, and a dummy variable separating the pre and post 1997 Asian financial crisis. To estimate the risky TRM value, this paper uses conditional Value-at-Risk (VaR, with the help of Glosten-Jagannathan-Runkle (GJR model to estimate the conditional volatility. The results suggest that all independent variables significantly influence TRM. They also suggest that the short and long run volatilities are evident, with the additional evidence of asymmetric effects of negative and positive past shocks. The VaR, which are calculated assuming both normal and t distributions, provide similar results, namely violations in 2005 and 2008.

  2. Cognitive Reserve Scale and ageing

    Directory of Open Access Journals (Sweden)

    Irene León

    2016-01-01

    Full Text Available The construct of cognitive reserve attempts to explain why some individuals with brain impairment, and some people during normal ageing, can solve cognitive tasks better than expected. This study aimed to estimate cognitive reserve in a healthy sample of people aged 65 years and over, with special attention to its influence on cognitive performance. For this purpose, it used the Cognitive Reserve Scale (CRS and a neuropsychological battery that included tests of attention and memory. The results revealed that women obtained higher total CRS raw scores than men. Moreover, the CRS predicted the learning curve, short-term and long-term memory, but not attentional and working memory performance. Thus, the CRS offers a new proxy of cognitive reserve based on cognitively stimulating activities performed by healthy elderly people. Following an active lifestyle throughout life was associated with better intellectual performance and positive effects on relevant aspects of quality of life.

  3. Factors associated with successful self-directed learning using individualized learning plans during pediatric residency.

    Science.gov (United States)

    Li, Su-Ting T; Tancredi, Daniel J; Co, John Patrick T; West, Daniel C

    2010-01-01

    The aim of this study was to determine whether resident or program characteristics are associated with effective self-directed learning of residents. A cross-sectional survey of pediatric and medicine/pediatric residents and program directors from a nationally representative sample of residency programs was conducted. Self-directed learning efficacy was measured by resident-reported progress on learning goals from their most recent individualized learning plan (ILP). Multilevel linear regression models were used to analyze the relationship between learner and program characteristics and self-directed learning efficacy of residents. All program directors of participating programs (N = 46) completed the survey; the response rate from residents was 57% (992/1739). At the time of the survey, 78% of residents had previously written an ILP. Most residents achieved moderate self-directed learning efficacy. The most important factors associated with greater self-directed learning efficacy included using a system to track one's own progress in achieving learning goals, higher score on a propensity toward lifelong learning scale, and reporting greater confidence in self-directed learning abilities. Program characteristics, including program-level support for ILPs, had little or mixed association with resident self-directed learning efficacy. The most important factors associated with effective self-directed learning were resident characteristics. Our findings imply that residency programs should invest their limited resources in curricula that help residents develop measurable goals and systems for tracking progress toward goal attainment. Since propensity toward lifelong learning was an important factor, medical schools and residency training programs should enhance their efforts to develop this characteristic in learners. Copyright 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. Fractional Reserve Banking: Some Quibbles

    OpenAIRE

    Bagus, Philipp; Howden, David

    2010-01-01

    We explore several unaddressed issues in George Selgin’s (1988) claim that the best monetary system to maintain monetary equilibrium is a fractional reserve free banking one. The claim that adverse clearing balances would limit credit expansion in a fractional reserve free banking system is more troublesome than previously reckoned. Both lengthened clearing periods and interbank agreements render credit expansion unrestrained. “The theory of free banking” confuses increases in money held with...

  5. Textual Analysis of General Surgery Residency Personal Statements: Topics and Gender Differences.

    Science.gov (United States)

    Ostapenko, Laura; Schonhardt-Bailey, Cheryl; Sublette, Jessica Walling; Smink, Douglas S; Osman, Nora Y

    2017-10-25

    Applicants to US general surgery residency training programs submit standardized applications. Applicants use the personal statement to express their individual rationale for a career in surgery. Our research explores common topics and gender differences within the personal statements of general surgery applicants. We analyzed the electronic residency application service personal statements of 578 applicants (containing 3,82,405 words) from Liaison Committee on Medical Education-accredited medical schools to a single ACGME-accredited general surgery program using an automated textual analysis program to identify common topics and gender differences. Using a recursive algorithm, the program identified common words and clusters, grouping them into topic classes, which are internally validated. We identified and labeled 8 statistically significant topic classes through independent review: "my story," "the art of surgery," "clinical vignettes," "why I love surgery," "residency program characteristics," "working as a team," "academics and research," and "global health and policy." Although some classes were common to all applications, we also identified gender-specific differences. Notably, women were significantly more likely than men to be represented within the class of "working as a team." (p differences between the statements of men and women. Women were more likely to discuss surgery as a team endeavor while men were more likely to focus on the details of their surgical experiences. Our work mirrors what has been found in social psychology research on gender-based differences in how men and women communicate their career goals and aspirations in other competitive professional situations. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational

  7. Reserve Retirement Equality: Treating Reserves Fairly While Saving Taxpayer Dollars

    Science.gov (United States)

    2010-06-09

    rata .121 For example, a Reserve who performs the equivalent of five years of active duty, will receive one-fourth the retired pay of his active duty...4,225 per month.124 But because reserve-retirement benefits are based on pro rata years of service, this officer’s years of service for retirement...purposes are 3,146 retirement points divided by 360.125 This results in 8.74 years pro rata years of service.126 His retirement benefits thus are

  8. Vision impairment and nutritional status among older assisted living residents.

    Science.gov (United States)

    Muurinen, Seija M; Soini, Helena H; Suominen, Merja H; Saarela, Riitta K T; Savikko, Niina M; Pitkälä, Kaisu H

    2014-01-01

    Vision impairment is common among older persons. It is a risk factor for disability, and it may be associated with nutritional status via decline in functional status. However, only few studies have examined the relationship between vision impairment and nutritional status, which was investigated in this cross-sectional study. The study included all residents living in the assisted living facilities in Helsinki and Espoo in 2007. Residents in temporary respite care were excluded (5%). Of permanent residents (N=2214), 70% (N=1475) consented. Trained nurses performed a personal interview and assessment of each resident including the Mini Nutritional Assessment (MNA), functional and health status. Patient records were used to confirm demographic data and medical history. Mortality in 2010 was retrieved from central registers. Of the residents, 17.5% (N=245) had vision impairment and they were not able to read regular print. Those with vision impairment were older, more often females, and malnourished according to MNA. They had lower BMI, and suffered more often from dementia and chewing problems than those without vision impairment. In logistic regression analysis controlling for age, gender, chewing problems and dementia, vision impairment was independently associated with resident's malnutrition (OR 2.51, 95% CI 1.80-3.51). According to our results older residents in assisted living with vision impairment are at high risk for malnutrition. Therefore it is important to assess nutritional status of persons with vision impairment. It would be beneficial to repeat this kind of a study also in elderly community population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Nationwide survey of US integrated 6-year cardiothoracic surgical residents.

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

    Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. A 63-question web-based survey was distributed to 83 residents enrolled in 21 Accreditation Council for Graduate Medical Education-accredited integrated 6-year programs in November 2013. There was an outstanding 69% response rate. The median age of integrated 6-year residents was 29 years with women comprising 24%. A clear majority had faculty mentorship (95%) and significant clinical exposure in medical school. Focused (100%) and abbreviated (74%) training curricula were identified as the top advantages of integrated 6-year programs; the format itself was a significant factor (46%) in career choice. Most integrated 6-year residents (95%) were satisfied with their program; 80.7% were satisfied with their operative experience thus far. Career plans skewed toward adult cardiac surgery (67%), followed by pediatric cardiac (24%) and general thoracic (9%) surgery; 49% were not particularly concerned about future employment, with 65% foreseeing an increase in opportunities. Specialized training (eg, aortic, heart failure, minimally invasive, congenital) was anticipated by 77%. Most integrated 6-year residents envision an academic career (94.7%). This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. Hands-on Physics Education of Residents in Diagnostic Radiology.

    Science.gov (United States)

    Zhang, Jie; Hardy, Peter A; DiSantis, David J; Oates, M Elizabeth

    2017-06-01

    questions improved from 13.6 ± 2.4 to 19 ± 1.2. The survey shows that the physics rotation during the first week of residency is favored by all residents and that 1 week's duration is appropriate. All residents are of the opinion that the intensive workshop would benefit them in upcoming clinical rotations. Residents acknowledge becoming more comfortable regarding the use of radiation and providing counsel regarding radiation during pregnancy. An immersive, short-duration, clinically oriented physics rotation is well received by new or less experienced radiology trainees, correlates basic physics concepts with their relevance to clinical imaging, and more closely parallels expectations of the American Board of Radiology Core Examination. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Surgical resident perspective on deceased donor organ procurement.

    Science.gov (United States)

    Osband, Adena J; Laskow, David A

    2015-06-01

    Deceased donor organ procurement provides unparalleled opportunity for surgical residents with extensive surgical exposure. We hypothesize that surgical residents regard organ donation positively and organ procurement enhances their education. We conducted an institutional review board approved anonymous national survey to evaluate organ procurement experiences and attitudes of general surgical residents. Three hundred ninety-seven residents representing all postgraduate years responded, with 97% completion rate. Organ procurement increased with training level (92% seniors vs. 53% interns). Over 85% agree organ procurement is a good educational and operative experience, and 73% believe that it will benefit their future surgical career. About 68% agree that organ procurement provided knowledge of anatomy and exposures; under 10% felt organ procurement could be duplicated with simulation. Presence of transplant program did not affect attitudes or experience. Eighty-eight percent women versus77% men plan to donate their own organs. Results indicate that surgical residents value organ procurement, and it remains an essential encounter that applies to general surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [Patient safety culture in Family practice residents of Galicia].

    Science.gov (United States)

    Portela Romero, Manuel; Bugarín González, Rosendo; Rodríguez Calvo, María Sol

    To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. A cross-sectional study. Seven FP of Galicia teaching units. 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. Surgical resident learning styles have changed with work hours.

    Science.gov (United States)

    Quillin, Ralph C; Cortez, Alexander R; Pritts, Timothy A; Hanseman, Dennis J; Edwards, Michael J; Davis, Bradley R

    2016-01-01

    The Accreditation Council for Graduate Medical Education instituted the 80-h workweek for residency programs in 2003. This presented a unique challenge for surgery residents who must acquire a medical and technical knowledge base during training. Therefore, learning should be delivered in an environment congruent with an individual's learning style. In this study, we evaluated the learning styles of general surgery residents to determine how learning styles changed after the implementation to the 80-h workweek. Kolb learning style inventory was taken by general surgery residents at the University of Cincinnati's Department of Surgery, and results from 1999-2012 were analyzed. Statistical analysis was performed using the chi-squared, logistic regression and Wilcoxon rank-sum test. Significance was defined as a P value of learning styles after the institution of the 80-h workweek to converging (43.9%) and accommodating (40.4%, P learning. This change paralleled the transition to a more team-based approach to patient care with the implementation of the 80-h workweek. These findings are important for surgical educators to consider in the development of surgical resident curriculum. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Demand as frequency controlled reserve

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Z.; Togeby, M.; OEstergaard, J.

    2008-09-15

    Using demand as frequency controlled reserve (DFR) is an emerging technology which allow demand to participate actively in maintaining the system operation without reducing the energy service delivered to the customer and without need of user interaction. The basic premise is that traditional frequency controlled reserves from power plants and interconnections with neighbouring systems can be costly, slow and not fulfil the need for future power grids with a high share of wind power and fewer central power plants, and an intention to perform flexible operation such as is landing. Electricity demands, on the other hand, have advantages as frequency reserve including fast activation speed, smooth linear activation, low expected costs, and well-dispersed in the distribution grid. The main challenge of DFR is new methods for monitoring the available capacity. This project has investigated the technology of using electricity demands for providing frequency reserve to power systems. Within the project the potential and economy of DFR compatible loads in Denmark has been investigated, control logic has been designed, power system impact has been investigated, potential business models has been evaluated and an implementation strategy has been suggested. The tasks and goals of the project have been successfully accomplished based on which the conclusion and future recommendation are made. This project has developed the DFR technology that enables electricity demands to autonomously disconnect or reconnect to the grid in response to system frequency variations. The developed DFR technology is proved to be a promising technology from several perspectives. Technically, using DFR is feasible to provide reserves and enhance power system frequency control, while fulfilling technical requirements such as linear activation (or reconnection) according to frequency (or time). Environmentally, the DFR technology is pollution free in contrast to traditional reserves from generation

  15. What are internal medicine residents missing? A communication needs assessment of outpatient clinical encounters.

    Science.gov (United States)

    Lundberg, Kristina L

    2014-09-01

    In order to guide curricular innovation, we looked at the feasibility and utility of performing a targeted needs assessment of the communication skills of PGY2 internal medicine (IM) residents in their continuity clinic, utilizing faculty direct observation with a validated instrument for communication skills evaluation. A convenience sample of PGY2 residents in the Emory University School of Medicine IM Residency Program was invited to participate. Using the SEGUE Framework, a checklist of medical communication tasks, faculty assessed residents during a clinic encounter. Thirty out of 53 (57%) PGY2 residents were assessed. SEGUE results indicate residents were most likely to "maintain patient's privacy" (100%), "greet patient appropriately" (97%) and "check/clarify information" (100%). Residents were least likely to "acknowledge waiting time" (7%), "explore psychosocial/emotional factors" (27%) and "outline agenda for visit" (33%). The SEGUE Framework is a feasible tool to evaluate the communication skills of IM residents in a clinic setting. Many PGY2 IM residents in a large, urban practice do not elicit important psychosocial information during outpatient clinic visits. More observation and evaluation of residents' communication skills are needed, with emphasis on building skills to "Understand the Patient's Perspective." Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Improved Effectiveness of Reserve Forces During Reserve Duty Training.

    Science.gov (United States)

    Treadaway, Harry H.

    The problem areas of motivation, job enrichment, recruiting, and retention are addressed from the viewpoint of the behavioral scientist. Special attention is given to relating job enrichment and motivation techniques, as successfully demonstrated in industry, to the United State Army Reserve. Research method utilized was a literature review…

  17. Spinning Reserve From Responsive Loads

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, B.J.

    2003-04-08

    Responsive load is the most underutilized reliability resource available to the power system today. It is currently not used at all to provide spinning reserve. Historically there were good reasons for this, but recent technological advances in communications and controls have provided new capabilities and eliminated many of the old obstacles. North American Electric Reliability Council (NERC), Federal Energy Regulatory Commission (FERC), Northeast Power Coordinating Council (NPCC), New York State Reliability Council (NYSRC), and New York Independent System Operator (NYISO) rules are beginning to recognize these changes and are starting to encourage responsive load provision of reliability services. The Carrier ComfortChoice responsive thermostats provide an example of these technological advances. This is a technology aimed at reducing summer peak demand through central control of residential and small commercial air-conditioning loads. It is being utilized by Long Island Power Authority (LIPA), Consolidated Edison (ConEd), Southern California Edison (SCE), and San Diego Gas and Electric (SDG&E). The technology is capable of delivering even greater response in the faster spinning reserve time frame (while still providing peak reduction). Analysis of demand reduction testing results from LIPA during the summer of 2002 provides evidence to back up this claim. It also demonstrates that loads are different from generators and that the conventional wisdom, which advocates for starting with large loads as better ancillary service providers, is flawed. The tempting approach of incrementally adapting ancillary service requirements, which were established when generators were the only available resources, will not work. While it is easier for most generators to provide replacement power and non-spinning reserve (the slower response services) than it is to supply spinning reserve (the fastest service), the opposite is true for many loads. Also, there is more financial

  18. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study.

    Science.gov (United States)

    Kolade, Victor O; Staton, Lisa J; Jayarajan, Ramesh; Bentley, Nanette K; Huang, Xiangke

    2014-01-01

    The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Thirteen junior (first- or second-year) resident responses reported that the chief residents elicited input from others (mean rating 6.8), were committed to the team (6.8), resolved conflict (6.7), ensured efficiency, organization and productivity of the team (6.7), participated actively (7.0), and managed resources (6.6). Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4) than with being chief resident (5.8). The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year) chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  19. Cerebral correlates of cognitive reserve.

    Science.gov (United States)

    Whalley, Lawrence J; Staff, Roger T; Fox, Helen C; Murray, Alison D

    2016-01-30

    Cognitive reserve is a hypothetical concept introduced to explain discrepancies between severity of clinical dementia syndromes and the extent of dementia pathology. We examined cognitive reserve in a research programme that followed up a non-clinical sample born in 1921 or 1936 and IQ-tested age 11 years in 1932 or 1947. Structural MRI exams were acquired in about 50% of the sample from whom a subsample were recruited into an additional fMRI study. Here, we summarise findings from seven inter-related studies. These support an understanding of cognitive reserve as a balance between positive life course activity-driven experiences and the negative effects of brain pathologies including cerebrovascular disease and total and regional brain volume loss. Hypothesised structural equation models illustrate the relative causal effects of these positive and negative contributions. Cognitive reserve is considered in the context of choice of interventions to prevent dementia and the opposing effects of cerebrovascular disease and Alzheimer like brain appearances. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Extractive reserves in Brazilian Amazonia

    Energy Technology Data Exchange (ETDEWEB)

    Fearnside, P.M (National Institute for Research in the Amazon, Manaus-Amazonas (Brazil))

    1989-06-01

    In 1985 an opportunity arose for maintaining tracts of Amazonian forest under sustainable use. Brazil's National Council of Rubber Tappers and the Rural Worker's Union proposed the creation of a set of reserves of a new type, called extractive reserves. The first six are being established in one of the Brazilian states most threatened by deforestatation. The creation of extractive reserves grants legal protection to forest land traditionally used by rubber tappers, Brazil-nut gatherers, and other extractivists. The term extrativismo (extractivism) in Brazil refers to removing nontimber forest products, such as latex, resins, and nuts, without felling the trees. Approximately 30 products are collected for commercial sale. Many more types of forest materials are gathered, for example as food and medicines, for the extractivists' own use. The reserve proposal is attractive for several reasons related to social problems. It allows the rubber tappers to continue their livelihood rather than be expelled by deforestation. However, it is unlikely that sufficient land will be set aside as extractive reserves to employ all the tappers. Displaced rubber tappers already swell the ranks of urban slum dwellers in Brazil's Amazonian cities, and they have become refugees to continue their profession in the forests of neighboring countries, such as Bolivia.

  1. Hydrocarbon Reserves: Abundance or Scarcity

    International Nuclear Information System (INIS)

    2005-01-01

    IFP and the OAPEC jointly organize a regular international seminar dealing with world oil-related problems appearing in the news. For the first time, this seminar has been opened to oil and gas company specialists, service companies, research centers and independents. This year's theme concerns oil and gas reserves: are they abundant or are we headed towards the shortages announced by some experts? This theme is especially topical in that: oil and gas currently meet two thirds of world energy needs and almost completely dominate the transport sector; the reserves declared by the OAPEC countries account for nearly half of world reserves; the price of a barrel of oil went through the roof in 2004; world energy demand is growing fast and alternative sources of energy are far from ready to take over from oil and gas in the next few decades. Since the reserves correspond to the volume it is technically and economically viable to produce, the seminar has, of course, dealt with the technical and economic questions that arise in connection with exploration and production, but it has also considered changes in the geopolitical context. Presentations by the leading companies of the OAPEC countries and by the IFP group were completed by presentation from the International Energy Agency (IEA), the United States Geological Survey (USGS), the IHS Energy Group, Total and Gaz de France. This document gathers the transparencies of the following presentations: Hydrocarbon reserves in OAPEC members countries: current and future (M. Al-Lababidi); Non OAPEC liquid reserves and production forecasts (Y. Mathieu); World oil and gas resources and production outlook (K. Chew); Global investments in the upstream (F. Birol); Total's policy in the oil and gas sector (C. de Margerie); Gaz de France's policy in the oil and gas sector (J. Abiteboul); NOC/IOC's opportunities in OPEC countries (I. Sandrea); Relationships between companies, countries and investors: How they may impact on the growth

  2. Hydrocarbon Reserves: Abundance or Scarcity

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    IFP and the OAPEC jointly organize a regular international seminar dealing with world oil-related problems appearing in the news. For the first time, this seminar has been opened to oil and gas company specialists, service companies, research centers and independents. This year's theme concerns oil and gas reserves: are they abundant or are we headed towards the shortages announced by some experts? This theme is especially topical in that: oil and gas currently meet two thirds of world energy needs and almost completely dominate the transport sector; the reserves declared by the OAPEC countries account for nearly half of world reserves; the price of a barrel of oil went through the roof in 2004; world energy demand is growing fast and alternative sources of energy are far from ready to take over from oil and gas in the next few decades. Since the reserves correspond to the volume it is technically and economically viable to produce, the seminar has, of course, dealt with the technical and economic questions that arise in connection with exploration and production, but it has also considered changes in the geopolitical context. Presentations by the leading companies of the OAPEC countries and by the IFP group were completed by presentation from the International Energy Agency (IEA), the United States Geological Survey (USGS), the IHS Energy Group, Total and Gaz de France. This document gathers the transparencies of the following presentations: Hydrocarbon reserves in OAPEC members countries: current and future (M. Al-Lababidi); Non OAPEC liquid reserves and production forecasts (Y. Mathieu); World oil and gas resources and production outlook (K. Chew); Global investments in the upstream (F. Birol); Total's policy in the oil and gas sector (C. de Margerie); Gaz de France's policy in the oil and gas sector (J. Abiteboul); NOC/IOC's opportunities in OPEC countries (I. Sandrea); Relationships between companies, countries and investors: How they may

  3. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  4. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  5. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  6. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  7. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  8. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  9. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  10. Demand as Frequency Controlled Reserve

    DEFF Research Database (Denmark)

    Xu, Zhao; Østergaard, Jacob; Togeby, Mikael

    2011-01-01

    Relying on generation side alone is deemed insufficient to fulfill the system balancing needs for future Danish power system, where a 50% wind penetration is outlined by the government for year 2025. This paper investigates using the electricity demand as frequency controlled reserve (DFR) as a new...... balancing measure, which has a high potential and can provide many advantages. Firstly, the background of the research is reviewed, including conventional power system reserves and the electricity demand side potentials. Subsequently, the control logics and corresponding design considerations for the DFR...

  11. Betting on Their Future: Reservation Casinos Offer Hope for Tribal Members and Challenges for Their Leaders.

    Science.gov (United States)

    Coates, Karen

    1993-01-01

    Discusses the effects of the recent proliferation of casinos on Native American reservations. Suggests that supporters feel that the economic prosperity and availability of jobs associated with the casinos are crucial for providing for the needs of the reservation's residents, whereas opponents fear an increase in serious gambling addictions. (MAB)

  12. Operative experience of residents in US general surgery programs: a gap between expectation and experience.

    Science.gov (United States)

    Bell, Richard H; Biester, Thomas W; Tabuenca, Arnold; Rhodes, Robert S; Cofer, Joseph B; Britt, L D; Lewis, Frank R

    2009-05-01

    The purpose of the study was to identify a group of operations which general surgery residency program directors believed residents should be competent to perform by the end of 5 years of training and then ascertain actual resident experience with these procedures during their training. There is concern about the adequacy of training of general surgeons in the United States. The American Board of Surgery and the Association of Program Directors in Surgery undertook a study to determine what operative procedures residency program directors consider to be essential to the practice of general surgery and then we measured the actual operative experience of graduating residents in those procedures, as reported to the Residency Review Committee for Surgery (RRC). An electronic survey was sent to residency program directors at the 254 general surgery programs in the US accredited by the RRC as of spring 2006. The program directors were presented with a list of 300 types of operations. Program directors graded the 300 procedures "A," "B," or "C" using the following criteria: A--graduating general surgery residents should be competent to perform the procedure independently; B--graduating residents should be familiar with the procedure, but not necessarily competent to perform it; and C--graduating residents neither need to be familiar with nor competent to perform the procedure. After ballots were tallied, the actual resident operative experience reported to the RRC by all residents finishing general surgery training in June 2005 was reviewed. One hundred twenty-one of the 300 operations were considered A level procedures by a majority of program directors (PDs). Graduating 2005 US residents (n = 1022) performed only 18 of the 121 A procedures, an average of more than 10 times during residency; 83 of 121 procedures were performed on an average less than 5 times and 31 procedures less than once. For 63 of the 121 procedures, the mode (most commonly reported) experience was 0

  13. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

    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.

  14. A single-institution experience: the integrated vascular surgery residency's effect on fellowship and general surgery resident case volume and diversity.

    Science.gov (United States)

    Carroll, Megan I; Downes, Kathryne; Miladinovic, Branko; Illig, Karl A; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

    2014-01-01

    our general surgery residents pursued vascular training, 1 resident in each of the 2011, 2012, and 2013 graduating years has now done so. At our institution, the introduction of a 0 + 5 vascular residency has correlated with a modest drop (15%) in overall case volume for the 5 + 2 fellows, but the number of primary cases have actually increased slightly and they continue to meet or exceed Accreditation Council for Graduate Medical Education requirements and national 50th percentile rates. General surgery residents' vascular volumes, by contrast, have remained stable, and interest in vascular surgery by residents has increased. Our integrated vascular residents are projected to exceed the fellows' 50th percentile case volume and diversity targets during their residency experience. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Results of the 2013 Association of Residents in Radiation Oncology career planning survey of practicing physicians in the United States.

    Science.gov (United States)

    Mattes, Malcolm D; Golden, Daniel W; Mohindra, Pranshu; Kharofa, Jordan

    2014-08-01

    The goal of this study was to develop insights about the job application process for graduating radiation oncology residents from the perspective of those involved in hiring. In May and June 2013, a nationwide electronic survey was sent to 1,671 practicing radiation oncologists in academic and private practice settings. Descriptive statistics are reported. In addition, subgroup analysis was performed. Surveys were completed by 206 physicians. Ninety-six percent were willing to hire individuals directly from residency. Participants believed that the first half of the fourth postgraduate year is the most appropriate time for residents to begin networking and the beginning of the fifth postgraduate year is the most appropriate time to begin contacting practices in pursuit of employment. Seventy percent began interviewing 4 to 9 months before the job start date, and 84% interviewed ≤6 candidates per available position. The 5 most important factors to participants when evaluating prospective candidates were (from most to least important) work ethic, personality, interview impression, experience in intensity-modulated radiation therapy, and flexibility. Factors that participants believed should be most important to candidates when evaluating practices included a collegial environment; emphasis on best patient care; quality of equipment, physics, dosimetry, and quality assurance; quality of the support staff and facility; and a multidisciplinary approach to patient care. Those in academics rated research-related factors higher than those in private practice, who rated business-related factors higher. The perspectives of practicing physicians on the job application process are documented to provide a comprehensive resource for current and future residents and employers. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Financial Contribution of Residents When Billing as "Junior Associates" in the "Surgical Firm".

    Science.gov (United States)

    Stoller, Jeremy; Pratt, Sarah; Stanek, Stephen; Zelenock, Gerald; Nazzal, Munier

    2016-01-01

    There is an increasing number of proposals to change the way Graduate Medical Education is funded. This study attempts to estimate the potential financial contribution of surgical residents using an alternative funding mechanism similar to that used by law firms, which would allow surgery departments to bill for resident activity as "junior associates." Following 24 residents over a period of 12 weeks, we were able to estimate the annual revenue that they generated from operating room procedures, independent consultations, patient management, and minor procedures using Medicare reimbursement rates. The appropriate first assistant modifier was used to calculate the operating room procedure fees, but full price was used to calculate the revenue for minor procedures, patient management, and consultations done independently. We adjusted for vacation time and academic activities. Including postgraduate year 1 residents, the estimated yearly revenue generated per resident in first assistant operative services was $33,305.67. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $37,350.66. The total estimated financial contribution per resident per year was $70,656.33. Excluding postgraduate year 1 residents, as most states require completion of the intern year before full licensure, the estimated yearly revenue generated per resident in first assistant operative services was $38,914.56. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $55,957.33. The total estimated financial contribution per resident per year was $94,871.89. Residents provide a significant service to hospitals. If resident activity was compensated at the level of supervised "junior associates" of a surgery department, more than 75% of the direct educational costs of training could be offset. Furthermore, we believe this value is underestimated. Given the foreseeable

  17. Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program.

    Science.gov (United States)

    Riall, Taylor S; Teiman, Joshua; Chang, Michelle; Cole, Denzel; Leighn, Tambre; McClafferty, Hilary; Nfonsam, Valentine N

    2018-04-01

    There have been few programs designed to improve surgical resident well-being, and such efforts often lack formal evaluation. General surgery residents participated in the Energy Leadership Well-Being and Resiliency Program. They were assessed at baseline and 1 year after implementation using the Energy Leadership Index (measures emotional intelligence), Maslach Burnout Inventory General Survey, Perceived Stress Scale, the Beck Depression Inventory, and the annual required ACGME resident survey. Scores before and after implementation were compared using paired t-tests for continuous variables and chi-square tests for categorical variables. Forty-nine general surgery residents participate in the program. One year after implementation, resident score on the Energy Leadership Index improved (from 3.16 ± 0.24 to 3.24 ± 0.32; p = 0.03). Resident perceived stress decreased from baseline (Perceived Stress Scale score, from 17.0 ± 7.2 to 15.7 ± 6.2; p = 0.05). Scores on the emotional exhaustion scale of the Maslach Burnout Inventory decreased (from 16.8 ± 8.4 to 14.4 ± 8.5; p = 0.04). Resident-reported satisfaction improved in many areas; satisfaction with leadership skills, work relationships, communication skills, productivity, time management, personal freedom, and work-life balance, increased during the 1-year intervention (p = NS). On the annual ACGME resident survey, residents' evaluation of the program as positive or very positive increased from 80% to 96%. This study demonstrates that formal implementation of a program to improve resident well-being positively impacted residents' perceived stress, emotional exhaustion, emotional intelligence, life satisfaction, and their perception of the residency program. Formal evaluation and reporting of such efforts allow for reproducibility and scalability, with the potential for widespread impact on resident well-being. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. [Pediatric palliative care: a national survey of French pediatric residents' knowledge, education, and clinical experience].

    Science.gov (United States)

    Lefeubvre, C; Viallard, M-L; Schell, M

    2014-08-01

    The need for educational training of healthcare professionals in palliative care is an important issue. Training and practice of pediatric residents in the field of pediatric palliative care (PPC) has never been assessed, although the organization of the medical curriculum in France is currently being revised. This study presents a national survey of pediatric residents, using a computerized anonymous questionnaire. Four different areas were studied: epidemiological data, theoretical and practical knowledge, education, and clinical experience in PPC. The response rate was 39% (n=365/927). Whatever their age or regional location, 25% of residents did not know any details of the French law concerning patients' rights and the end of life. Experience with PPC starts very early since 77% of the first-year pediatric residents experienced at least one child in a palliative care and/or end-of-life situation. During their entire residency, 87% of the residents had experience with PPC and nearly all (96%) end-of-life care. Furthermore, 76% had participated in announcing palliative care (cancer, ICU, etc.) or a serious illness, and 45% had met and discussed with bereaved parents. Furthermore, while 97% of the pediatric residents received training in adult palliative care, mainly before their residency, only 60% received specific PPC training. Ninety-six percent of all French pediatric residents encountered a PPC situation during their residency. That 77% of them had experienced PPC during their first year of residency shows the importance of early training in PPC for pediatric residents. Furthermore, this study points out that there is a significant lack in PPC training since 40% of all residents in the study received no specific PPC training. Progress in education remains insufficient in the dissemination of knowledge on the legal framework and concepts of palliative medicine: while the medical curriculum is being revised, we suggest that training in medical ethics and PPC

  19. 77 FR 40253 - Reserve Account

    Science.gov (United States)

    2012-07-09

    .... The commentators represented Rural Development employees who work with the Multi-Family Housing Direct... their annual over-inflated tax bills and assessments. As a result, rent income funding that could be..., as rents cannot be raised to an amount that will cover all current and future reserve expenses...

  20. Demand as Frequency Controlled Reserve

    DEFF Research Database (Denmark)

    Xu, Zhao; Togeby, Mikael; Østergaard, Jacob

    This report summaries the research outcomes of the project ‘Demand as Frequency Controlled Reserve (DFR)’, which has received the support from Energinet.dk’s PSO program, Grant no. 2005-2-6380. The objective of this project is to investigate the technology of using electricity demands for providing...

  1. 45 CFR 233.40 - Residence.

    Science.gov (United States)

    2010-10-01

    .... For purposes of this section: (1) A resident of a State is one: (i) Who is living in the State... resident of the State in which he or she is living other than on a temporary basis. Residence may not depend upon the reason for which the individual entered the State, except insofar as it may bear upon...

  2. Breaking Bad News - Perceptions of Pediatric Residents.

    Science.gov (United States)

    Geeta, M G; Krishnakumar, P

    2017-08-15

    The present study evaluated the perceptions and practice of 92 final year pediatric residents with regard to breaking bad news. Only 16% of residents had received any training in communication skills. Majority (65%) of the residents were not comfortable while breaking bad news.

  3. 8 CFR 325.3 - Residence.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Residence. 325.3 Section 325.3 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS NATIONALS BUT NOT CITIZENS OF THE UNITED STATES; RESIDENCE WITHIN OUTLYING POSSESSIONS § 325.3 Residence. (a) For purposes of applying the...

  4. Sexual Health Education: A Psychiatric Resident's Perspective

    Science.gov (United States)

    Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

    2010-01-01

    Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

  5. Pioneering partnerships: Resident involvement from multiple perspectives

    NARCIS (Netherlands)

    Baur, V.E.; Abma, T.A.; Boelsma, F.; Woelders, S.

    2013-01-01

    Resident involvement in residential care homes is a challenge due to shortcomings of consumerist and formal approaches such as resident councils. The PARTNER approach aims to involve residents through collective action to improve their community life and wellbeing. The purpose of this article is to

  6. 24 CFR 206.39 - Principal residence.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Principal residence. 206.39 Section... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgagors § 206.39 Principal residence. The property must be the principal residence of each mortgagor at closing. For purposes of this section, the...

  7. 25 CFR 700.97 - Residence.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Residence. 700.97 Section 700.97 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.97 Residence. (a) Residence is established by proving that the head of household...

  8. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

  9. Does Targeted Training Improve Residents' Teaching Skills?

    Science.gov (United States)

    Polreis, Sean; D'Eon, Marcel F.; Premkumar, Kalyani; Trinder, Krista; Bonnycastle, Deirdre

    2015-01-01

    Resident doctors have an important and integral responsibility of teaching a number of individuals. The purpose of this study was to measure the effectiveness of the University of Saskatchewan's resident-as-teacher training course--Teaching Improvement Project Systems (TIPS). Residents who attended the TIPS course from January, 2010 through June,…

  10. Negotiations of Acknowledgement among Middle Class Residents

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2013-01-01

    The article presents an analysis of communication processes between residents, between residents and people in the broader societal context as well as of media coverage of a fireworks disaster in a Danish suburb. It demonstrates how residents (all members of the Danish middle class) were able...

  11. A survey of primary care resident attitudes toward continuity clinic patient handover

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-11-01

    Full Text Available Background: Transfer of clinic patients from graduating residents to interns or junior residents occurs every year, affecting large numbers of patients. Breaches in care continuity may occur, with potential for risk to patient safety. Several guidelines have been developed for implementing standardized inpatient sign-outs, but no specific guidelines exist for outpatient handover. Methods: Residents in primary care programs – internal medicine, family medicine, and pediatrics – at a US academic medical center were invited to participate in an online survey. The invitation was extended approximately 2 years after electronic medical record (EMR rollout began at the institution. Results: Of 71 eligible residents, 22 (31% responded to the survey. Of these, 18 felt that handover of ambulatory patients was at least moderately important – but only one affirmed the existence of a system for handover. IM residents perceived that they had the highest proportion of high-risk patients (p=0.042; transition-of-care letters were more important to IM residents than other respondents (p=0.041. Conclusion: There is room for improvement in resident acknowledgement of handover processes in continuity clinics. In this study, IM residents attached greater importance to a specific handover tool than other primary care residents. Thus, the different primary care specialties may need to have different handover tools available to them within a shared EMR system.

  12. The importance of international medical rotations in selection of an otolaryngology residency.

    Science.gov (United States)

    Boyd, Nathan H; Cruz, Raul M

    2011-09-01

    The objective of this study was to determine the extent of interest in international electives among prospective otolaryngology residents and to determine whether the availability of international electives affected students' interest in ranking a particular residency program. A 3-part survey was given to all medical students enrolled in the 2008 otolaryngology match via the Electronic Residency Application Service. Part 1 elicited demographic information. Part 2 explored general interest in international rotations. Part 3 involved ranking several factors affecting students' choice of residency programs. This survey was developed at our institution, with no formal validation. Participation was anonymous and voluntary. A total of 307 students entered the otolaryngology match, and 55 surveys (18%) were completed. Twenty-five of 55 students (55%) had completed an international elective during or prior to medical school, and 51 of 55 respondents (93%) had a "strong" or "very strong" desire to participate in an international elective during residency; 48 of 55 students (87%) had a "strong" or "very strong" desire to participate in international surgical missions after residency. Future practice goals had no correlation with interest in international rotations, either during or after residency training. Respondents ranked 8 factors that had an impact on residency program selection in the following order of importance: operative experience, location, lifestyle, research opportunities, didactics, international electives, prestige of program, and salary. Interest in international medicine among prospective otolaryngologists was high in this subset of respondents but did not appear to affect residency program selection.

  13. Education Research: Neurology resident education: Trending skills, confidence, and professional preparation.

    Science.gov (United States)

    Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John

    2016-03-15

    To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. © 2016 American Academy of Neurology.

  14. Electronic Cigarettes

    Science.gov (United States)

    ... New FDA Regulations Text Size: A A A Electronic Cigarettes Electronic cigarettes (e-cigarettes) are battery operated products designed to ... more about: The latest news and events about electronic cigarettes on this FDA page Electronic cigarette basics on ...

  15. Interactive distance learning for orthodontic residents: utilization and acceptability.

    Science.gov (United States)

    Klein, Katherine P; Hannum, Wallace M; Koroluk, Lorne D; Proffit, William R

    2012-03-01

    likely to use the seminars again (P = 0.0018). Despite feedback regarding the need for technologic improvements of the recorded seminars, such as better editing, more frequent slides, quicker pace, and improved sound quality, most residents and faculty agreed that they would like to use this approach to distance learning again. Blended distance learning is an acceptable method of instruction that allows residents to access various experts, supplement traditional instructor-led training, and ease the strain of current faculty shortages. The content of the recorded seminars needs to remain evidence-based, and some technologic aspects of the recordings should be improved. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  16. Electronic technology

    International Nuclear Information System (INIS)

    Kim, Jin Su

    2010-07-01

    This book is composed of five chapters, which introduces electronic technology about understanding of electronic, electronic component, radio, electronic application, communication technology, semiconductor on its basic, free electron and hole, intrinsic semiconductor and semiconductor element, Diode such as PN junction diode, characteristic of junction diode, rectifier circuit and smoothing circuit, transistor on structure of transistor, characteristic of transistor and common emitter circuit, electronic application about electronic equipment, communication technology and education, robot technology and high electronic technology.

  17. Recognition and assessment of resident' deterioration in the nursing home setting: a critical ethnography.

    Science.gov (United States)

    Laging, Bridget; Kenny, Amanda; Bauer, Michael; Nay, Rhonda

    2018-02-03

    To explore the recognition and assessment of resident deterioration in the nursing home setting. There is a dearth of research exploring how nurses and personal-care-assistants manage a deteriorating nursing home resident. Critical ethnography. Observation and semi-structured interviews with 66 participants (residents, family, nurses, personal-care-assistants and general practitioners) in two Australian nursing homes. The study has been reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. The value of nursing assessment is poorly recognized in the nursing home setting. A lack of clarity regarding the importance of nursing assessments associated with resident care has contributed to a decreasing presence of registered nurses and an increasing reliance on personal-care-assistants who had inadequate skills and knowledge to recognize signs of deterioration. Registered nurses experienced limited organizational support for autonomous decision-making and were often expected to undertake protocol-driven decisions that contributed to potentially avoidable hospital transfers. Nurses need to demonstrate the importance of assessment, in association with day-to-day resident care, and demand standardized, regulated, educational preparation of an appropriate workforce who are competent in undertaking this role. Workforce structures that enhance familiarity between nursing home staff and residents could result in improved resident outcomes. The value of nursing assessment, in guiding decisions at the point of resident deterioration, warrants further consideration. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. The Electron

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, George

    1972-01-01

    Electrons are elementary particles of atoms that revolve around and outside the nucleus and have a negative charge. This booklet discusses how electrons relate to electricity, some applications of electrons, electrons as waves, electrons in atoms and solids, the electron microscope, among other things.

  19. Oral health educational interventions for nursing home staff and residents.

    Science.gov (United States)

    Albrecht, Martina; Kupfer, Ramona; Reissmann, Daniel R; Mühlhauser, Ingrid; Köpke, Sascha

    2016-09-30

    Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. We included nine RCTs involving

  20. Evaluation of resident attitudes and self-reported competencies in health advocacy

    Directory of Open Access Journals (Sweden)

    Fok Mark C

    2010-11-01

    Full Text Available Abstract Background The CanMEDS Health Advocate role, one of seven roles mandated by the Royal College of Physicians and Surgeons Canada, pertains to a physician's responsibility to use their expertise and influence to advance the wellbeing of patients, communities, and populations. We conducted our study to examine resident attitudes and self-reported competencies related to health advocacy, due to limited information in the literature on this topic. Methods We conducted a pilot experience with seven internal medicine residents participating in a community health promotion event. The residents provided narrative feedback after the event and the information was used to generate items for a health advocacy survey. Face validity was established by having the same residents review the survey. Content validity was established by inviting an expert physician panel to review the survey. The refined survey was then distributed to a cohort of core Internal Medicine residents electronically after attendance at an academic retreat teaching residents about advocacy through didactic sessions. Results The survey was completed by 76 residents with a response rate of 68%. The majority agreed to accept an advocacy role for societal health needs beyond caring for individual patients. Most confirmed their ability to identify health determinants and reaffirmed the inherent requirements for health advocacy. While involvement in health advocacy was common during high school and undergraduate studies, 76% of residents reported no current engagement in advocacy activity, and 36% were undecided if they would engage in advocacy during their remaining time as residents, fellows or staff. The common barriers reported were insufficient time, rest and stress. Conclusions Medical residents endorsed the role of health advocate and reported proficiency in determining the medical and bio-psychosocial determinants of individuals and communities. Few residents, however, were

  1. Hard electronics; Hard electronics

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    Hard material technologies were surveyed to establish the hard electronic technology which offers superior characteristics under hard operational or environmental conditions as compared with conventional Si devices. The following technologies were separately surveyed: (1) The device and integration technologies of wide gap hard semiconductors such as SiC, diamond and nitride, (2) The technology of hard semiconductor devices for vacuum micro- electronics technology, and (3) The technology of hard new material devices for oxides. The formation technology of oxide thin films made remarkable progress after discovery of oxide superconductor materials, resulting in development of an atomic layer growth method and mist deposition method. This leading research is expected to solve such issues difficult to be easily realized by current Si technology as high-power, high-frequency and low-loss devices in power electronics, high temperature-proof and radiation-proof devices in ultimate electronics, and high-speed and dense- integrated devices in information electronics. 432 refs., 136 figs., 15 tabs.

  2. Uranium reserves and exploration activity

    International Nuclear Information System (INIS)

    Meehan, R.J.

    1975-01-01

    The strategy that ERDA plans to employ regarding resource appraisal is outlined. All types of uranium occurrences will be evaluated as sources of domestic ore reserves. Industry's exploration efforts will be compiled. These data will include information on land acquisition and costs, footage drilled and costs, estimates of exploration activities and expenditures, exploration for non-sandstone deposits, exploration in non-established areas, and foreign exploration plans and costs. Typical data in each of these areas are given

  3. Gas reserves, discoveries and production

    International Nuclear Information System (INIS)

    Saniere, A.

    2006-01-01

    Between 2000 and 2004, new discoveries, located mostly in the Asia/Pacific region, permitted a 71% produced reserve replacement rate. The Middle East and the offshore sector represent a growing proportion of world gas production Non-conventional gas resources are substantial but are not exploited to any significant extent, except in the United States, where they account for 30% of U.S. gas production. (author)

  4. Demand Response Spinning Reserve Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Joseph H.; Nelson-Hoffman, Janine; Torres, Carlos; Hirth,Scott; Yinger, Bob; Kueck, John; Kirby, Brendan; Bernier, Clark; Wright,Roger; Barat, A.; Watson, David S.

    2007-05-01

    The Demand Response Spinning Reserve project is a pioneeringdemonstration of how existing utility load-management assets can providean important electricity system reliability resource known as spinningreserve. Using aggregated demand-side resources to provide spinningreserve will give grid operators at the California Independent SystemOperator (CAISO) and Southern California Edison (SCE) a powerful, newtool to improve system reliability, prevent rolling blackouts, and lowersystem operating costs.

  5. Indian Reserves: Canada's Developing Nations

    OpenAIRE

    Musto, Richard J.

    1990-01-01

    Indian reserves are the most visible reminder of the separation of aboriginal people from the rest of Canada and other Canadians. Illness patterns and social conditions in Native communities closely parallel those in developing nations. While they continue to have a large burden of infectious diseases, these groups also have an increased incidence of chronic and lifestyle diseases as well as environment-related conditions. Similarities can be seen in urban areas between immigrants from abroad...

  6. Electron crystallography and aquaporins.

    Science.gov (United States)

    Schenk, Andreas D; Hite, Richard K; Engel, Andreas; Fujiyoshi, Yoshinori; Walz, Thomas

    2010-01-01

    Electron crystallography of two-dimensional (2D) crystals can provide information on the structure of membrane proteins at near-atomic resolution. Originally developed and used to determine the structure of bacteriorhodopsin (bR), electron crystallography has recently been applied to elucidate the structure of aquaporins (AQPs), a family of membrane proteins that form pores mostly for water but also other solutes. While electron crystallography has made major contributions to our understanding of the structure and function of AQPs, structural studies on AQPs, in turn, have fostered a number of technical developments in electron crystallography. In this contribution, we summarize the insights electron crystallography has provided into the biology of AQPs, and describe technical advancements in electron crystallography that were driven by structural studies on AQP 2D crystals. In addition, we discuss some of the lessons that were learned from electron crystallographic work on AQPs. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. The impact of emergency department overcrowding on resident education.

    Science.gov (United States)

    Mahler, Simon A; McCartney, Jeannie R; Swoboda, Thomas K; Yorek, Lauren; Arnold, Thomas C

    2012-01-01

    Few studies have evaluated the effect of Emergency Department (ED) overcrowding on resident education. To determine the impact of ED overcrowding on Emergency Medicine (EM) resident education. A prospective cross-sectional study was performed from March to May 2009. Second- and third-year EM residents, blinded to the research objective, completed a questionnaire at the end of each shift. Residents were asked to evaluate the educational quality of each shift using a 10-point Likert scale. Number of patients seen and procedures completed were recorded. Responses were divided into ED overcrowding (group O) and non-ED overcrowding (group N) groups. ED overcrowding was defined as >2 h of ambulance diversion per shift. Questionnaire responses were compared using Mann-Whitney U tests. Number of patients and procedures were compared using unpaired T-tests. During the study period, 125 questionnaires were completed; 54 in group O and 71 in group N. For group O, the median educational value score was 8 (interquartile range [IQR] 7-10), compared to 8 (IQR 8-10) for group N (p = 0.24). Mean number of patients seen in group O was 12.3 (95% confidence interval [CI] 11.4-13.2), compared to 13.9 (95% CI 12.7-15) in group N (p = 0.034). In group O, mean number of procedures was 0.9 (95% CI 0.6-1.2), compared to 1.3 (95% CI 1-1.6) in group N (p = 0.047). During overcrowding, EM residents saw fewer patients and performed fewer procedures. However, there was no significant difference in resident perception of educational value during times of overcrowding vs. non-overcrowding. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-01-01

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  9. Operative Landscape at Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

    Tso, Michael K; Dakson, Ayoub; Ahmed, Syed Uzair; Bigder, Mark; Elliott, Cameron; Guha, Daipayan; Iorio-Morin, Christian; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Wang, Bill; Winkler-Schwartz, Alexander; Sankar, Tejas; Christie, Sean D

    2017-07-01

    Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

  10. Resident-Led Palliative Care Education Project.

    Science.gov (United States)

    Karlen, Naomi; Cruz, Brian; Leigh, A E

    2016-04-01

    Despite the growth of palliative medicine, 39% of hospitals do not have palliative care teams for consultation or to provide resident education. We examined the impact of resident-led education in palliative care principles on attitudes toward and comfort with palliative medicine and end-of-life care among internal medicine residents. An educational module designed by the authors was presented to other internal medicine residents in the program. Pre- and post-intervention survey data measuring residents' agreement with various statements regarding palliative medicine and end-of-life care were analyzed. Residents' agreement with various statements regarding palliative medicine and end-of-life care on a 5-point Likert scale was analyzed. Following the intervention, participants reported improved comfort with general knowledge of palliative medicine (p palliative care and end-of-life care (p curriculum in palliative medicine can improve resident comfort within this still-under-represented area of medicine.

  11. Expert consensus of general surgery residents' proficiency with common endocrine operations.

    Science.gov (United States)

    Phitayakorn, Roy; Kelz, Rachel R; Petrusa, Emil; Sippel, Rebecca S; Sturgeon, Cord; Patel, Kepal N; Perrier, Nancy D

    2017-01-01

    Proficiency with common endocrine operations is expected of graduating, general surgery residents. However, no expert consensus guidelines exist about these expectations. Members of the American Association of Endocrine Surgeons were surveyed about their opinions on resident proficiency with common endocrine operations. Overall response rate was 38%. A total of 92% of the respondents operate with residents. On average, they believed that the steps of a total thyroidectomy for benign disease and a well-localized parathyroidectomy could be performed by a postgraduate year 4 surgery resident. Specific steps that they thought might require more training included decisions to divide the strap muscles or leaving a drain. Approximately 66% of respondents thought that a postgraduate year 5 surgery resident could independently perform a total thyroidectomy for benign disease, but only 45% felt similarly for malignant thyroid disease; 79% thought that a postgraduate year 5 surgery resident could independently perform a parathyroidectomy. Respondents' years of experience correlated with their opinions about resident autonomy for total thyroidectomy (benign r = 0.38, P general agreement among responding members of the AAES about resident proficiency and autonomy with common endocrine operations. As postgraduate year 5 residents may not be proficient in advanced endocrine operations, opportunities exist to improve training prior to the transition to independent practice for graduates that anticipate performing endocrine operations routinely. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Integration of QR codes into an anesthesia information management system for resident case log management.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles; Levin, Phillip D

    2015-04-01

    Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Impact of high-fidelity transvaginal ultrasound simulation for radiology on residents' performance and satisfaction.

    Science.gov (United States)

    Ahmad, Rani; Alhashmi, Ghufran; Ajlan, Amr; Eldeek, Bassem

    2015-02-01

    Because of the intimate and uncomfortable nature of transvaginal ultrasound, training residents to perform this type of examination is a difficult task. As a consequence, residents may receive inadequate training that leads to a lack of the skills and confidence needed to perform this examination. The aim of the study was to assess the effectiveness of using simulation sessions to teach residents how to perform transvaginal ultrasound, enabling them to diagnose obstetric and gynecologic emergencies and helping them survive on-calls alone while keeping their patients safe. We used an experimental study design to compare the confidence levels of 20 senior residents who received clinical training only to those of 25 junior residents who were enrolled in a simulation-based teaching session. We also compared the junior residents' levels of performance and confidence using transvaginal ultrasound before and after the sessions. The performance of transvaginal ultrasound by the junior residents and their confidence levels significantly improved after they attended the simulation sessions. They had higher levels of confidence than the senior residents who did not attend the session. It was also observed that the number of nondiagnostic transvaginal ultrasounds performed by the on-call resident that needed to be repeated the next day had significantly dropped. Simulation-based teaching sessions are an effective method of education, which improve trainees' skills and confidence levels and improve patient safety. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  14. The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives.

    Science.gov (United States)

    Oristrell, J; Oliva, J C; Casanovas, A; Comet, R; Jordana, R; Navarro, M

    2014-01-01

    The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents. To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction. All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis. An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction. Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  15. Instruction in teaching and teaching opportunities for residents in US dermatology programs: Results of a national survey.

    Science.gov (United States)

    Burgin, Susan; Homayounfar, Gelareh; Newman, Lori R; Sullivan, Amy

    2017-04-01

    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.

  16. Pediatric Residents? Perceptions of Potential Professionalism Violations on Social Media: A US National Survey

    OpenAIRE

    Dawkins, Rachel; King, William D; Boateng, Beatrice; Nichols, Michele; Desselle, Bonnie C

    2017-01-01

    Background The ubiquitous use of social media by physicians poses professionalism challenges. Regulatory bodies have disseminated guidelines related to physicians? use of social media. Objective This study had 2 objectives: (1) to understand what pediatric residents view as appropriate social media postings, and (2) to recognize the degree to which these residents are exposed to postings that violate social media professionalism guidelines. Methods We distributed an electronic survey to pedia...

  17. Electron radiography

    Science.gov (United States)

    Merrill, Frank E.; Morris, Christopher

    2005-05-17

    A system capable of performing radiography using a beam of electrons. Diffuser means receive a beam of electrons and diffuse the electrons before they enter first matching quadrupoles where the diffused electrons are focused prior to the diffused electrons entering an object. First imaging quadrupoles receive the focused diffused electrons after the focused diffused electrons have been scattered by the object for focusing the scattered electrons. Collimator means receive the scattered electrons and remove scattered electrons that have scattered to large angles. Second imaging quadrupoles receive the collimated scattered electrons and refocus the collimated scattered electrons and map the focused collimated scattered electrons to transverse locations on an image plane representative of the electrons' positions in the object.

  18. Reliable and valid tools for measuring surgeons' teaching performance: residents' vs. self evaluation.

    Science.gov (United States)

    Boerebach, Benjamin C M; Arah, Onyebuchi A; Busch, Olivier R C; Lombarts, Kiki M J M H

    2012-01-01

    In surgical education, there is a need for educational performance evaluation tools that yield reliable and valid data. This paper describes the development and validation of robust evaluation tools that provide surgeons with insight into their clinical teaching performance. We investigated (1) the reliability and validity of 2 tools for evaluating the teaching performance of attending surgeons in residency training programs, and (2) whether surgeons' self evaluation correlated with the residents' evaluation of those surgeons. We surveyed 343 surgeons and 320 residents as part of a multicenter prospective cohort study of faculty teaching performance in residency training programs. The reliability and validity of the SETQ (System for Evaluation Teaching Qualities) tools were studied using standard psychometric techniques. We then estimated the correlations between residents' and surgeons' evaluations. The response rate was 87% among surgeons and 84% among residents, yielding 2625 residents' evaluations and 302 self evaluations. The SETQ tools yielded reliable and valid data on 5 domains of surgical teaching performance, namely, learning climate, professional attitude towards residents, communication of goals, evaluation of residents, and feedback. The correlations between surgeons' self and residents' evaluations were low, with coefficients ranging from 0.03 for evaluation of residents to 0.18 for communication of goals. The SETQ tools for the evaluation of surgeons' teaching performance appear to yield reliable and valid data. The lack of strong correlations between surgeons' self and residents' evaluations suggest the need for using external feedback sources in informed self evaluation of surgeons. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Measuring general surgery residents' communication skills from the patient's perspective using the Communication Assessment Tool (CAT).

    Science.gov (United States)

    Stausmire, Julie M; Cashen, Constance P; Myerholtz, Linda; Buderer, Nancy

    2015-01-01

    The Communication Assessment Tool (CAT) has been used and validated to assess Family and Emergency Medicine resident communication skills from the patient's perspective. However, it has not been previously reported as an outcome measure for general surgery residents. The purpose of this study is to establish initial benchmarking data for the use of the CAT as an evaluation tool in an osteopathic general surgery residency program. Results are analyzed quarterly and used by the program director to provide meaningful feedback and targeted goal setting for residents to demonstrate progressive achievement of interpersonal and communication skills with patients. The 14-item paper version of the CAT (developed by Makoul et al. for residency programs) asks patients to anonymously rate surgery residents on discrete communication skills using a 5-point rating scale immediately after the clinical encounter. Results are reported as the percentage of items rated as "excellent" (5) by the patient. The setting is a hospital-affiliated ambulatory urban surgery office staffed by the residency program. Participants are representative of adult patients of both sexes across all ages with diverse ethnic backgrounds. They include preoperative and postoperative patients, as well as those needing diagnostic testing and follow-up. Data have been collected on 17 general surgery residents from a single residency program representing 5 postgraduate year levels and 448 patient encounters since March 2012. The reliability (Cronbach α) of the tool for surgery residents was 0.98. The overall mean percentage of items rated as excellent was 70% (standard deviations = 42%), with a median of 100%. The CAT is a useful tool for measuring 1 facet of resident communication skills-the patient's perception of the physician-patient encounter. The tool provides a unique and personalized outcome measure for identifying communication strengths and improvement opportunities, allowing residents to receive

  20. The professionalism curriculum as a cultural change agent in surgical residency education.

    Science.gov (United States)

    Hochberg, Mark S; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Gillespie, Colleen; Pachter, H Leon

    2012-01-01

    prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. A survey of residents' experience with patient safety and quality improvement concepts in radiation oncology.

    Science.gov (United States)

    Spraker, Matthew B; Nyflot, Matthew; Hendrickson, Kristi; Ford, Eric; Kane, Gabrielle; Zeng, Jing

    The safety and quality of radiation therapy have recently garnered increased attention in radiation oncology (RO). Although patient safety guidelines expect physicians and physicists to lead clinical safety and quality improvement (QI) programs, trainees' level of exposure to patient safety concepts during training is unknown. We surveyed active medical and physics RO residents in North America in February 2016. Survey questions involved demographics and program characteristics, exposure to patient safety topics, and residents' attitude regarding their safety education. Responses were collected from 139 of 690 (20%) medical and 56 of 248 (23%) physics RO residents. More than 60% of residents had no exposure or only informal exposure to incident learning systems (ILS), root cause analysis, failure mode and effects analysis (FMEA), and the concepts of human factors engineering. Medical residents had less exposure to FMEA than physics residents, and fewer medical than physics residents felt confident in leading FMEA in clinic. Only 27% of residents felt that patient safety training was adequate in their program. Experiential learning through practical workshops was the most desired educational modality, preferred over web-based learning. Residents training in departments with ILS had greater exposure to patient safety concepts and felt more confident leading clinical patient safety and QI programs than residents training in departments without an ILS. The survey results show that most residents have no or only informal exposure to important patient safety and QI concepts and do not feel confident leading clinical safety programs. This represents a gaping need in RO resident education. Educational programs such as these can be naturally developed as part of an incident learning program that focuses on near-miss events. Future research should assess the needs of RO program directors to develop effective RO patient safety and QI training programs. Copyright © 2016

  2. New Media for Educating Urology Residents: An Interview Study in Canada and Germany.

    Science.gov (United States)

    Salem, Johannes; Borgmann, Hendrik; MacNeily, Andrew; Boehm, Katharina; Schmid, Marianne; Groeben, Christer; Baunacke, Martin; Huber, Johannes

    To investigate the usage and perceived usefulness of new media for educating urology residents in Canada and Germany. We designed an 11-item online survey to assess the use and perceived usefulness of new media for education. We performed a comparative analysis. The survey was distributed via e-mail to 143 Canadian and 721 German urology residents. The survey included 58 urology residents from Canada and 170 from Germany. A total of 58 residents from Canada (41% response rate) and 170 from Germany (24% response rate) responded to this survey. Residents spent 45% of their education time on new media. The Internet was used by 91% (n = 208) of the residents for professional education purposes, with a median time of 270 minutes (interquartile range [IQR]: 114-540) per month. Apps were used by 54% (n = 118) of the residents, with a median time of 101 minutes (IQR: 45-293) per month. A total of 23% (n = 47) of the residents used social media (SoMe) for education, with a median time of 90 minutes (IQR: 53-80) per month. In all, 100% (n = 228) rated the Internet, 76% (n = 173) apps, and 43% (n = 97) SoMe as being useful for professional education purposes. A total of 90% (n = 205) watched medical videos for education, and 89% (n = 203) of these videos were on surgical procedures. Canadian urology residents used more new media sources for professional education than did the Germans (58% vs. 41%, p media was higher among Canadian residents for the Internet (p media play a dominant role in the education of urology residents. The primary source for personal education in urology is the Internet. Future studies and technological developments should investigate and improve new media tools to optimize education during residency. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Foreign Exchange Reserves: Bangladesh Perspective

    Directory of Open Access Journals (Sweden)

    Md Zahangir Alam

    2013-10-01

    Full Text Available This study is about foreign exchangereserves of Bangladesh. The mainpurpose of this study is to the influence of exchange rates on foreign exchangereserves to the Bangladesh context.  Both the primary and secondary data has been used inthis study. The primary data has been collected through a structuredquestionnaire from 50 respondents. The secondary data, namely Bangladeshforeign exchange reserves (FER, Bangladesh current account balance (CAB,Bangladesh capital andfinancial account balance (CFAB, and BDT/USD exchange rates (ER.  This study covers yearly data from July 01,1996 to June 30, 2005 and quarterly data from July 01, 2005 to June 30, 2012. Findingsof this study shows that out of the selected 16 factors affecting foreignexchange reserves, exchange rates occupy the first position, weighted averagescore (WAS being 4.56. Foreign exchange reserves (FER and current accountbalance (CAB have increased by 502.9087% and 1451.218%,whereas capital and financial account (CFAB has decreased by -649.024% on June30, 2012 compared to June 30, 1997. The influence of other factors heldconstant, as ER changes by 285.6894 units due to one unit change in FER, onaverage in the same direction which represents that ER has positive effect on theFER and this relationship is statistically significant.  62.1526 percentof the variation in FER is explained by ER. The outcomes of Breusch-Godfrey test (LM test, ARCHtest, and the Normality test are that there is a serial correlation among residuals, the variance of residuals is notconstant, and the residuals are not normally distributed.

  4. Brain reserve and cognitive reserve in multiple sclerosis

    Science.gov (United States)

    Rocca, Maria A.; Leavitt, Victoria M.; Riccitelli, Gianna; Comi, Giancarlo; DeLuca, John; Filippi, Massimo

    2013-01-01

    Objective: We first tested the brain reserve (BR) hypothesis in multiple sclerosis (MS) by examining whether larger maximal lifetime brain volume (MLBV; determined by genetics) protects against disease-related cognitive impairment, and then investigated whether cognitive reserve (CR) gained through life experience (intellectually enriching leisure activities) protects against cognitive decline independently of MLBV (BR). Methods: Sixty-two patients with MS (41 relapsing-remitting MS, 21 secondary progressive MS) received MRIs to estimate BR (MLBV, estimated with intracranial volume [ICV]) and disease burden (T2 lesion load; atrophy of gray matter, white matter, thalamus, and hippocampus). Early-life cognitive leisure was measured as a source of CR. We assessed cognitive status with tasks of cognitive efficiency and memory. Hierarchical regressions were used to investigate whether higher BR (ICV) protects against cognitive impairment, and whether higher CR (leisure) independently protects against cognitive impairment over and above BR. Results: Cognitive status was positively associated with ICV (R2 = 0.066, p = 0.017). An ICV × disease burden interaction (R2 = 0.050, p = 0.030) revealed that larger ICV attenuated the impact of disease burden on cognition. Controlling for BR, higher education (R2 = 0.047, p = 0.030) and leisure (R2 = 0.090, p = 0.001) predicted better cognition. A leisure × disease burden interaction (R2 = 0.037, p = 0.030) showed that leisure independently attenuated the impact of disease burden on cognition. Follow-up analyses revealed that BR protected against cognitive inefficiency, not memory deficits, whereas CR was more protective against memory deficits than cognitive inefficiency. Conclusion: We provide evidence of BR in MS, and show that CR independently protects against disease-related cognitive decline over and above BR. Lifestyle choices protect against cognitive impairment independently of genetic factors outside of one's control

  5. A Time Study of Plastic Surgery Residents.

    Science.gov (United States)

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly efficient and fragmented, with the majority of all activities requiring 4 minutes or less. Residents spent a large portion of their time waiting for other services. In light of these data, we

  6. Error tolerance: an evaluation of residents' repeated motor coordination errors.

    Science.gov (United States)

    Law, Katherine E; Gwillim, Eran C; Ray, Rebecca D; D'Angelo, Anne-Lise D; Cohen, Elaine R; Fiers, Rebekah M; Rutherford, Drew N; Pugh, Carla M

    2016-10-01

    The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric. Residents' laparoscopic skills were evaluated during a simulated laparoscopic ventral hernia repair for motor coordination errors when grasping for intra-abdominal mesh or suture. Tolerance was defined as repeated, failed attempts to correct an error and the time required to recover. Residents (N = 20) committed an average of 15.45 (standard deviation [SD] = 4.61) errors and 1.70 (SD = 2.25) motor coordination errors during mesh placement. Total errors correlated with motor coordination errors (r[18] = .572, P = .008). On average, residents required 5.09 recovery attempts for 1 motor coordination error (SD = 3.15). Recovery approaches correlated to total error load (r[13] = .592, P = .02). Residents' motor coordination errors and recovery approaches predict total error load. Error tolerance proved to be a valid assessment metric relating to overall performance. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Teaching and Assessing Professionalism in Radiology Resident Education.

    Science.gov (United States)

    Kelly, Aine Marie; Gruppen, Larry D; Mullan, Patricia B

    2017-05-01

    Radiologists in teaching hospitals and in practices with residents rotating through are involved in the education of their residents. The Accreditation Council for Graduate Medical Education requires evidence that trainees are taught and demonstrate competency not only in medical knowledge and in patient care-the historic focus of radiology education-but also in the so-called non-interpretative core competencies, which include professionalism and interpersonal skills. In addition to accreditation agencies, the prominent assessment practices represented by the American Board of Radiology core and certifying examinations for trainees, as well as Maintenance of Certification for practitioners, are planning to feature more non-interpretative competency assessment, including professionalism to a greater extent. Because professionalism was incorporated as a required competency in medical education as a whole, more clarity about the justification and expected content for teaching about competence in professionalism, as well as greater understanding and evidence about appropriate and effective teaching and assessment methods, have emerged. This article summarizes justifications and expectations for teaching and assessing professionalism in radiology residents and best practices on how to teach and evaluate professionalism that can be used by busy radiology faculty in their everyday practice supervising radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. Enhancing interest in nephrology careers during medical residency.

    Science.gov (United States)

    Jhaveri, Kenar D; Shah, Hitesh H; Mattana, Joseph

    2012-09-01

    Promoting interest in nephrology as a career is vital to sustain a workforce adequate to meet the projected demand for nephrologists. The educational experiences that internal medicine residents have may play an important role in influencing such choices, and attempts to enrich such experiences could prove a useful strategy to help facilitate interest in careers in nephrology. Like many electives, nephrology rotations typically consist of activities heavily weighted toward inpatient care. This type of elective is unlikely to provide a representative exposure to the breadth of nephrologists' roles and may lack sufficient mentoring opportunities. We describe an innovative design for a nephrology elective that provides residents with educational experiences in both inpatient and outpatient venues and exposure to faculty with diverse interests and areas of expertise. Our experience with this elective in comparison to a traditional inpatient-based elective suggests that the combined elective format is perceived favorably by medical residents and provides them with a better educational experience, more representative exposure to nephrology, positive mentoring experiences, and the potential for greater interest in pursuing nephrology as a career. Our findings offer the possibility that interventions at the level of medical resident education might be a means to help promote interest in careers in nephrology. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  9. Neurocritical care education during neurology residency

    Science.gov (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: 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. Methods: 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. Results: 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%. Conclusions: 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. PMID:22573636

  10. [The Computer Book of the Internal Medicine resident: validity and reliability of a questionnaire for self-assessment of competences in internal medicine residents].

    Science.gov (United States)

    Oristrell, J; Casanovas, A; Jordana, R; Comet, R; Gil, M; Oliva, J C

    2012-12-01

    There are no simple and validated instruments for evaluating the training of specialists. To analyze the reliability and validity of a computerized self-assessment method to quantify the acquisition of medical competences during the Internal Medicine residency program. All residents of our department participated in the study during a period of 28 months. Twenty-two questionnaires specific for each rotation (the Computer-Book of the Internal Medicine Resident) were constructed with items (questions) corresponding to three competence domains: clinical skills competence, communication skills and teamwork. Reliability was analyzed by measuring the internal consistency of items in each competence domain using Cronbach's alpha index. Validation was performed by comparing mean scores in each competence domain between senior and junior residents. Cut-off levels of competence scores were established in order to identify the strengths and weaknesses of our training program. Finally, self-assessment values were correlated with the evaluations of the medical staff. There was a high internal consistency of the items of clinical skills competences, communication skills and teamwork. Higher scores of clinical skills competence and communication skills, but not in those of teamwork were observed in senior residents than in junior residents. The Computer-Book of the Internal Medicine Resident identified the strengths and weaknesses of our training program. We did not observe any correlation between the results of the self- evaluations and the evaluations made by staff physicians. The items of Computer-Book of the Internal Medicine Resident showed high internal consistency and made it possible to measure the acquisition of medical competences in a team of Internal Medicine residents. This self-assessment method should be complemented with other evaluation methods in order to assess the acquisition of medical competences by an individual resident. Copyright © 2012 Elsevier Espa

  11. Evaluation of ethics education in obstetrics and gynecology residency programs.

    Science.gov (United States)

    Byrne, John; Straub, Heather; DiGiovanni, Laura; Chor, Julie

    2015-03-01

    education in residency training. Therefore, additional resources are needed to assist program directors in enhancing resident ethics education. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation.

    Science.gov (United States)

    Childers, Julie W; Bost, James E; Kraemer, Kevin L; Cluss, Patricia A; Spagnoletti, Carla L; Gonzaga, Alda Maria R; Arnold, Robert M

    2012-11-01

    To determine whether a motivational interviewing (MI) curriculum is effective in teaching internal medicine residents core MI skills and the empathic, nonjudgmental MI style. Nineteen third-year residents met for 12 h with a faculty instructor. Teaching methods included lecture, written exercises, a simulated patient exercise, and discussion of residents' behavior change issues. Residents' adoption of MI skills was evaluated before and after the course with the Helpful Responses Questionnaire. Residents decreased use of closed-ended questions (from a score of 1.13 to 0.37, p=0.036) and MI roadblocks (4.00-1.08, pcommunication skills in a written measure, and was highly rated. Future work should examine whether teaching of the empathic, collaborative MI stance impacts patient outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Nursing home practices following resident death: the experience of Certified Nursing Assistants.

    Science.gov (United States)

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R

    2015-01-01

    This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Internal Medicine Residents' Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study.

    Science.gov (United States)

    Soones, Tacara N; O'Brien, Bridget C; Julian, Katherine A

    2015-09-01

    In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting. To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education. This was a qualitative study of focus groups with internal medicine residents. Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study. Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational. Residents' experiences practicing team-based care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in

  15. Psychiatry Resident Training in Cultural Competence: An Educator's Toolkit.

    Science.gov (United States)

    Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver

    2017-06-01

    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.

  16. ESR measurements of background doses in teeth of Japanese residents

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, S., E-mail: toyoda@dap.ous.ac.jp [Department of Applied Physics, Okayama University of Science, Okayama (Japan); Kondo, A. [Department of Applied Physics, Okayama University of Science, Okayama (Japan); Zumadilov, K.; Hoshi, M. [Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima (Japan); Miyazawa, C. [Deparment of Dentistry, Ohu University, Fukushima (Japan); Ivannikov, A. [Medical Radiological Research Center, Obninsk (Russian Federation)

    2011-09-15

    The background doses for the teeth of Japanese residents were obtained by electron spin resonance (ESR) method. The doses obtained from 77 of 92 samples are less than 100 mGy while the doses of the other samples are high up to 250 mGy. The doses for buccal part of the teeth are higher than lingual part possibly due to contributions from dental X ray examination. A positive correlation was found between the ages of the donors and the obtained doses. The averaged annual ESR dose was calculated to be 0.87 mGy/y. These doses have to be considered in actual retrospective dosimetry studies for possible radiation accidents. The statistically significant critical level for Japanese residents would be about 200 mGy for individual doses and about 100 mGy for averaged group doses for {alpha} = 5% for those with ages older than 50.

  17. Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.

    Science.gov (United States)

    Henderson, Kamal H; DeWalt, Darren A; Halladay, Jacquie; Weiner, Bryan J; Kim, Jung I; Fine, Jason; Cykert, Samuel

    2018-04-01

    Our purpose was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control. We divided practices into quartiles of blood pressure control performance and considered the top quartile as the benchmark for comparison. Using abstracted clinical data from electronic health records, we performed a cross-sectional study to assess the association of top quartile hypertension control and (1) the baseline practice adaptive reserve (PAR) scores and (2) baseline practice leadership scores, using modified Poisson regression models adjusting for practice-level characteristics. Among 181 practices, 46 were in the top quartile, which averaged 68% or better blood pressure control. Practices with higher PAR scores compared with lower PAR scores were not more likely to reside in the top quartile of performance (prevalence ratio [PR] = 1.92 for highest quartile; 95% CI, 0.9-4.1). Similarly, high quality improvement leadership capability compared with lower capability did not predict better blood pressure control performance (PR = 0.94; 95% CI, 0.57-1.56). Practices with higher proportions of commercially insured patients were more likely than practices with lower proportions of commercially insured patients to have top quartile performance (37% vs 26%, P =.002), whereas lower proportions of the uninsured (8% vs 14%, P =.055) were associated with better performance. Our findings show that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project. Our findings, however, may be limited by a lack of patient-related factors and small sample size to preclude strong conclusions. © 2018 Annals of Family Medicine, Inc.

  18. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  19. Learning environment: assessing resident experience.

    Science.gov (United States)

    Byszewski, Anna; Lochnan, Heather; Johnston, Donna; Seabrook, Christine; Wood, Timothy

    2017-06-01

    Given their essential role in developing professional identity, academic institutions now require formal assessment of the learning environment (LE). We describe the experience of introducing a novel and practical tool in postgraduate programmes. The Learning Environment for Professionalism (LEP) survey, validated in the undergraduate setting, is relatively short, with 11 questions balanced for positive and negative professionalism behaviours. LEP is anonymous and focused on rotation setting, not an individual, and can be used on an iterative basis. We describe how we implemented the LEP, preliminary results, challenges encountered and suggestions for future application. Academic institutions now require formal assessment of the learning environment METHODS: The study was designed to test the feasibility of introducing the LEP in the postgraduate setting, and to establish the validity and the reliability of the survey. Residents in four programmes completed 187 ratings using LEP at the end of one of 11 rotations. The resident response rate was 87 per cent. Programme and rotation ratings were similar but not identical. All items rated positively (favourably), but displays of altruism tended to have lower ratings (meaning less desirable behaviour was witnessed), as were ratings for derogatory comments (again meaning that less desirable behaviour was witnessed). We have shown that the LEP is a feasible and valid tool that can be implemented on an iterative basis to examine the LE. Two LEP questions in particular, regarding derogatory remarks and demonstrating altruism, recorded the lowest scores, and these areas deserve attention at our institution. Implementation in diverse programmes is planned at our teaching hospitals to further assess reliability. This work may influence other postgraduate programmes to introduce this assessment tool. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  20. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

    Science.gov (United States)

    Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

    2017-06-01

    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.

  1. Understanding how residents' preferences for supervisory methods change throughout residency training: a mixed-methods study.

    Science.gov (United States)

    Olmos-Vega, Francisco; Dolmans, Diana; Donkers, Jeroen; Stalmeijer, Renée E

    2015-10-16

    A major challenge for clinical supervisors is to encourage their residents to be independent without jeopardising patient safety. Residents' preferences according to level of training on this regard have not been completely explored. This study has sought to investigate which teaching methods of the Cognitive Apprenticeship (CA) model junior, intermediate and senior residents preferred and why, and how these preferences differed between groups. We invited 301 residents of all residency programmes of Javeriana University, Bogotá, Colombia, to participate. Each resident was asked to complete a Maastricht Clinical Teaching Questionnaire (MCTQ), which, being based on the teaching methods of CA, asked residents to rate the importance to their learning of each teaching method and to indicate which of these they preferred the most and why. A total of 215 residents (71 %) completed the questionnaire. All concurred that all CA teaching methods were important or very important to their learning, regardless of their level of training. However, the reasons for their preferences clearly differed between groups: junior and intermediate residents preferred teaching methods that were more supervisor-directed, such as modelling and coaching, whereas senior residents preferred teaching methods that were more resident-directed, such as exploration and articulation. The results indicate that clinical supervision (CS) should accommodate to residents' varying degrees of development by attuning the configuration of CA teaching methods to each level of residency training. This configuration should initially vest more power in the supervisor, and gradually let the resident take charge, without ever discontinuing CS.

  2. Z' reservation at LEP2

    CERN Document Server

    Montagna, G.; Piccinini, F.; Renard, F.M.; Verzegnassi, C.

    1995-01-01

    We consider the possibility that one extra Z\\equiv Z' exists with arbitrary mass and fermion couplings that do not violate (charged) lepton universality. We show that, in such a situation, a functional relationship is generated between the \\underline{deviations} from the SM values of three leptonic observables of two-fermion production at future e^+e^- colliders that is completely independent of the values of the Z' mass and couplings. This selects a certain region in the 3-d space of the deviations that is \\underline{characteristic} of the model (Z' "reservation"). As a specific and relevant example, we show the picture that would emerge at LEP2 under realistic experimental conditions.

  3. Financial and Time Burdens for Medical Students Interviewing for Residency.

    Science.gov (United States)

    Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

    2017-02-01

    Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

  4. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-07-01

    Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  5. What is an anesthesiology resident worth?

    Science.gov (United States)

    Ferrera, Marisa H; Beaman, Shawn T; Metro, David G; Handley, Linda J; Walker, James E

    2009-08-01

    To determine the cost of replacing an anesthesiology resident with a certified registered nurse anesthetist (CRNA) for equal operating room (OR) work. Retrospective financial analysis. Academic anesthesiology department. Clinical anesthesia (CA)-1 through CA-3 residents. Cost of replacing anesthesiology residents with CRNAs for equal OR work was determined. The cost of replacing one anesthesiology resident with a CRNA for the same number of OR hours ranged from $9,940.32 to $43,300 per month ($106,241.68 to $432,937.50 per yr). Numbers varied depending on the CRNA pay scale and whether the calculations were based on the number of OR hours worked at our residency program or OR hours worked in a maximum duty hour model. A CRNA is paid substantially more per OR hour worked, at all pay levels, than an anesthesiology resident.

  6. Do international rotations make surgical residents more resource-efficient? A preliminary study.

    Science.gov (United States)

    Oliphant, Jason L; Ruhlandt, Ronell R; Sherman, Stanley R; Schlatter, Marc G; Green, Joel A

    2012-01-01

    of the ISR residents perceived that their attitude toward ordering tests and laboratories was influenced greatly by their ISR, and all the ISR residents perceived that they became more resource efficient than their peers after their ISRs. These preliminary findings seem to indicate increased resource efficiency among general surgery residents who completed an ISR. However, the sample size of residents was small, and we could not establish conclusively a causal relationship to their ISRs. A more extensive study is needed if reliable conclusions are to be drawn regarding the effect of ISRs on the resource efficiency of residents. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. General surgery residents' perception of robot-assisted procedures during surgical training.

    Science.gov (United States)

    Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

    2015-01-01

    have a robot at their institution and have participated in robotic surgery cases, very few residents received formal training before participating in a robotic case. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Treatment of foods with 'soft-electrons' (low-energy electrons)

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Toru [Japan International Research Center for Agricultural Sciences (JIRCAS), Tsukuba, Ibaraki (Japan); Todoriki, Setsuko [National Food Research Institute (NFRI), Tsukuba, Ibaraki (Japan)

    2003-02-01

    Electrons with energies of 300 keV or lower were defined as soft-electrons'. Soft-electrons can eradicate microorganisms residing on the surface of grains, pulses, spices, dehydrated vegetables, tea leaves and seeds, and reduce their microbial loads to levels lower than 10 CFU/g with little quality deterioration. Soft-electrons can inactivate insect pests infesting grains and pulses and inhibit sprouting of potatoes. (author)

  9. Motherhood during residency training: challenges and strategies.

    Science.gov (United States)

    Walsh, Allyn; Gold, Michelle; Jensen, Phyllis; Jedrzkiewicz, Michelle

    2005-07-01

    To determine what factors enable or impede women in a Canadian family medicine residency program from combining motherhood with residency training. To determine how policies can support these women, given that in recent decades the number of female family medicine residents has increased. Qualitative study using in-person interviews. McMaster University Family Medicine Residency Program. Twenty-one of 27 family medicine residents taking maternity leave between 1994 and 1999. Semistructured interviews. The research team reviewed transcripts of audiotaped interviews for emerging themes; consensus was reached on content and meaning. NVIVO software was used for data analysis. Long hours, unpredictable work demands, guilt because absences from work increase workload for colleagues, and residents' high expectations of themselves cause pregnant residents severe stress. This stress continues upon return to work; finding adequate child care is an added stress. Residents report receiving less support from colleagues and supervisors upon return to work; they associate this with no longer being visibly pregnant. Physically demanding training rotations put additional strain on pregnant residents and those newly returned to work. Flexibility in scheduling rotations can help accommodate needs at home. Providing breaks, privacy, and refrigerators at work can help maintain breastfeeding. Allowing residents to remain involved in academic and clinical work during maternity leave helps maintain clinical skills, build new knowledge, and promote peer support. Pregnancy during residency training is common and becoming more common. Training programs can successfully enhance the experience of motherhood during residency by providing flexibility at work to facilitate a healthy balance among the competing demands of family, work, and student life.

  10. [Heart failure in nursing home residents].

    Science.gov (United States)

    Daamen, M A M J; Hamers, J P H; Brunner-la Rocca, H P; Schols, J M G A

    2016-01-01

    To determine the prevalence of heart failure (HF) in nursing home residents and to gain insight into the clinical characteristics of residents with heart failure. Multi-centre, observational, cross-sectional study. 501 nursing home residents aged 65 years and over, in a department for chronic somatic diseases or a psychogeriatric department, participated in this study. The diagnosis of HF and the related characteristics were based on data collected from clinical examinations for heart failure (including history, physical examination, ECG, cardiac markers and echocardiography), patient records and questionnaires. A panel of two cardiologists and an internist-geriatrician made the final diagnosis of HF. The prevalence of HF in nursing home residents was 33%. Dyspnoea, oedema and a history of cardiac disease were more common in residents with heart failure. Diabetes mellitus and chronic obstructive pulmonary disease also appeared to be more prevalent in this group. In 54% of the residents with HF, the diagnosis had not previously been made. Diagnosis of HF was not confirmed by the expert panel in 31% of residents with a history of HF. Heart failure does indeed appear to be very prevalent in nursing home residents. Heart failure had not been previously diagnosed in many cases but also a previous diagnosis of heart failure could be disproved in many participants. It is therefore important that the diagnostic process for heart failure in nursing home residents be improved.

  11. Radiology residents' experience with intussusception reduction.

    Science.gov (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang

    2011-06-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  12. Internal medicine residency training in Turkey.

    Science.gov (United States)

    Sahin, Hatice; Akcicek, Fehmi

    2005-12-01

    Medical school entrance depends on passing a central examination that is given annually by the National Selection and Placement Center. Undergraduate medical education takes 6 years. About 5000 students graduate from medical faculties annually. The central exam necessary for residency training is given by the National Selection and Placement Center. A Specialist Training Regulation regulates residency training. Internal medicine residency training takes 4 years and includes inpatient and outpatient care in wards and rotations. Residents prepare a dissertation that is used in the evaluation of residency competency. At the end of the residency period, residents who have been successful in previous evaluations take an oral exam followed by a written exam, which lead to their certification in internal medicine. Residents' scientific knowledge and skills are assessed by a jury consisting of five people, four from the same department and one from the equivalent department in another training institution. The title of specialist is granted after a certification exam given by training institutions and approved by the Ministry of Health. Internists are mainly employed in state hospitals, which are under the Ministry of Health. Subspecialty areas in internal medicine include gastroenterology, geriatrics, endocrinology, nephrology, hematology, rheumatology, immunology, allergology, and oncology. The training period for a subspecialty is 2 years. A substantial effort is being made all over the country to improve regulations and health care service delivery. These changes will also affect the residency training and manpower planning and employment of internists.

  13. The challenges of residents teaching neurology.

    Science.gov (United States)

    Frank, Samuel A; Józefowicz, Ralph F

    2004-07-01

    Teaching is integrated into the daily practice of residents, and it is a skill necessary for practice as well as academics. The settings in which teaching and learning take place are ubiquitous but include classrooms, small groups, bedside rounds, and grand rounds. Given the learning environment of residency, neurology residents should have working knowledge of basic principles of effective teaching to make learning successful. Teaching also reinforces knowledge, and residents will likely be better practitioners if some basic skills of teaching are practiced. Neurology teaching techniques for residents are rarely addressed in the medical literature. Although information regarding teaching principles in medicine exists, there is little information regarding how residents teach. We examine and review some of the more effective methods and appreciated qualities in teachers, with a particular emphasis for the neurology resident. We also review whom neurologists need to teach and the various settings in which teaching may take place. Neurology residents encounter a variety of audiences in a variety of settings that require diverse teaching skills to effectively convey information to other providers as well as patients. The majority of these skills should be learned in residency to establish a foundation for teaching, regardless of future practice settings.

  14. Perceived Value of a Program to Promote Surgical Resident Well-being.

    Science.gov (United States)

    Salles, Arghavan; Liebert, Cara A; Esquivel, Micaela; Greco, Ralph S; Henry, Rebecca; Mueller, Claudia

    The demands of surgical residency are intense and threaten not only trainees' physical wellness, but also risk depression, burnout, and suicide. Our residency program implemented a multifaceted Balance in Life program that is designed to improve residents' well-being. The purpose of this study was to evaluate the program utilization and perceived value by residents. Residents (n = 56, 76% response rate) were invited to participate in a voluntary survey from December 2013 to February 2014 regarding utilization, barriers to use, and perceived value of 6 program components (refrigerator, After Hours Guide, psychological counseling sessions, Resident Mentorship Program, Class Representative System, and social events). They were also asked questions about psychological well-being, burnout, grit, and sleep and exercise habits before and after implementation of the program. The most valued components of the program were the refrigerator (mean = 4.61) and the psychological counseling sessions (mean = 3.58), followed by social events (mean = 3.48), the Resident Mentorship Program (mean = 2.79), the Class Representative System (mean = 2.62), and the After Hours Guide (mean = 2.10). When residents were asked how they would allocate $100 among the different programs, the majority was allocated to the refrigerator ($54.31), social events ($26.43), and counseling sessions ($24.06). There was no change in psychological well-being or burnout after the program. Residents had higher levels of grit (β = 0.26, p valued, and positively perceived by the residents. Further research is needed to quantify the effectiveness and longitudinal impact such a program has on resident depression, burnout, and other psychological factors. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Residency Programs and Clinical Leadership Skills Among New Saudi Graduate Nurses.

    Science.gov (United States)

    Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

    2016-01-01

    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.

  16. Communication Skills Training for Surgical Residents: Learning to Relate to the Needs of Older Adults.

    Science.gov (United States)

    Roberts, Linda; Cornell, Charles; Bostrom, Mathias; Goldsmith, Sandra; Ologhobo, Titilayo; Roberts, Timothy; Robbins, Laura

    2018-03-30

    It is vital for physicians and surgeons to communicate successfully with older adults, who will constitute one-fifth of the US population by 2030. Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Effective communication leads to better patient compliance and satisfaction, which is now a component of Medicare hospital reimbursement and physician and surgeon compensation from hospitals and networks. To increase orthopaedic surgery resident understanding of the unique needs of older adults in order to maintain effective and sensitive communication with this vulnerable population. A two-part training program (ongoing for 8 years) comprised of: 1) small-group interactive didactic sessions on aging issues; and 2) workshop demonstrations given by the residents to a group of older adults, followed by a Question & Answer session. Residents were assessed using a 22-item pre-post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Older adult participants were surveyed for perceptions of residents' sensitivity toward them. Hospital for Special Surgery in New York City, a specialized urban academic center, with a 5-year Orthopedic Surgery Residency program. 70 PGY3 residents, for whom the program is a requirement, and 711 older adult participants recruited from a community convenience sample. Older adult participants: Of 711 participants, 672 (95%) responded; 96% strongly agreed/agreed that the residents had demonstrated sensitivity toward them. Residents: Of 70 residents, 35 (50%) were assessed. Mean knowledge scores increased significantly (p ≤ 0.001); five of nine attitude items (p ≤ 0.05) and one of four anxiety items improved significantly (p ≤ 0.001). Significant change was seen in residents' attitudes and anxiety levels toward older adults, attributes that are usually deep seated and hard to change. Residents moved along the Accreditation Council for Graduate

  17. Breaking Bad News: A Survey of Radiology Residents' Experiences Communicating Results to Patients.

    Science.gov (United States)

    Narayan, Anand; Dromi, Sergio; Meeks, Adam; Gomez, Erin; Lee, Bonmyong

    The practice of radiology often includes routine communication of diagnostic test results directly to patients in breast imaging and interventional radiology. There is increasing interest in expanding direct communication throughout radiology. Though these conversations can substantially affect patient well-being, there is limited evidence indicating that radiology residents are specifically taught methods to effectively convey imaging results to patients. Our purpose is to evaluate resident experience communicating imaging results to patients. An IRB-approved study with a total of 11 pilot-tested questions was used. Surveyed programs included radiology residents (PGY2-PGY5) at 2 urban residency programs. Online surveys were administered using SurveyMonkey and e-mailed to residents at both programs (starting November 20, 2015, completed March 31, 2016). Demographics were obtained with survey proportions compared using logistic regression (P < 0.05, statistically significant). A total of 73 residents responded (93.6% response rate) with similar response rates at each institution (P = 0.689). Most were male (71.2%) with 17.8% planning to go into breast imaging (21.9%, interventional radiology (IR)). Furthermore, 83.6% described no training in communicating radiology results to patients; 91.8% of residents communicated results with patients (87.7% diagnostic imaging tests and 57.5% biopsies). Residents most commonly communicated results in person (75.3%) followed by phone (64.4%), and 79.4% agreed or strongly agreed that additional training relaying results would be helpful. A large majority of radiology residents have communicated test results to patients, yet few have received training in how to communicate these results. A large majority of residents expressed interest in obtaining additional communication training. Additional research is required to determine ideal methods to educate residents on communicating test results. Copyright © 2018 Elsevier Inc. All

  18. Distributed learning or medical tourism? A Canadian residency program's experience in global health.

    Science.gov (United States)

    Kelly, Kate; McCarthy, Anne; McLean, Laurie

    2015-01-01

    Global health experiences (GHEs) are becoming increasingly prevalent in surgical residency education. Although it may seem intuitive that participation in GHEs develops CanMEDS competencies, this has not been studied in depth in surgery. The purpose of this study is (1) to explore if and how otolaryngology-head and neck surgery (OHNS) resident participation in GHEs facilitates the development of CanMEDS competencies and (2) to develop an OHNS GHE tool to facilitate the integration of CanMEDS into GHE participation and evaluation. An online survey explored the GHEs of current and past OHNS residents in Canada. Based on the data collected and a literature review, a foundational tool was then created to (1) enable OHNS residents to structure their GHEs into CanMEDS-related learning objectives and (2) enable OHNS program directors to more effectively evaluate residents' GHEs with respect to CanMEDS competencies. Participants' GHEs varied widely. These experiences often contributed informally to the development of several CanMEDS competencies. However, few residents had concrete objectives, rarely were CanMEDS roles clearly incorporated, and most residents were not formally evaluated during their experience. Residents felt they achieved greater learning when predeparture objectives and postexperience reflections were integrated into their GHEs. Although GHEs vary widely, they can serve as valuable forums for developing CanMEDS competencies among participating residents. Without clear objectives that adhere to the CanMEDS framework or formal assessment methods however, residents in GHEs risk becoming medical tourists. The use of an objective and evaluation tool may facilitate the creation of predeparture learning objectives, encourage self-reflection on their GHE, and better enable program directors to evaluate residents participating in GHEs. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Career outcomes of nondesignated preliminary general surgery residents at an academic surgical program.

    Science.gov (United States)

    Ahmad, Rima; Mullen, John T

    2013-01-01

    There remains a debate as to whether nondesignated preliminary (NDP) positions in surgery ultimately translate into successful surgical careers for those who pursue them. We sought to identify the success with which our NDP residents were able to transition to their desired career and what, if any, factors contributed to their success. The records of all NDP residents accepted into the Massachusetts General Hospital General Surgery Residency Program from 1995 to 2010 were examined and long-term follow-up was completed. Thirty-four NDP residents were identified, including 26.5% US graduates and 73.5% international medical graduates. At the end of the initial preliminary year, 30 (88%) got placed in a postgraduate residency program, whereas 4 (12%) pursued other career paths. Of those who got placed, 25 (83%) attained surgical residency positions, including 17 (57%) who continued as preliminary residents at our institution and 8 (27%) who got placed in categorical surgical positions at other programs. After multiple preliminary years, 15 of 17 achieved a categorical position, of which, 93% were in surgical fields. Overall, 64.7% of all entering NDP residents eventually went on to have careers in general surgery (50%) or surgical subspecialties (14.7%), and 24 of 34 (71%) fulfilled their desired career goals. No factor predicted success. From 1995 to 2012 there have been 15 midlevel (11 postgraduate year 4) vacancies in our program, 4 of which were filled by preliminary residents, 2 from our program and 2 from elsewhere. All have gone on to board certifications and careers in surgery. More than 70% of NDP residents in our program successfully transitioned to their desired career paths, many achieving categorical surgical positions and academic surgical careers, thus demonstrating the benefit of this track to both residency programs and trainees. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. CT training of nuclear medicine residents in the United States, 2013-2014.

    Science.gov (United States)

    Harolds, Jay A; Metter, Darlene; Oates, M Elizabeth; Guiberteau, Milton J

    2015-01-01

    In 2011, the ACGME Nuclear Medicine (NM) Residency Review Committee revised the NM program requirements, which increased CT training for NM residents. This article examines the effect of this revision. Requests were e-mailed to all NM program directors asking that their residents be given the opportunity to complete an online survey regarding their CT training. Subsequently, an identical online survey regarding CT training was e-mailed directly to all members of the NM Residents Organization of the American College of NM asking that they complete the survey regarding their CT training if they had not already done so. Resident responses, compared with those from a similar 2011 survey, indicate a perception that CT training and CT expertise gained in ACGME-accredited NM programs have improved. However, some NM residents are not provided with the opportunity to develop critical skills in interpreting and dictating CT scans during their time on dedicated CT services. The survey indicates that experience gained during NM residency in head and neck/neuroradiology, emergency, and musculoskeletal CT is marginal at best. A slight majority felt that CT training should be further increased. Compared with a 2011 survey of NM residents and the 2011 implementation of expanded CT training requirements, a follow-up survey seems to indicate improvement in CT training for most NM residents. Nevertheless, an opportunity clearly remains to further improve the breadth and depth of CT skills during NM residency. However, whether such an improvement will result in a reversal of multiyear downward trends in the number of NM residents and training programs in the United States is not clear. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. SU-E-E-02: Dashboard for Tracking Physics Resident Progress

    International Nuclear Information System (INIS)

    Becker, SJ

    2014-01-01

    Purpose: Design a system to easily and securely track the progress of medical physics residents through their residency. Paper sign-offs while offering a real signature are not easily updated or summarized. A resident or mentor needs to be able to quickly assess what the current assignments are, what are overdue, and whether the resident is on track to complete all the tasks in a timely fashion. An electronic version can accomplish all these goals. Methods: An electronic dashboard was created in excel to not only house the tasks and sign-off but to succinctly summarize the residents progress. The first tab contains the dashboard which displays tables of the progress of the residents in each rotation, their current task, and overdue tasks. It also displays the last meetings with the residents, and timeline of important items, and a burn-down chart of the remaining tasks. This are all tied to the data and current date which auto fills the tables. The second tab contains the data. This is comprised of lists of rotations and their associated tasks along with their due dates. A signature column was also created which is password protected but allows special subset users i.e. mentors to alter without using a password. Results: The dashboard has allowed residents to better track their progress and tells them what they should be working on. It has also allowed the mentors and the program director to rapid assess their progress. Conclusion: The dashboard is successful and has been created to allow easy addition and subtraction of required tasks as the residency evolves. The next step is to create a web app version of the excel sheet with logins

  2. Technical Innovation: The Automated Residency Match Rank List.

    Science.gov (United States)

    Strickland, Colin; Rubinstein, David

    2016-01-01

    The creation of the final rank list for the National Residency Matching Program every year is a laborious task requiring the time and input of numerous faculty members and residents. This article describes the creation of an automated visual rank list to efficiently organize and guide discussion at the yearly rank meeting so that the task may be efficiently and fairly completed. The rank list was created using a PowerPoint (Microsoft) macro that can pull information directly from a spreadsheet to generate a visual rank list that can be modified on-the-fly during the final rank list meeting. An automatically created visual rank list helps facilitate an efficient meeting and creates an open and transparent process leading to the final ranking. Copyright © 2015 Mosby, Inc. All rights reserved.

  3. Behavior and function of tissue-resident memory T cells.

    Science.gov (United States)

    Ariotti, Silvia; Haanen, John B; Schumacher, Ton N

    2012-01-01

    Our understanding of memory T cell function in mice and men is to date in large part restricted to the behavior of circulating memory T cells. Emerging evidence, however, suggests that in addition to such systemic memory T cell populations, a separate population of locally confined memory T cells is generated at former sites of antigen encounter. Here, we discuss the potential function of these long-term tissue-resident memory T cells (T(TRM)), how such local T cell memory can be maintained for prolonged periods of time, and how the induction of long-term tissue-resident memory T cells may potentially be exploited during vaccination. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. How Effective are Your Mentoring Relationships? Mentoring Quiz for Residents.

    Science.gov (United States)

    Wadhwa, Vibhor; Nagy, Paul; Chhabra, Avneesh; Lee, Cindy S

    Mentoring is an essential part of a resident's career development. It plays an important role in nurturing, and sustaining success along the career path of a young physician. Mentoring is a long-term goal that is development-driven rather than performance-driven. Although specific learning goals may be used as a basis, the focus of mentoring may also include self-confidence, self-perception, and work-life balance. A number of residency programs have implemented mentoring programs in their institutions. This article discusses the importance of mentoring, illustrates "do's and don'ts" for mentees and demonstrates how to choose the ideal mentor. Finally, a "mentoring quiz" is designed to evaluate your mentoring relationship. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Introducing a psychosomatic medicine interest group for psychiatry residents.

    Science.gov (United States)

    Puri, Neil V; Azzam, Pierre; Gopalan, Priya

    2015-01-01

    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.

  6. Innovation in Pediatric Surgical Education for General Surgery Residents: A Mobile Web Resource.

    Science.gov (United States)

    Rouch, Joshua D; Wagner, Justin P; Scott, Andrew; Sullins, Veronica F; Chen, David C; DeUgarte, Daniel A; Shew, Stephen B; Tillou, Areti; Dunn, James C Y; Lee, Steven L

    2015-01-01

    General surgery residents lack a standardized educational experience in pediatric surgery. We hypothesized that the development of a mobile educational interface would provide general surgery residents broader access to pediatric surgical education materials. We created an educational mobile website for general surgery residents rotating on pediatric surgery, which included a curriculum, multimedia resources, the Operative Performance Rating Scale (OPRS), and Twitter functionality. Residents were instructed to consult the curriculum. Residents and faculty posted media using the Twitter hashtag, #UCLAPedSurg, and following each surgical procedure reviewed performance via the OPRS. Site visits, Twitter posts, and OPRS submissions were quantified from September 2013 to July 2014. The pediatric surgery mobile website received 257 hits; 108 to the homepage, 107 to multimedia, 28 to the syllabus, and 19 to the OPRS. All eligible residents accessed the content. The Twitter hashtag, #UCLAPedSurg, was assigned to 20 posts; the overall audience reach was 85 individuals. Participants in the mobile OPRS included 11 general surgery residents and 4 pediatric surgery faculty. Pediatric surgical education resources and operative performance evaluations are effectively administered to general surgery residents via a structured mobile platform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Results of the 2014 survey of the American Alliance of Academic Chief Residents in Radiology.

    Science.gov (United States)

    Shetty, Anup; Hammer, Mark; Gould, Jennifer; Evens, Ronald

    2014-10-01

    The American Alliance of Academic Chief Residents in Radiology (A³CR²) conducts an annual survey of chief residents in accredited radiology programs in North America. The survey serves as a tool for observing trends and disseminating ideas among radiology programs. An online survey conducted through the SurveyMonkey Web site was distributed to chief residents from 187 Accreditation Council on Graduate Medical Education (ACGME)-accredited radiology training programs. A variety of multiple-choice and free-response questions were designed to gather information about residency program details, benefits, chief resident responsibilities, call, preparations for the recent American Board of Radiology Core Examination, implementation of selectives (mini-fellowships), fellowships, health care economics and the job market, and ACGME milestones. Among those surveyed, 212 unique responses from 136 programs were provided, yielding a 73% response rate. Data were compared to historical data from prior surveys dating back through 2002. Programs are increasingly providing 24-hour sonographer coverage, full day routine services on weekends, and 24-hour attending radiologist coverage. The new American Board of Radiology examination format and schedule has driven many changes, including when chief residents serve, board preparation and review, and how the final year of residency training is structured. Despite facing many changes, there is slightly more optimism among chief residents regarding their future job prospects. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  8. The Right Way to Teach Left-Handed Residents: Strategies for Training by Right Handers.

    Science.gov (United States)

    Prasad, Nikhil K; Kvasnovsky, Charlotte; Wise, Eric S; Kavic, Stephen M

    Left-handed (LH) residents remain underrepresented among surgical trainees, and there are few available data on how best to train them. The challenge is amplified when pairing a LH resident with a right-handed (RH) mentor. This report provides recommendations on how to improve the training of LH surgeons in a safe and effective manner. A comprehensive literature review was performed using different databases and search engines to identify all articles relevant to the training of LH residents. A total of 40 articles highlighted the challenges for LH surgical residents and RH mentors. Our recommendations are based on the following 4 themes: identifying inherent differences in left vs. RH residents, providing guidance to RH mentors training LH residents, adapting the RH environment to the LH surgeon, and maximizing safety during training. An organized approach needs to be taken in training the LH resident. Changes should be instituted at program-wide and national levels to ensure that the training experience of the sinistral surgical resident is optimized. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. [Assessment of shoulder dystocia related knowledge among French obstetrics and gynecology residents].

    Science.gov (United States)

    Schmitt, A; Heckenroth, H; Cravello, L; Boubli, L; d'Ercole, C; Courbiere, B

    2016-09-01

    To study the related knowledge of French residents in obstetrics concerning maneuvers for shoulder dystocia (SD). Multicenter descriptive transversal study conducted from June to September 2014. Data collection was performed through questionnaires sent by email to French resident in obstetrics. Among the 1080 questionnaires sent, 366 responses were obtained with a response rate of 33.9%. One hundred and forty-three residents (39.1%) were in the first part of their training (≤5th semester) and 60.9% (n=223) were in the second part of their training. Theoretical training on the SD was provided to 88.2% of resident (n=323). In total, 38.8% (n=142) obtained their French degree in mechanical and technical obstetric and among them 77.5% (n=110) had the opportunity to train on simulators and dummies. Concerning their practical experiences, 31.5% (n=45) residents ≤5th semester reported having experienced SD during their residency vs 58.3% (n=130) amongst oldest residents (PObstetrics and Gynecology, which have to develop dependable measures to assess resident competencies to execute practical maneuvers for clinical emergencies in obstetrics. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. A Simulation-based, cognitive assessment of resident decision making during complex urinary catheterization scenarios.

    Science.gov (United States)

    Nathwani, Jay N; Law, Katherine E; Witt, Anna K; Ray, R D; DiMarco, S M; Pugh, C M

    2017-04-01

    This study explores general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios. 40 residents were presented with two scenarios. Scenario A was a male with traumatic urethral injury and scenario B was a male with complete urinary blockage. Residents verbalized whether they would catheterize the patient and described the workup and management of suspected pathologies. Residents' decision paths were documented and analyzed. In scenario A, 45% of participants chose to immediately consult Urology. 47.5% named five diagnostic tests to decide if catheterization was safe. In scenario B, 27% chose to catheterize with a 16 French Coude. When faced with catheterization failure, participants randomly upsized or downsized catheters. Chi-square analysis revealed no measurable consensus amongst participants. Residents need more training in complex decision making for urinary catheterization. The decision trees generated in this study provide a useful blueprint of residents' learning needs. Exploration of general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios revealed major deficiencies. The resulting decision trees reveal residents' learning needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Weekly e-mailed teaching tips and reading material influence teaching among general surgery residents.

    Science.gov (United States)

    Watkins, Ammara A; Gondek, Stephen P; Lagisetty, Kiran H; Castillo-Angeles, Manuel; Gangadharan, Sidharta P; Cahalane, Michael J; Kent, Tara S

    2017-01-01

    A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the resident role of teaching were distributed to general surgery house staff through a weekly e-mail series. House staff completed surveys before and after the 20-week e-mail series. Thirty (43%) and 28 (40%) respondents completed the pre-e-mail and post-e-mail survey, respectively. Residents found teaching tips to be more helpful than manuscripts. Weekly e-mail reminders were "just right" in frequency according to 74% of respondents. Forty percent of residents felt the weekly e-mails helped them teach more often and 50% of residents changed their teaching style. Weekly reminders are an easy way to encourage resident teaching without a significant resident time commitment. Residents typically find teaching tips to be more useful than manuscripts. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Performance goals on simulators boost resident motivation and skills laboratory attendance.

    Science.gov (United States)

    Stefanidis, Dimitrios; Acker, Christina E; Greene, Frederick L

    2010-01-01

    To assess the impact of setting simulator training goals on resident motivation and skills laboratory attendance. Residents followed a proficiency-based laparoscopic curriculum on the 5 Fundamentals of Laparoscopic Surgery and 9 virtual reality tasks. Training goals consisted of the average expert performance on each task + 2 SD (mandatory) and best expert performance (optional). Residents rated the impact of the training goals on their motivation on a 20-point visual analog scale. Performance and attendance data were analyzed and correlated (Spearman's). Data are reported as medians (range). General Surgery residency program at a regional referral Academic Medical Center. General surgery residents (n = 15). During the first 5 months of the curriculum, weekly attendance rate was 51% (range, 8-96). After 153 (range, 21-412) repetitions, resident speed improved by 97% (range, 18-230), errors improved by 17% (range, 0-24), and motion efficiency by 59% (range, 26-114) compared with their baseline. Nine (60%) residents achieved proficiency in 7 (range, 3-14) and the best goals in 3.5 (range, 1-9) tasks; the other 6 residents had attendance rates performance goals on their motivation as 15 (range, 1-18) and setting a best goal as 13 (range, 1-18). Motivation ratings correlated positively with attendance rates, number of repetitions, performance improvement, and achievement of proficiency and best goals (r = 0.59-0.75; p attendance. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. Resident participation in neighbourhood audit tools - a scoping review.

    Science.gov (United States)

    Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

    2018-02-01

    Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. In total, 13 participatory instruments were identified. The role of residents in most instruments was as 'data collectors'; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  14. Factors associated with residents' satisfaction with their training as specialists.

    Science.gov (United States)

    Ayala-Morillas, L E; Fuentes-Ferrer, M E; Sánchez-Díaz, J; Rumayor-Zarzuelo, M; Fernández-Pérez, C; Marco-Martínez, F

    2014-05-01

    We do not know what factors influence residents' perceived satisfaction during their training. The aim of this study was to analyze the satisfaction of specialists with their training and its associated factors. This was a cross-sectional study using self-completion surveys of residents in training at the Clinic Hospital San Carlos for the courses conducted in 2006, 2009, 2010 and 2012. The study's dependent variable was overall satisfaction with the training; the independent factors were demographic and occupational characteristics, variables related to healthcare, teaching and research activity. The total participation percentage was 83.7% (1,424/1,701), and the mean age was 28.4 years (SD, 3.2 years). The overall satisfaction percentage was 75.2%. The factors statistically associated with overall satisfaction in the multivariate analysis were the involvement of the teaching staff (tutors and assistants) in the training, greater satisfaction in medical versus surgical specialties, the year of residence, the facilities for completing the thesis, working less than 40 h a week, adequate time to perform daily tasks, appropriate number of department meetings and not having a previous specialty. the activities related to research and teaching are associated with the overall satisfaction of residents. The routine activity factors most closely associated with satisfaction were the time available and the work hours. More studies are necessary to understand the impact of resident satisfaction on care quality and in their activity as future specialists. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  15. Radiology Resident Supply and Demand: A Regional Perspective.

    Science.gov (United States)

    Pfeifer, Cory M

    2017-09-01

    Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future. The number of per capita radiology trainees in each region was derived from data published by the National Resident Matching Program, as were annual match statistics over the years 2012 through 2016. Data regarding new interventional radiology and diagnostic radiology enrollees were also obtained from the National Resident Matching Program. The seven states with the most per capita radiology residents were in the Mid-Atlantic and Northeastern United States in both 2006 and 2016, and three of these seven also showed the greatest per capita growth over the course of the 10 years studied. New radiology programs were accredited during the peak of the job shortage. Integrated interventional radiology training created 24 de novo radiology residents in the 2017 match. Fill rates are weakly positively correlated with program size. Unregulated radiology program growth persisted during the decade leading up to 2016. The region with the fewest jobs available since 2012 is also home to the greatest number of per capita radiology residents. Numerous published opinions during the crisis did not result in enforced policy change. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. CNA Training Requirements and Resident Care Outcomes in Nursing Homes.

    Science.gov (United States)

    Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy B; Yang, Bo Kyum; Han, Kihye

    2017-06-01

    To examine the relationship between certified nursing assistant (CNA) training requirements and resident outcomes in U.S. nursing homes (NHs). The number and type of training hours vary by state since many U.S. states have chosen to require additional hours over the federal minimums, presumably to keep pace with the increasing complexity of care. Yet little is known about the impact of the type and amount of training CNAs are required to have on resident outcomes. Compiled data on 2010 state regulatory requirements for CNA training (clinical, total initial training, in-service, ratio of clinical to didactic hours) were linked to 2010 resident outcomes data from 15,508 NHs. Outcomes included the following NH Compare Quality Indicators (QIs) (Minimum Data Set 3.0): pain, antipsychotic use, falls with injury, depression, weight loss and pressure ulcers. Facility-level QIs were regressed on training indicators using generalized linear models with the Huber-White correction, to account for clustering of NHs within states. Models were stratified by facility size and adjusted for case-mix, ownership status, percentage of Medicaid-certified beds and urban-rural status. A higher ratio of clinical to didactic hours was related to better resident outcomes. NHs in states requiring clinical training hours above federal minimums (i.e., >16hr) had significantly lower odds of adverse outcomes, particularly pain falls with injury, and depression. Total and in-service training hours also were related to outcomes. Additional training providing clinical experiences may aid in identifying residents at risk. This study provides empirical evidence supporting the importance of increased requirements for CNA training to improve quality of care. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. [Burnout in Tunisian medical residents: About 149 cases].

    Science.gov (United States)

    Ben Zid, A; Homri, W; Ben Romdhane, I; Bram, N; Labbane, R

    2017-09-01

    Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout. A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment. A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (Pburnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (Pburnout was not found. Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors

  18. Impact of night shifts on emergency medicine resident resuscitation performance.

    Science.gov (United States)

    Edgerley, Sarah; McKaigney, Conor; Boyne, Devon; Ginsberg, Darrell; Dagnone, J Damon; Hall, Andrew K

    2018-03-12

    Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. This retrospective cohort study enrolled EM residents at a single Canadian academic centre over a six-year period. Residents completed twice-annual simulation-based resuscitation-focused objective structured clinical examinations (OSCEs) with assessment in four domains (primary assessment, diagnostic actions, therapeutic actions and communication), and a global assessment score (GAS). Primary and secondary exposures of interest were the presence of a nightshift (late-evening shifts ending between midnight and 03h00 or overnight shifts ending after 06h00) the day before or within three days before an OSCE. A random effects linear regression model was used to quantify the association between nightshifts and OSCE scores. From 57 residents, 136 OSCE scores were collected. Working a nightshift the day before an OSCE did not affect male trainee scores but was associated with a significant absolute decrease in mean total scores (-6% [95% CI -12% to 0%]), GAS (-7% [-13% to 0%]), and communication (-9% [-16% to -2%]) scores among women. Working any nightshift within three days before an OSCE lowered absolute mean total scores by 4% [-7% to 0%] and communication scores by 5% [-5% to 0%] irrespective of gender. Our results suggest that shift work may impact EM resident resuscitation performance, particularly in the communication domain. This impact may be more significant in women than men, suggesting a need for further investigation. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Wildlife resource utilisation at Moremi Game Reserve and Khwai community area in the Okavango Delta, Botswana.

    Science.gov (United States)

    Mbaiwa, Joseph E

    2005-10-01

    This paper uses the concept of sustainable development to examine the utilisation of wildlife resources at Moremi Game Reserve (MGR) and Khwai community area (NG 18/19) in the Okavango Delta, Botswana. Using both secondary and primary data sources, results show that the establishment of MGR in 1963 led to the displacement of Khwai residents from their land; affected Basarwa's hunting and gathering economy; marked the beginning of resource conflicts between Khwai residents and wildlife managers; and, led to the development of negative attitudes of Khwai residents towards wildlife conservation. Since the late 1980s, a predominantly foreign owned tourism industry developed in and around MGR, however, Khwai residents derive insignificant benefits from it and hence resource conflicts increased. In an attempt to address problems of resource conflicts and promote sustainable wildlife utilisation, the Botswana Government adopted the Community-Based Natural Resource Management (CBNRM) programme, which started operating at Khwai village in 2000. The CBNRM programme promotes local participation in natural resource management and rural development through tourism. It is beginning to have benefits to Khwai residents such as income generation, employment opportunities and local participation in wildlife management. These benefits from CBNRM are thus having an impact in the development of positive attitudes of Khwai residents towards wildlife conservation and tourism development. This paper argues that if extended to MGR, CBNRM has the potential of minimising wildlife conflicts between Khwai residents and the wildlife-tourism sectors. This approach may in the process promote the sustainable wildlife use in and around MGR.

  20. Engineered phages for electronics.

    Science.gov (United States)

    Cui, Yue

    2016-11-15

    Phages are traditionally widely studied in biology and chemistry. In recent years, engineered phages have attracted significant attentions for functionalization or construction of electronic devices, due to their specific binding, catalytic, nucleating or electronic properties. To apply the engineered phages in electronics, these are a number of interesting questions: how to engineer phages for electronics? How are the engineered phages characterized? How to assemble materials with engineered phages? How are the engineered phages micro or nanopatterned? What are the strategies to construct electronics devices with engineered phages? This review will highlight the early attempts to address these questions and explore the fundamental and practical aspects of engineered phages in electronics, including the approaches for selection or expression of specific peptides on phage coat proteins, characterization of engineered phages in electronics, assembly of electronic materials, patterning of engineered phages, and construction of electronic devices. It provides the methodologies and opens up ex-cit-ing op-por-tu-ni-ties for the development of a variety of new electronic materials and devices based on engineered phages for future applications. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Contemporary Trends in Radiation Oncology Resident Research

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska, Omaha, Nebraska (United States); Burt, Lindsay [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Gimotty, Phyllis A. [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ojerholm, Eric, E-mail: eric.ojerholm@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2016-11-15

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  2. Contemporary Trends in Radiation Oncology Resident Research

    International Nuclear Information System (INIS)

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A.; Ojerholm, Eric

    2016-01-01

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  3. Lawful Permanent Residents Fiscal Year 2014 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  4. Lawful Permanent Residents Fiscal Year 2015 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  5. Lawful Permanent Residents Fiscal Year 2016 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  6. Lawful Permanent Residents Fiscal Year 2011 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  7. Communicating about vaccines and vaccine safety: what are medical residents learning and what do they want to learn?

    Science.gov (United States)

    Sarnquist, Clea; Sawyer, Mark; Calvin, Kris; Mason, Wilbert; Blumberg, Dean; Luther, Jeffrey; Maldonado, Yvonne

    2013-01-01

    Physicians spend significant amounts of time discussing vaccine safety concerns with patients and parents. This study aimed to better understand the educational needs of US residents regarding vaccine safety communication, primarily by quantifying the vaccine safety communication training that residents currently receive and elucidating residents' preferences around education about vaccines and vaccine safety communication. A mixed-methods needs assessment consisting of focus groups and a survey. A convenience sample of 303 medical residents in pediatrics, family medicine, and internal medicine from across the United States participated in an online, anonymous survey from March through June 2010. In addition, 9 focus groups with 47 resident participants were held. The sample included residents in pediatrics (239, 80.2%), internal or family medicine (30, 10.1%), and dual medicine-pediatrics (29, 9.7%); 20.6% of the residents reported "not learning" about vaccine safety communication in their residency programs. Preferred learning methods, which were also the most commonly used methods, included didactic lectures and role-modeling/cases. Electronic teaching method were not only less desired but also very rarely utilized. More than 95% of residents reported thinking that vaccine safety communication would be very or somewhat important in their careers. Improving education on vaccine safety communication within US residency programs, as well as offering self-learning opportunities, can better prepare physicians for their careers.

  8. Should we Google it? Resource use by internal medicine residents for point-of-care clinical decision making.

    Science.gov (United States)

    Duran-Nelson, Alisa; Gladding, Sophia; Beattie, Jim; Nixon, L James

    2013-06-01

    To determine which resources residents use at the point-of-care (POC) for decision making, the drivers for selection of these resources, and how residents use Google/Google Scholar to answer clinical questions at the POC. In January 2012, 299 residents from three internal medicine residencies were sent an electronic survey regarding resources used for POC decision making. Resource use frequency and factors influencing choice were determined using descriptive statistics. Binary logistic regression analysis was performed to determine relationships between the independent variables. A total of 167 residents (56%) responded; similar numbers responded at each level of training. Residents most frequently reported using UpToDate and Google at the POC at least daily (85% and 63%, respectively), with speed and trust in the quality of information being the primary drivers of selection. Google, used by 68% of residents, was used primarily to locate Web sites and general information about diseases, whereas Google Scholar, used by 30% of residents, tended to be used for treatment and management decisions or locating a journal article. The findings suggest that internal medicine residents use UpToDate most frequently, followed by consultation with faculty and the search engines Google and Google Scholar; speed, trust, and portability are the biggest drivers for resource selection; and time and information overload appear to be the biggest barriers to resources such as Ovid MEDLINE. Residents frequently used Google and may benefit from further training in information management skills.

  9. Brand Name Statin Prescribing in a Resident Ambulatory Practice: Implications for Teaching Cost-Conscious Medicine.

    Science.gov (United States)

    Ryskina, Kira L; Pesko, Michael F; Gossey, J Travis; Caesar, Erica Phillips; Bishop, Tara F

    2014-09-01

    Several national initiatives aim to teach high-value care to residents. While there is a growing body of literature on cost impact of physicians' therapeutic decisions, few studies have assessed factors that influence residents' prescribing practices. We studied factors associated with intensive health care utilization among internal medicine residents, using brand name statin prescribing as a proxy for higher-cost care. We conducted a retrospective, cross-sectional analysis of statin prescriptions by residents at an urban academic internal medicine program, using electronic health record data between July 1, 2010, and June 30, 2011. For 319 encounters by 90 residents, patients were given a brand name statin in 50% of cases. When categorized into quintiles, the bottom quintile of residents prescribed brand name statins in 2% of encounters, while the top quintile prescribed brand name statins in 98% of encounters. After adjusting for potential confounders, including patient characteristics and supervising attending, being in the primary care track was associated with lower odds (odds ratio [OR], 0.38; P  =  .02; 95% confidence interval [CI], 0.16-0.86), and graduating from a medical school with an above-average hospital care intensity index was associated with higher odds of prescribing brand name statins (OR, 1.70; P  =  .049; 95% CI, 1.003-2.88). We found considerable variation in brand name statin prescribing by residents. Medical school attended and residency program type were associated with resident prescribing behavior. Future interventions should raise awareness of these patterns in an effort to teach high-value, cost-conscious care to all residents.

  10. Electron detector

    International Nuclear Information System (INIS)

    Hashimoto, H.; Mogami, A.

    1975-01-01

    A device for measuring electron densities at a given energy level in an electron beam or the like having strong background noise, for example, in the detection of Auger electric energy spectrums is described. An electron analyzer passes electrons at the given energy level and at the same time electrons of at least one adjacent energy level. Detecting means associated therewith produce signals indicative of the densities of the electrons at each energy level and combine these signals to produce a signal indicative of the density of the electrons of the given energy level absent background noise

  11. Invitational Engineering in the Residence Halls.

    Science.gov (United States)

    Murphy, Jack; Purkey, William

    1981-01-01

    Presents various ways in which a residence hall environment may be specifically engineered to encourage individual participation in the process of education. Invitational engineering is defined as one way to transpose psychological principles to residence halls so they contribute to the developmental life of students. (RC)

  12. Sedation practice among Nigerian radiology residents | Omisore ...

    African Journals Online (AJOL)

    Background: Providing safe and effective sedation to patients, especially those with multiple medical problems, can be challenging for radiology residents and fellows. This study aimed to determine knowledge, attitude and practice of Nigerian radiology residents concerning sedation. Keywords: anaesthetist, guidelines ...

  13. 42 CFR 483.10 - Resident rights.

    Science.gov (United States)

    2010-10-01

    ... to Medicaid benefits, in writing, at the time of admission to the nursing facility or, when the resident becomes eligible for Medicaid of— (A) The items and services that are included in nursing facility... eligibility for Medicaid or SSI. (6) Conveyance upon death. Upon the death of a resident with a personal fund...

  14. Tax treaty entitlement issues concerning dual residents

    NARCIS (Netherlands)

    Sanghavi, D.

    2014-01-01

    The question whether a dual resident taxpayer is entitled to tax treaties concluded by each residence state with a third state has been controversial. Since 2008, the Organisation for Economic Co-operation and Development (OECD) Commentary on Article 4(1) of the OECD Model states that such a

  15. Displacing Media: LCD LAB Artistic Residency

    Directory of Open Access Journals (Sweden)

    Filipe Pais

    2012-12-01

    Full Text Available This review refers to an artistic residency which took place at LCD LAB -  CAAA at Guimarães, in March, exploring a strategy for media art called Media Displacement. The text introduces the strategy very briefly and describes the residency's organization, structure, processses and the results produced.

  16. 20th Annual Residence Hall Construction Report

    Science.gov (United States)

    Agron, Joe

    2009-01-01

    Even in difficult economic times, colleges and universities continue to invest in residence hall construction projects as a way to attract new students and keep existing ones on campus. According to data from "American School & University"'s 20th annual Residence Hall Construction Report, the median new project completed in 2008 was…

  17. 38 CFR 3.653 - Foreign residence.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Foreign residence. 3.653 Section 3.653 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Adjustments and Resumptions § 3.653 Foreign residence...

  18. Medication Refusal: Resident Rights, Administration Dilemma.

    Science.gov (United States)

    Haskins, Danielle R; Wick, Jeannette Y

    2017-12-01

    Occasionally, residents actively or passively refuse to take medications. Residents may refuse medication for a number of reasons, including religious beliefs, dietary restrictions, misunderstandings, cognitive impairment, desire to self-harm, or simple inconvenience. This action creates a unique situation for pharmacists and long-term facility staff, especially if patients have dementia. Residents have the legal right to refuse medications, and long-term care facilities need to employ a process to resolve disagreement between the health care team that recommends the medication and the resident who refuses it. In some cases, simple interventions like selecting a different medication or scheduling medications in a different time can address and resolve the resident's objection. If the medical team and the resident cannot resolve their disagreement, often an ethics consultation is helpful. Documenting the resident's refusal to take any or all medications, the health care team's actions and any other outcomes are important. Residents' beliefs may change over time, and the health care team needs to be prepared to revisit the issue as necessary.

  19. 42 CFR 436.403 - State residence.

    Science.gov (United States)

    2010-10-01

    ...) Definition. For purposes of this section—Institution has the same meaning as Institution and Medical... intention to remain there permanently or for an indefinite period. (2) For any individual not residing in an... of residence is the State where the individual is— (i) Living with the intention to remain there...

  20. 42 CFR 435.403 - State residence.

    Science.gov (United States)

    2010-10-01

    ... set forth in § 431.52 of this chapter. (b) Definition. For purposes of this section—Institution has... intent, the State of residence is the State where the individual is living with the intention to remain...), the State of residence is the State where the individual is— (i) Living with the intention to remain...

  1. Adult neurology training during child neurology residency.

    Science.gov (United States)

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  2. Teaching Forensic Psychiatry to General Psychiatry Residents

    Science.gov (United States)

    Lewis, Catherine F.

    2004-01-01

    Objective: The Accreditation Council on Graduate Medical Education (ACGME) requires that general psychiatry residency training programs provide trainees with exposure to forensic psychiatry. Limited information is available on how to develop a core curriculum in forensic psychiatry for general psychiatry residents and few articles have been…

  3. Simulation and resident education in spinal neurosurgery.

    Science.gov (United States)

    Bohm, Parker E; Arnold, Paul M

    2015-01-01

    A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education.

  4. Introducing "optimal challenges" in resident training

    DEFF Research Database (Denmark)

    Sørensen, Anette Bagger; Christensen, Mette Krogh

    Background: Residents are often caught between two interests: the resident’s desire to participate in challenging learning situations and the department’s work planning. However, these interests may clash if they are not coordinated by the senior doctors, and challenging learning situations risk...... being subject to work planning. Summary of work: Inspired by Csikszentmihalyi’s concept of optimal challenges, an intervention study aimed at introducing a more suitable planning of residents' learning in terms of optimal allocation of educational patient contacts. The objective was to coordinating...... residents’ individual competences and learning needs with patient characteristics in order to match each resident with a case (an outpatient or a patient) that meets the learning needs of the resident and thus pose an optimal challenge to the resident. Summary of results: The preliminary results show...

  5. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  6. Evolution of the Pathology Residency Curriculum

    Science.gov (United States)

    Powell, Suzanne Z.; Black-Schaffer, W. Stephen

    2016-01-01

    The required medical knowledge and skill set for the pathologist of 2020 are different than in 2005. Pathology residency training curriculum must accordingly change to fulfill the needs of these ever-changing requirements. In order to make rational curricular adjustments, it is important for us to know the current trajectory of resident training in pathology—where we have been, what our actual current training curriculum is now—to understand how that might change in anticipation of meeting the needs of a changing patient and provider population and to fit within the evolving future biomedical and socioeconomic health-care setting. In 2013, there were 143 Accreditation Council for Graduate Medical Education-accredited pathology residency training programs in the United States, with approximately 2400 residents. There is diversity among residency training programs not only with respect to the number of residents but also in training venue(s). To characterize this diversity among pathology residency training programs, a curriculum survey was conducted of pathology residency program directors in 2013 and compared with a similar survey taken almost 9 years previously in 2005 to identify trends in pathology residency curriculum. Clinical pathology has not changed significantly in the number of rotations over 9 years; however, anatomic pathology has changed dramatically, with an increase in the number of surgical pathology rotations coupled with a decline in stand-alone autopsy rotations. With ever-expanding medical knowledge that the graduating pathology resident must know, it is necessary to (1) reflect upon what are the critical need subjects, (2) identify areas that have become of lesser importance, and then (3) prioritize training accordingly. PMID:28725779

  7. Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Nonreservation.

    Science.gov (United States)

    Hirchak, Katherine A; Murphy, Sean M

    2017-01-01

    Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substance-use disorder therapy. Assess differences in the number of opioid agonist therapy (OAT) facilities and physicians with Drug Addiction Treatment Act (DATA) waivers for rural versus urban, and AI reservation/trust land versus non-AI reservation/trust land areas in Washington State. The unit of analysis was the ZIP code. The dependent variables were the number of OAT facilities and DATA-waivered physicians in a region per 10,000 residents aged 18-64 in a ZIP code. A region was defined as a ZIP code and its contiguous ZIP codes. The independent variables were binary measures of whether a ZIP code was classified as rural versus urban, or AI reservation/trust land versus non-AI reservation/trust land. Zero-inflated negative binomial regressions with robust standard errors were estimated. The number of OAT clinics in a region per 10,000 ZIP-code residents was significantly lower in rural versus urban areas (P = .002). This did not differ significantly between AI reservation/trust land and non-AI reservation/trust land areas (P = .79). DATA-waivered physicians in a region per 10,000 ZIP-code residents was not significantly different between rural and urban (P = .08), or AI reservation/trust land versus non-AI reservation/trust land areas (P = .21). It appears that the potential for Washington State residents of rural and AI reservation areas to receive OAT is similar to that of residents outside of those areas; however, difficulties in accessing therapy may remain, highlighting the importance of expanding health care insurance and providing support for DATA-waivered physicians. © 2016 National Rural Health Association.

  8. Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

    Science.gov (United States)

    McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

    2011-12-01

    An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

  9. Education on the Brain: A Partnership Between a Pediatric Primary Care Center and Neurology Residency.

    Science.gov (United States)

    Zwemer, Eric; Bernson-Leung, Miya; Rea, Corinna; Patel, Archana A; Guerriero, Rejean; Urion, David K; Toomey, Sara L

    2018-01-01

    The national shortage of pediatric neurologists is worsening, yet referral rates by pediatricians are high. Suboptimal training of pediatric residents in care of patients with neurologic disease may be a contributing factor. We formed a partnership between the Boston Children's Primary Care at Longwood clinic and Child Neurology Residency Training Program. The educational intervention included lectures, observed neurologic examinations, in-person and virtual triage, and an electronic medical record-based consult system. Residents in other primary care clinics served as the comparison group. Intervention-group residents reported significantly improved confidence in diagnosis of chronic/recurrent headache, attention deficit hyperactivity disorder (ADHD), and developmental delay; initial management of ADHD and developmental delay; and secondary management of ADHD, developmental delay, and concussion/traumatic brain injury. Comparison-group residents reported significantly improved confidence only in diagnosis of developmental delay. Our multipronged intervention is a promising approach to improving pediatric resident training in pediatric neurology and may be generalizable to subspecialty collaborations for other residency programs.

  10. Internal Medicine Resident Engagement with a Laboratory Utilization Dashboard: Mixed Methods Study.

    Science.gov (United States)

    Kurtzman, Gregory; Dine, Jessica; Epstein, Andrew; Gitelman, Yevgenly; Leri, Damien; Patel, Miltesh S; Ryskina, Kyra

    2017-09-01

    The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents. Using grounded theory approach, the transcripts were analyzed for common themes focusing on barriers and facilitators of dashboard use. Among 80 residents, 74% opened the e-mail containing a link to the dashboard and 21% accessed the dashboard itself. We did not observe a statistically significant difference in routine laboratory ordering by dashboard use, although residents who opened the link to the dashboard ordered 0.26 fewer labs per doctor-patient-day than those who did not (95% confidence interval, -0.77 to 0.25; = 0 .31). While they raised several concerns, focus group participants had positive attitudes toward receiving individualized feedback delivered in real time. © 2017 Society of Hospital Medicine.

  11. Implementation of full patient simulation training in surgical residency.

    Science.gov (United States)

    Fernandez, Gladys L; Lee, Patrick C; Page, David W; D'Amour, Elizabeth M; Wait, Richard B; Seymour, Neal E

    2010-01-01

    -measures analysis of variance and Wilcoxon rank sum tests. Residents participated in 4.5 ± 1.4 sessions per academic year. Compliance with scheduled training was 88%, 90%, and 99% over successive years. Performance data were available for 39 PGY1, 2, and 3 residents. Ten individual residents could be followed between PGY1 and PGY2. For these individuals, improvement in mean performance was detected for the PGY2 (81% ± 5% vs 86% ± 4%; p 2 standard deviations below mean for the PGY level and 5 of these had deficiencies in clinical performance noted by other evaluation methods. Patient simulation training was implemented successfully with good compliance in this medium-sized surgical residency training program, but clear challenges were encountered with issues related to the number and range of experiences available per resident, competition with other educational activities, and fidelity and realism. Initial experience suggests that the associated assessment methods can detect predictable improvements in patient management skills across successive residency years, as well as potentially deficient management. Additional work is required to determine the educational effect of this training on resident clinical competency. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Federal Reserve System Semiannual Regulatory Agenda

    Science.gov (United States)

    2010-12-20

    ... [The Regulatory Plan and Unified Agenda of Federal Regulatory and Deregulatory Actions] [Federal Reserve System Semiannual Regulatory Agenda ] Part XXI Federal Reserve System Semiannual Regulatory Agenda... Flexibility Agenda AGENCY: Board of Governors of the Federal Reserve System. ACTION: Semiannual regulatory...

  13. Evaluation of clinical teaching quality in competency-based residency training in Lithuania.

    Science.gov (United States)

    Vaižgėlienė, Eglė; Padaiga, Žilvinas; Rastenytė, Daiva; Tamelis, Algimantas; Petrikonis, Kęstutis; Fluit, Cornelia

    2017-12-01

    In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training. The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. MOS for domains of "role modeling", "task allocation", "feedback", "teaching methodology" and "assessment" valued by residents were significantly higher than those valued by teachers (Pevaluation questionnaires were rated significantly higher by residents in role modeling subdomains (Phigher than the female teachers (Phigher (Pevaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers

  14. Strategies to accommodate resident work-hour restrictions: impact on surgical education.

    Science.gov (United States)

    Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

    2011-01-01

    The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Residents Perceptions of Friendship and Positive Social Networks Within a Nursing Home.

    Science.gov (United States)

    Casey, Anne-Nicole S; Low, Lee-Fay; Jeon, Yun-Hee; Brodaty, Henry

    2016-10-01

    (i) To describe nursing home residents' perceptions of their friendship networks using social network analysis (SNA) and (ii) to contribute to theory regarding resident friendship schema, network structure, and connections between network ties and social support. Cross-sectional interviews, standardized assessments, and observational data were collected in three care units, including a Dementia Specific Unit (DSU), of a 94-bed Sydney nursing home. Full participation consent was obtained for 36 residents aged 63-94 years. Able residents answered open-ended questions about friendship, identified friendship ties, and completed measures of nonfamily social support. Residents retained clear concepts of friendship and reported small, sparse networks. Nonparametric pairwise comparisons indicated that DSU residents reported less perceived social support (median = 7) than residents from the other units (median = 17; U = 10.0, p = .034, r = -.51), (median = 14; U = 0.0, p = .003, r = -.82). Greater perceived social support was moderately associated with higher number of reciprocated ties [ρ(25) = .49, p = .013]. Though some residents had friendships, many reported that nursing home social opportunities did not align with their expectations of friendship. Relationships with coresidents were associated with perceptions of social support. SNA's relational perspective elucidated network size, tie direction, and density, advancing understanding of the structure of residents' networks and flow of subjective social support through that structure. Understanding resident expectations and perceptions of their social networks is important for care providers wishing to improve quality of life in nursing homes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

    Science.gov (United States)

    Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

    Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Electron/electron acoustic instability

    International Nuclear Information System (INIS)

    Gary, S.P.

    1987-01-01

    The electron acoustic wave becomes a normal mode of an unmagnetized collisionless plasma in the presence of two electron components with similar densities, but strongly disparate temperatures. The characteristic frequency of this mode is the plasma frequency of the cooler electron component. If these two electron components have a relative drift speed several times the thermal speed of the cooler component, the electron/electron acoustic instability may arise. This paper describes the parametric dependences of the threshold drift speed and maximum growth rate of this instability, and compares these with the same properties of the electron/ion acoustic instability. Under the condition of zero current, the electron/ion acoustic instability typically has the lower threshold drift speed, so that observation of the electron/electron acoustic instability is a strong indication of the presence of an electrical current in the plasma

  18. ABR Core examination preparation: results of a survey of fourth-year radiology residents who took the 2013 examination.

    Science.gov (United States)

    Shetty, Anup S; Grajo, Joseph R; Decker, Summer; Heitkamp, Darel E; DeStigter, Kristen K; Mezwa, Duane G; Deitte, Lori

    2015-01-01

    A survey was administered to fourth-year radiology residents after receiving their results from the first American Board of Radiology (ABR) Core examination in 2013. The purpose was to gather information regarding resources and study strategies to share with program directors and future resident classes. An online survey was distributed to examinees nationwide. The survey included free-response and multiple choice questions that covered examination results, perceived value of enumerated study resources, case-based and didactic teaching conferences, board reviews, study materials for noninterpretive skills, multidisciplinary conference attendance, and free-form comments. Two hundred sixty-six of 1186 residents who took the Core examination responded to the survey. Some resources demonstrated a significant difference in perceived value between residents who passed the examination and residents who failed, including internal board reviews (1.10, P multiple choice questions, audience response, and integration of clinical physics and patient safety topics compared to residents who failed. Radiology residents and residency programs have adapted their preparations for the ABR Core examination in a variety of ways. Certain practices and study tools, including daily conferences and internal board reviews, had greater perceived value by residents who passed the examination than by residents who failed. This survey provides insights that can be used to assess and modify current preparation strategies for the ABR Core examination. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  19. Microparticles from apoptotic platelets promote resident macrophage differentiation.

    Science.gov (United States)

    Vasina, E M; Cauwenberghs, S; Feijge, M A H; Heemskerk, J W M; Weber, C; Koenen, R R

    2011-09-29

    Platelets shed microparticles not only upon activation, but also upon ageing by an apoptosis-like process (apoptosis-induced platelet microparticles, PM(ap)). While the activation-induced microparticles have widely been studied, not much is known about the (patho)physiological consequences of PM(ap) formation. Flow cytometry and scanning electron microscopy demonstrated that PM(ap) display activated integrins and interact to form microparticle aggregates. PM(ap) were chemotactic for monocytic cells, bound to these cells, an furthermore stimulated cell adhesion and spreading on a fibronectin surface. After prolonged incubation, PM(ap) promoted cell differentiation, but inhibited proliferation. Monocyte membrane receptor analysis revealed increased expression levels of CD11b (integrin α(M)β(2)), CD14 and CD31 (platelet endothelial cell adhesion molecule-1), and the chemokine receptors CCR5 and CXCR4, but not of CCR2. This indicated that PM(ap) polarized the cells into resident M2 monocytes. Cells treated with PM(ap) actively consumed oxidized low-density lipoprotein (oxLDL), and released matrix metalloproteinases and hydrogen peroxide. Further confirmation for the differentiation towards resident professional phagocytes came from the finding that PM(ap) stimulated the expression of the (ox)LDL receptors, CD36 and CD68, and the production of proinflammatory and immunomodulating cytokines by monocytes. In conclusion, interaction of PM(ap) with monocytic cells has an immunomodulating potential. The apoptotic microparticles polarize the cells into a resident M2 subset, and induce differentiation to resident professional phagocytes.

  20. Food intake, body reserves and reproductive success of barnacle geese Branta leucopsis staging in different habitats

    NARCIS (Netherlands)

    Prop, J; Black, JM; Mehlum, F; Black, JM; Madsen, J

    1998-01-01

    This paper concerns the effect of habitat choice on the dynamics of deposition of body reserves in spring-staging barnacle geese Branta leucopsis. On their way to breeding areas in Spitsbergen, these geese reside for several weeks on islands off the coast of Helgeland, Norway. They use three

  1. Senior Surgical Resident Confidence in Performing Flexible Endoscopy: What Can We Do Differently?

    Science.gov (United States)

    Fonseca, Annabelle L; Reddy, Vikram; Yoo, Peter S; Gusberg, Richard J; Longo, Walter E

    2016-01-01

    increasing the number of cases required for graduation has likely helped improve the training of residents in endoscopy, additional improvements in training are required. The Flexible Endoscopic Curriculum helps standardize the curriculum and demonstrate that the graduating resident has the fundamental knowledge and skills required in the performance of endoscopy. Simulation training and dedicated endoscopic rotations during the course of residency training could help improve endoscopy training and proficiency for future graduating residents. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Simulated disclosure of a medical error by residents: development of a course in specific communication skills.

    Science.gov (United States)

    Raper, Steven E; Resnick, Andrew S; Morris, Jon B

    2014-01-01

    demonstrate both competency and opportunities for improvement across a wide range of domains of interpersonal and communication skills. Residents are expected to communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds. As academic surgeons, we must be mindful of our roles as teachers, mentors, and coaches by teaching good communication skills to our residents. Courses such as the one described here can help in improving physician-patient communication. The differing perspectives of faculty and SPs regarding resident performance warrants further study. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Do otolaryngology residency applicants relocate for training?

    Science.gov (United States)

    Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

    2016-04-01

    To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Neurosurgery resident leadership development: an innovative approach.

    Science.gov (United States)

    Pettit, Jeffrey E; Dahdaleh, Nader S; Albert, Gregory W; Greenlee, Jeremy D

    2011-02-01

    A great deal of time and resources go into the development and training of neurosurgeons. One area that has minimal literature and assessment is leadership development. Under the core competency of interpersonal and communication skills, the Accreditation Council for Graduate Medical Education has indicated that residents are expected to work effectively as a member or leader of a healthcare team. This article reveals how a structured leadership program was developed so that residents are better prepared for the role of chief resident and future leadership roles. Beginning in October 2006, residents attended a series of 1-hour workshops conducted monthly. Topics included leadership style, conflict management, effective feedback, team building, team leadership, motivation, and moving from peer to leader. A retrospective pretest was conducted at the end of the program. Residents reported a significant knowledge gain for the majority of topics. Resident comments indicated a greater awareness of the impact of leading and ways to improve their personal leadership. Quantitatively and qualitatively, residents and faculty reported that the leadership program made a significant impact on the development of future neurosurgical leaders.

  5. Is your residency program ready for Generation Y?

    Science.gov (United States)

    Schlitzkus, Lisa L; Schenarts, Kimberly D; Schenarts, Paul J

    2010-01-01

    Current residency applicants are members of Generation Y and are significantly different from previous generations of trainees as well as the faculty who attract, recruit, and manage them. Generation Y has been affected by globalization, diversification, terrorism, and international crisis. They are products of the self-esteem movement in child rearing, education, and extracurricular activities where they were all declared winners. Children's activities no longer had winners and losers or first, second, and third place; every child received a participation trophy. Even though they were raised to be a team player, their parents always told them they are special. Technology is ingrained into their daily lives, and they expect its use to be effective and efficient. Generation Y-ers desire to impact the world and give back to their communities and demand immediate access to leadership. This generation poses a challenge to residency programs that will need to attract, recruit, and manage them effectively. This article will provide an overview of Generation Y, contrast Generation Y with Generation X, and discuss how to use generation-specific strategies to attract, recruit, and manage a Generation Y resident. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Program for developing leadership in pharmacy residents.

    Science.gov (United States)

    Fuller, Patrick D

    2012-07-15

    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.

  7. 26 CFR 25.2702-5 - Personal residence trusts.

    Science.gov (United States)

    2010-04-01

    ... a portion of the residence is used in an activity meeting the requirements of section 280A(c) (1) or... provision of lodging (e.g. a hotel or a bed and breakfast). A residence is not a personal residence if... portion of their interests in the residence) to the same personal residence trust, provided that the...

  8. Association Between Patient- Centered Medical Home Features and Satisfaction With Family Medicine Residency Training in the US.

    Science.gov (United States)

    Carney, Patricia A; Waller, Elaine; Dexter, Eve; Marino, Miguel; Rosener, Stephanie E; Green, Larry A; Jones, Geoffrey; M Keister, J Drew; Dostal, Julie A; Jones, Samuel M; Eiff, M Patrice

    2016-11-01

    Primary care residencies are undergoing dramatic changes because of changing health care systems and evolving demands for updated training models. We examined the relationships between residents' exposures to patient-centered medical home (PCMH) features in their assigned continuity clinics and their satisfaction with training. Longitudinal surveys were collected annually from residents evaluating satisfaction with training using a 5-point Likert-type scale (1=very unsatisfied to 5=very satisfied) from 2007 through 2011, and the presence or absence of PCMH features were collected from 24 continuity clinics during the same time period. Odds ratios on residents' overall satisfaction were compared according to whether they had no exposure to PCMH features, some exposure (1-2 years), or full exposure (all 3 or more years). Fourteen programs and 690 unique residents provided data to this study. Resident satisfaction with training was highest with full exposure for integrated case management compared to no exposure, which occurred in 2010 (OR=2.85, 95% CI=1.40, 5.80). Resident satisfaction was consistently statistically lower with any or full exposure (versus none) to expanded clinic hours in 2007 and 2009 (eg, OR for some exposure in 2009 was 0.31 95% CI=0.19, 0.51, and OR for full exposure 0.28 95% CI=0.16, 0.49). Resident satisfaction for many electronic health record (EHR)-based features tended to be significantly lower with any exposure (some or full) versus no exposure over the study period. For example, the odds ratio for resident satisfaction was significantly lower with any exposure to electronic health records in continuity practice in 2008, 2009, and 2010 (OR for some exposure in 2008 was 0.36; 95% CI=0.19, 0.70, with comparable results in 2009, 2010). Resident satisfaction with training was inconsistently correlated with exposure to features of PCMH. No correlation between PCMH exposure and resident satisfaction was sustained over time.

  9. Duty hours, quality of care, and patient safety: general surgery resident perceptions.

    Science.gov (United States)

    Borman, Karen R; Jones, Andrew T; Shea, Judy A

    2012-07-01

    The balance between patient treatment risks and training residents to proficiency is confounded by duty-hour limits. Stricter limits have been recommended to enhance quality and safety, although supporting data are scarce. A previously piloted survey was delivered with the 2010 American Board of Surgery In-Training Examination (ABSITE). First postgraduate year (PGY1) and PGY2 trainees took the Junior examination (IJE); PGY3 and above took the Senior examination (ISE). Residency type, size, and location were linked to examinees using program codes. Five survey items queried all residents about the impact of further hour limits on care quality; online test residents answered 7 more items probing medical error sources. Data were analyzed using factorial ANOVA for association with sex, PGY level, and program demographics. There were 6,161 categorical surgery residents who took the ABSITE: 60% men, 60% ISE, and two-thirds in university programs. Paper (n = 5,079) and online (n = 1,082) examinees were similar. Item response rates ranged from 91% to 98%. Few (surgery residents do not perceive that reduced duty hours will noticeably improve quality of care. Resident perceptions of causes of medical errors suggest that system changes are more likely to enhance patient safety than further hour limits. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. StrengthsFinder®signature themes of talent in pharmacy residents at four midwestern pharmacy schools.

    Science.gov (United States)

    Yee, Gary C; Janke, Kristin K; Fuller, Patrick D; Kelley, Katherine A; Scott, Steven A; Sorensen, Todd D

    StrengthsFinder ® is a widely-used assessment that can be used to help student pharmacists discover their talents (i.e., signature themes [STs]) and develop their leadership skills. The assessment has also been used in pharmacy residents, but the prevalence of various STs in that group has not been compared to those in student pharmacists. Residents from four midwestern pharmacy institutions completed StrengthsFinder ® 2.0 and received their top five STs. STs were organized and examined by domains (executing, influencing, relationship building, and strategic thinking). StrengthsFinder ® data on student pharmacists were obtained from a previously published study. The distribution of the themes and domains was compared between residents and student pharmacists. Responses from 31 residency program cohorts, including 290 pharmacy residents from a pool of 304 (95.4%) possible respondents, were included in the study. The learner ST was more frequently reported in the top five in pharmacy residents versus student pharmacists (42.8% versus 35.5%, p = 0.022). The woo and communication STs were also more frequently reported in the top five, while the consistency ST was reported less frequently in the top five in pharmacy residents versus student pharmacists (p marketing and design of programs and ranking of candidates. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Development and implementation of a writing program to improve resident authorship rates.

    Science.gov (United States)

    Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B

    2015-09-01

    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.

  12. Attending Surgeons' Leadership Style in the Operating Room: Comparing Junior Residents' Experiences and Preferences.

    Science.gov (United States)

    Kissane-Lee, Nicole A; Yule, Steven; Pozner, Charles N; Smink, Douglas S

    2016-01-01

    Recent studies have focused on surgeons' nontechnical skills in the operating room (OR), especially leadership. In an attempt to identify trainee preferences, we explored junior residents' opinions about the OR leadership style of teaching faculty. Overall, 20 interns and 20 mid-level residents completed a previously validated survey on the style of leadership they encountered, the style they preferred to receive, and the style they personally employed in the OR. In all, 4 styles were explored; authoritative: leader makes decisions and communicates them firmly; explanatory: leader makes decisions promptly, but explains them fully; consultative: leader consults with trainees when important decisions are made, and delegative: leader puts the problem before the group and makes decisions by majority opinion. Comparisons were completed using chi-square analysis. Junior resident preference for leadership style of attending surgeons in the OR differed from what they encountered. Overall, 62% of residents encountered an authoritative leadership style; however, only 9% preferred this (p < 0.001). Instead, residents preferred explanatory (53%) or consultative styles (41%). Preferences differed by postgraduate year. Although 40% of interns preferred a consultative style, 50% of mid-level residents preferred explanatory leadership. Junior resident preference of leadership style in the OR differs from what they actually encounter. This has the potential to create unwanted tension and may erode team performance. Awareness of this difference provides an opportunity for an educational intervention directed at both attendings and trainees. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

    Science.gov (United States)

    Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

    2017-08-01

    Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. Can Future Academic Surgeons be Identified in the Residency Ranking Process?

    Science.gov (United States)

    Beninato, Toni; Kleiman, David A; Zarnegar, Rasa; Fahey, Thomas J

    2016-01-01

    The goal of surgical residency training programs is to train competent surgeons. Academic surgical training programs also have as a mission training future academicians-surgical scientists, teachers, and leaders. However, selection of surgical residents is dependent on a relatively unscientific process. Here we sought to determine how well the residency selection process is able to identify future academicians in surgery. Rank lists from an academic surgical residency program from 1992 to 1997 were examined. All ranked candidates׳ career paths after residency were reviewed to determine whether they stayed in academics, were university affiliated, or in private practice. The study was performed at New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. A total of 663 applicants for general surgery residency participated in this study. In total 6 rank lists were evaluated, which included 663 candidates. Overall 76% remained in a general surgery subspecialty. Of those who remained in general surgery, 49% were in private practice, 20% were university affiliated, and 31% had academic careers. Approximately 47% of candidates that were ranked in the top 20 had ≥20 publications, with decreasing percentages as rank number increased. There was a strong correlation between the candidates׳ rank position and pursuing an academic career (p career. The residency selection process can identify candidates likely to be future academicians. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Dysphonia in nursing home and assisted living residents: prevalence and association with frailty.

    Science.gov (United States)

    G Nichols, Brent; Varadarajan, Varun; Bock, Jonathan M; Blumin, Joel H

    2015-01-01

    Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. Prospective epidemiological survey. Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the voice handicap index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES > 3 = frailty). A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2-12.5. There was a significant relationship between VHI-10 and VES-13 score (P = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases. Copyright © 2015 The Voice Foundation. All rights reserved.

  16. How residency duration affects the outcome of a territorial contest: Complementary game-theoretic models.

    Science.gov (United States)

    Mesterton-Gibbons, Mike; Sherratt, Tom N

    2016-04-07

    While the first individuals to discover and maintain territories are generally respected as owners, under some conditions there may be ambiguity as to who got there first. Here we attempt to understand the evolutionary consequences of this ambiguity by developing a pair of game-theoretic models in which we explicitly consider rival residency-based claims to ownership. Following earlier qualitative explanations for residency effects, we assume that either the value of the territory (Model A) or an interloper׳s self-belief that it is the owner (Model B) increases with duration of residency. Model A clearly demonstrates that if the value of a territory increases to a resident over time, so should its motivation to fight in terms of the effort it invests in fighting. Indeed, only a small increase in territory value with residency duration can be sufficient for longer established residents to win disputes, even without any arbitrary convention or other form of priority effect. Likewise, Model B shows that the observed increase in fighting persistence with residency duration can be readily explained as a consequence of increasing confidence on behalf of the interloper that it is the rightful owner. Collectively, the models help to explain some general findings long observed by empiricists, and shed light on the nature of conflicts that can arise when individuals do not have complete information about rival claims to ownership. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Trends in Resident Operative Teaching Opportunities for Treatment of Intracranial Aneurysms.

    Science.gov (United States)

    Piazza, Matthew; Nayak, Nikhil; Ali, Zarina; Heuer, Gregory; Sanborn, Matthew; Stein, Sherman; Schuster, James; Grady, M Sean; Malhotra, Neil R

    2017-07-01

    The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame, neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). The NIS was used to estimate the number of aneurysms treated with either surgical clipping and endovascular methods from 2002 through 2011 at teaching institutions. Teaching opportunities per year per resident or chief resident were calculated as the ratio of the number of specified cases to the average number of neurosurgical trainees by year. Annualized trends were assessed. Over the study period, the percent change in odds of occurrence of a clipped ruptured aneurysm was -15.6% per year (P institutions. This corresponded to a decline in teaching opportunities for clipped ruptured aneurysms for both residents and chief residents (P < 0.001). In contrast, teaching opportunities for endovascular treatment of both ruptured and unruptured aneurysms increased dramatically over the study period. There has been a significant decrease in opportunity for operative exposure to craniotomy for ruptured aneurysm clipping over the past decade, whereas the volume of endovascular procedures for aneurysms has dramatically increased, highlighting the need for a shift in training strategy for those neurosurgeons graduating from residency desiring to subspecialize in neurovascular neurosurgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A multi-institutional study of the emotional intelligence of resident physicians.

    Science.gov (United States)

    McKinley, Sophia K; Petrusa, Emil R; Fiedeldey-Van Dijk, Carina; Mullen, John T; Smink, Douglas S; Scott-Vernaglia, Shannon E; Kent, Tara S; Black-Schaffer, W Stephen; Phitayakorn, Roy

    2015-01-01

    Although emotional intelligence (EI) may have a role in the development of Accreditation Council for Graduate Medical Education core competencies, few studies have measured resident EI across specialties. This study aimed to describe the EI of resident physicians across multiple specialties. Three hundred twenty five surgery, pediatric, and pathology residents at 3 large academic institutions were invited to complete the psychometrically validated Trait Emotional Intelligence Questionnaire. The response rate was 42.8% (n = 139). Global EI of all residents (101.0 ± 8.1) was comparable with, but less variable than, the general population sample and was not statistically different between specialties. Compared with the norm sample, residents in the 3 specialty groups demonstrated unique combinations of areas of relative high and low development. There exist distinct strengths and opportunities for the development for surgery, pediatrics, and pathology residents. Future investigations could use EI profiling to create educational interventions to develop specific areas of EI and assess correlation with resident performance. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Educational feedback in the operating room: a gap between resident and faculty perceptions.

    Science.gov (United States)

    Jensen, Aaron R; Wright, Andrew S; Kim, Sara; Horvath, Karen D; Calhoun, Kristine E

    2012-08-01

    Immediate feedback regarding performance in the operating room remains a key component of resident education. The aim of this study was to assess resident and faculty perceptions regarding postoperative feedback. Anonymous surveys were distributed to residents and faculty members. Questions addressed the timing, amount, and specificity of feedback; satisfaction; and the definition and importance of feedback. Additional questions regarded the importance and frequency of feedback in 7 specific areas of surgical competency. Resident satisfaction with timing, amount, and specificity of feedback was significantly lower than faculty satisfaction. Perceptions of the importance of feedback for each of the 7 specific areas did not differ. Faculty members' perceptions on the frequency of feedback were higher than residents' perception in all competencies of feedback (5-point scale, all P values = .001). There are significant differences between resident and faculty perceptions regarding postoperative feedback. Although faculty members believed they delivered appropriate amounts of timely, quality feedback, this perception was not shared by residents. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Creation and Evaluation of a Laboratory Administration Curriculum for Pathology Residents.

    Science.gov (United States)

    Guarner, Jeannette; Hill, Charles E; Amukele, Timothy

    2017-10-01

    A clinical laboratory management (CLM) curriculum that can objectively assess the Accreditation Council for Graduate Medical Education pathology systems-based practice milestones and can provide consistent resident training across institutions is needed. Faculty at Emory University created a curriculum that consists of assay verification exercises and interactive, case-based online modules. Beta testing was done at Emory University and Johns Hopkins. Residents were required to obtain a score of more than 80% in the online modules to achieve levels 3 to 4 in the milestones. In addition, residents shadowed a laboratory director, performed an inspection of a laboratory section, and completed training in human subjects research and test utilization. Fourteen residents took and evaluated the laboratory administration curriculum. The printed certificates from the modules were used for objective faculty evaluation of mastery of concepts. Of all the activities the residents performed during the rotation, the online modules were ranked most helpful by all residents. A 25-question knowledge assessment was performed before and after the rotation and showed an average increase of 8 points (P = .0001). The multimodal CLM training described here is an easily adoptable, objective system for teaching CLM. It was well liked by residents and provided an objective measurement of mastery of concepts for faculty. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

    Science.gov (United States)

    Wang, Ning; Yu, Ping; Hailey, David

    2015-08-01

    The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, Ppaper-based system (Ppaper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright

  2. The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

    Science.gov (United States)

    Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

    2015-01-01

    Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half

  3. Electron Microscopy.

    Science.gov (United States)

    Beer, Michael

    1980-01-01

    Reviews technical aspects of structure determination in biological electron microscopy (EM). Discusses low dose EM, low temperature microscopy, electron energy loss spectra, determination of mass or molecular weight, and EM of labeled systems. Cites 34 references. (CS)

  4. General surgery training without laparoscopic surgery fellows: the impact on residents and patients.

    Science.gov (United States)

    Linn, John G; Hungness, Eric S; Clark, Sara; Nagle, Alexander P; Wang, Edward; Soper, Nathaniel J

    2011-10-01

    To evaluate resident case volume after discontinuation of a laparoscopic surgery fellowship, and to examine disparities in patient care over the same time period. Resident case logs were compared for a 2-year period before and 1 year after discontinuing the fellowship, using a 2-sample t test. Databases for bariatric and esophageal surgery were reviewed to compare operative time, length of stay (LOS), and complication rate by resident or fellow over the same time period using a 2-sample t test. Increases were seen in senior resident advanced laparoscopic (Mean Fellow Year = 21 operations vs Non Fellow Year = 61, P surgery. Operative time for complex operations may increase in the absence of a fellow. Other patient outcomes are not affected by this change. Copyright © 2011 Mosby, Inc. All rights reserved.

  5. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

    Directory of Open Access Journals (Sweden)

    M. Fernanda Bellolio

    2014-09-01

    Full Text Available Introduction: Compassion fatigue (CF is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM resident physicians, including an assessment of contributing factors. Methods: We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress, with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results: We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013, or did not work overnight (mean score 23.5 vs 21.3; p=0.022. EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048, and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012. Conclusion: CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily

  6. 24 CFR 891.605 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 891.605... 8 Assistance § 891.605 Replacement reserve. (a) Establishment of reserve. The Borrower shall establish and maintain a replacement reserve to aid in funding extraordinary maintenance, and repair and...

  7. 24 CFR 891.405 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 891.405....405 Replacement reserve. (a) Establishment of reserve. The Owner shall establish and maintain a replacement reserve to aid in funding extraordinary maintenance and repair and replacement of capital items...

  8. Electronic components

    CERN Document Server

    Colwell, Morris A

    1976-01-01

    Electronic Components provides a basic grounding in the practical aspects of using and selecting electronics components. The book describes the basic requirements needed to start practical work on electronic equipment, resistors and potentiometers, capacitance, and inductors and transformers. The text discusses semiconductor devices such as diodes, thyristors and triacs, transistors and heat sinks, logic and linear integrated circuits (I.C.s) and electromechanical devices. Common abbreviations applied to components are provided. Constructors and electronics engineers will find the book useful

  9. Understand electronics

    CERN Document Server

    Bishop, Owen

    2013-01-01

    Understand Electronics provides a readable introduction to the exciting world of electronics for the student or enthusiast with little previous knowledge. The subject is treated with the minimum of mathematics and the book is extensively illustrated.This is an essential guide for the newcomer to electronics, and replaces the author's best-selling Beginner's Guide to Electronics.The step-by-step approach makes this book ideal for introductory courses such as the Intermediate GNVQ.

  10. Vacuum electronics

    CERN Document Server

    Eichmeier, Joseph A

    2008-01-01

    Nineteen experts from the electronics industry, research institutes and universities have joined forces to prepare this book. ""Vacuum Electronics"" covers the electrophysical fundamentals, the present state of the art and applications, as well as the future prospects of microwave tubes and systems, optoelectronics vacuum devices, electron and ion beam devices, light and X-ray emitters, particle accelerators and vacuum interrupters. These topics are supplemented by useful information about the materials and technologies of vacuum electronics and vacuum technology.

  11. Electronic Commerce

    OpenAIRE

    Slavko Đerić

    2016-01-01

    Electronic commerce can be defined in different ways. Any definition helps to understand and explain that concept as better as possible.. Electronic commerce is a set of procedures and technologies that automate the tasks of financial transactions using electronic means. Also, according to some authors, electronic commerce is defined as a new concept, which is being developed and which includes process of buying and selling or exchanging products, services or information via computer networks...

  12. Do resident's leadership skills relate to ratings of technical skill?

    Science.gov (United States)

    Gannon, Samantha J; Law, Katherine E; Ray, Rebecca D; Nathwani, Jay N; DiMarco, Shannon M; D'Angelo, Anne-Lise D; Pugh, Carla M

    2016-12-01

    This study sought to compare general surgery research residents' survey information regarding self-efficacy ratings to their observed performance during a simulated small bowel repair. Their observed performance ratings were based on their leadership skills in directing their assistant. Participants were given 15 min to perform a bowel repair using bovine intestines with standardized injuries. Operative assistants were assigned to help assist with the repair. Before the procedure, participants were asked to rate their expected skills decay, task difficulty, and confidence in addressing the small bowel injury. Interactions were coded to identify the number of instructions given by the participants to the assistant during the repair. Statistical analyses assessed the relationship between the number of directional instructions and participants' perceptions self-efficacy measures. Directional instructions were defined as any dialog by the participant who guided the assistant to perform an action. Thirty-six residents (58.3% female) participated in the study. Participants who rated lower levels of decay in their intraoperative decision-making and small bowel repair skills were noted to use their assistant more by giving more instructions. Similarly, a higher number of instructions correlated with lower perceived difficulty in selecting the correct suture, suture pattern, and completing the entire surgical task. General surgery research residents' intraoperative leadership skills showed significant correlations to their perceptions of skill decay and task difficulty during a bowel repair. Evaluating resident's directional instructions may provide an additional individualized intraoperative assessment metric. Further evaluation relating to operative performance outcomes is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Psychosomatic medicine and psychiatry residents: a pan-Canadian survey.

    Science.gov (United States)

    Nguyen, Tuong-Vi; Sockalingam, Sanjeev; Granich, Annette; Chan, Peter; Abbey, Susan; Galbaud du Fort, Guillaume

    2011-01-01

    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.

  14. Specialty Palliative Care Consultations for Nursing Home Residents With Dementia.

    Science.gov (United States)

    Miller, Susan C; Lima, Julie C; Intrator, Orna; Martin, Edward; Bull, Janet; Hanson, Laura C

    2017-07-01

    U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. The objective of this study was to examine the value of expanded palliative care access for NH residents with moderate-to-very severe dementia. We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate-to-very severe dementia, and deaths in 2006-2010. Initial palliative consultations were identified as occurring later and earlier (1-30 days and 31-180 days before death, respectively). Three controls for each consultation recipient were selected using propensity score matching. Weighted multivariate analyses evaluated the effect of consultations on hospital or acute care use seven and 30 days before death and on (potentially) burdensome transitions (i.e., hospital or hospice admission three days before death or two plus acute care transitions 30 days before death). With earlier consultation (vs. no consultation), hospitalization rates in the seven days before death were on average 13.2 percentage points lower (95% confidence interval [CI] -21.8%, -4.7%) and with later consultation 5.9 percentage points lower (95% CI -13.7%, +4.9%). For earlier consultations (vs. no consultations), rates were 18.4 percentage points lower (95% CI -28.5%, -8.4%) for hospitalizations and 11.9 lower (95% CI -20.7%, -3.1%) for emergency room visits 30 days before death; they were 20.2 percentage points lower (95% CI -28.5%, -12.0%) for burdensome transitions. Consultations appear to reduce acute care use and (potentially) burdensome transitions for dying residents with dementia. Reductions were greater when consultations were earlier. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  15. Vision Impairment Among Older Adults Residing in Subsidized Housing Communities.

    Science.gov (United States)

    Elliott, Amanda F; McGwin, Gerald; Kline, Lanning B; Owsley, Cynthia

    2015-06-01

    To examine the rate of vision impairment and the relationship between vision impairment, cognitive impairment, and chronic comorbid conditions in residents of federally subsidized senior housing facilities. Cross-sectional, observational study. Vision screening events were held at 14 subsidized senior housing facilities in Jefferson County, Alabama for residents aged 60 years and older. Visual function (distance vision, near vision, and contrast sensitivity) measured with habitual correction if worn, cognitive status, and chronic comorbid conditions (hypertension, heart problems, circulation problems, and diabetes) were assessed. A total of 238 residents participated in the vision screenings. Most residents (75%) were African American. Vision impairment was common, with 40% of participants failing the distance acuity screening and 58% failing the near acuity screening; failure was defined as vision worse than 20/40 in either eye. Additionally, 65% failed the contrast sensitivity screening. A total of 30.6% of seniors had cognitive impairment. Regarding comorbid chronic conditions, 31% had circulation problems, 39% had diabetes, 41% had heart problems, and 76% had hypertension (59% had 2 or more of these). Visual acuity differed significantly between cognitive status groups and with the presence of heart and circulation problems. This study is among the first to provide information about vision impairment in this socioeconomically disadvantaged group of older adults. Vision impairment was common. Cognitive impairment and comorbid chronic conditions accounted for a small to moderate percentage of the variance in distance vision, near vision, and contrast sensitivity. Future studies should focus on strategies to facilitate access to eye care in this vulnerable population. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Residency patterns of migrating sandpipers at a midcontinental stopover

    Science.gov (United States)

    Skagen, Susan K.; Knopf, Fritz L.

    1994-01-01

    Arctic-nesting shorebirds require several refueling stops during their long migrations between breeding grounds and Central and South American wintering areas. The protection of stopover habitats for transcontinental migrants depends on whether birds fly long distances between a few select sites or fly short distances and stop at several wetlands. Although the Great Plains historically provided a vast array of wetlands for use by migrants, wetland loss and conversion have reduced the availability of stopover sites in recent decades. In this study, we examined (1) residency periods, (2) fat dynamics, and (3) migration chronology of two shorebird species, the Semipalmated Sandpiper (Calidris pusilla) and White-rumped Sandpiper (C. fuscicollis) at Quivira National Wildlife Refuge (NWR), Kansas. Semipalmated Sandpipers had prolonged periods of species residency with overlapping arrivals and departures. Individual residency periods were highly variable and were unrelated to lipid reserves upon arrival. In contrast, White-rumped Sandpipers arrived and departed more synchronously. Birds that arrived in poor condition stayed longer than those with more body fat in 1991, but not in 1992. Wind direction did not influence patterns of departures of either species. We hypothesize that Semipalmated Sandpipers are ecologically eurytopic when migrating across the Great Plains in the spring. Highly variable patterns in arrival, residency, and lipid levels indicate that spring migration of this species is relaxed and opportunistic. White-rumped Sandpipers showed a pattern of reduced flexibility. Flight range estimates suggest that most birds require intermediate stopovers before reaching the breeding grounds. Interior wetlands appear to function as migration stopovers rather than staging areas for shorebirds.

  17. Electronic Publishing.

    Science.gov (United States)

    Lancaster, F. W.

    1989-01-01

    Describes various stages involved in the applications of electronic media to the publishing industry. Highlights include computer typesetting, or photocomposition; machine-readable databases; the distribution of publications in electronic form; computer conferencing and electronic mail; collaborative authorship; hypertext; hypermedia publications;…

  18. ELECTRONIC SIGNATURES

    African Journals Online (AJOL)

    10332324

    (a) facilitate ecommerce;2. (b) remove and prevent barriers to electronic communications in South Africa;3. (c) ensure that electronic transactions in the Republic conform to the highest international standards;4. (d) promote the development of electronic transactions services which are responsive to the needs of users and ...

  19. Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

    Directory of Open Access Journals (Sweden)

    Javad Sarabadani

    2015-09-01

    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.

  20. Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

    Science.gov (United States)

    Hsieh, Cindy M; Nolan, Norris J

    2015-01-01

    To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

  1. Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study.

    Science.gov (United States)

    Law, Marcus; Lam, Michelle; Wu, Diana; Veinot, Paula; Mylopoulos, Maria

    2017-11-01

    Residency poses challenges for residents' personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents' personal relationships and the effects changes in those relationships could have on their wellness. The authors used a constructivist grounded theory approach. In 2012-2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory. Residents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work-life imbalance imposed by their training. This poor work-life balance seemed to result in relationship issues and diminish residents' wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation. Erosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.

  2. Emergency Medicine Residency Applicant Characteristics Associated with Measured Adverse Outcomes During Residency

    Directory of Open Access Journals (Sweden)

    Jesse Bohrer-Clancy

    2017-12-01

    Full Text Available Introduction Negative outcomes in emergency medicine (EM programs use a disproportionate amount of educational resources to the detriment of other residents. We sought to determine if any applicant characteristics identifiable during the selection process are associated with negative outcomes during residency. Methods Primary analysis consisted of looking at the association of each of the descriptors including resident characteristics and events during residency with a composite measure of negative outcomes. Components of the negative outcome composite were any formal remediation, failure to complete residency, or extension of residency. Results From a dataset of 260 residents who completed their residency over a 19-year period, 26 (10% were osteopaths and 33 (13% were international medical school graduates A leave of absence during medical school (p <.001, failure to send a thank-you note (p=.008, a failing score on United States Medical Licensing Examination Step I (p=.002, and a prior career in health (p=.034 were factors associated with greater likelihood of a negative outcome. All four residents with a “red flag” during their medicine clerkships experienced a negative outcome (p <.001. Conclusion “Red flags” during EM clerkships, a leave of absence during medical school for any reason and failure to send post-interview thank-you notes may be associated with negative outcomes during an EM residency.

  3. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role.

    Science.gov (United States)

    Hosein Nejad, Hooman; Bagherabadi, Mehdi; Sistani, Alireza; Dargahi, Helen

    2017-01-01

    Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents' teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students' perception of the residents' teaching quality. This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick's model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents' teaching skills based on their self-evaluation and Mann-Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop. The results indicated that residents' attitude towards their teaching ability was improved significantly after participating in the workshop (pTeacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick's model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of teaching ability and performance. However, implementing training sessions for resident physicians, although effective in improving their confidence and self-assessment of their teaching skills, seems to cause no positive change in the third

  4. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Nicole Battaglioli

    2018-02-01

    Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS focused on wellness program innovations and initiatives in emergency medicine (EM residency programs. Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. Results: An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern’s model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. Conclusion: The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME’s expanded focus on resident wellbeing.

  5. Cognitive Reserve: Implications for Assessment and Intervention

    OpenAIRE

    Stern, Yaakov

    2013-01-01

    The concept of reserve is used to explain the observation that some individuals function better than others in the presence of brain pathology. This paper reviews the concept of reserve from its theoretical basis to the implication of reserve for clinical practice. A distinction between brain reserve, referring to individual differences in the anatomic substrate, and cognitive reserve, referring to differences in the flexibility or adaptivity of cognitive networks, is useful. Epidemiologic ev...

  6. Knowledge, attitudes, and intentions toward fertility awareness and oocyte cryopreservation among obstetrics and gynecology resident physicians.

    Science.gov (United States)

    Yu, L; Peterson, B; Inhorn, M C; Boehm, J K; Patrizio, P

    2016-02-01

    reproductive treatments (ARTs). Residents were likely to support oocyte cryopreservation in cancer patients irrespective of the woman's age, but much less likely to support elective oocyte cryopreservation. For elective oocyte cryopreservation, 40% believed OB/GYNs should initiate discussions with patients (mean age 31.1), while only 20% believed this topic should be part of an annual exam. Because the study invitation was sent through US OB/GYN residency program directors rather than directly to residents, it is possible that some residents did not receive the invitation to participate. This limits the generalizability of the findings. Within the USA, there appears to be a critical need for improved education on fertility decline in OB/GYN residency programs. To promote informed reproductive decision-making among patients, efforts should be made to help OB/GYNs provide comprehensive fertility education to all women, while also respecting patient choices. None. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Introducing "optimal challenges" in resident training

    DEFF Research Database (Denmark)

    Sørensen, Anette Bagger; Christensen, Mette Krogh

    Background: Residents are often caught between two interests: the resident’s desire to participate in challenging learning situations and the department’s work planning. However, these interests may clash if they are not coordinated by the senior doctors, and challenging learning situations risk...... that the residents benefit from the intervention because they experienced more optimal challenges than before the intervention. However, the matching of resident and case seems to work against the established culture in the department: The daily work has for many years been organized so that senior doctors have...... relationships in order to meet the health system’s and the patients’ call for continuity in the treatment. Take-home message: The matching of resident and case stimulates optimal learning situations, but cultural and organizational values concerning the doctor-patient continuity are challenged....

  8. Resident Station Contact Information for Application Developers

    Data.gov (United States)

    Social Security Administration — SSA provides a web service and downloadable file for SSA Resident Station locations, telephone numbers, and hours of operation. (Note: If you think an office might...

  9. Request by the Resident Representative of Iraq

    International Nuclear Information System (INIS)

    1990-01-01

    The attached clarification by a spokesman of the Iraqi Ministry of Foreign Affairs is being circulated for the information of Member States pursuant to a request made by the Resident Representative of Iraq

  10. Ore reserve estimation: a summary of principles and methods

    International Nuclear Information System (INIS)

    Marques, J.P.M.

    1985-01-01

    The mining industry has experienced substantial improvements with the increasing utilization of computerized and electronic devices throughout the last few years. In the ore reserve estimation field the main methods have undergone recent advances in order to improve their overall efficiency. This paper presents the three main groups of ore reserve estimation methods presently used worldwide: Conventional, Statistical and Geostatistical, and elaborates a detaited description and comparative analysis of each. The Conventional Methods are the oldest, less complex and most employed ones. The Geostatistical Methods are the most recent precise and more complex ones. The Statistical Methods are intermediate to the others in complexity, diffusion and chronological order. (D.J.M.) [pt

  11. Mainframe computer use and residency cohort data.

    Science.gov (United States)

    Hotch, D; Helford, M; Rivers, D

    1987-01-01

    This paper describes a computer based method that was developed to prepare a profile of the patient care experiences of a cohort in a three-year, university based family practice residency. Sample pages from the report produced by this method and a description of the computer program are presented. This method of presenting patient encounter information may be particularly useful for program-level evaluation and for monitoring resident training.

  12. Basic electronics

    CERN Document Server

    Holbrook, Harold D

    1971-01-01

    Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

  13. Sticker electronics

    KAUST Repository

    Hussain, Muhammad Mustafa

    2017-09-08

    Electronic stickers may be manufactured on flexible substrates (110, 120, 130) as layers and packaged together. The package may then have an adhesive applied to one side to provide capability for sticking the electronic devices to surfaces. The stickers can be wrappable, placed on surfaces, glued on walls or mirrors or wood or stone, and have electronics (112, 122, 132) which may or may not be ultrathin. Packaging for the electronic sticker can use polymer on cellulose manufacturing and/or three dimensional (3-D) printing. The electronic stickers may provide lighting capability, sensing capability, and/or recharging capabilities.

  14. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds

    2002-10-01

    Full Text Available Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each. Self-rated ability or comfort was compared by gender, status (year of residency, faculty, and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted.

  15. Electron Tree

    DEFF Research Database (Denmark)

    Appelt, Ane L; Rønde, Heidi S

    2013-01-01

    The photo shows a close-up of a Lichtenberg figure – popularly called an “electron tree” – produced in a cylinder of polymethyl methacrylate (PMMA). Electron trees are created by irradiating a suitable insulating material, in this case PMMA, with an intense high energy electron beam. Upon discharge......, during dielectric breakdown in the material, the electrons generate branching chains of fractures on leaving the PMMA, producing the tree pattern seen. To be able to create electron trees with a clinical linear accelerator, one needs to access the primary electron beam used for photon treatments. We...... appropriated a linac that was being decommissioned in our department and dismantled the head to circumvent the target and ion chambers. This is one of 24 electron trees produced before we had to stop the fun and allow the rest of the accelerator to be disassembled....

  16. Effect of Educational Debt on Emergency Medicine Residents: A Qualitative Study Using Individual Interviews.

    Science.gov (United States)

    Young, Timothy P; Brown, Madison M; Reibling, Ellen T; Ghassemzadeh, Sassan; Gordon, Dawn M; Phan, Tammy H; Thomas, Tamara L; Brown, Lance

    2016-10-01

    In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. Median educational debt was $212