Sample records for residences cateringmcgill residences

  1. Resident resistance. (United States)

    Price, J L; Cleary, B


    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.

  2. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher


    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.

  3. Permanent resident. (United States)

    Fisher, John F


    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.

  4. 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.

  5. Residency Allocation Database (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...

  6. 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).

  7. Resident Characteristics Report (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...

  8. [Burnout in nursing residents]. (United States)

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


    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.

  9. Facility Focus: Residence Halls. (United States)

    College Planning & Management, 2003


    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)

  10. Rain Forest Dance Residency. (United States)

    Watson, Dawn


    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)

  11. Psychologic effects of residency. (United States)

    Reuben, D B


    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.

  12. Residents in difficulty

    DEFF Research Database (Denmark)

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


    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...

  13. Technology in Residence. (United States)

    Fox, Jordan


    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)

  14. Satisfaction among residents in ASHP-accredited pharmacy residency programs. (United States)

    VanDenBerg, C; Murphy, J E


    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.

  15. Burnout Syndrome During Residency. (United States)

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


    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.

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

    DEFF Research Database (Denmark)

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


    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  17. Residents as teachers: survey of Canadian family medicine residents. (United States)

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


    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.

  18. Resident fatigue in otolaryngology residents: a Web based survey. (United States)

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


    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. Leadership Training in Otolaryngology Residency. (United States)

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


    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.

  20. Lawful Permanent Residents - Annual Report (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...

  1. Education Research: Neurology resident education (United States)

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


    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. Factors Influencing Resident Choice of Prosthodontic Residency Program. (United States)

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


    The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most

  3. Pathology Informatics Essentials for Residents (United States)

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


    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 (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

  4. Pathology Informatics Essentials for Residents

    Directory of Open Access Journals (Sweden)

    Walter H. Henricks MD


    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 (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.

  5. Incorporating resident research into the dermatology residency program (United States)

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


    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

  6. 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.


    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

  7. 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 ...

  8. Early resident-to-resident physics education in diagnostic radiology. (United States)

    Kansagra, Akash P


    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.

  9. Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency. (United States)

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


    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.

  10. Helping Residents Protect Water Sources (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.

  11. the contribution of resident physicians


    Trusch, Klaus


    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 ...

  12. Minimum Data Set Active Resident Information Report (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....

  13. Sleep Quality Among Psychiatry Residents. (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


    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.

  14. Selection criteria of residents for residency programs in Kuwait. (United States)

    Marwan, Yousef; Ayed, Adel


    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.

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

    Directory of Open Access Journals (Sweden)

    Shweiki E


    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

  16. Evaluating Dermatology Residency Program Websites. (United States)

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


    Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool ( 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

  17. Simulation Activity in Otolaryngology Residencies. (United States)

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


    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.

  18. Plagiarism in residency application essays. (United States)

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


    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.

  19. 38 CFR 51.70 - Resident rights. (United States)


    ... 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...

  20. 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, ...

  1. Surgery resident learning styles and academic achievement. (United States)

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


    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.

  2. The resident's view of residency training in Canada. (United States)

    Fish, D G


    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.

  3. Conversations with Holocaust survivor residents. (United States)

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


    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.

  4. Model Legislation on Student Residency. (United States)

    Higher Education in the States, 1971


    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…

  5. From Residency to Lifelong Learning. (United States)

    Brandt, Keith


    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.

  6. Student Expenses in Residency Interviewing. (United States)

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


    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

  7. Teaching residents to write a research paper. (United States)

    Coleridge, S T


    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.

  8. 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.


    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

  9. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study. (United States)

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


    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.

  10. Lawful Permanent Residents Fiscal Year 2011 Country (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...

  11. Lawful Permanent Residents Fiscal Year 2014 Country (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...

  12. Lawful Permanent Residents Fiscal Year 2015 State (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...

  13. Lawful Permanent Residents Fiscal Year 2014 State (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...

  14. Lawful Permanent Residents Fiscal Year 2011 State (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...

  15. Lawful Permanent Residents Fiscal Year 2016 State (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...

  16. Lawful Permanent Residents Fiscal Year 2015 Country (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...

  17. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH


    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  18. Pediatric Program Leadership's Contribution Toward Resident Wellness. (United States)

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


    Residency program leaders are required to support resident well-being, but often do not receive training in how to do so. Determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. National cross-sectional web-based survey of pediatric program directors, associate program directors, and coordinators in June 2015, on their experience supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. 39.3% (322/820) of participants responded. Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10% of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (pProgram leaders spend a significant amount of time supporting resident well-being. While they feel that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. 45 CFR 233.40 - Residence. (United States)


    .... 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...

  20. Breaking Bad News - Perceptions of Pediatric Residents. (United States)

    Geeta, M G; Krishnakumar, P


    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.

  1. 8 CFR 325.3 - Residence. (United States)


    ... 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...

  2. Sexual Health Education: A Psychiatric Resident's Perspective (United States)

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


    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…

  3. Pioneering partnerships: Resident involvement from multiple perspectives

    NARCIS (Netherlands)

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


    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

  4. 24 CFR 206.39 - Principal residence. (United States)


    ... 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...

  5. 25 CFR 700.97 - Residence. (United States)


    ... 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...

  6. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

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


    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

  7. Does Targeted Training Improve Residents' Teaching Skills? (United States)

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


    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,…

  8. Negotiations of Acknowledgement among Middle Class Residents

    DEFF Research Database (Denmark)

    Andersen, Nina Blom


    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...

  9. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

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


    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

  10. Operative Landscape at Canadian Neurosurgery Residency Programs. (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


    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.

  11. Resident-Led Palliative Care Education Project. (United States)

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


    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.

  12. A Time Study of Plastic Surgery Residents. (United States)

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


    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

  13. Neurocritical care education during neurology residency (United States)

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


    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


    Directory of Open Access Journals (Sweden)

    Renato Eržen


    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

  15. Learning environment: assessing resident experience. (United States)

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


    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.

  16. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors. (United States)

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


    Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

  17. Understanding how residents' preferences for supervisory methods change throughout residency training: a mixed-methods study. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade


    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.

  19. What is an anesthesiology resident worth? (United States)

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


    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.

  20. Motherhood during residency training: challenges and strategies. (United States)

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


    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.

  1. [Heart failure in nursing home residents]. (United States)

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


    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.

  2. Radiology residents' experience with intussusception reduction. (United States)

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


    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.

  3. Internal medicine residency training in Turkey. (United States)

    Sahin, Hatice; Akcicek, Fehmi


    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.

  4. The challenges of residents teaching neurology. (United States)

    Frank, Samuel A; Józefowicz, Ralph F


    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.

  5. 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: [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)


    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

  6. Contemporary Trends in Radiation Oncology Resident Research. (United States)

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


    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. 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. 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 (Pcontemporary 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. We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These contemporary figures may be useful to medical students considering

  7. Contemporary Trends in Radiation Oncology Resident Research

    International Nuclear Information System (INIS)

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


    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

  8. Lawful Permanent Residents Fiscal Year 2014 Core Based Statistical Area (CBSA) of Residence (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 Core Based Statistical Area (CBSA) of Residence (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. Lawful Permanent Residents Fiscal Year 2016 Core Based Statistical Area (CBSA) of Residence (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...

  11. Lawful Permanent Residents Fiscal Year 2011 Core Based Statistical Area (CBSA) of Residence (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...

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

    Donovan, Andrea


    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.

  13. Radiology resident teaching skills improvement: impact of a resident teacher training program. (United States)

    Donovan, Andrea


    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

  14. Invitational Engineering in the Residence Halls. (United States)

    Murphy, Jack; Purkey, William


    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)

  15. Emotional intelligence in orthopedic surgery residents (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit


    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

  16. 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 ...

  17. Emotional intelligence in orthopedic surgery residents. (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit


    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.

  18. 42 CFR 483.10 - Resident rights. (United States)


    ... 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...

  19. Tax treaty entitlement issues concerning dual residents

    NARCIS (Netherlands)

    Sanghavi, D.


    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

  20. Displacing Media: LCD LAB Artistic Residency

    Directory of Open Access Journals (Sweden)

    Filipe Pais


    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.

  1. 20th Annual Residence Hall Construction Report (United States)

    Agron, Joe


    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…

  2. 38 CFR 3.653 - Foreign residence. (United States)


    ... 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...

  3. Medication Refusal: Resident Rights, Administration Dilemma. (United States)

    Haskins, Danielle R; Wick, Jeannette Y


    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.

  4. 42 CFR 436.403 - State residence. (United States)


    ...) 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...

  5. 42 CFR 435.403 - State residence. (United States)


    ... 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...

  6. Adult neurology training during child neurology residency. (United States)

    Schor, Nina F


    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.

  7. Teaching Forensic Psychiatry to General Psychiatry Residents (United States)

    Lewis, Catherine F.


    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…

  8. Simulation and resident education in spinal neurosurgery. (United States)

    Bohm, Parker E; Arnold, Paul M


    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.

  9. 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...

  10. Child Neurology Education for Pediatric Residents. (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


    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.

  11. Pregnancy and the Plastic Surgery Resident. (United States)

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


    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.

  12. Evaluation of stress experienced by pharmacy residents. (United States)

    Le, Hung M; Young, Shardae D


    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.

  13. Evolution of the Pathology Residency Curriculum (United States)

    Powell, Suzanne Z.; Black-Schaffer, W. Stephen


    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

  14. Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop. (United States)

    McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A


    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

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


    Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

  16. Pediatric dermatology training during residency: a survey of the 2014 graduating residents. (United States)

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


    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.

  17. Do otolaryngology residency applicants relocate for training? (United States)

    Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina


    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.

  18. Neurosurgery resident leadership development: an innovative approach. (United States)

    Pettit, Jeffrey E; Dahdaleh, Nader S; Albert, Gregory W; Greenlee, Jeremy D


    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.

  19. Problem neurology residents: a national survey. (United States)

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


    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.

  20. Are neurology residents interested in headache? (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.

  1. Program for developing leadership in pharmacy residents. (United States)

    Fuller, Patrick D


    An innovative, structured approach to incorporating leadership development activities into pharmacy residency training is described. The American Society of Health-System Pharmacists (ASHP) has called for increased efforts to make leadership development an integral component of the training of pharmacy students and new practitioners. In 2007, The Nebraska Medical Center (TNMC) took action to systematize leadership training in its pharmacy residency programs by launching a new Leadership Development Series. Throughout the residency year, trainees at TNMC participate in a variety of activities: (1) focused group discussions of selected articles on leadership concepts written by noted leaders of the past and present, (2) a two-day offsite retreat featuring trust-building exercises and physical challenges, (3) a self-assessment designed to help residents identify and use their untapped personal strengths, (4) training on the effective application of different styles of communication and conflict resolution, and (5) education on the history and evolution of health-system pharmacy, including a review and discussion of lectures by recipients of ASHP's Harvey A. K. Whitney Award. Feedback from residents who have completed the series has been positive, with many residents indicating that it has stimulated their professional growth and helped prepared them for leadership roles. A structured Leadership Development Series exposes pharmacy residents to various leadership philosophies and principles and, through the study of Harvey A. K. Whitney Award lectures, to the thoughts of past and present pharmacy leaders. Residents develop an increased self-awareness through a resident fall retreat, a StrengthsFinder assessment, and communication and conflict-mode assessment tools.

  2. 26 CFR 25.2702-5 - Personal residence trusts. (United States)


    ... 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...

  3. Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

    Directory of Open Access Journals (Sweden)

    Javad Sarabadani


    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.

  4. Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents. (United States)

    Hsieh, Cindy M; Nolan, Norris J


    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.

  5. Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study. (United States)

    Law, Marcus; Lam, Michelle; Wu, Diana; Veinot, Paula; Mylopoulos, Maria


    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.

  6. Emergency Medicine Residency Applicant Characteristics Associated with Measured Adverse Outcomes During Residency

    Directory of Open Access Journals (Sweden)

    Jesse Bohrer-Clancy


    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.

  7. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role. (United States)

    Hosein Nejad, Hooman; Bagherabadi, Mehdi; Sistani, Alireza; Dargahi, Helen


    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

  8. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Nicole Battaglioli


    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.

  9. Anesthesiology resident personality type correlates with faculty assessment of resident performance. (United States)

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


    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

  10. General Surgery Resident Satisfaction on Cardiothoracic Rotations. (United States)

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


    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.

  11. 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....

  12. Drug target residence time: a misleading concept. (United States)

    Folmer, Rutger H A


    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.

  13. Resident Station Contact Information for Application Developers (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...

  14. Request by the Resident Representative of Iraq

    International Nuclear Information System (INIS)


    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

  15. Mainframe computer use and residency cohort data. (United States)

    Hotch, D; Helford, M; Rivers, D


    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.

  16. Thoracic surgical resident education: a costly endeavor. (United States)

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


    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.

  17. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds


    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.

  18. Informatics and Technology in Resident Education. (United States)

    Niehaus, William


    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.

  19. Canadian Plastic Surgery Resident Work Hour Restrictions: Practices and Perceptions of Residents and Program Directors. (United States)

    McInnes, Colin W; Vorstenbosch, Joshua; Chard, Ryan; Logsetty, Sarvesh; Buchel, Edward W; Islur, Avinash


    The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety. An anonymous online survey developed by the authors was sent to all Canadian plastic surgery residents and program directors. Basic summary statistics were calculated. Eighty (53%) residents and 10 (77%) program directors responded. Residents reported working an average of 73 hours in hospital per week with 8 call shifts per month and sleep 4.7 hours/night while on call. Most residents (88%) reported averaging 0 post-call days off per month and 61% will work post-call without any sleep. The majority want the option of working post-call (63%) and oppose an 80-hour weekly maximum (77%). Surgical and medical errors attributed to post-call fatigue were self-reported by 26% and 49% of residents, respectively. Residents and program directors expressed concern about the ability to master surgical skills without working post-call. The majority of respondents oppose duty hour restrictions. The reason is likely multifactorial, including the desire of residents to meet perceived expectations and to master their surgical skills while supervised. If duty hour restrictions are aggressively implemented, many respondents feel that an increased duration of training may be necessary.

  20. The Resident Academic Project Program: A Structured Approach to Inspiring Academic Development During Residency Training. (United States)

    Eckert, Jill; Vaida, Sonia J; Bezinover, Dmitri; McCloskey, Diane E; Mets, Berend


    We report the successful implementation of structured resident academic projects in our Department of Anesthesiology at the Penn State Hershey Medical Center. Beginning with the graduating class of 2010, we adopted an expectation that each resident complete a project that results in a manuscript of publishable quality. Defining a clear timeline for all steps in the project and providing research education, as well as the necessary infrastructure and ongoing support, has helped grow the academic productivity of our anesthesia residents.

  1. Assessment of medical residents technology readiness for an online residents-as-teachers curriculum. (United States)

    Silva, Débora; Lewis, Kadriye O


    The University of Puerto Rico School of Medicine has a need to expand the current Residents-as-Teachers workshops into a comprehensive curriculum. One way to do so is to implement an online curriculum, but prior to this, the readiness of the medical residents to participate in such a curriculum should be assessed. Our objective was to determine whether the residents at the University of Puerto Rico School of Medicine are prepared to engage in an online Residents-as-Teachers program. This was a descriptive, mixed-method-design study that collected qualitative and quantitative data using an online survey and a focus-group interview. The study was conducted with students from 11 of the residency programs at the University of Puerto Rico School of Medicine. More than 80% of the participating residents had the technical knowledge to engage in an online program; 90.5% thought an online Residents-as-Teachers course would be a good alternative to what was currently available; 87.5% would be willing to participate in an online program, and 68.6% of the residents stated that they preferred an online course to a traditional one. Determinants of readiness for online learning at the University of Puerto Rico School of Medicine were identified and discussed. Our results suggest that the majority of the residents who participated in this study are ready to engage in an online Residents-as-Teachers program. The only potential barrier found was that one-third of the residents still preferred a traditional curriculum, even when they thought an online Residents-as-Teachers curriculum was a good alternative and were willing to participate in the course or courses forming part of such a curriculum. Therefore, prior to wide-spread implementation of such a curriculum, a pilot test should be conducted to maximize the presumed and eventual success of that curriculum.

  2. Personal Therapy in Psychiatry Residency Training: A National Survey of Canadian Psychiatry Residents. (United States)

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


    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. Local Determinants of Crime: Distinguishing Between Resident and Non-resident Offenders


    Spengler, Hannes; Büttner, Thiess


    The paper revisits the local determinants of crime using a spatial model distinguishing between resident and non-resident offenders. Employing data for German municipalities, the model is estimated by means of a spatial GMM approach. Focusing on resident offenders legal earnings opportunities and the expected gain from offenses are found to be important determinants of crime. Also the socio-economic background in terms of unemployment, poverty, and inequality proves significant for both prope...

  4. Evaluation of otolaryngology residency program websites. (United States)

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


    Prior to applying or interviewing, most prospective applicants turn to the Internet when evaluating residency programs, making maintenance of a comprehensive website critical. While certain "intangibles" such as reputation may not be communicated effectively online, residency websites are invaluable for conveying other aspects of a program. Prior analyses have reported that certain criteria such as research experience and didactics are important considerations for applicants. To evaluate the comprehensiveness of otolaryngology residency websites. Review of otolaryngology residency program websites. Websites of 99 civilian residency programs were searched for the presence of 23 criteria. Presence of 23 criteria for application process, incentives, instruction, research, clinical training, and other. Only 5 programs contained at least three-quarters of the criteria analyzed; on average programs reported less than 50% of information sought. Among the 99 residency program websites, a description of the following criteria was noted: comprehensive faculty listing (88%), didactics (80%), contact e-mail (77%), current residents (74%), description of facilities (70%), intern schedule (70%), research requirements (69%), otolaryngology rotation schedule (64%), other courses (61%), ERAS (Electronic Residency Application Service) link (55%), year-to-year responsibility progression (47%), call schedule (40%), active/past research projects (37%), area information (34%), message from the program director (33%) or chair (23%), selection criteria (30%), salary (directly on site) (23%), surgical statistics (18%), parking (9%), and meal allowance (7%). The mean (SD) percentage present of factors encompassing "clinical training" was 55% (23%), significantly higher than the mean (SD) percentage of factors covered under the "incentives" category (19% [11%]; P = .01). The proportion of overall criteria present on websites did not differ on organizing programs by region (range, 42

  5. Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career? (United States)

    Laliberté, Vincent; Rapoport, Mark J; Andrew, Melissa; Davidson, Marla; Rej, Soham


    Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents' future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. © The Author(s) 2015.

  6. International Programs in the Education of Residents: Benefits for the Resident and the Home Program. (United States)

    Rodriguez, Abigail; Ho, Trung; Verheyden, Charles


    There is a significant need for basic surgical care worldwide. In recent years, modest improvement in fulfilling this demand has been achieved through international medical mission trips from various organizations. These humanitarian endeavors and global health experiences have generated increasing interest in participating in international missions from surgical residents. However, many academic institutions currently do not have the infrastructure or desire to support surgical residents participating in medical missions. This paper aims to illustrate that careful, planned integration of medical mission trips into the residency curriculum will develop and enhance resident education and experience by fulfilling all six Accreditation Council for Graduate Medical Education (ACGME) core competencies and by benefitting the native program.

  7. Elective time during dermatology residency: A survey of residents and program directors. (United States)

    Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn


    Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

  8. Neuroscience and humanistic psychiatry: a residency curriculum. (United States)

    Griffith, James L


    Psychiatry residencies with a commitment to humanism commonly prioritize training in psychotherapy, cultural psychiatry, mental health policy, promotion of human rights, and similar areas reliant upon dialogue and collaborative therapeutic relationships. The advent of neuroscience as a defining paradigm for psychiatry has challenged residencies with a humanistic focus due to common perceptions that it would entail constriction of psychiatric practice to diagnostic and psychopharmacology roles. The author describes a neuroscience curriculum that has taught psychopharmacology effectively, while also advancing effectiveness of language-based and relationship-based therapeutics. In 2000, the George Washington University psychiatry residency initiated a neuroscience curriculum consisting of (1) a foundational postgraduate year 2 seminar teaching cognitive and social neuroscience and its integration into clinical psychopharmacology, (2) advanced seminars that utilized a neuroscience perspective in teaching specific psychotherapeutic skill sets, and (3) case-based teaching in outpatient clinical supervisions that incorporated a neuroscience perspective into traditional psychotherapy supervisions. Curricular assessment was conducted by (1) RRC reaccreditation site visit feedback, (2) examining career trajectories of residency graduates, (3) comparing PRITE exam Somatic Treatments subscale scores for 2010-2012 residents with pre-implementation residents, and (4) postresidency survey assessment by 2010-2012 graduates. The 2011 RRC site visit report recommended a "notable practice" citation for "innovative neurosciences curriculum." Three of twenty 2010-2012 graduates entered neuroscience research fellowships, as compared to none before the new curriculum. PRITE Somatic Treatments subscale scores improved from the 23rd percentile to the 62nd percentile in pre- to post-implementation of curriculum (p neuroscience curriculum for a residency committed to humanistic psychiatry

  9. [Evaluation in medical residency training programs]. (United States)

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


    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.

  10. Learning styles in two otolaryngology residency programs. (United States)

    Laeeq, Kulsoom; Weatherly, Robert A; Carrott, Alice; Pandian, Vinciya; Cummings, Charles W; Bhatti, Nasir I


    Kolb portrays four learning styles depending on how an individual grasps or transforms experience: accommodating, assimilating, diverging, and converging. Past studies in surgery, medicine, and anesthesia identified the predominant learning style in each of these specialties. The prevalence of different learning styles and existence of a predominant style, if any, has not been reported for otolaryngology residency programs. The purpose of our study was to determine if otolaryngology residents have a preferred learning style that is different from the predominant learning styles reported for other specialties. We conducted a survey of the otolaryngology-head and neck surgery residents at two residency programs. Kolb's Learning Style Index (LSI) version 3.1 was administered to 46 residents from Johns Hopkins University and Kansas University Otolaryngology-Head and Neck Surgery programs. LSI is a widely used 12-item questionnaire, with each item followed by four options. The subjects graded the options depending on how the options applied to them. Forty-three otolaryngology residents completed the survey, with a response rate of 93.47%. The predominant learning style was converging (55.81%) followed by accommodating (18.61%), accounting for the learning styles of 74.42% of the total population. There were only 13.95% assimilating and 6.98% diverging learning styles. Two residents (4.65%) had their preference balanced across four learning styles. The predominant learning styles in otolaryngology were converging and accommodating, accounting for three fourths of the population. It would be desirable to modify our curriculum in a way that will optimize and facilitate learning.

  11. Use and utility of Web-based residency program information: a survey of residency applicants. (United States)

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


    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

  12. The "resident's dilemma"? Values and strategies of medical residents for education interactions: a cellular automata simulation. (United States)

    Heckerling, P S; Gerber, B S; Weiner, S J


    Medical residents engage in formal and informal education interactions with fellow residents during the working day, and can choose whether to spend time and effort on such interactions. Time and effort spent on such interactions can bring learning and personal satisfaction to residents, but may also delay completion of clinical work. Using hypothetical cases, we assessed the values and strategies of internal medicine residents at one hospital for both cooperative and non-cooperative education interactions with fellow residents. We then used these data and cellular automata models of two-person games to simulate repeated interactions between residents, and to determine which strategies resulted in greatest accrued value. We conducted sensitivity analyses on several model parameters, to test the robustness of dominant strategies to model assumptions. Twenty-nine of the 57 residents (50.9%) valued cooperation more than non-cooperation no matter what the other resident did during the current interaction. Similarly, thirty-six residents (63.2%) endorsed an unconditional always-cooperate strategy no matter what the other resident had done during their previous interaction. In simulations, an always-cooperate strategy accrued more value (776.42 value units) than an aggregate of strategies containing non-cooperation components (675.0 value units, p = 0.052). Only when the probability of strategy errors reached 50%, or when values were re-ordered to match those of a Prisoner's Dilemma, did non-cooperation-based strategies accrue the most value. Cooperation-based values and strategies were most frequent among our residents, and dominated in simulations of repeated education interactions between them.

  13. Pregnancy during otolaryngology residency: experience and recommendations. (United States)

    Cole, Stephanie; Arnold, Michelle; Sanderson, Alicia; Cupp, Craig


    Pregnancy during graduate medical training became a pertinent issue in the United States during the 10-year interval between 1992 and 2002 as the number of female residents trended steadily upward to over 25 per cent. Surgical training programs characteristically present unique challenges and stressors for all trainees, and pregnancy introduces additional physical, professional, and emotional demands for the pregnant woman and her coworkers. A qualitative study was performed using in-person interviews of female otolaryngology residents who had given birth within the previous 12 months. Items addressed included the pregnancy course and its complications, specific stressors during and after pregnancy, and solutions implemented by the resident and her program director. Reactions and level of support from coworkers were also discussed. Five pregnancies were reported among three residents interviewed. One resident experienced preterm delivery, which necessitated a week-long stay in the neonatal intensive care unit for her infant. Another had chorioamnionitis during delivery of two infants. One child had low birth weight. The third resident had a miscarriage during the first trimester of her first pregnancy and sustained a minor head injury after fainting in the operating room during her second pregnancy. Overall, long hours, unpredictable work demands, and guilt over colleagues' increased workloads and altered schedules were noted as significant sources of stress among these residents; the women also described high expectations of themselves, along with misgivings over their ability to balance pregnancy and parenthood with career demands. The most significant postpartum stress indicator was the matter of child care, especially as it related to finding adequate coverage for on-call periods ranging from 3 to 14 days per month. Maintaining breastfeeding was an additional concern in the postpartum period. Pregnancy during surgical residency is a significant source of

  14. Teacher in Residence: Bringing Science to Students

    CERN Multimedia

    Daisy Yuhas

    CERN welcomes its first Teacher in Residence, Terrence Baine of the University of Oslo. Baine, who originally hails from Canada, will be concurrently completing his PhD in Physics Education during his time at CERN. Like CERN’s High School Teacher Programme (HST), of which Baine is an alumnus, the Teacher in Residence position is designed to help educators spread the science of CERN in a form that is accessible to students and can encourage them to pursue physics throughout their education.   Terrence Baine, first 'teacher in residence' at CERN Baine explains, “It’s very important to have a teacher present who can be that middle person between the young peoplecoming here, whom we are trying to enlighten, and the physicists who work at CERN. The Teacher in Residence can act as an on-site educational consultant.” As Teacher in Residence, Baine’s primary project will be to develop teaching modules, or a series of lesson plans, that can help high schoo...

  15. Factors influencing resident's decision to reside in gated and guarded community (United States)

    Shamsudin, Zarina; Shamsudin, Shafiza; Zainal, Rozlin


    Gated communities are residential areas developed with restricted access with strictly controlled entrances and surrounded by a close perimeter of wall or fences. Developers, conscious of the need to fulfill the requirement of living in modern and sophisticated lifestyle and gated properties become the trend and mushroomed over the past decade. Nowadays, it is obvious that gated and guarded communities become almost a dominant feature of Malaysia housing development projects. The focus of this paper is to identify the factors contribute resident's decision to reside in gated and guarded community and to study social interaction among gated communities' residents. 150 questionnaires were distributed to the residents of selected gated and guarded community area in order to achieve the objectives and analyzed by using Statistical Package for Social Science (SPSS) and descriptive analysis. The result was tabulated and presented in charts and graphs for a clear and better understanding. The five main factors contribute to resident decision to reside in gated communities were identified and ranked; there are privacy, security, location, lifestyle and prestige. Besides, the residents are feeling neutral towards the facilities and services provided in their gated and guarded residential area. A comprehensive improvement towards the facilities and services is needed to reach higher satisfaction from the residents.

  16. Four Residents' Narratives on Abortion Training: A Residency Climate of Reflection, Support, and Mutual Respect. (United States)

    Singer, Janet; Fiascone, Stephen; Huber, Warren J; Hunter, Tiffany C; Sperling, Jeffrey


    The decision on the part of obstetrics and gynecology residents to opt in or out of abortion training is, for many, a complex one. Although the public debate surrounding abortion can be filled with polarizing rhetoric, residents often discover that the boundaries between pro-choice and pro-life beliefs are not so neatly divided. We present narratives from four residents, training at a 32-resident program in the Northeast, who have a range of views surrounding abortion. Their stories reveal how some struggle with the real-life experience of providing abortions, while others feel angst over lacking the skills to terminate a life-threatening pregnancy. These residents have found that close relationships with coworkers from all sides of this issue, along with a residency program that encourages open conversation, have fostered understanding. Their narratives demonstrate that reasonable providers can disagree fundamentally and still work effectively with one another and that the close relationships formed in residency can allow both sides to see beyond the black and white of the public abortion debate. Our objectives in this commentary are to encourage a more nuanced discussion of abortion among obstetrician-gynecologists, to describe the aspects of our residency program that facilitate open dialogue and respect across diverse viewpoints, and to demonstrate that the clear distinction between being pro-life and pro-choice often breaks down when one is immediately responsible for the care of pregnant women.

  17. Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career? (United States)

    Laliberté, Vincent; Rapoport, Mark J.; Andrew, Melissa; Davidson, Marla


    Objectives: Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Method: Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents’ future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Results: Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Conclusions: Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. PMID:27253699

  18. Sleep pattern in medical students and residents. (United States)

    Nojomi, Marzieh; Ghalhe Bandi, Mir Farhad; Kaffashi, Siyamak


    Sleep disturbances is a distressing and disabling condition that affects many people, and can affect on quality of work and education of medical students and residents. The objective of this study was to determine the prevalence of sleep disorders in medical students and residents. A representative sample of medical students and residents of Iran University of medical students in Teharn, Iran, were assessed by a self-administered questionnaire. This study covers 400 medical students from the first to seventh year and residents from the first to the last year between December 2007 and February 2008. The questionnaire includes questions on demographic characteristics (6 questions), sleep/wake habits (6 questions), insomnia-related symptoms (4 questions), symptoms of parasomnia (6 questions), cognitive and psychomotor behaviors (6 questions), lifestyle (4 questions), self-perception of sleep satisfaction, and use of sleeping pills (2 questions). The sample included 135 (33.8%) pre-internship students, 150 (37.5%) interns, and 115 (28.7%) medical residents. Sleep satisfaction was reported as "perfect" in only 14%. 44% and 30% reported "good" and "fair" satisfaction. The use of sleeping pills in the previous 30 days was reported by only 3.3% of respondents. One hundred and three (25.7%) participants reported working while studying (sometimes to full-time). Between 43% and 48% of participants had gone to bed later than usual one to three times a week. About 14% of subjects reported snoring. The mean+/-SD of insomnia and parasomnia scales were 7.0+/-2.3 and 6.8+/-1.2, respectively. The mean of insomnia were more among females, subjects with noise in their living place, and students who worked full-time while studying, and was less in person who did exercise (PSleep disturbances are an important issue among medical students and residents and associated with age, gender, living conditions, doing exercise, and workload.

  19. 31 CFR 515.335 - Permanent resident alien. (United States)


    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  20. 22 CFR 42.22 - Returning resident aliens. (United States)


    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Returning resident aliens. 42.22 Section 42.22... Returning resident aliens. (a) Requirements for returning resident status. An alien shall be classifiable as... presented that: (1) The alien had the status of an alien lawfully admitted for permanent residence at the...

  1. Features of residency training and psychological distress among ...

    African Journals Online (AJOL)

    To investigate perceptions of the residency training programme and levels of psychological distress among residents. Methods. All 250 resident doctors at UCH were invited to complete questionnaires about their residency training and general health as part of a cross-sectional study. Data were analysed using SPSS 16.

  2. Common Factors Among Family Medicine Residents Who Encounter Difficulty. (United States)

    Binczyk, Natalia M; Babenko, Oksana; Schipper, Shirley; Ross, Shelley


    Residents in difficulty are costly to programs in both time and resources, and encountering difficulty can be emotionally harmful to residents. Approximately 10% of residents will encounter difficulty at some point in training. While there have been several studies looking at common factors among residents who encounter difficulty, some of the findings are inconsistent. The objective of this study was to determine whether there are common factors among the residents who encounter difficulty during training in a large Canadian family medicine residency program. Secondary data analysis was performed on archived resident files from a Canadian family medicine residency program. Residents who commenced an urban family medicine residency program between the years of 2006 and 2014 were included in the study. Five hundred nine family medicine residents were included in data analysis. Residents older than 30 years were 2.33 times (95% CI: 1.27-4.26) more likely to encounter difficulty than residents aged 30 years or younger. Nontransfer residents were 8.85 times (95% CI: 1.17-66.67) more likely to encounter difficulty than transfer residents. The effects of sex, training site, international medical graduate status, and rotation order on the likelihood of encountering difficulty were nonsignificant. Older and nontransfer residents may be facing unique circumstances and may benefit from additional support from the program.

  3. 24 CFR 902.50 - Resident service and satisfaction assessment. (United States)


    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Resident service and satisfaction... URBAN DEVELOPMENT PUBLIC HOUSING ASSESSMENT SYSTEM PHAS Indicator #4: Resident Service and Satisfaction § 902.50 Resident service and satisfaction assessment. (a) Objective. The objective of the Resident...

  4. Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching. (United States)

    Ricciotti, Hope A; Freret, Taylor S; Aluko, Ashley; McKeon, Bri Anne; Haviland, Miriam J; Newman, Lori R


    To pilot a short video-based resident-as-teacher training toolkit and assess its effect on resident teaching skills in clinical settings. A video-based resident-as-teacher training toolkit was previously developed by educational experts at Beth Israel Deaconess Medical Center, Harvard Medical School. Residents were recruited from two academic hospitals, watched two videos from the toolkit ("Clinical Teaching Skills" and "Effective Clinical Supervision"), and completed an accompanying self-study guide. A novel assessment instrument for evaluating the effect of the toolkit on teaching was created through a modified Delphi process. Before and after the intervention, residents were observed leading a clinical teaching encounter and scored using the 15-item assessment instrument. The primary outcome of interest was the change in number of skills exhibited, which was assessed using the Wilcoxon signed-rank test. Twenty-eight residents from two academic hospitals were enrolled, and 20 (71%) completed all phases of the study. More than one third of residents who volunteered to participate reported no prior formal teacher training. After completing two training modules, residents demonstrated a significant increase in the median number of teaching skills exhibited in a clinical teaching encounter, from 7.5 (interquartile range 6.5-9.5) to 10.0 (interquartile range 9.0-11.5; Pteaching skills assessed, there were significant improvements in asking for the learner's perspective (P=.01), providing feedback (P=.005), and encouraging questions (P=.046). Using a resident-as-teacher video-based toolkit was associated with improvements in teaching skills in residents from multiple specialties.

  5. Ontario Radiation Oncology Residents' Needs in the First Postgraduate Year-Residents' Perspective Survey

    International Nuclear Information System (INIS)

    Szumacher, Ewa; Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Voruganti, Sachi; Rappolt, Susan


    Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies

  6. An Evidence-based, Longitudinal Curriculum for Resident Physician Wellness: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Jacob Arnold


    Full Text Available Introduction: Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. Methods: A 30-person (27 residents, three attending physicians Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank – an online resident community – conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics. Results: Seventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module “Self-Care Series” focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module “Clinical Care Series” focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame. Conclusion: The resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.

  7. Equipping Residents to Address Alcohol and Drug Abuse: The National SBIRT Residency Training Project (United States)

    Pringle, Janice L.; Kowalchuk, Alicia; Meyers, Jessica Adams; Seale, J. Paul


    Background The Screening, Brief Intervention and Referral to Treatment (SBIRT) service for unhealthy alcohol use has been shown to be one of the most cost-effective medical preventive services and has been associated with long-term reductions in alcohol use and health care utilization. Recent studies also indicate that SBIRT reduces illicit drug use. In 2008 and 2009, the Substance Abuse Mental Health Service Administration funded 17 grantees to develop and implement medical residency training programs that teach residents how to provide SBIRT services for individuals with alcohol and drug misuse conditions. This paper presents the curricular activities associated with this initiative. Methods We used an online survey delivery application (Qualtrics) to e-mail a survey instrument developed by the project directors of 4 SBIRT residency programs to each residency grantee's director. The survey included both quantitative and qualitative data. Results All 17 (100%) grantees responded. Respondents encompassed residency programs in emergency medicine, family medicine, pediatrics, obstetrics-gynecology, psychiatry, surgery, and preventive medicine. Thirteen of 17 (76%) grantee programs used both online and in-person approaches to deliver the curriculum. All 17 grantees incorporated motivational interviewing and validated screening instruments in the curriculum. As of June 2011, 2867 residents had been trained, and project directors reported all residents were incorporating SBIRT into their practices. Consistently mentioned challenges in implementing an SBIRT curriculum included finding time in residents' schedules for the modules and the need for trained faculty to verify resident competence. Conclusions The SBIRT initiative has resulted in rapid development of educational programs and a cohort of residents who utilize SBIRT in practice. Skills verification, program dissemination, and sustainability after grant funding ends remain ongoing challenges. PMID:23451308

  8. Global Health Imaging in Radiology Residency: A Survey of Canadian Radiology Residents. (United States)

    Zener, Rebecca; Ross, Ian


    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. The "hidden curriculum" and residents' attitudes about medical error disclosure: comparison of surgical and nonsurgical residents. (United States)

    Martinez, William; Lehmann, Lisa Soleymani


    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.

  10. Deprivation of Dignity in Nursing Home Residents

    DEFF Research Database (Denmark)

    Høy, Bente


    deepened knowledge in how to maintain and promote dignity in nursing home residents. The purpose of this paper is to present results concerning the question: How is nursing home residents’ dignity maintained or deprived from the perspective of close family caregivers? In this presentation we only focus...... on deprivation of dignity. Methodology: The overall design of this study is modified clinical application research. The study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods were individual research interviews. All together the sample consisted of 28...

  11. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    Joshua Jauregui


    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in

  12. Discharge residence of TLD tagged fish

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.


    Although visual observations suggested that fish remained in the discharge for considerable periods, temperature-sensitive tags indicated the majority of fish spend less than 50 hr or 10 percent of the time at discharge temperatures. During 1974 a second fish tagging study was conducted, using temperature-sensitive tags to yield discharge residence times of Lake Michigan salmonids at Point Beach thermal discharge. Preliminary results revealed that many fish tag values were close to Unit I line indicating that calculated maximum discharge residence times for these fish will be nearly 100 percent of the elapsed time

  13. Ultrafine particle exposure in Danish residencies

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Karottki, Dorina Gabriela; Wierzbicka, Aneta


    We measured ultrafine particle concentrations in 56 Danish residences, estimated the daily integrated exposure of the occupants and apportioned this exposure to source events. The residential daily integrated particle number (PN) exposure in the homes was substantial and source events, especially...... candle burning, cooking, toasting and unknown activities, were responsible on average for ∼65% of the residential integrated exposure. Residents of another 60 homes were then asked to carry a backpack equipped with a GPS recorder and a portable monitor to measure real-time individual exposure over ~48 h...

  14. Analysis of a Resident Aesthetic Clinic: Process for Rhinoplasty, Resident Experience, and Patient Satisfaction. (United States)

    Brandel, Michael G; DʼSouza, Gehaan F; Reid, Christopher M; Dobke, Marek K; Gosman, Amanda A


    Plastic surgery residents often desire additional training in rhinoplasty than what is provided by their residency program. The goal of this study was to define and evaluate a specific process used to structure preoperative, intraoperative, and postoperative protocols for rhinoplasty patients in the resident aesthetic clinic (RAC) to enhance qualitative and quantitative experience. Complication rates and patient/resident satisfaction scores were also examined. Resident clinic rhinoplasty patients underwent a well-defined and established process that included patient education and informed consent, preoperative planning in a conference-based session, specific adherence to established surgical techniques, and structured postoperative management and follow-up. This process also included supervision criteria for residents in the operating room and clinical setting. Patient and resident satisfaction at the RAC was evaluated by a Web-based survey. A database of procedural complications and methods was compiled and evaluated. Between June 2012 and June 2015, 146 aesthetic resident cases were completed through the University of California, San Diego Residency Aesthetic Surgery Program. Of these cases, 34 (17%) were rhinoplasty procedures. Residents at our institution assisted on an average of 55 rhinoplasty procedures with the faculty and performed an average of 12 rhinoplasty procedures as primary surgeons. The residents surveyed felt that they had a good autonomous experience (P < 0.001), and 90% reported confidence with rhinoplasty. Postoperative complications were recorded and included asymmetry (n = 4, 10.5%), septal perforation (n = 1, 2.6%), and difficulty in breathing (n = 6, 15.8%). There were no patients who experienced infections, and the complication rate requiring revision in the operating room was 0%. Optimizing protocols in rhinoplasty in an RAC has allowed for the RAC to flourish in the breadth and complexity of rhinoplasty operations. This has enabled

  15. Reformulating corporate residence: a coherent response to international tax avoidance


    Geoffrey Loomer


    This thesis analyzes the concept of corporate residence, with particular reference to the law in the UK and Canada. It explores why corporate residence is relevant in tax policy, how corporate residence is understood in law, and how revenue authorities respond to the use and alleged 'abuse' of residence rules. Part I argues that the residence of taxpayers generally (individual or corporate) remains a relevant factor in international tax design, that taxation of corporations on the basis of re...

  16. 26 CFR 1.82-1 - Payments for or reimbursements of expenses of moving from one residence to another residence... (United States)


    ... moving from one residence to another residence attributable to employment or self-employment. 1.82-1... TAX (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Included in Gross Income § 1.82-1 Payments for or reimbursements of expenses of moving from one residence to another residence attributable to...

  17. Development and implementation of a residency project advisory board. (United States)

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


    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.

  18. Benefits of externships with pediatric dentistry programs for potential residents: program directors' and current residents' perceptions. (United States)

    Klein, Ulrich; Storey, Bryan; Hanson, Peter D


    This study's goal was to understand the extent, framework, and benefits of externships with prospective residency programs undertaken by predoctoral dental students or dentists interested in applying for a residency program. In 2012, a questionnaire was sent to all pediatric dentistry residents and program directors in the United States (63 percent and 74 percent return rate, respectively). Externships were offered by fifty-seven of the seventy-six programs. Most program directors (95 percent) agreed that externships are beneficial and compensate at least partially for the lack of numerical National Board Dental Examination scores or class rankings. Among the responding residents, 61 percent were female. The top reasons given by residents for choosing to extern with a certain program were its location and perceived reputation. Of the 249 respondents who did an externship, 47 percent externed with their current program. The acceptance rate into the number one choice of program was similar among those who did an externship vs. those who did not (73 percent vs. 75 percent). No relationship was found between gender and externships among the 341 respondents who were accepted into their top choice. Most of the residents (98.8 percent) felt that completing an externship was beneficial, and 88 percent got an increased understanding for the differences between university- and non-university-based residency programs.


    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A


    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value job security and financial remuneration related variables. Using marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

  20. Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care. (United States)

    Smalley, Hannah K; Keskinocak, Pinar


    At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms.

  1. Facebook Use between College Resident Advisors' and Their Residents: A Mixed Methods Approach. (United States)

    Kacvinsky, Lauren E; Moreno, Megan A


    Facebook use is nearly ubiquitous among college students. Studies have shown links between Facebook displays of depression or problem drinking and risk of these problems. This project aimed to determine whether Facebook could be used to help Resident Advisors (RAs) identify college students at risk for depression or problem drinking. Interviews were conducted with college freshmen to investigate whether they were Facebook "friends" with their RA. Focus groups were conducted with RAs to determine their views on Facebook friending their dormitory residents and using Facebook to help identify at-risk students. 72 freshmen were interviewed and 25 RAs participated in focus groups; both agreed it is common for RAs and residents to be Facebook friends. RAs commonly noted references to depression and problem drinking on residents' Facebook pages, which often led to in-person discussions with the resident. This study provides support that RAs use Facebook to identify issues that may impact their student residents. RAs emphasized benefits of in-person interactions in order to provide support and obtain additional details about the situation. Universities could consider whether providing RA education about Facebook interactions with residents merits encouragement within their existing RA training programs.

  2. Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

    International Nuclear Information System (INIS)

    Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; Amorim Bernstein, Karen L. de; Dad, Luqman K.; Li, Linna; Poppe, Matthew M.; Strauss, Jonathan B.; Chollet, Casey T.


    Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

  3. Judicious Leadership for Residence Hall Living. (United States)

    Gathercoal, Forrest

    This book presents a theory of judicious leadership for residence hall management that advocates the creation of an ethical and educational perspective based on the U.S. Bill of Rights. It argues that by recognizing college students' citizenship rights, providing them an opportunity to experience individual liberties, and helping them to…

  4. Knowledge and Utilization of Electrocardiogram among Resident ...

    African Journals Online (AJOL)

    Background: Electrocardiogram (ECG) is a simple, readily affordable, and noninvasive tool for the evaluation of cardiac disorders. There is a dearth of information on the utility of ECG in general practice in Nigeria. We assessed the knowledge and utilization of ECG among family medicine residents in Nigeria. Materials and ...

  5. Otolaryngology Training for Family Practice Residents. (United States)

    And Others; Rood, Stewart R.


    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  6. Experiencing Architecture: Teacher Residency at Fallingwater. (United States)

    Mims, Sandra K.


    Describes a one-week residency program for art educators at Fallingwater, a Frank Lloyd Wright-designed retreat in western Pennsylvania. Discusses the significance of the architecture on the goals and outcomes of the program. Asserts that the experience encouraged the participants to include architecture education in their art education programs.…

  7. Knowledge and Utilization of Electrocardiogram among Resident ...

    African Journals Online (AJOL)


    Oct 26, 2017 ... knowledge and utilization of ECG among family medicine residents in Nigeria. Materials and Methods: A cross-sectional evaluation was conducted between. November 2011 and May 2012 in four family ..... study on ECG interpretative skills and challenges among family physicians. The utilization of ECG ...

  8. [Motivation and learning strategies in pediatric residents]. (United States)

    Sepúlveda-Vildósola, Ana Carolina; Carrada-Legaria, Sol; Reyes-Lagunes, Isabel


    Motivation is an internal mood that moves individuals to act, points them in certain directions, and maintains them in activities, playing a very important role in self-regulated learning and academic performance. Our objective was to evaluate motivation and self-regulation of knowledge in pediatric residents in a third-level hospital, and to determine if there are differences according to the type of specialty and sociodemographic variables. All residents who agreed to participate responded to the Motivated Strategies for Learning Questionnaire. Cronbach alpha was performed to determine reliability. The mean value of each subscale was compared with Student's t test or ANOVA, correlation of subscales with Pearson test. A value of p≤0.05 was considered significant. We included 118 residents. The questionnaire was highly reliable (α=0.939). There were no significant differences in motivation or learning strategies according to sex, marital status, or age. Those residents studying a second or third specialization had significantly higher scores in elaboration, critical thinking, and peer learning. There were significant correlations between intrinsic motivation and self-efficacy with the development of knowledge strategies such as elaboration, critical thinking, and metacognitive self-regulation. Our students present average-to-high scores of motivation and knowledge strategies, with a significant difference according to type of specialization. There is a high correlation between motivation and knowledge strategies.

  9. Improving Health Care for Assisted Living Residents (United States)

    Kane, Robert L.; Mach, John R., Jr.


    Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary…

  10. Interior moisture design loads for residences (United States)

    Anton TenWolde; Iain S. Walker


    This paper outlines a methodology to obtain design values for indoor boundary conditions for moisture design calculations for residences. This is part of a larger effort by ASHRAE Standard Project Committee 160P, Design Criteria for Moisture Control in Buildings, to formulate criteria for moisture design loads, analysis techniques, and material and building performance...

  11. Educational contracts in family medicine residency training.


    Mahood, S.; Rojas, R.; Andres, D.; Zagozeski, C.; White, G.; Bradel, T.


    An educational contract for family medicine residency training and evaluation addresses many of the difficulties and challenges of current postgraduate medical education. This article identifies important principles for developing a contractual approach; describes the contract used in one program and its implementation; and discusses its theory, advantages, and limitations.

  12. Training in radiological protection of residents

    International Nuclear Information System (INIS)

    Vicent, M. D.; Fernandez, M. J.; Olmos, C.; Isidoro, B.; Espana, M. L.; Arranz, L.


    In compliance with the current laws, radiation protection (RP) training is required during the formative programs of certain Health Sciences specialties. Laws entrust to official bodies in specialized training the adoption of necessary measures to coordinate and ensure a correct implementation. The aim of this study is to describe Community of Madrid experience in RP training to specialists during their formative programs, and to determine the number of residents trained and analyze their satisfaction level with the training. A descriptive cross-sectional study was performed, including all training specialists from the Community of Madrid during the 2007-2011 period. We determined the number of residents trained per year and we evaluated their satisfaction level with the training through a survey. A total of 55 training courses were carried out and 5820 residents have been trained during the 2007-2011 period. the student satisfaction level with the training has increased gradually from 6.1 points in 2007 to 7.0 points in 2011. The development of the RP formative program for residents in the Community of Madrid has meant the start up o the necessary official mechanisms to ensure the quality and adequacy of training in this area, covering the formative needs of the collective. (Author)

  13. Correlates of Burnout Among Family Practice Residents. (United States)

    Lemkau, Jeanne P.; And Others


    A study of burnout among 67 residents in four programs found little relationship between burnout scores and situational and background factors, but numerous relationships were found among personality measures, burnout scores, and measures of regret about career choice, indicating the importance of interpersonal skills and comfort in mitigating…

  14. Mobbing Exposure of Anaesthesiology Residents in Turkey. (United States)

    Aykut, Gülnihal; Efe, Esra Mercanoğlu; Bayraktar, Selcan; Şentürk, Sinem; Başeğmez, İrem; Özkumit, Özlem; Kabak, Elmas; Yavaşçaoğlu, Belgin; Bilgin, Hülya


    In recent years, psychological problems that are caused by working conditions, like burn out syndrome, are more commonly observed. In our study, we aimed to evaluate mobbing exposure, factors causing mobbing and precautions for mobbing in residency students who are educated in anaesthesiology and reanimation clinics in Turkey. After obtaining consent from the ethics committee, we sent our questionnaires to the secretariats of the departments by postal mail. Completed questionnaires were collected in our department's secretariat blindly and randomly mixed. One hundred and one participants were returned the questionnaires. Data was statistically analysed in SPSS 21.0 software programme. During residency programme, sated to have experienced mobbing one or more time. Interestingly, 5.9% participants complained of physical mobbing. Mobbing exposure was more common in females. The most serious new onset psychosomatic symptoms stated during residency were committing suicide (2%), addiction (16%), severe depression (18%), panic attack (8%), more accidents (7%) and tendency of violence (15%). In mobbing group there was statistically significant dissatisfaction rate. In professions where mobbing is common, incidences of psychiatric diseases and suicide attempts are high are increased. Who are under risk for experiencing mobbing should be noticed carefully to ensure good judgement and problems should be inspected objectively in a detailed manner. Anesthesiology societies and other medical professional societies should establish mobbing committees. Thus, mobbing problems can be resolved and healthy career oppurtunities can be presented to residents.

  15. Research in Psychiatry: Residents' Attitudes and Use. (United States)

    Hershberg, Richard I.; And Others


    Results of a survey are reported that sought to obtain information on the attitudes of psychiatric residents towards research, their backgrounds in research training, their assessment of their departments and their own personal research activities, and the role of psychiatric research in their future careers. (JMD)

  16. Relationships among residence environment and individual levels ...

    African Journals Online (AJOL)

    The present study explored the relationship among urban and rural residence living and level of exercise in the Republic of Korea. The study analysed the data from the 2012 Korean Survey of Citizens' Sports Participation project with a total of 4,479 males and 4,521 females participating. The sampling method used the ...

  17. 38 CFR 51.110 - Resident assessment. (United States)


    ... 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...

  18. 2009 Canadian Radiation Oncology Resident Survey

    International Nuclear Information System (INIS)

    Debenham, Brock; Banerjee, Robyn; Fairchild, Alysa; Dundas, George; Trotter, Theresa; Yee, Don


    Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.

  19. The Role of Regional Conferences in Research Resident Career Development: The California Psychiatry Research Resident Retreat. (United States)

    Besterman, Aaron D; Williams, Jody K; Reus, Victor I; Pato, Michele T; Voglmaier, Susan M; Mathews, Carol A


    For psychiatry research resident career development, there is a recognized need for improved cross-institutional mentoring and networking opportunities. One method to address this need is via regional conferences, open to current and recently graduated research residents and their mentors. With this in mind, we developed the biennial California Psychiatry Research Resident Retreat (CPRRR) and collected feedback from participants to 1) Assess resident satisfaction, 2) Determine the utility of the retreat as a networking and mentorship tool, and 3) Identify areas for improvement. We gathered survey data from resident attendees at the two first CPRRRs. We analyzed the data to look for trends in satisfaction as well as areas that need improvement. Thirty-two residents from five California training programs attended the CPRRR in 2013 while 33 attended from six programs in 2015. The residents were from all years of training, but concentrated in their second and third years. Approximately 41% and 49% of the attendees were female and 53% and 39% had an MD/PhD in 2013 and 2015, respectively. Twenty-four and 32 residents provided anonymous feedback in 2013 and 2015, respectively. Mean feedback scores were very high (> 4/5) for overall satisfaction, peer- and faculty-networking, the keynote speaker and the flash talks for both years. Mean feedback scores for the ethics debates and mentoring sessions were somewhat lower (≤ 4/5), however, both showed significant improvement from 2013 to 2015. The CPRRRs appear to be an effective mechanism for providing psychiatry research residents with a meaningful cross-institutional opportunity for networking and mentorship. Feedback-driven changes to the CPRRRs improved participant satisfaction for several components of the conference. Future efforts will be aimed at broadening mentorship and networking opportunities, optimizing teaching approaches for research ethics, and considering different feedback-gathering approaches to allow for

  20. Measuring resident well-being: impostorism and burnout syndrome in residency. (United States)

    Legassie, Jenny; Zibrowski, Elaine M; Goldszmidt, Mark A


    Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

  1. Measuring the intensity of resident supervision in the department of veterans affairs: the resident supervision index. (United States)

    Byrne, John M; Kashner, Michael; Gilman, Stuart C; Aron, David C; Cannon, Grant W; Chang, Barbara K; Godleski, Linda; Golden, Richard M; Henley, Steven S; Holland, Gloria J; Kaminetzky, Catherine P; Keitz, Sheri A; Kirsh, Susan; Muchmore, Elaine A; Wicker, Annie B


    To develop a survey instrument designed to quantify supervision by attending physicians in nonprocedural care and to assess the instrument's feasibility and reliability. In 2008, the Department of Veterans Affairs (VA) Office of Academic Affiliations convened an expert panel to adopt a working definition of attending supervision in nonprocedural patient care and to construct a survey to quantify it. Feasibility was field-tested on residents and their supervising attending physicians at primary care internal medicine clinics at the VA Loma Linda Healthcare System in their encounters with randomly selected outpatients diagnosed with either major depressive disorder or diabetes. The authors assessed both interrater concurrent reliability and test-retest reliability. The expert panel adopted the VA's definition of resident supervision and developed the Resident Supervision Index (RSI) to measure supervision in terms of residents' case understanding, attending physicians' contributions to patient care through feedback to the resident, and attending physicians' time (minutes). The RSI was field-tested on 60 residents and 37 attending physicians for 148 supervision episodes from 143 patient encounters. Consent rates were 94% for residents and 97% for attending physicians; test-retest reliability intraclass correlations (ICCs) were 0.93 and 0.88, respectively. Concurrent reliability between residents' and attending physicians' reported time was an ICC of 0.69. The RSI is a feasible and reliable measure of resident supervision that is intended for research studies in graduate medical education focusing on education outcomes, as well as studies assessing quality of care, patient health outcomes, care costs, and clinical workload.

  2. Medical residency: factors relating to "difficulty in helping" in the resident physician-patient relationship

    Directory of Open Access Journals (Sweden)

    Mario Alfredo De Marco


    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have attempted to understand what leads physicians to label patients as 'difficult'. Understanding this process is particularly important for resident physicians, who are developing attitudes that may have long-term impact on their interactions with patients. The aim of this study was to distinguish between patients' self-rated emotional state (anxiety and depression and residents' perceptions of that state as a predictor of patients being considered difficult. DESIGN AND SETTING: Cross-sectional survey conducted in the hospital of Universidade Federal de São Paulo (Unifesp. METHODS: The residents completed a sociodemographic questionnaire and rated their patients using the Hospital Anxiety and Depression Scale (HADS and Difficulty in Helping the Patient Questionnaire (DTH. The patients completed HADS independently and were rated using the Karnofsky Performance Status scale. RESULTS: On average, the residents rated the patients as presenting little difficulty. The residents' ratings of difficulty presented an association with their ratings for patient depression (r = 0.35, P = 0.03 and anxiety (r = 0.46, P = 0.02, but not with patients' self-ratings for depression and anxiety. Residents from distant cities were more likely to rate patients as difficult to help than were residents from the city of the hospital (mean score of 1.93 versus 1.07; P = 0.04. CONCLUSIONS: Understanding what leads residents to label patients as having depression and anxiety problems may be a productive approach towards reducing perceived difficulty. Residents from distant cities may be more likely to find their patients difficult

  3. Burnout during residency training: a literature review. (United States)

    Ishak, Waguih William; Lederer, Sara; Mandili, Carla; Nikravesh, Rose; Seligman, Laurie; Vasa, Monisha; Ogunyemi, Dotun; Bernstein, Carol A


    Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. An examination of the burnout literature reveals that it is prevalent in medical students (28%-45%), residents (27%-75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can result in negative consequences as a working physician. Burnout also poses significant challenges during early training years in residency. Time demands, lack of control, work planning, work organization, inherently difficult job situations, and interpersonal relationships, are considered factors contributing to residents' burnout. Potential interventions include workplace-driven and individual-driven measures. Workplace interventions include education about burnout, workload modifications, increasing the diversity of work duties, stress management training, mentoring, emotional intelligence training, and wellness workshops. Individual-driven behavioral, social, and physical activities include promoting interpersonal professional relations, meditation, counseling, and exercise. Educators need to develop an active awareness of burnout and ought to consider incorporating relevant instruction and interventions during the process of training resident physicians.

  4. Eating disorder training and attitudes among primary care residents. (United States)

    Banas, David A; Redfern, Roberta; Wanjiku, Stephen; Lazebnik, Rina; Rome, Ellen S


    The ability to diagnose eating disorders (ED) is important and difficult for primary care physicians (PCPs). Previous reports suggest that PCPs feel their training is inadequate. To explore residents' interest and comfort diagnosing and treating ED. An internet survey was sent to primary care residencies. Logistic regression models were fitted to identify factors correlated with residents' interest and comfort in diagnosing and treating ED. Family Medicine and Internal Medicine residents had higher interest in ED than Pediatric residents, as did female residents and residents exposed to teenagers with unexplained weight loss. Residents in programs with an ED program and faculty interested in ED were more comfortable diagnosing ED. Interest in, and comfort diagnosing and treating ED are associated with specialty type, presence of an ED program, presence of faculty interested in ED, and resident exposure to ED outpatients and teenagers with unexplained weight loss.

  5. Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident. (United States)

    Badran, Karam W; Kelley, Kanwar; Conderman, Christian; Mahboubi, Hossein; Armstrong, William B; Bhandarkar, Naveen D


    To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents. Self-reported Internet and paper-based survey. An anonymous survey was distributed to 152 current and former program directors (PDs) in 2012. The factors associated with unsuccessful otolaryngology residents and those associated with the successful remediation of problematic residents were investigated. An unsuccessful resident is defined as one who quit or was removed from the program for any reason, or one whose actions resulted in criminal action or citation against their medical license after graduation from residency. Remediation is defined as an individualized program implemented to correct documented weaknesses. The overall response rate was 26% (40 PDs). Seventy-three unsuccessful or problematic residents were identified. Sixty-six problematic or unsuccessful residents were identified during residency, with 58 of 66 (88%) undergoing remediation. Thirty-one (47%) residents did not graduate. The most commonly identified factors of an unsuccessful resident were: change in specialty (21.5%), interpersonal and communication skills with health professionals (13.9%), and clinical judgment (10.1%). Characteristics of those residents who underwent successful remediation include: poor performance on in-training examination (17%, P otolaryngology PDs in this sample identified at least one unsuccessful resident. Improved methods of applicant screening may assist in optimizing otolaryngology resident selection. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Defining and implementing a model for pharmacy resident research projects

    Directory of Open Access Journals (Sweden)

    Dick TB


    Full Text Available Objective: To describe a standard approach to provide a support structure for pharmacy resident research that emphasizes self-identification of a residency research project. Methods: A subcommittee of the residency advisory committee was formed at our institution. The committee was initially comprised of 2 clinical pharmacy specialists, 1 drug information pharmacist, and 2 pharmacy administrators. The committee developed research guidelines that are distributed to residents prior to the residency start that detail the research process, important deadlines, and available resources. Instructions for institutional review board (IRB training and deadlines for various assignments and presentations throughout the residency year are clearly defined. Residents conceive their own research project and emphasis is placed on completing assignments early in the residency year. Results: In the 4 years this research process has been in place, 15 of 16 (94% residents successfully identified their own research question. All 15 residents submitted a complete research protocol to the IRB by the August deadline. Four residents have presented the results of their research at multi-disciplinary national professional meetings and 1 has published a manuscript. Feedback from outgoing residents has been positive overall and their perceptions of their research projects and the process are positive. Conclusion: Pharmacy residents selecting their own research projects for their residency year is a feasible alternative to assigning or providing lists of research projects from which to select a project.

  7. Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition. (United States)

    Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian


    Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery

  8. Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance. (United States)

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


    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

  9. [Competency-based Neurosurgery Residency Programme]. (United States)

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


    A programme proposal for competency-based Neurosurgery training adapted to the specialization project is presented. This proposal has been developed by a group of neurosurgeons commissioned by the SENEC (Spanish Society of Neurosurgery) and could be modified to generate a final version that could come into force coinciding with the implementation of the specialization programme. This document aims to facilitate the test of the new programme included in the online version of our journal. Total training period is 6 years; initial 2 years belong to the surgery specialization and remaining 4 years belong to core specialty period. It is a competency-based programmed based on the map used by the US Accreditation Council for Graduate Medical Education (ACGME) including the following domains of clinical competency: Medical knowledge, patient care, communication skills, professionalism, practice-based learning and improvement, health systems, interprofessional collaboration and professional and personal development. Subcompetencies map in the domains of Knowledge and Patient care (including surgical competencies) was adapted to the one proposed by AANS and CNS (annex 1 of the programme). A subcompetency map was also used for the specialization rotations. Resident's training is based on personal study (self-learning) supported by efficient use of information sources and supervised clinical practice, including bioethical instruction, clinical management, research and learning techniques. Resident evaluation proposal includes, among other instruments, theoretical knowledge tests, objective and structured evaluation of the level of clinical competency with real or standardised patients, global competency scales, 360-degree evaluation, clinical record audits, milestones for residents progress and self-assessment (annex 2). Besides, residents periodically assess the teaching commitment of the department's neurosurgeons and other professors participating in rotations, and annually

  10. Neurosurgical Resident Error: A Survey of U.S. Neurosurgery Residency Training Program Directors' Perceptions. (United States)

    Gupta, Raghav; Moore, Justin M; Adeeb, Nimer; Griessenauer, Christoph J; Schneider, Anna M; Gandhi, Chirag D; Harsh, Griffith R; Thomas, Ajith J; Ogilvy, Christopher S


    Efforts to address resident errors and to enhance patient safety have included systemic reforms, such as the Accreditation Council for Graduate Medical Education's (ACGME's) mandated duty-hour restrictions, and specialty-specific initiatives such as the neurosurgery Milestone Project. However, there is currently little data describing the basis for these errors or outlining trends in neurosurgical resident error. An online questionnaire was distributed to program directors of 108 U.S. neurosurgery residency training programs to assess the frequency, most common forms and causes of resident error, the resulting patient outcomes, and the steps taken by residency programs to address these errors. Thirty-one (28.7%) responses were received. Procedural/surgical error was the most commonly observed type of error. Transient injury and no injury to the patient were perceived to be the 2 most frequent outcomes. Inexperience or resident mistake despite adequate training were cited as the most common causes of error. Twenty-three (74.2%) respondents stated that a lower post graduate year level correlated with an increased incidence of errors. There was a trend toward an association between an increased number of residents within a program and the number of errors attributable to a lack of supervision (r = 0.36; P = 0.06). Most (93.5%) program directors do not believe that mandated duty-hour restrictions reduce error frequency. Program directors believe that procedural error is the most commonly observed form of error, with post graduate year level believed to be an important predictor of error frequency. The perceived utility of systemic reforms that aim to reduce the incidence of resident error remains unclear. Copyright © 2017. Published by Elsevier Inc.

  11. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives. (United States)

    Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S


    For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

  12. Using Reflections of Recent Resident Graduates and their Pediatric Colleagues to Evaluate a Residency Program

    Directory of Open Access Journals (Sweden)

    Robert K. Kamei, M.D.


    Full Text Available Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduate’s self-assessment and the graduate’s clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication as important. They specifically cited the graduate’s skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our program’s curriculum and can be used to direct future educational initiatives of our training program

  13. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

    Directory of Open Access Journals (Sweden)

    Patten Scott


    Full Text Available Abstract Background Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. Methods A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. Results In total 415 (51 % residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p Residents highly valued their colleagues (67%, program directors (60% and external psychiatrist/psychologist (49% as well-being resources. Over one third of residents wished to have a career counselor (39% and financial counselor (38%. Conclusion Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

  14. [Assessment of a residency training program in endocrinology and nutrition: results of a resident survey]. (United States)

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


    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.

  15. Resident-to-resident relational aggression and subjective well-being in assisted living facilities. (United States)

    Trompetter, Hester; Scholte, Ron; Westerhof, Gerben


    Research in settings similar to assisted living facilities suggests that relational aggression, an indirect and mature form of aggression, might occur in assisted living facilities. This empirical study investigates the existence of relational aggression in a sample of residents and the relationship between relational aggression and resident's subjective well-being. 121 residents from six assisted living facilities completed questionnaires assessing personal experiences as victims of relational aggression and subjective well-being. Also nurses reported on victimization of relational aggression for every participant. Linear regression models were used to examine the association between both reports of relational aggression and subjective well-being. Relational aggression was shown to exist in assisted living facilities according to both residents (prevalence: 19%) and nurses (prevalence: 41%). Chi-square testing revealed no association between ratings by nurses and residents. Self-reports of victimization of relational aggression were related to depression, anxiety, satisfaction with life and social loneliness, but not to emotional loneliness. Nurse-reports of victimization of relational aggression were not related to subjective well-being. Self-reports of relational aggression seem to be better predictors of resident's well-being than nurse-reports of relational aggression. Awareness of these findings and the discrepancy between nurse-reports and self-reports are important for practice and for future research regarding social dynamics and living arrangements in elderly care settings.

  16. The role of the resid solvent in coprocessing

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    Curtis, C.W. [Auburn Univ., AL (United States)


    The objective of this project is to determine the role of petroleum resid in coprocessing of coal and resid. The question being asked is whether the resid is a reactant in the system or whether the resid is a merely a diluent that is being simultaneously upgraded? To fulfill the objective the hydrogen transfer from model compounds, naphthenes that represent petroleum resids to model acceptors is being determined. The specificity of different catalytic systems for promoting the hydrogen transfer from naphthenes to model acceptors and to coal is also being determined. In addition the efficacy of hydrogen transfer from and solvancy of whole and specific resid fractions under coprocessing conditions is being determined.

  17. An Innovative Approach to Resident Scheduling: Use of a Point-Based System to Account for Resident Preferences (United States)

    Chow, Robert Tao-Ping; Tamhane, Shrikant; Zhang, Manling; Fisher, Lori-Ann; Yoon, Jenni; Sehgal, Sameep; Lumbres, Madel; Han, Ma Ai Thanda; Win, Tiffany


    Background The scheduling of residents for rotation assignments and on-call responsibilities is a time-consuming process that challenges the resources of residency programs. Assignment of schedules is traditionally done by chief residents or program administration with variable input from the residents involved. Intervention We introduced an innovative point-based scheduling system to increase transparency in the scheduling process, foster a sense of fairness and equality in scheduling, and increase resident ownership for making judicious scheduling choices. Methods We devised a point-based system in which each resident in our 40-member program was allocated an equal number of points. The residents assigned these points to their preferred choices of rotations. Residents were then surveyed anonymously on their perceptions of this new scheduling system and were asked to compare it with their traditional scheduling system. Results The schedule was successfully implemented, and it allowed residents to express their scheduling preferences using an innovative point-based approach. Residents were generally satisfied with the new system, would recommend it to other programs, and perceived a greater sense of involvement. However, resident satisfaction with the new system was not significantly greater compared with the previous approach to scheduling (P = .20). Chief residents expressed satisfaction with the new scheduling model. Conclusions Residents were equally satisfied with the traditional preference-based scheduling approach and the new point-based system. Chief residents' feedback on the new system reflected reduced stress and time commitment in the new point-based system. PMID:26457154

  18. Therapeutic kitchens for residents with dementia. (United States)

    Marsden, J P; Meehan, R A; Calkins, M P


    Long-term care facilities are increasingly incorporating some sort of kitchen, often referred to as a therapeutic kitchen, for resident, staff, and family use through remodeling efforts or new construction. A study, consisting of five site visits and a questionnaire mailed to 631 facilities providing dementia care, was conducted to identify physical features that are typically included in therapeutic kitchen design and to explore how these features support daily use in relation to activities programming and food service systems. Findings indicate that universal design features should be incorporated to a greater extent and certain features are more common, reinforce homelike imagery, or enhance safety. Results also suggest that a higher number of residents participate in more recreational activities, such as baking, than they do in household chores, such as meal set-up, and therapeutic kitchens are not always linked to food service systems.

  19. Global health education in emergency medicine residency programs. (United States)

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid


    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.

  20. Variable Operative Experience in Hand Surgery for Plastic Surgery Residents. (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.

  1. Teaching strategies used by internal medicine residents on the wards. (United States)

    Smith, Dustin T; Kohlwes, R Jeffrey


    Residents serve as teachers to interns and students in most internal medicine residency programs. The purpose of our study is to explore what internal medicine residents perceive as effective teaching strategies in the inpatient setting and to formulate a guideline for preparing residents to lead their ward teams. Housestaff identified as excellent teaching residents were recruited from a large internal medicine residency program. Focus groups were formed and interviews were conducted using open-ended questions. Transcripts of the interviews were reviewed, analyzed, and compared for accuracy by two investigators. The transcripts were then coded to categorize data into similar subjects from which recurrent themes in resident teaching were identified. Twenty-two residents participated in four focus group interviews held in 2008. We identified five principal themes for effective teaching by residents: (T)aking advantage of teaching opportunities, (E)mpowering learners, (A)ssuming the role of leader, (C)reating a learning environment, and (H)abituating the practice of teaching. Strategies for effective teaching by residents exist. The TEACH mnemonic is a resident-identified method of instruction. Use of this tool could enable residency programs to create instructional curricula to prepare their residents and interns to take on the roles of team leaders and teachers.

  2. Implementation of a "Flipped Classroom" for Neurosurgery Resident Education. (United States)

    Girgis, Fady; Miller, Jonathan P


    Engaging residents across a multiyear training spectrum is challenging given the heterogeneity of experience and limited time available for educational activities. A "flipped classroom" model, in which residents prepare ahead of time for mentored topic discussions, has potential advantages. We implemented a curriculum consisting of topics distributed across the specialty. Weekly, each resident was randomly assigned to research a specific aspect of an assigned topic appropriate to his or her level of experience: junior residents about what characterizes each clinical entity, midlevel residents about when to intervene, and chief residents about how to administer treatment. Residents completed an anonymous survey 6 months after implementation. Board examination performance was assessed before and after implementation. A total of 12 residents participated in the program. Weekly, 1.75±0.40 hours were spent in preparation, with senior residents reporting less time than junior residents. All residents indicated that the accumulation of experience across 7 years of residency was a major advantage of this program, and all preferred it to lectures. Performance on the board examination significantly increased after implementation (from 316±36 to 468±45, pflipped classroom is a viable approach to resident education and is associated with increased engagement and improved performance using validated knowledge-assessment tools.

  3. Leadership for All: An Internal Medicine Residency Leadership Development Program. (United States)

    Moore, Jared M; Wininger, David A; Martin, Bryan


    Developing effective leadership skills in physicians is critical for safe patient care. Few residency-based models of leadership training exist. We evaluated residents' readiness to engage in leadership training, feasibility of implementing training for all residents, and residents' acceptance of training. In its fourth year, the Leadership Development Program (LDP) consists of twelve 90-minute modules (eg, Team Decision Making and Bias, Leadership Styles, Authentic Leadership) targeting all categorical postgraduate year (PGY) 1 residents. Modules are taught during regularly scheduled educational time. Focus group surveys and discussions, as well as annual surveys of PGY-1s assessed residents' readiness to engage in training. LDP feasibility was assessed by considering sustainability of program structures and faculty retention, and resident acceptance of training was assessed by measuring attendance, with the attendance goal of 8 of 12 modules. Residents thought leadership training would be valuable if content remained applicable to daily work, and PGY-1 residents expressed high levels of interest in training. The LDP is part of the core educational programming for PGY-1 residents. Except for 2 modules, faculty presenters have remained consistent. During academic year 2014-2015, 45% (13 of 29) of categorical residents participated in at least 8 of 12 modules, and 72% (21 of 29) participated in at least 7 of 12. To date, 125 categorical residents have participated in training. Residents appeared ready to engage in leadership training, and the LDP was feasible to implement. The attendance goal was not met, but attendance was sufficient to justify program continuation.

  4. Assessment of otolaryngic knowledge in primary care residents. (United States)

    Error, Marc E; Wilson, Kevin F; Ward, P Daniel; Gale, Derrick C; Meier, Jeremy D


    (1) Determine the amount of exposure to otolaryngology in medical training of non-otolaryngology residents. (2) Evaluate the general otolaryngic knowledge in these residents. Cross-sectional survey. Academic medical center. A 10-question multiple-choice quiz was given to residents in family practice, pediatrics, emergency medicine, and internal medicine during scheduled educational conferences. Residents were also asked if they ever participated in an otolaryngology rotation during medical school or residency. Medical students and otolaryngology residents completed the quiz to act as controls. A total of 98 examinations were analyzed (49 non-otolaryngology residents, 10 otolaryngology residents, and 39 second-year medical students). Only 24% of the non- otolaryngology residents had an otolaryngology rotation during medical school. The same amount (24%) had a rotation during residency. The average percentage correct on the quiz was 48%, 56%, and 92% for medical students, non-otolaryngology, and otolaryngology residents, respectively (P medical school or residency. This nonvalidated questionnaire also suggested significant deficiencies in basic otolaryngic knowledge in these residents. Identifying mechanisms to improve exposure to otolaryngology in the medical training curriculum is needed.

  5. Research Experience in Psychiatry Residency Programs Across Canada: Current Status (United States)

    Shanmugalingam, Arany; Ferreria, Sharon G; Norman, Ross M G; Vasudev, Kamini


    Objective: To determine the current status of research experience in psychiatry residency programs across Canada. Method: Coordinators of Psychiatric Education (COPE) resident representatives from all 17 psychiatry residency programs in Canada were asked to complete a survey regarding research training requirements in their programs. Results: Among the 17 COPE representatives, 15 completed the survey, representing 88% of the Canadian medical schools that have a psychiatry residency program. Among the 15 programs, 11 (73%) require residents to conduct a scholarly activity to complete residency. Some of these programs incorporated such a requirement in the past 5 years. Ten respondents (67%) reported availability of official policy and (or) guidelines on resident research requirements. Among the 11 programs that have a research requirement, 10 (91%) require residents to complete 1 scholarly activity; 1 requires completion of 2 scholarly activities. Eight (53%) residency programs reported having a separate research track. All of the programs have a research coordinator and 14 (93%) programs provide protected time to residents for conducting research. The 3 most common types of scholarly activities that qualify for the mandatory research requirement are a full independent project (10 programs), a quality improvement project (8 programs), and assisting in a faculty project (8 programs). Six programs expect their residents to present their final work in a departmental forum. None of the residency programs require publication of residents’ final work. Conclusions: The current status of the research experience during psychiatry residency in Canada is encouraging but there is heterogeneity across the programs. PMID:25565474

  6. [Experiences of bullying in medical residents]. (United States)

    Ortiz-León, Silvia; Jaimes-Medrano, Aurora Leonila; Tafoya-Ramos, Silvia Aracely; Mujica-Amaya, María Luisa; Olmedo-Canchola, Víctor Hugo; Carrasco-Rojas, José Antonio


    Harassment and abuse are forms of persistent intimidating behavior against a person and in medical practice those are accepted and justified at all levels of education and are considered specific to the hospital culture. To identify the frequency of harassment and some factors related to its existence on residents of medical specialties in Mexico City. A linear study was carried out in which a total of 260 interns pertaining to the following medical specialties: surgery, internal medicine, gynecology and obstetrics, and pediatrics participated. The study took place in three general hospitals in Mexico City. Two evaluations with Leymann Inventory of Psychological-Terrorization (LIPT-60) with 6 months between assessments were performed. Comparison between the first and second evaluations did not show differences in any of the harassment measurements obtained. Of all residents, 265 (98.5%) claimed to have experienced some type of harassing behavior against them at least once during the previous 6 months, with a 1.4 (±0.5) average intensity, showing no difference between men and women. Women received a higher grade than men on the communication block scale. Harassing behaviors that obtained the highest average values were evident intimidation and occupational discredit. Among all harassment measurements, the specialty of gynecology and obstetrics showed the highest grade. The hospital influenced the reported harassment. The most common harassing behaviors were occupational discredit, verbal threats, shouting, and mockery. The high frequency of harassment that medical residents experience during their hospital training deserves our attention.

  7. Tickborne Powassan virus infections among Wisconsin residents. (United States)

    Johnson, Diep K Hoang; Staples, J Erin; Sotir, Mark J; Warshauer, David M; Davis, Jeffrey P


    Powassan virus (POWV) is a tickborne Flavivirus that causes a rare but potentially life-threatening illness. The first reported case of POWV infection in a Wisconsin resident occurred in 2003. Enhanced surveillance and testing detected 2 additional cases. Patient specimens with a positive or equivocal immunoglobulin M (IgM) antibody to an arbovirus were sent from commercial laboratories to the Wisconsin State Laboratory of Hygiene and forwarded to the Centers for Disease Control and Prevention (CDC) for confirmatory testing. Patients with laboratory confirmed POWV infections were interviewed to obtain demographic, clinical, and epidemiologic information. POWV infections were confirmed in 3 adult Wisconsin residents in 2003, 2006, and 2007; illness onsets occurred during May and June. Two patients were hospitalized and all survived. One patient had a dual infection with POWV and Anaplasma phaghocytophilum. Specimens from all 3 patients were initially reported as positive for IgM antibody to either St Louis encephalitis or California serogroup viruses; POWV-specific antibody was detected during confirmatory testing at the CDC. Each patient had exposures to known or likely tick habitats in different counties within 30 days before illness onset. These are the first diagnosed human POWV infections in Wisconsin. Because all 3 patients were initially identified as having other arboviral infections using commercial screening kits, routine confirmatory testing is essential for proper diagnosis of most arboviral infections. Wisconsin residents should be educated regarding risks of acquiring and ways to prevent POWV infection and other tickborne diseases when spending time outdoors.

  8. [Snacks consumption among residents in Shenzhen City]. (United States)

    Shang, Qinggang; Cao, Keke; Xu, Jiazhang; Yuan, Xueli; Zhuo, Zhipeng; Xu, Jian; Pan, Peng


    To describe the status of snacks consumption among residents in Shenzhen. By a multiple stage probability proportionate to size sampling, 12 communities were randomly selected from 8 districts of Shenzhen based on population proportion. In the second stage, 30 households were randomly selected from each community. In each household, 2 years or older were invited to take dietary survey. There were 66.1% residents consuming snacks. More girls ate snacks than boys (chi2 = 11.552, P snacks than adults (chi2 = 27.207, P snacks were 107.8 kcal (451.5 kJ), 1.7 g, 0.8 g, 22.0 g, 1.1 g, 23.1 microg, 8.3 mg, 1.1 mg,17.0 mg, 9.3 mg, 21.0 mg, 0.8 mg and 0.4 mg. Food categories the most frequently consumed as snacks were fruit, pastry, milk and products, beverages and grains. It's important to strengthen the diet education among residents in Shenzhen, especially the knowledge how to select snacks correctly and rationally.

  9. Perspectives on healthy eating among Appalachian residents. (United States)

    Schoenberg, Nancy E; Howell, Britteny M; Swanson, Mark; Grosh, Christopher; Bardach, Shoshana


    Extensive attention has been focused on improving the dietary intake of Americans. Such focus is warranted due to increasing rates of overweight, obesity, and other dietary-related disease. To address suboptimal dietary intake requires an improved, contextualized understanding of the multiple and intersecting influences on healthy eating, particularly among those populations at greatest risk of and from poor diet, including rural residents. During 8 focus groups (N = 99) and 6 group key informant interviews (N = 20), diverse Appalachian rural residents were queried about their perceptions of healthy eating, determinants of healthy food intake, and recommendations for improving the dietary intake of people in their communities. Participants included church members and other laypeople, public health officials, social service providers, health care professionals, and others. Participants offered insights on healthy eating consistent with the categories of individual, interpersonal, community, physical, environmental, and society-level influences described in the socioecological model. Although many participants identified gaps in dietary knowledge as a persistent problem, informants also identified extraindividual factors, including the influence of family, fellow church members, and schools, policy, advertising and media, and general societal trends, as challenges to healthy dietary intake. We highlight Appalachian residents' recommendations for promoting healthier diets, including support groups, educational workshops, cooking classes, and community gardening. We discuss the implications of these findings for programmatic development in the Appalachian context. © 2013 National Rural Health Association.

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

    Directory of Open Access Journals (Sweden)

    Allen Ghareeb


    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

  11. In Pursuit of Meaningful Use of Learning Goals in Residency: A Qualitative Study of Pediatric Residents. (United States)

    Lockspeiser, Tai M; Li, Su-Ting T; Burke, Ann E; Rosenberg, Adam A; Dunbar, Alston E; Gifford, Kimberly A; Gorman, Gregory H; Mahan, John D; McKenna, Michael P; Reed, Suzanne; Schwartz, Alan; Harris, Ilene; Hanson, Janice L


    Medical education aims to equip physicians for lifelong learning, an objective supported by the conceptual framework of self-regulated learning (SRL). Learning goals have been used to develop SRL skills in learners across the medical education continuum. This study's purpose was to elicit residents' perspectives on learning goal use and to develop explanations suggesting how aspects of the learning environment may facilitate or hinder the meaningful use of learning goals in residency. Resident focus groups and program director interviews were conducted in 2012-2013, audio-recorded, and transcribed. Programs were selected to maximize diversity of size, geographic location, type of program, and current use of learning goals. Data were analyzed using the constant comparative method associated with grounded theory. Further analysis compared themes frequently occurring together to strengthen the understanding of relationships between the themes. Through iterative discussions, investigators built a grounded theory. Ninety-five third-year residents and 12 program directors at 12 pediatric residency programs participated. The analysis identified 21 subthemes grouped into 5 themes: program support, faculty roles, goal characteristics and purposes, resident attributes, and accountability and goal follow-through. Review of relationships between the themes revealed a pyramid of support with program support as the foundation that facilitates the layers above it, leading to goal follow-through. Program support facilitates each step of the SRL process that leads to meaningful use of learning goals in residency. A strong foundation of program support should include attention to aspects of the implicit curriculum as well as the explicit curriculum.

  12. Inequality in healthcare costs between residing and non-residing patients: evidence from Vietnam. (United States)

    Nguyen, Hieu M


    Place of residence has been shown to impact health. To date, however, previous studies have only focused on the variability in health outcomes and healthcare costs between urban and rural patients. This study takes a different approach and investigates cost inequality facing non-residing patients - patients who do not reside in the regions in which the hospitals are located. Understanding the sources for this inequality is important, as they are directly related to healthcare accessibility in developing countries. The causal impact of residency status on individual healthcare spending is documented with a quasi-experimental design. The propensity score matching method is applied to a unique patient-level dataset (n = 900) collected at public general and specialist hospitals across North Vietnam. Propensity score matching shows that Vietnamese patients who do not reside in the regions in which the hospitals are located are expected to pay about 15 million Vietnamese dongs (approximately 750 USD) more than those who do, a sizable gap, given the distribution of total healthcare costs for the overall sample. This estimate is robust to alternative matching specifications. The obtained discrepancy is empirically attributable to the differences in three potential contributors, namely spending on accompanying relatives, "courtesy funds," and days of hospitalization. The present study finds that there is significant inequality in healthcare spending between residing and non-residing patients at Vietnamese hospitals and that this discrepancy can be partially explained by both institutional and non-institutional factors. These factors signal practical channels through which policymakers can improve healthcare accessibility.

  13. A NACURH White Paper on Residence Hall Government. (United States)

    Wyatt, Kevin W.; Stoner, Kenneth L.


    Presents a white paper on residence hall government, summarizing fundamental principles in organizing and maintaining a residence hall association on campus. These include determining needs, identifying support, obtaining income, ensuring effective leadership, and developing system maintenance. (JAC)

  14. Cosmetic Surgery Training in Plastic Surgery Residency Programs

    Directory of Open Access Journals (Sweden)

    Colton H. L. McNichols, MD


    Conclusions:. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

  15. Features of residency training and psychological distress among ...

    African Journals Online (AJOL)

    Features of residency training and psychological distress among residents in a Nigerian teaching hospital. O Esan, A Adeoye, P Onakoya, O Opeodu, K Owonikoko, D Olulana, M Bello, A Adeyemo, L Onigbogi, O Idowu, T Akute ...

  16. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  17. U.S. Legal Permanent Residents: Fiscal Year 2012 (United States)

    Department of Homeland Security — A legal 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...

  18. U.S. Legal Permanent Residents: Fiscal Year 2011 (United States)

    Department of Homeland Security — A legal 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...

  19. U.S. Legal Permanent Residents: Fiscal Year 2007 (United States)

    Department of Homeland Security — A legal 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...

  20. U.S. Legal Permanent Residents: Fiscal Year 2009 (United States)

    Department of Homeland Security — A legal 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...

  1. U.S. Lawful Permanent Residents: Fiscal Year 2013 (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...

  2. U.S. Legal Permanent Residents: Fiscal Year 2010 (United States)

    Department of Homeland Security — A legal 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...

  3. U.S. Legal Permanent Residents: Fiscal Year 2008 (United States)

    Department of Homeland Security — A legal 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...

  4. Results of the 2003 Association of Residents in Radiation Oncology (ARRO) surveys of residents and chief residents in the United States

    International Nuclear Information System (INIS)

    Jagsi, Reshma; Buck, David A.; Singh, Anurag K.; Engleman, Mark; Thakkar, Vipul; Frank, Steven J.; Flynn, Daniel


    Purpose: To document demographic characteristics of current residents, career motivations and aspirations, and training program policies and resources. Methods: In 2003, the Association of Residents in Radiation Oncology (ARRO) conducted two nationwide surveys: one of all U.S. radiation oncology residents and one of chief residents. Results: The Chief Residents' Survey was completed by representatives from all 77 programs (response rate, 100%). The Residents' Survey was returned by 229 respondents (response rate, 44%). In each, 32% of respondents were female. The most popular career after residency was private practice (46%), followed by permanent academic practice (28%). Changes that would entice those choosing private practice to consider an academic career included more research experience as a resident (76%), higher likelihood of tenure (69%), lesser time commitment (66%), and higher salary (54%). Although the majority of respondents were satisfied with educational experience overall, a number of programs were reported to provide fewer resources than required. Conclusions: Median program resources and numbers of outliers are documented to allow residents and program directors to assess the relative adequacy of experience in their own programs. Policy-making bodies and individual programs should consider these results when developing interventions to improve educational experiences of residents and to increase retention of radiation oncologists in academic practice

  5. Text messaging among residents and faculty in a university general surgery residency program: prevalence, purpose, and patient care. (United States)

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


    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.

  6. Longitudinal Outcomes of an Institutionally Developed Nurse Residency Program. (United States)

    Cline, Debbie; La Frentz, Kelly; Fellman, Bryan; Summers, Barbara; Brassil, Kelly

    Nurse residency programs are widely implemented to enhance integration of new graduate nurses entering the workforce. This article presents a retrospective analysis of 10 years of residency data from an internally developed residency program that used the Casey-Fink Graduate Nurse Experience Survey. Outcomes of this program were similar to those from studies using commercially available products, suggesting that an internally developed residency curricula may be equally beneficial to the development of new graduate nurses.

  7. Pediatric Oncology Branch - training- resident electives | Center for Cancer Research (United States)

    Resident Electives Select pediatric residents may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The resident is supervised directly by the Branch’s attending physician and clinical fellows. Residents attend daily in-patient and out-patient rounds, multiple weekly Branch conferences, and are expected to research relevant topics and present a 30-minute talk toward the end of their rotation.

  8. Resident-as-teacher in family medicine: a CERA survey. (United States)

    Al Achkar, Morhaf; Davies, M Kelly; Busha, Michael E; Oh, Robert C


    Teaching has been increasingly recognized as a primary responsibility of residents. Residents enjoy teaching, and their majority report interest in the continuation of teaching activities after graduation. Resident-as-teacher programs have emerged nationally as a means of enhancing teaching skills. This study examined the current use of residents-as-teachers programs in family medicine residencies through a national survey of family medicine residency program directors. This survey project was part of the Council of Academic Family Medicine Education Research Alliance (CERA) 2014 survey to family medicine program directors that was conducted between February 2014 and May 2014. The response rate of the survey was 49.6% (224/451). The majority (85.8%) of residency programs offer residents formal instruction in teaching skills. The vast majority (95.6%) of programs mandated the training. The average total hours of teaching instruction residents receive while in residency training was 7.72. The residents are asked to formally evaluate the teaching instruction in 68.1% of the programs. Less than a quarter (22.6%) of residency programs offer the teaching instruction in collaboration with other programs. "Retreat, workshop, and seminars" were identified as the main form of instruction by 33.7% of programs. In 83.3% of programs not offering instruction, lack of resources was identified as the primary barrier. The majority of family medicine residency programs provide resident-as-teacher instructions, which reflects increasing recognition of importance of the teaching role of residents. Further research is needed to assess the effectiveness of such instruction on residents' teaching skills and their attitudes toward teaching.

  9. The Impact of the 80-Hour Resident Workweek on Surgical Residents and Attending Surgeons (United States)

    Hutter, Matthew M.; Kellogg, Katherine C.; Ferguson, Charles M.; Abbott, William M.; Warshaw, Andrew L.


    Objective: To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. Summary Background Data: The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the resident and attending surgeons, specifically with regards to the impact on motivation, job satisfaction, the quality of surgeon training, the quality of the surgeon's life, and the quality of patient care. Methods: Four prospective studies were performed at a single academic surgical program with data collected both before the necessary workforce restructuring and 1 year after, including: 1) time cards to assess changes in components of daily activity; 2) Web-based surveys using validated instruments to assess burnout and motivation to work; 3) structured, taped, one-on-one interviews with an external PhD investigator; and 4) statistical analyses of objective, quantitative data. Results: After the work-hour changes, surgical residents have decreased “burnout” scores, with significantly less “emotional exhaustion” (Maslach Burnout Inventory: 29.1 “high” vs. 23.1 “medium,” P = 0.02). Residents have better quality of life both in and out of the hospital. They felt they got more sleep, have a lighter workload, and have increased motivation to work (Herzberg Motivation Dimensions). We found no measurable, statistically significant difference in the quality of patient care (NSQIP data). Resident training and education objectively were not statistically diminished (ACGME case logs, ABSITE scores). Attending surgeons perceived that their quality of their life inside and outside of the hospital was “somewhat worse” because of the work-hour changes, as they had anticipated. Many concerns were identified with regards to the professional development of future surgeons, including a change toward a shift-worker mentality that is not patient

  10. Burnout, engagement and resident physicians' self-reported errors

    NARCIS (Netherlands)

    Prins, J.T.; van der Heijden, F.M.M.A.; Hoekstra-Weebers, J.E.H.M.; Bakker, A.B.; van de Wiel, H.B.M.; Jacobs, B.; Gazendam-Donofrio, S.M.


    Burnout is a work-related syndrome that may negatively affect more than just the resident physician. On the other hand, engagement has been shown to protect employees; it may also positively affect the patient care that the residents provide. Little is known about the relationship between residents'

  11. Residents' Perception of Postgraduate Radiology Training in Nigeria ...

    African Journals Online (AJOL)

    BACKGROUND: Literature on radiology residency in Nigeria is sparse, even for decades after its commencement. There is therefore the need to inquire into the problems and prospects of the programme, at least from the perspectives of the residents. OBJECTIVE: To determine residents' perception of the radiology ...

  12. Burnout among Canadian Psychiatry Residents: A National Survey. (United States)

    Kealy, David; Halli, Priyanka; Ogrodniczuk, John S; Hadjipavlou, George


    Burnout is a serious problem for health care providers that has implications for clinical practice and personal health. While burnout is known to affect residents, no studies have examined the prevalence or impact of burnout among Canadian psychiatry residents. Residents in all Canadian psychiatry training programs were surveyed between May 1, 2014, and July 1, 2014. The survey included a well-validated, single-item measure to assess symptoms of burnout, several demographic questions, and Likert-scale items to assess residents' appraisals of empathic functioning and strategies for coping with stress from patient encounters. Responses were obtained from 400 residents, for a response rate of 48%. Twenty-one percent (N = 84) of residents reported symptoms of burnout. Burnout was reported more frequently by residents in postgraduate year 2 than by those in other years and was associated with engagement in personal psychotherapy during residency. No association was found between burnout and age, gender, or location of residency program. Residents who endorsed symptoms of burnout reported higher levels of compromised empathic functioning, were less likely to consult with supervisors about stressful clinical experiences, and were more likely to engage in unhealthy coping strategies. Symptoms of burnout affect one-fifth of Canadian psychiatry residents. The associations between burnout symptoms and problematic clinical and personal functioning suggest areas of concern for those involved in the training of Canadian psychiatry residents. © The Author(s) 2016.

  13. 26 CFR 301.7701(b)-1 - Resident alien. (United States)


    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Resident alien. 301.7701(b)-1 Section 301.7701... ADMINISTRATION PROCEDURE AND ADMINISTRATION Definitions § 301.7701(b)-1 Resident alien. (a) Scope. Section 301.7701(b)-1(b) provides rules for determining whether an alien individual is a lawful permanent resident...

  14. 26 CFR 1.871-3 - Residence of alien seamen. (United States)


    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Residence of alien seamen. 1.871-3 Section 1.871... (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-3 Residence of alien seamen. In order to determine whether an alien seaman is a resident of the United States for purposes of the income...

  15. Burnout, Perceived Stress, and Depression among Cardiology Residents in Argentina (United States)

    Waldman, Silvina V.; Diez, Juan Cruz Lopez; Arazi, Hernan Cohen; Linetzky, Bruno; Guinjoan, Salvador; Grancelli, Hugo


    Objective: Because medical residency is a stressful time for training physicians, placing residents at increased risk for psychological distress, the authors studied the prevalence of burnout, perceived stress, and depression in cardiology residents in Argentina and examined the association between sociodemographic characteristics and these…

  16. Resident Transitions to Assisted Living: A Role for Social Workers (United States)

    Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly


    This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide,…

  17. The Marketing of Residence Halls: A Question of Positioning. (United States)

    Parker, R. Stephen; And Others


    A survey of 343 college residence hall directors revealed percentages of private and public institutions offering different amenities, main selling points in promotional brochures, and the most common resident complaints. Results were compared with those of a resident survey concerning the importance of various housing attributes. Implications for…

  18. Burnout Comparison among Residents in Different Medical Specialties (United States)

    Martini, Shahm; Arfken, Cynthia L.; Churchill, Amy; Balon, Richard


    Objective: To investigate resident burnout in relation to work and home-related factors. Method: Maslach Burnout Inventory was mailed to residents in eight different medical specialties, with a response rate of 35%. Results: Overall, 50% of residents met burnout criteria, ranging from 75% (obstetrics/gynecology) to 27% (family medicine). The first…

  19. Child temperament and paternal transition to non-residence. (United States)

    Flouri, Eirini; Malmberg, Lars-Erik


    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.

  20. Structural Analysis of the Resident Assistant Cultural Diversity Questionnaire (United States)

    Johnson, Vanessa D.; Kang, Young-Shin; Thompson, George F.


    This study investigated the five-factor structure of the Resident Assistant Cultural Diversity (RACD) instrument, which assesses resident assistant (RA) confidence in addressing issues of cultural diversity in college and university residence halls. The instrument has five components that explore RA confidence: (1) belief in the need for cultural…

  1. E-Learning and Medical Residents, a Qualitative Perspective (United States)

    Segerman, Jill; Crable, Elaine; Brodzinski, James


    Medical education helps ensure doctors acquire skills and knowledge needed to care for patients. However, resident duty hour restrictions have impacted the time residents have available for medical education, leaving resident educators searching for alternate options for effective medical education. Classroom situated e-learning, a blended…

  2. 8 CFR 289.2 - Lawful admission for permanent residence. (United States)


    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Lawful admission for permanent residence... AMERICAN INDIANS BORN IN CANADA § 289.2 Lawful admission for permanent residence. Any American Indian born... of April 2, 1928 (45 Stat. 401), or section 289 of the Act, and has maintained residence in the...

  3. 8 CFR 316.5 - Residence in the United States. (United States)


    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Residence in the United States. 316.5... REQUIREMENTS FOR NATURALIZATION § 316.5 Residence in the United States. (a) General. Unless otherwise specified, for purposes of this chapter, including § 316.2 (a)(3), (a)(5), and (a)(6), an alien's residence is...

  4. 38 CFR 21.4279 - Combination correspondence-residence program. (United States)


    ... correspondence-residence program. 21.4279 Section 21.4279 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... Assistance Programs Assessment and Pursuit of Courses § 21.4279 Combination correspondence-residence program. (a) Requirements for pursuit. A program of education may be pursued partly in residence and partly by...

  5. 24 CFR 206.211 - Annual determination of principal residence. (United States)


    ... residence. 206.211 Section 206.211 Housing and Urban Development Regulations Relating to Housing and Urban... determination of principal residence. At least once during each calendar year, the mortgagee shall determine whether or not the property is the principal residence of at least one mortgagor. The mortgagee shall...

  6. 19 CFR 148.2 - Residence status of arriving persons. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Residence status of arriving persons. 148.2... Residence status of arriving persons. (a) General. Persons arriving from foreign countries shall be divided... established a home elsewhere. For this purpose, the residence of a wife shall be deemed to be that of her...

  7. Training in Psychiatric Genomics during Residency: A New Challenge (United States)

    Winner, Joel G.; Goebert, Deborah; Matsu, Courtenay; Mrazek, David A.


    Objective: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. Methods: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and…

  8. Are the French neurology residents satisfied with their training? (United States)

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


    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.

  9. Resident and Non resident Persons in Theory and Practice Tax – Case of Kosovo

    Directory of Open Access Journals (Sweden)

    Fitore Morina


    Full Text Available In each country there is the attempt to impose their jurisdiction persons who derive income and require sufficient connection between the state and these persons to enable the collection of these revenues on behalf of taxes. However, it should be asked which connection is required between the state and subjects of law to achieve this goal. There is a number of factors stemming from the subjects of law that can create report - link between the state and subjects of law, such as: citizenship, residence, nationality, presence in the state concerned, etc. Tax systems in the country (domestic tax systems will determine which subject will be considered for the purposes of the tax legislation of the respective state tax subject to domestic (resident and which foreign (non- resident. In this context, local tax legislation must modulate two basic issues: The first, are the characteristics of natural and legal persons who are established, organized and operate within the boundaries of the respective state (resident and the Second, the characteristics of natural and legal persons who are established and organized under the laws of foreign (non- resident.

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

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


    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. Nursing home resident quality of life: testing for measurement equivalence across resident, family, and staff perspectives. (United States)

    Godin, Judith; Keefe, Janice; Kelloway, E Kevin; Hirdes, John P


    This study explores the factor structure of the interRAI self-report nursing home quality of life survey and develops a measure that will allow researchers to compare predictors of quality of life (QOL) across resident, family, and staff perspectives. Nursing home residents (N = 319), family members (N = 397), and staff (N = 862) were surveyed about their perceptions of resident QOL. Exploratory factor analyses were conducted on a random half of the staff data. Subsequently, confirmatory factor analysis was used to test for measurement equivalence across the three perspectives. The final model had a four-factor structure (i.e., care and support, food, autonomy, and activities) across all three perspectives. Each factor had at least two items that were equivalent across all three perspectives, which suggests at least partial measurement equivalence. The finding of partial measurement equivalence acknowledges there are important differences between perspectives and provides a tool that researchers can use to compare predictors of QOL, but not levels of agreement across perspectives. Targeting these four aspects is likely to have the additional benefit of improving family and staff perceptions of resident QOL in addition to the resident's own QOL.

  12. Evaluating residents in the nuclear medicine residency training program: an educational perspective

    International Nuclear Information System (INIS)

    Pascual, T.N.; San Luis, T.O.L.; Leus, M.


    Full text: The comprehensive evaluation of medical residents in a residency-training program includes the use of educational tools to measure the attainment of competencies in the cognitive, psychomotor and affective domains as prescribed in the training curriculum. Attention is almost always focused on the testing of cognitive domain of the learners with limited attention given on the psychomotor and affective parameters, which are in fact, together with the cognitive domain, integral to the students' learning behaviour. This paper aims to review the principles of test construction, including the perspectives on the roles, types and purpose of tests in the domains of learning (cognitive, psychomotor and affective) as well as the use of Non-Test materials for measuring affective learning outcomes and the construction of Performance Tests and Portfolio Assessment tools which are all essential for the effective and efficient evaluation of residents in a Nuclear Medicine Training Program. (author)

  13. [Regulations governing the training of diagnostic imaging residents: the residents' statute and the medical specialties law]. (United States)

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


    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.

  14. Evaluating a novel resident role-modelling programme. (United States)

    Sternszus, Robert; Steinert, Yvonne; Bhanji, Farhan; Andonian, Sero; Snell, Linda S


    Role modelling is a fundamental method by which students learn from residents. To our knowledge, however, resident-as-teacher curricula have not explicitly addressed resident role modelling. The purpose of this project was to design, implement and evaluate an innovative programme to teach residents about role modelling. The authors designed a resident role-modelling programme and incorporated it into the 2015 and 2016 McGill University resident-as-teacher curriculum. Influenced by experiential and social learning theories, the programme incorporated flipped-classroom and simulation approaches to teach residents to be aware and deliberate role models. Outcomes were assessed through a pre- and immediate post-programme questionnaire evaluating reaction and learning, a delayed post-programme questionnaire evaluating learning, and a retrospective pre-post questionnaire (1 month following the programme) evaluating self-reported behaviour changes. Thirty-three of 38 (87%) residents who participated in the programme completed the evaluation, with 25 residents (66%) completing all questionnaires. Participants rated the programme highly on a five-point Likert scale (where 1 = not helpful and 5 = very helpful; mean score, M = 4.57; standard deviation, SD = 0.50), and showed significant improvement in their perceptions of their importance as role models and their knowledge of deliberate role modelling. Residents also reported an increased use of deliberate role-modelling strategies 1 month after completing the programme. Resident-as-teacher curricula have not explicitly addressed resident role modelling DISCUSSION: The incorporation of resident role modelling into our resident-as-teacher curriculum positively influenced the participants' perceptions of their role-modelling abilities. This programme responds to a gap in resident training and has the potential to guide further programme development in this important and often overlooked area. © 2017 John Wiley & Sons

  15. Adverse Event Reporting: Harnessing Residents to Improve Patient Safety. (United States)

    Tevis, Sarah E; Schmocker, Ryan K; Wetterneck, Tosha B


    Reporting of adverse and near miss events are essential to identify system level targets to improve patient safety. Resident physicians historically report few events despite their role as front-line patient care providers. We sought to evaluate barriers to adverse event reporting in an effort to improve reporting. Our main outcomes were as follows: resident attitudes about event reporting and the frequency of event reporting before and after interventions to address reporting barriers. We surveyed first year residents regarding barriers to adverse event reporting and used this input to construct a fishbone diagram listing barriers to reporting. Barriers were addressed, and resident event reporting was compared before and after efforts were made to reduce obstacles to reporting. First year residents (97%) recognized the importance of submitting event reports; however, the majority (85%) had not submitted an event report in the first 6 months of residency. Only 7% of residents specified that they had not witnessed an adverse event in 6 months, whereas one third had witnessed 10 or more events. The main barriers were as follows: lack of knowledge about how to submit events (38%) and lack of time to submit reports (35%). After improving resident education around event reporting and simplifying the reporting process, resident event reporting increased 230% (68 to 154 annual reports, P = 0.025). We were able to significantly increase resident event reporting by educating residents about adverse events and near misses and addressing the primary barriers to event reporting. Moving forward, we will continue annual resident education about patient safety, focus on improving feedback to residents who submit reports, and empower senior residents to act as role models to junior residents in patient safety initiatives.

  16. Climate Responsive Design and the Milam Residence

    Directory of Open Access Journals (Sweden)

    Mohammad Shahadat


    Full Text Available Energy conservation and efficiency is an essential area of focus in contemporary building design. The perception that the designers of buildings during the Modernist period of architecture ignored these principles is a false one. The present study, an examination of Paul Rudolph’s Milam Residence, a masterpiece of American residential architecture, is part of a larger project endeavoring to create a knowledge base of the environmental performance of iconic modernist homes. A critical examination of the Milam House allows insight into specific design characteristics that impact energy efficiency and conservation. Located in Ponte Vedra Beach, Florida, the Milam Residence was constructed in 1962. It was the last of a series of Florida residences designed by Rudolph, Chairman of the Department of Architecture at Yale University (1958–1965. The structure’s form is strongly related to its location on a subtropical beachfront. This paper presents a detailed analysis of the building’s solar responsiveness. Specifically, we examine design strategies such as orientation and sunscreening and their effect on daylighting, shading, and heat gain. The analysis is based on parametric energy modeling studies using Autodesk’s Ecotect, an environmental analysis tool that allows simulation of building performance. While the initial target of the program was early design, the program allows the input of complex geometries and detailed programming of zones, materials, schedules, etc. The program's excellent analyses of desired parameters are augmented by visualizations that make it especially valuable in communicating results. Our findings suggest that the building, as built and situated on the site, does take advantage of daylighting and solar shading and does so in both expected and unexpected ways.

  17. Loss aversion and duration of residence

    Directory of Open Access Journals (Sweden)

    Philip S. Morrison


    Full Text Available Background: Studies of internal migration ask who moves, why they move, and what are the consequences - to themselves, their origin, and their destination. By contrast, studies of those who stay for very long durations are less common, despite the fact that most people move relatively infrequently. Objective: We argue that staying is the dominant, preferred state and that moving is simply an adjustment toward a desired state of stability (or equilibrium. The core of our argument, already recognized in the literature, is that migration is risky. However, we extend the argument to loss aversion as developed within prospect theory. Prospect theory posits that existing possessions, including the dwelling and existing commodities, are attributed a value well beyond their purchase price and that this extends the average period of staying among the loss-averse. Methods: Applying prospect theory has several challenges, including measurement of the reference point and potential degrees of gain and loss households face in deciding to change residence, as well as their own degree of loss aversion. The growing number of large panel sets should make it possible to estimate the degree to which endowment effects are likely to extend durations of residence as predicted by prospect theory. Conclusions: Rational expectations models of mobility focus on the changes in the level of consumption of residential services. By contrast, prospect theory focuses on potential gains and losses relative to the existing dwelling - the reference point. As we confront increasing durations of residence in contemporary society, an application of prospect theory is likely to yield important advantages over existing models of mobility and staying.

  18. Optimizing Residents' Performance of Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle


    Background: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given...... of three interventions as preparation for performing lumbar puncture: 1) goal- and learner-centered video (GLV) presenting procedure-specific process goals and learner-centered information; 2) traditional video (TV) providing expert-driven content, but no process goals; and 3) written text (WT...... a traditionally designed video or written text. Participants’ self-confidence was not predictive of their actual performance....

  19. Are psychiatric residents still interested in psychoanalysis? A brief report. (United States)

    Damsa, Cristian; Bryois, Christian; Morelli, Dawn; Cailhol, Lionel; Adam, Eric; Coman, Adrian; Stamatoiu, Daniela; Lazignac, Coralie; Freymann, Jean-Richard


    In spite of the efficacy of the psychodynamic psychotherapies, the number of young psychiatric residents interested in psychodynamic therapies is decreasing. Our psychoanalytical group, Genden (Genève-Denver), explored the possible reasons for psychiatric residents' hesitation to get psychoanalytic training. Five psychoanalytical psychotherapists met weekly for a year in order to debate that question, focusing on personal feedbacks from all of our 100 residents in psychiatry working with us for at least 4 years. Following the residents' responses, our focus group proposed ten commonsense feedbacks for psychoanalysts regarding stimulating young psychiatric residents' interest in psychoanalytic approaches.

  20. Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum. (United States)

    Brodsky, Beth S; Cabaniss, Deborah L; Arbuckle, Melissa; Oquendo, Maria A; Stanley, Barbara


    Dialectical behavior therapy (DBT) is an evidence-based psychosocial treatment with efficacy in reducing self-harm behaviors in borderline personality disorder (BPD). This study describes and evaluates a clinical curriculum to teach DBT to psychiatry residents, developed at a large urban university hospital. The curriculum objectives are to (1) have psychiatry residents achieve basic understanding of DBT theory and clinical skill, (2) increase residents' ability and confidence in treating self-harm behaviors (both suicidal behavior and non-suicidal self-injury), and (3) enhance residents' willingness to treat individuals with BPD. In addition to a 6-week didactic course on DBT offered to all residents (n = 62), 25 elected to enroll in a year-long DBT clinical training curriculum over the course of a 5-year period. The DBT clinical training consisted of 15 h of additional didactics, ongoing conduct of individual therapy and group DBT skills training, videotaping of individual therapy sessions, and weekly supervision meetings utilizing videotape to provide feedback. Residents participating in the clinical training program videotaped baseline and later sessions, which were rated for DBT adherence. All 62 graduates of the program were surveyed regarding the impact of the training on their practice of psychiatry. Upon graduation, a high percentage (87 % in the curriculum and 70 % in the didactic course only) reported incorporating DBT into their psychiatry practice, as well as willingness and confidence in treating BPD and self-harm behaviors. Residents participating in the clinical training demonstrated significant improvement in their ability to utilize DBT interventions, particularly in structuring sessions, problem assessment, problem solving, and using validation and dialectical strategies. This DBT curriculum was effective in preparing psychiatrists-in-training to incorporate evidence-based practices for effective treatment of BPD and self-harm behaviors

  1. Surgical resident learning styles: faculty and resident accuracy at identification of preferences and impact on ABSITE scores. (United States)

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


    As a consequence of surgical resident duty hour restrictions, there is a need for faculty to utilize novel teaching methods to convey information in a more efficient manner. The current paradigm of surgical training, which has not changed significantly since the time of Halsted, assumes that all residents assimilate information in a similar fashion. However, recent data has shown that learners have preferences for the ways in which they receive and process information. The VARK model categorizes learners as visual (V), aural (A), read/write (R), and kinesthetic (K). The VARK learning style preferences of surgical residents have not been previously evaluated. In this study, the preferred learning styles of general surgery residents were determined, along with faculty and resident perception of resident learning styles. In addition, we hypothesized that American Board of Surgery In-Training Exam (ABSITE) scores are associated with preference for a read/write (R) learning style. The Fleming VARK learning styles inventory was administered to all general surgery residents at a university hospital-based program. Responses on the inventory were scored to determine the preferred learning style for each resident. Faculty members were surveyed to determine their accuracy in identifying the preferred learning style of each resident. All residents were also surveyed to determine their accuracy in identifying their peers' VARK preferences. Resident ABSITE scores were examined for association with preferred learning styles. Twenty-nine residents completed the inventory. Most (18 of 29, 62%) had a multimodal preference, although more than a third (11 of 29, 38%) demonstrated a single-modality preference. Seventy-six percent of all residents (22 of 29) had some degree of kinesthetic (K) learning, while under 50% (14 of 29) were aural (A) learners. Although not significant, dominant (R) learners had the highest mean ABSITE scores. Faculty identified residents' learning styles

  2. Tailoring Morning Reports to an Internal Medicine Residency in Qatar. (United States)

    Dousa, Khalid Mohamed Ali; Muneer, Mohammed; Rahil, Ali; Al-Mohammed, Ahmed; AlMohanadi, Dabia; Elhiday, Abdelhaleem; Hamad, Abdelrahman; Albizreh, Bassim; Suliman, Noor; Muhsin, Saif


    Morning report, a case-based conference that allows learners and teachers to interact and discuss patient care, is a standard educational feature of internal residency programs, as well as some other specialties. Our intervention was aimed at enhancing the format for morning report in our internal medicine residency program in Doha, Qatar. In July 2011, we performed a needs assessment of the 115 residents in our internal medicine residency program, using a questionnaire. Resident input was analyzed and prioritized using the percentage of residents who agreed with a given recommendation for improving morning report. We translated the input into interventions that enhanced the format and content, and improved environmental factors surrounding morning report. We resurveyed residents using the questionnaire that was used for the needs assessment. Key changes to the format for morning report included improving organization, adding variety to the content, enhancing case selection and the quality of presentations, and introducing patient safety and quality improvement topics into discussions. This led to a morning report format that is resident-driven, and resident-led, and that produces resident-focused learning and quality improvement activities. Our revised morning report format is a dynamic tool, and we will continue to tailor and modify it on an ongoing basis in response to participant feedback. We recommend a process of assessing and reassessing morning report for other programs that want to enhance resident interest and participation in clinical and safety-focused discussions.

  3. Atypical presentation of scabies among nursing home residents. (United States)

    Wilson, M M; Philpott, C D; Breer, W A


    Scabies epidemics are not uncommon in nursing homes. Effective treatment is enhanced by prompt clinical diagnosis and early intervention. The clinical presentation of scabies may vary in older, immunocompromised or cognitively impaired persons. We performed a retrospective study of all residents diagnosed with scabies in a multilevel long-term care geriatric facility. The duration of the outbreak was from May to September 2000. Fifteen residents contracted scabies during the outbreak. All affected residents had predominantly truncal lesions. Twelve residents had diffuse erythematous, papulosquamous lesions. Pruritus occurred in only 5 residents. Three residents with severe dementia and notably impaired functional status failed to respond to Permethrin cream (5%). All 3 residents responded to treatment with oral Ivermectin. Older nursing home residents with scabies may present with atypical skin lesions. Residents with cognitive impairment and restricted mobility may be treatment resistant. The diagnosis of scabies should be considered in any nursing home resident with an unexplained generalized rash. Residents with dementia and severe functional impairment that fail to respond to Permethrin cream (5%) may benefit from treatment with oral Ivermectin.

  4. Cosmetic Surgery Training in Plastic Surgery Residency Programs. (United States)

    McNichols, Colton H L; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur; Rasko, Yvonne


    Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

  5. Training Pediatric Residents to Provide Smoking Cessation Counseling to Parents

    Directory of Open Access Journals (Sweden)

    Rebecca L. Collins


    Full Text Available The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.

  6. Pediatric dermatology training survey of United States dermatology residency programs. (United States)

    Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B


    Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.

  7. Burnout among Canadian Psychiatry Residents: A National Survey (United States)

    Halli, Priyanka; Ogrodniczuk, John S.; Hadjipavlou, George


    Objective: Burnout is a serious problem for health care providers that has implications for clinical practice and personal health. While burnout is known to affect residents, no studies have examined the prevalence or impact of burnout among Canadian psychiatry residents. Method: Residents in all Canadian psychiatry training programs were surveyed between May 1, 2014, and July 1, 2014. The survey included a well-validated, single-item measure to assess symptoms of burnout, several demographic questions, and Likert-scale items to assess residents’ appraisals of empathic functioning and strategies for coping with stress from patient encounters. Results: Responses were obtained from 400 residents, for a response rate of 48%. Twenty-one percent (N = 84) of residents reported symptoms of burnout. Burnout was reported more frequently by residents in postgraduate year 2 than by those in other years and was associated with engagement in personal psychotherapy during residency. No association was found between burnout and age, gender, or location of residency program. Residents who endorsed symptoms of burnout reported higher levels of compromised empathic functioning, were less likely to consult with supervisors about stressful clinical experiences, and were more likely to engage in unhealthy coping strategies. Conclusions: Symptoms of burnout affect one-fifth of Canadian psychiatry residents. The associations between burnout symptoms and problematic clinical and personal functioning suggest areas of concern for those involved in the training of Canadian psychiatry residents. PMID:27310237

  8. Developing a curriculum for emergency medicine residency orientation programs. (United States)

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


    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.

  9. Facilitation of resident scholarly activity: strategy and outcome analyses using historical resident cohorts and a rank-to-match population. (United States)

    Sakai, Tetsuro; Emerick, Trent D; Metro, David G; Patel, Rita M; Hirsch, Sandra C; Winger, Daniel G; Xu, Yan


    Facilitation of residents' scholarly activities is indispensable to the future of medical specialties. Research education initiatives and their outcomes, however, have rarely been reported. Since academic year 2006, research education initiatives, including research lectures, research problem-based learning discussions, and an elective research rotation under a new research director's supervision, have been used. The effectiveness of the initiatives was evaluated by comparing the number of residents and faculty mentors involved in residents' research activity (Preinitiative [2003-2006] vs. Postinitiative [2007-2011]). The residents' current postgraduation practices were also compared. To minimize potential historical confounding factors, peer-reviewed publications based on work performed during residency, which were written by residents who graduated from the program in academic year 2009 to academic year 2011, were further compared with those of rank-to-match residents, who were on the residency ranking list during the same academic years, and could have been matched with the program of the authors had the residents ranked it high enough on their list. The Postinitiative group showed greater resident research involvement compared with the Preinitiative group (89.2% [58 in 65 residents] vs. 64.8% [35 in 54]; P = 0.0013) and greater faculty involvement (23.9% [161 in 673 faculty per year] vs. 9.2% [55 in 595]; P < 0.0001). Choice of academic practice did not increase (50.8% [Post] vs. 40.7% [Pre]; P = 0.36). Graduated residents (n = 38) published more often than the rank-to-match residents (n = 220) (55.3% [21 residents] vs. 13.2% [29]; P < 0.0001, odds ratio 8.1 with 95% CI of 3.9 to 17.2). Research education initiatives increased residents' research involvement.

  10. The General Surgery Chief Resident Operative Experience (United States)

    Drake, Frederick Thurston; Horvath, Karen D.; Goldin, Adam B.; Gow, Kenneth W.


    IMPORTANCE The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. OBJECTIVE To evaluate changes in operative experience for general surgery CRs. DESIGN, SETTING, AND PARTICIPANTS Review of Accreditation Council for Graduate Medical Education case logs from 1989–1990 through 2011–2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. MAIN OUTCOMES AND MEASURES Total cases and defined categories were evaluated for changes over time. RESULTS The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P general surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves. PMID:23864049

  11. Improving reliability of a residency interview process. (United States)

    Peeters, Michael J; Serres, Michelle L; Gundrum, Todd E


    To improve the reliability and discrimination of a pharmacy resident interview evaluation form, and thereby improve the reliability of the interview process. In phase 1 of the study, authors used a Many-Facet Rasch Measurement model to optimize an existing evaluation form for reliability and discrimination. In phase 2, interviewer pairs used the modified evaluation form within 4 separate interview stations. In phase 3, 8 interviewers individually-evaluated each candidate in one-on-one interviews. In phase 1, the evaluation form had a reliability of 0.98 with person separation of 6.56; reproducibly, the form separated applicants into 6 distinct groups. Using that form in phase 2 and 3, our largest variation source was candidates, while content specificity was the next largest variation source. The phase 2 g-coefficient was 0.787, while confirmatory phase 3 was 0.922. Process reliability improved with more stations despite fewer interviewers per station-impact of content specificity was greatly reduced with more interview stations. A more reliable, discriminating evaluation form was developed to evaluate candidates during resident interviews, and a process was designed that reduced the impact from content specificity.

  12. Family functionality in oldest old household residents. (United States)

    Vera, Ivania; Lucchese, Roselma; Nakatani, Adélia Yaeko Kyosen; Pagotto, Valeria; Montefusco, Selma Rodrigues Alves; Sadoyama, Geraldo


    The aim of this study was to identify factors associated with family functionality of non-institutionalized long-lived subjects, who were residents in Goiânia (GO), Brazil. This was a population-based epidemiological study with cross-sectional outline. Evaluation scales of the functional and cognitive capacities were used. Family dynamics was measured using the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) instrument by making home interviews with 131 long-lived individuals. There was prevalence of the female gender, average of age of 83.87 years old, widowhood condition, and residence in a big family, primary schooling, and self-perception of regular health. A great amount showed independence for self-care and partial dependence for daily life instrumental activities. Family functionality prevailed with score average of 9.06 points. In conclusion, family functionality in long-lived subjects is associated with self-perception of poor/bad health, osteoporosis, and fall. Results allowed characterizing long-lived subjects' family functionality with the aim of valuing and prioritizing family as a caregiver.

  13. Teaching Communication Skills to Radiology Residents. (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.

  14. Residency Training: Work engagement during neurology training. (United States)

    Zis, Panagiotis; Anagnostopoulos, Fotios; Artemiadis, Artemios K


    Work engagement, defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption, can ameliorate patient care and reduce medical errors. The purpose of this cross-sectional study was to investigate work engagement among neurology residents in the region of Attica, Greece. In total, 113 residents participated in this study. Demographic and work-related characteristics, as well as emotional exhaustion and personality traits (neuroticism), were examined via an anonymous questionnaire. Work engagement was measured by the Utrecht Work Engagement Scale. The study sample had a mean age of 34.6 ± 3.6 years, ranging from 26 to 45 years. Sixty-two (54.9%) participants were women and 45 (39.8%) were married. After adjusting for sex, emotional exhaustion, and neuroticism, the main factors associated with work engagement were autonomy and chances for professional development. Providing more chances for trainees' professional development as well as allowing for and supporting greater job autonomy may improve work engagement during neurology training. © 2016 American Academy of Neurology.

  15. Teaching Our Students, Our Residents and Ourselves. (United States)

    Kayhan, Zeynep


    Even though postgraduate medical education has been the focus of interest in anaesthesiology education, in a broader sense the entire medical community can be considered appropriate learners of anaesthesiology. Anaesthesiologists are equipped to teach physiology, pharmacology, resuscitation, pain management, perioperative assessment, and medical technology. For residency training, an approach based on competencies, skills and professionalism should be used instead of the traditional "apprenticeship" model. When teaching ourselves as qualified anaesthesiologists, areas of continuing professional development, academic career training and continuing medical education should be taken into account. Whereas the responsibility for undergraduate medical education rests with university medical schools, postgraduate medical education is carried out by universities and/or the national health authorities/services. Establishment of partnerships between health-care services and universities should be central to the provision of postgraduate education so as not to dissociate various stages of education. When determining educational strategies, institutional preferences, target populations and their learning styles should be taken into account. To this end, especially for high risk situations simulation-based approaches, scenarios, standardized patients, research, mentoring, journal clubs, seminars, lectures, case discussions, bed-side discussions, courses, games and portfolios have been and are being used widely. Departments of anaesthesiology should establish and maintain a strong presence in undergraduate medical education. Besides being good clinicians, anaesthesiologists should understand all aspects of education and educational outcome in order to better teach students, residents and themselves. Quality of education and the teaching environment should continually be evaluated within the context of quality assurance.

  16. Residence time and physical processes in lakes

    Directory of Open Access Journals (Sweden)

    Nicoletta SALA


    Full Text Available The residence time of a lake is highly dependent on internal physical processes in the water mass conditioning its hydrodynamics; early attempts to evaluate this physical parameter emphasize the complexity of the problem, which depends on very different natural phenomena with widespread synergies. The aim of this study is to analyse the agents involved in these processes and arrive at a more realistic definition of water residence time which takes account of these agents, and how they influence internal hydrodynamics. With particular reference to temperate lakes, the following characteristics are analysed: 1 the set of the lake's caloric components which, along with summer heating, determine the stabilizing effect of the surface layers, and the consequent thermal stratification, as well as the winter destabilizing effect; 2 the wind force, which transfers part of its momentum to the water mass, generating a complex of movements (turbulence, waves, currents with the production of active kinetic energy; 3 the water flowing into the lake from the tributaries, and flowing out through the outflow, from the standpoint of hydrology and of the kinetic effect generated by the introduction of these water masses into the lake. These factors were studied in the context of the general geographical properties of the lake basin and the watershed (latitude, longitude, morphology, also taking account of the local and regional climatic situation. Also analysed is the impact of ongoing climatic change on the renewal of the lake water, which is currently changing the equilibrium between lake and atmosphere, river and lake, and relationships

  17. Simulation Training in Obstetrics and Gynaecology Residency Programs in Canada. (United States)

    Sanders, Ari; Wilson, R Douglas


    The integration of simulation into residency programs has been slower in obstetrics and gynaecology than in other surgical specialties. The goal of this study was to evaluate the current use of simulation in obstetrics and gynaecology residency programs in Canada. A 19-question survey was developed and distributed to all 16 active and accredited obstetrics and gynaecology residency programs in Canada. The survey was sent to program directors initially, but on occasion was redirected to other faculty members involved in resident education or to senior residents. Survey responses were collected over an 18-month period. Twelve programs responded to the survey (11 complete responses). Eleven programs (92%) reported introducing an obstetrics and gynaecology simulation curriculum into their residency education. All respondents (100%) had access to a simulation centre. Simulation was used to teach various obstetrical and gynaecological skills using different simulation modalities. Barriers to simulation integration were primarily the costs of equipment and space and the need to ensure dedicated time for residents and educators. The majority of programs indicated that it was a priority for them to enhance their simulation curriculum and transition to competency-based resident assessment. Simulation training has increased in obstetrics and gynaecology residency programs. The development of formal simulation curricula for use in obstetrics and gynaecology resident education is in early development. A standardized national simulation curriculum would help facilitate the integration of simulation into obstetrics and gynaecology resident education and aid in the shift to competency-based resident assessment. Obstetrics and gynaecology residency programs need national collaboration (between centres and specialties) to develop a standardized simulation curriculum for use in obstetrics and gynaecology residency programs in Canada.

  18. Obstetrics and Gynecology Resident Interest and Participation in Global Health. (United States)

    Stagg, Amy R; Blanchard, May Hsieh; Carson, Sandra A; Peterson, Herbert B; Flynn, Erica B; Ogburn, Tony


    To evaluate obstetrics and gynecology resident interest and participation in global health experiences and elucidate factors associated with resident expectation for involvement. A voluntary, anonymous survey was administered to U.S. obstetrics and gynecology residents before the 2015 Council on Resident Education in Obstetrics and Gynecology in-training examination. The 23-item survey gathered demographic data and queried resident interest and participation in global health. Factors associated with resident expectation for participation in global health were analyzed by Pearson χ tests. Of the 5,005 eligible examinees administered the survey, 4,929 completed at least a portion of the survey for a response rate of 98.5%. Global health was rated as "somewhat important" or "very important" by 96.3% (3,761/3,904) of residents. "Educational opportunity" (69.2%) and "humanitarian effort" (17.7%) were cited as the two most important aspects of a global health experience. Residents with prior global health experience rated the importance of global health more highly and had an increased expectation for future participation. Global health electives were arranged by residency programs for 18.0% (747/4,155) of respondents, by residents themselves as an elective for 44.0% (1,828/4,155), and as a noncredit experience during vacation time for 36.4% (1,514/4,155) of respondents. Female gender, nonpartnered status, no children, prior global health experience, and intention to incorporate global health in future practice were associated with expectations for a global health experience. Most obstetrics and gynecology residents rate a global health experience as somewhat or very important, and participation before or during residency increases the perceived importance of global health and the likelihood of expectation for future participation. A majority of residents report arranging their own elective or using vacation time to participate, suggesting that residency programs have

  19. An Objective Structured Clinical Examination to Assess Pharmacy Resident Performance

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    Kimberly A.B. Cauthon


    Full Text Available Objective: The objective was to utilize an Objective Structured Clinical Examination (OSCE for assessment of pharmacy residents. Innovation: Post-graduate year 1 (PGY1 and post-graduate year 2 (PGY2 pharmacy residents completing multiple, local residency programs were invited to participate in an OSCE. A total of eight PGY1 residents and one PGY2 resident completed the OSCE. American Society of Health-System Pharmacists (ASHP residency program goals were aligned for each case, which were originally developed for a fourth-year pharmacy student OSCE. Station design included outpatient and inpatient settings with patient and physician interactions. Median communication and clinical skills scores were evaluated. Critical Analysis: The OSCE allows for assessment of all residents on common scenarios. Pharmacy residents met competency requirements and demonstrated excellent communication skills. The OSCE was able to evaluate both physician-pharmacist communication and patient-pharmacist communication. Baseline performance related to the ASHP goals and objectives was not completed; however, the OSCE could highlight resident strengths and weaknesses in communication and clinical skills. The OSCE could simulate independent practice, may reduce bias, and could provide an evaluation of the resident by a patient. However, the OSCE incurs higher resource utilization, specifically monetary and time, than other assessment methods. Next Steps: The pilot study results provide a beginning for further study of OSCEs for pharmacy residents. Further study should include surveying the residency directors about use of the OSCE, a comparison of performance between the OSCE and preceptor evaluations of residents on ASHP goals and objectives, and an evaluation of OSCE implementation at different time points within the residency. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in

  20. Effect of the learning climate of residency programs on faculty's teaching performance as evaluated by residents

    NARCIS (Netherlands)

    Lombarts, Kiki M. J. M. H.; Heineman, Maas Jan; Scherpbier, Albert J. J. A.; Arah, Onyebuchi A.


    To understand teaching performance of individual faculty, the climate in which residents' learning takes place, the learning climate, may be important. There is emerging evidence that specific climates do predict specific outcomes. Until now, the effect of learning climate on the performance of the

  1. Prevalence of mental disorders in migrants compared with original residents and local residents in Ningxia, China

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    Zhizhong Wang


    Full Text Available Abstract Background Ecological migrants has a special background compared with other types of migrant. However, the mental health status of ecological migrants who were expected to benefit from a massive “ecological migration project” initiated by the Chinese government is unknown. This study aims to explore the influence of environmental change on individuals’ mental health and to improve current understanding of the mechanisms that mental disorders occurred. Methods The data were extracted from a cross-sectional study. Anxiety disorders, mood disorders and substance use disorders were assessed using the Chinese version WHO-CIDI. The prevalence of mental disorders was stratified by migration status into ecological migrant, local resident and original resident groups. Unconditional logistic regression models were used to calculate the risk of prevalence among these three groups. Results After controlling for gender, ethnicity, age, marriage, and education, the migrants had lower risk of mental disorders than original residents [OR = 0.70 (95 % CI: 0.57–0.86], p < 0.001, but had a higher risk of mental disorders than local residents [OR = 1.29 (95 % CI: 1.06–1.55], p = 0.007. Conclusion The ecological migration project may be beneficial to people’s mental health by improving their living environment and social economy.

  2. Resident-to-resident relational aggression and subjective well-being in assisted living facilities

    NARCIS (Netherlands)

    Trompetter, H.R.; Trompetter, Hester; Scholte, Ron; Westerhof, Gerben Johan


    Purpose: Research in settings similar to assisted living facilities suggests that relational aggression, an indirect and mature form of aggression, might occur in assisted living facilities. This empirical study investigates the existence of relational aggression in a sample of residents and the

  3. Urban residents' priorities for neighborhood features. A survey of New Orleans residents after Hurricane Katrina. (United States)

    Hong, Traci; Farley, Thomas A


    Efforts to promote physical activity through environmental changes in low-income, urban, and minority areas should be informed by an understanding of the value that residents place on different neighborhood features and characteristics. Neighborhood rebuilding preferences among 442 New Orleans residents after the damage from Hurricane Katrina were assessed by a random-digit-dialed telephone survey conducted between April 25, 2006 and May 2, 2006. The survey instrument assessed the importance (on a 5-point Likert-type scale on which 1=not at all important and 5=extremely important) for 24 neighborhood features and characteristics. Ratings of neighborhood features were compared by race and income. Overall, residents rated most highly the features that reflected low levels of neighborhood crime and disorder. There was moderate support for features that promote physical activity, specifically sidewalks and crosswalks, neighborhood grocery stores, and parks or playgrounds. Blacks rated more highly than whites 13 neighborhood features such as good schools, lack of noise, a park or playground, affordable housing, health clinics, and the absence of liquor stores. The low-income group rated the following features as being more important than the high-income group: affordable housing, a bus or streetcar line, and the presence of a corner store. New Orleans residents' top neighborhood priority is reducing crime and disorder, but all groups otherwise support neighborhood features that promote physical activity.

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

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    McGrath, Jillian


    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

  5. Deaths from Resident-to-Resident Aggression in Australian Nursing Homes. (United States)

    Murphy, Briony; Bugeja, Lyndal; Pilgrim, Jennifer; Ibrahim, Joseph E


    To describe the frequency and nature of deaths from resident-to-resident aggression (RRA) in nursing homes in Australia. National population-based retrospective cohort study. Accredited nursing homes in Australia. Residents whose deaths resulted from RRA and were reported to the coroner between July 1, 2000, and December 31, 2013. Cases were identified using the National Coronial Information System, and data on individual, interpersonal, organizational, and societal factors were collected through review of the paper-based coroners' files. This research identified 28 deaths from RRA over a 14-year study period (0.004 per 100,000 bed days). Most exhibitors of aggression were male (n = 24, 85.7%), and risk of death from RRA was twice as high for male as for female nursing home residents (relative risk (RR) = 2.13, 95% confidence interval (CI) = 0.93-4.80, P = .05). Almost 90% of residents involved in RRA had a diagnosis of dementia, and three-quarters had a history of behavioral problems, including wandering and aggression. Dyad analysis showed that exhibitors of aggression were often younger and more recently admitted to the nursing home than targets. RRA incidents commonly occurred in communal areas and during the afternoon and involved a "push and fall." Seven (25%) RRA deaths had a coronial inquest; criminal charges were rarely filed. This is the first national study in Australia, and the largest internationally, to examine RRA deaths using medicolegal data. This generates hypotheses for future research on the effect of environmental and organizational factors on the frequency and preventability of RRA. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

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


    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

  7. Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes. (United States)

    Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi


    Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

  8. Extremes in Otolaryngology Resident Surgical Case Numbers: An Update. (United States)

    Baugh, Tiffany P; Franzese, Christine B


    Objectives The purpose of this study is to examine the effect of minimum case numbers on otolaryngology resident case log data and understand differences in minimum, mean, and maximum among certain procedures as a follow-up to a prior study. Study Design Cross-sectional survey using a national database. Setting Academic otolaryngology residency programs. Subjects and Methods Review of otolaryngology resident national data reports from the Accreditation Council for Graduate Medical Education (ACGME) resident case log system performed from 2004 to 2015. Minimum, mean, standard deviation, and maximum values for total number of supervisor and resident surgeon cases and for specific surgical procedures were compared. Results The mean total number of resident surgeon cases for residents graduating from 2011 to 2015 ranged from 1833.3 ± 484 in 2011 to 2072.3 ± 548 in 2014. The minimum total number of cases ranged from 826 in 2014 to 1004 in 2015. The maximum total number of cases increased from 3545 in 2011 to 4580 in 2015. Multiple key indicator procedures had less than the required minimum reported in 2015. Conclusion Despite the ACGME instituting required minimum numbers for key indicator procedures, residents have graduated without meeting these minimums. Furthermore, there continues to be large variations in the minimum, mean, and maximum numbers for many procedures. Variation among resident case numbers is likely multifactorial. Ensuring proper instruction on coding and case role as well as emphasizing frequent logging by residents will ensure programs have the most accurate data to evaluate their case volume.

  9. Disparities in Aesthetic Procedures Performed by Plastic Surgery Residents. (United States)

    Silvestre, Jason; Serletti, Joseph M; Chang, Benjamin


    Operative experience in aesthetic surgery is an important issue affecting plastic surgery residents. This study addresses the variability of aesthetic surgery experience during plastic surgery residency. National operative case logs of chief residents in independent/combined and integrated plastic surgery residency programs were analyzed (2011-2015). Fold differences between the bottom and top 10th percentiles of residents were calculated for each aesthetic procedure category and training model. The number of residents not achieving case minimums was also calculated. Case logs of 818 plastic surgery residents were analyzed. There was marked variability in craniofacial (range, 6.0-15.0), breast (range, 2.4-5.9), trunk/extremity (range, 3.0-16.0), and miscellaneous (range, 2.7-22.0) procedure categories. In 2015, the bottom 10th percentile of integrated and independent/combined residents did not achieve case minimums for botulinum toxin and dermal fillers. Case minimums were achieved for the other aesthetic procedure categories for all graduating years. Significant variability persists for many aesthetic procedure categories during plastic surgery residency training. Greater efforts may be needed to improve the aesthetic surgery experience of plastic surgery residents. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission:

  10. Burnout, engagement and resident physicians' self-reported errors. (United States)

    Prins, J T; van der Heijden, F M M A; Hoekstra-Weebers, J E H M; Bakker, A B; van de Wiel, H B M; Jacobs, B; Gazendam-Donofrio, S M


    Burnout is a work-related syndrome that may negatively affect more than just the resident physician. On the other hand, engagement has been shown to protect employees; it may also positively affect the patient care that the residents provide. Little is known about the relationship between residents' self-reported errors and burnout and engagement. In our national study that included all residents and physicians in The Netherlands, 2115 questionnaires were returned (response rate 41.1%). The residents reported on burnout (Maslach Burnout Inventory-Health and Social Services), engagement (Utrecht Work Engagement Scale) and self-assessed patient care practices (six items, two factors: errors in action/judgment, errors due to lack of time). Ninety-four percent of the residents reported making one or more mistake without negative consequences for the patient during their training. Seventy-one percent reported performing procedures for which they did not feel properly trained. More than half (56%) of the residents stated they had made a mistake with a negative consequence. Seventy-six percent felt they had fallen short in the quality of care they provided on at least one occasion. Men reported more errors in action/judgment than women. Significant effects of specialty and clinical setting were found on both types of errors. Residents with burnout reported significantly more errors (p engaged residents reported fewer errors (p burnout and to keep residents engaged in their work.

  11. A theory-informed, process-oriented Resident Scholarship Program. (United States)

    Thammasitboon, Satid; Darby, John B; Hair, Amy B; Rose, Karen M; Ward, Mark A; Turner, Teri L; Balmer, Dorene F


    The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT) and emphasize the process of scholarly activity versus a scholarly product. The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents' intrinsic motivation to learn and to engage in scholarly activity. To this end, residents' engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Based on our experience, and in line with the SDT, supporting residents' autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products.

  12. The PRIME curriculum. Clinical research training during residency. (United States)

    Kohlwes, R J; Shunk, R L; Avins, A; Garber, J; Bent, S; Shlipak, M G


    The Primary Medical Education (PRIME) program is an outpatient-based, internal medicine residency track nested within the University of California, San Francisco (UCSF) categorical medicine program. Primary Medical Education is based at the San Francisco Veteran's Affairs Medical Center (VAMC), 1 of 3 teaching hospitals at UCSF. The program accepts 8 UCSF medicine residents annually, who differentiate into PRIME after internship. In 2000, we implemented a novel research methods curriculum with the dual purposes of teaching basic epidemiology skills and providing mentored opportunities for clinical research projects during residency. Single academic internal medicine program. The PRIME curriculum utilizes didactic lecture, frequent journal clubs, work-in-progress sessions, and active mentoring to enable residents to "try out" a clinical research project during residency. Among 32 residents in 4 years, 22 residents have produced 20 papers in peer-reviewed journals, 1 paper under review, and 2 book chapters. Their clinical evaluations are equivalent to other UCSF medicine residents. While learning skills in evidence-based medicine, residents can conduct high-quality research. Utilizing a collaboration of General Internal Medicine researchers and educators, our curriculum affords residents the opportunity to "try-out" clinical research as a potential future career choice.

  13. Interventional Pain Procedures in Physical Medicine and Rehabilitation Residencies. (United States)

    Agarwal, Sanjeev; Cicone, Caitlin; Chang, Philip


    Exposure to interventional pain procedures is now a required component of training in physical medicine and rehabilitation residencies as mandated by the Accreditation Council for Graduate Medical Education. Data regarding resident exposure and competency in these procedures remain limited. Objectives were to determine the volume and type of exposure physical medicine and rehabilitation residents have to interventional pain procedures and to obtain faculty-perceived opinions regarding competency of incoming fellows as it pertains to interventional pain management. Online surveys were sent to program directors of physical medicine and rehabilitation residencies and fellowship directors of interventional spine, sports medicine, and pain medicine fellowships. Surveys inquired about educational methods, the volume of procedures in which residents actively participate, and faculty-perceived competency of trainees performing procedures. Thirty-nine residency programs and 27 fellowships responded to the surveys. Of the 39 residencies that responded, there was great variation in the exposure residents receive. Most programs reported that residents have moderate exposure to common procedures such as ultrasound-guided knee injections and lumbar epidural injections. In addition, while most residency program directors report graduates to be "fairly prepared" (33%) to "well prepared" (20.5%) with regard to spine procedures, most fellowship directors (63%) describe incoming fellows to be at the "beginner" level.

  14. Scholar Quest: A Residency Research Program Aligned With Faculty Goals

    Directory of Open Access Journals (Sweden)

    Ashish R. Panchal


    Full Text Available Introduction: The ACGME requires that residents perform scholarly activities prior to graduation, but this is difficult to complete and challenging to support. We describe a residency research program, taking advantage of environmental change aligning resident and faculty goals, to become a contributor to departmental cultural change and research development. Methods: A research program, Scholar Quest (SQ, was developed as a part of an Information Mastery program. The goal of SQ is for residents to gain understanding of scholarly activity through a mentor-directed experience in original research. This curriculum is facilitated by providing residents protected time for didactics, seed grants and statistical/staff support. We evaluated total scholarly activity and resident/faculty involvement before and after implementation (PRE-SQ; 2003-2005 and POST-SQ; 2007-2009. Results: Scholarly activity was greater POST-SQ versus PRE-SQ (123 versus 27 (p<0.05 with an incidence rate ratio (IRR=2.35. Resident and faculty involvement in scholarly activity also increased PRE-SQ to POST-SQ (22 to 98 residents; 10 to 39 faculty, p<0.05 with an IRR=2.87 and 2.69, respectively. Conclusion: Implementation of a program using department environmental change promoting a resident longitudinal research curriculum yielded increased resident and faculty scholarly involvement, as well as an increase in total scholarly activity.

  15. Personality Testing May Improve Resident Selection in Anesthesiology Programs (United States)

    Merlo, Lisa J.; Matveevskii, Alexander S.


    Background Current methods of selecting future residents for anesthesiology training programs do not adequately distinguish those who will succeed from the pool of seemingly well-qualified applicants. Some residents, despite high exam scores, may struggle in the OR in stressful situations. Aims This study examined whether specific neuropsychological and personality measures can distinguish high competency residents from low competency residents to aid in resident selection. Methods 25 residents enrolled in an anesthesiology program at a major academic institution were identified for participation. 13 were evaluated identified as “high competency” residents and 12 as “low competency ” by the department's clinical competency committee. Groups were evaluated on measures of fine motor dexterity, executive functioning, processing speed, attention, and personality using IPIP-NEO. Results There were no significant differences between groups on measures of fine-motor dexterity, executive functioning, processing speed, or attention. High competency residents scored significantly higher than low competency residents on measures of cooperation, self-efficacy, and adventurousness, and lower on measures of neuroticism, anxiety, anger, and vulnerability. Conclusion Although measures of fine-motor dexterity, executive functioning, processing speed, and attention do not appear to distinguish between high- and low competency residents in anesthesiology, specific personality characteristics may be associated with future success in an anesthesiology training program. PMID:19995155

  16. Fellows as teachers: a model to enhance pediatric resident education. (United States)

    Backes, Carl H; Reber, Kris M; Trittmann, Jennifer K B; Huang, Hong; Tomblin, Jordanna; Moorehead, Pamela A; Bauer, John A; Smith, Charles V; Mahan, John D


    Pressures on academic faculty to perform beyond their role as educators has stimulated interest in complementary approaches in resident medical education. While fellows are often believed to detract from resident learning and experience, we describe our preliminary investigations utilizing clinical fellows as a positive force in pediatric resident education. Our objectives were to implement a practical approach to engage fellows in resident education, evaluate the impact of a fellow-led education program on pediatric resident and fellow experience, and investigate if growth of a fellowship program detracts from resident procedural experience. This study was conducted in a neonatal intensive care unit (NICU) where fellows designed and implemented an education program consisting of daily didactic teaching sessions before morning clinical rounds. The impact of a fellow-led education program on resident satisfaction with their NICU experience was assessed via anonymous student evaluations. The potential value of the program for participating fellows was also evaluated using an anonymous survey. The online evaluation was completed by 105 residents. Scores were markedly higher after the program was implemented in areas of teaching excellence (4.44 out of 5 versus 4.67, pteaching skills and enhanced knowledge of neonatal pathophysiology as the most valuable aspects of their participation in the education program. The anonymous survey revealed that 87.5% of participating residents believed that NICU fellows were very important to their overall training and education. While fellows are often believed to be a detracting factor to residency training, we found that pediatric resident attitudes toward the fellows were generally positive. In our experience, in the specialty of neonatology a fellow-led education program can positively contribute to both resident and fellow learning and satisfaction. Further investigation into the value of utilizing fellows as a positive force in

  17. Resident Preferences for Program Director Role in Wellness Management. (United States)

    Kolarik, Russ C; O'Neal, Richard L; Ewing, Joseph A


    Burnout and depression are prevalent among resident physicians, though the supportive role of the program director (PD) is not well defined. To understand the residents' view of the residency program director's role in assessing and promoting resident wellness. A single institution survey of all house staff was conducted in 2017. Rates of burnout and depression were identified via the 2-item Maslach Burnout Inventory (MBI) and the Patient Health Questionaire-2 (PHQ-2), respectively. Residents then qualified their preferences for various assistance services and for the role of their program directors in assisting them. One-hundred sixty-one of 202 (79.7%) residents completed the survey. The rate of depression was 28%. Rates of emotional exhaustion and depersonalization (2-item MBI) were 44 and 62%, respectively. Only 4% of respondents had used the Employee Assistance Program (EAP) in the prior 12 months. Eighty-two percent of residents were in favor of PDs inquiring about wellness regardless of their job performance and only 1% of residents stated the PD should not inquire about wellness at all. Thirty-three percent of residents reported that they would be likely to contact EAP on their own if they felt unwell. Significantly more residents (62%) reported being more likely to contact EAP if recommended by their PD (33 vs 62%, p < 0.001%). Important perceived barriers to seeking assistance were lack of time (65%), lack of knowledge of how to contact EAP (41%), and concerns about appearing weak (35%). Despite a high prevalence of burnout and depression, residents are unlikely to seek help on their own. Program directors have an important role in assessing and promoting the wellness of their residents. The majority of residents wants their PD to inquire about wellness and may be more likely to seek and receive help if recommended and facilitated by their PD.

  18. Abortion training in Canadian obstetrics and gynecology residency programs. (United States)

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


    To evaluate the current state of abortion training in Canadian Obstetrics and Gynecology residency programs. Surveys were distributed to all Canadian Obstetrics and Gynecology residents and program directors. Data were collected on inclusion of abortion training in the curriculum, structure of the training and expected competency of residents in various abortion procedures. We distributed and collected surveys between November 2014 and May 2015. In total, 301 residents and 15 program directors responded, giving response rates of 55% and 94%, respectively. Based on responses by program directors, half of the programs had "opt-in" abortion training, and half of the programs had "opt-out" abortion training. Upon completion of residency, 66% of residents expected to be competent in providing first-trimester surgical abortion in an ambulatory setting, and 35% expected to be competent in second-trimester surgical abortion. Overall, 15% of residents reported that they were not aware of or did not have access to abortion training within their program, and 69% desired more abortion training during residency. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, and residents desire more training in abortion. This suggests an ongoing unmet need for training in this area. Policies mandating standardized abortion training in obstetrics and gynecology residency programs are necessary to improve delivery of family planning services to Canadian women. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, does not meet resident demand and is unlikely to fulfill the Royal College of Physicians and Surgeons of Canada objectives of training in the specialty. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. How Useful are Orthopedic Surgery Residency Web Pages? (United States)

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


    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

  20. The Prevalence of Burnout Among US Neurosurgery Residents. (United States)

    Shakir, Hakeem J; McPheeters, Matthew J; Shallwani, Hussain; Pittari, Joseph E; Reynolds, Renée M


    Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Its prevalence among US physicians exceeds 50% and is higher among residents/fellows. This is important to the practice of neurosurgery, as burnout is associated with adverse physical health, increased risk of substance abuse, and increased medical errors. To date, no study has specifically addressed the prevalence of burnout among neurosurgery residents. To determine and compare the prevalence of burnout among US neurosurgery residents with published rates for residents/fellows and practicing physicians from other specialties. We surveyed 106 US neurosurgery residency training programs to perform a descriptive analysis of the prevalence of burnout among residents. Data on burnout among control groups were used to perform a cross-sectional analysis. Nonparametric tests assessed differences in burnout scores among neurosurgery residents, and the 2-tailed Fisher's exact test assessed burnout between neurosurgery residents and control populations. Of approximately 1200 US neurosurgery residents, 255 (21.3%) responded. The prevalence of burnout was 36.5% (95% confidence interval: 30.6%-42.7%). There was no significant difference in median burnout scores between gender (P = .836), age (P = .183), or postgraduate year (P = .963) among neurosurgery residents. Neurosurgery residents had a significantly lower prevalence of burnout (36.5%) than other residents/fellows (60.0%; P burnout than other residents/fellows and practicing physicians. The underlying causes for these findings were not assessed and are likely multifactorial. Future studies should address possible causes of these findings. Copyright © 2017 by the Congress of Neurological Surgeons

  1. Tissue-resident memory T cells. (United States)

    Shin, Haina; Iwasaki, Akiko


    Tissues such as the genital tract, skin, and lung act as barriers against invading pathogens. To protect the host, incoming microbes must be quickly and efficiently controlled by the immune system at the portal of entry. Memory is a hallmark of the adaptive immune system, which confers long-term protection and is the basis for efficacious vaccines. While the majority of existing vaccines rely on circulating antibody for protection, struggles to develop antibody-based vaccines against infections such as herpes simplex virus (HSV) and human immunodeficiency virus (HIV) have underscored the need to generate memory T cells for robust antiviral control. The circulating memory T-cell population is generally divided into two subsets: effector memory (TEM ) and central memory (TCM ). These two subsets can be distinguished by their localization, as TCM home to secondary lymphoid organs and TEM circulate through non-lymphoid tissues. More recently, studies have identified a third subset, called tissue-resident memory (TRM ) cells, based on its migratory properties. This subset is found in peripheral tissues that require expression of specific chemoattractants and homing receptors for T-cell recruitment and retention, including barrier sites such as the skin and genital tract. In this review, we categorize different tissues in the body based on patterns of memory T-cell migration and tissue residency. This review also describes the rules for TRM generation and the properties that distinguish them from circulating TEM and TCM cells. Finally, based on the failure of recent T-cell-based vaccines to provide optimal protection, we also discuss the potential role of TRM cells in vaccine design against microbes that invade through the peripheral tissues and highlight new vaccination strategies that take advantage of this newly described memory T-cell subset. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Atmospheric residence times of continental aerosols

    International Nuclear Information System (INIS)

    Balkanski, Y.J.


    The global atmospheric distributions of Rn-222 are simulated with a three-dimensional model of atmospheric transport based on the meteorology of the NASA Goddard Institute for Space Studies (GISS) general circulation model. The short-lived radioactive gas Rn-222 (half-life = 3.8d) is emitted almost exclusively from land, at a relatively uniform rate; hence it is an excellent tracer of continental influences. Lead-210 is produced by decay of Rn-222 and immediately condenses to preexisting aerosol surfaces. It provides an excellent measure of aerosol residence times in the atmosphere because its source is accurately defined by the Rn-222 distribution. Results from the three-dimensional model are compared to measurements of Rn-222 and Pb-210 atmospheric concentrations to evaluate model's long-range transport over oceanic regions and to study the deposition mechanisms of atmospheric aerosols. Model results for Rn-222 are used to examine the long-range transport of continental air over two selected oceanic regions, the subantarctic Indian Ocean and the North Pacific. It is shown that the fast transport of air from southern Africa causes substantial continental pollution at southern mid-latitudes, a region usually regarded as pristine. Air over the North Pacific is heavily impacted by continental influences year round, but the altitude at which the transport occurs varies seasonally. Observations of aerosols at island sites, which are commonly used as diagnostics of continental influences, may be misleading because they do not account for influences at high altitude and because aerosols are efficiently scavenged by deposition during transport. The study of Pb-210 focuses on defining the residence times of submicron aerosols in the troposphere. Scavenging in wet convective updrafts is found to provide the dominant sink on a global scale

  3. Patient satisfaction and resident postgraduate year status. (United States)

    Nadkarni, Girish N; Sabharwal, Manpreet Singh; Ammakkanavar, Natraj Reddy; Annapureddy, Narender; Malhan, Rishi; Mehta, Bijal; Kanakadandi, Vijay Naag; Agarwal, Shiv Kumar; Fried, Ethan D


    Patient satisfaction has been recognized as an important variable affecting healthcare behavior. However, there are limited data on the relationship between doctor post-graduate year (PGY) status and patient satisfaction with provider interpersonal skills and humanistic qualities. The authors aims to assess this relationship using an American Board of Internal Medicine (ABIM) questionnaire. Participants were: patients attending a primary care clinic at a large urban academic hospital; and physicians treating them. The survey questionnaire was the ABIM patient satisfaction instrument; ten questions pertaining to humanistic qualities and communication skills with responses from poor to excellent. Mann Whitney U test and multi-variable logistic regression analyses were used to explore score differences by PGY level. The postgraduate year one (PGY1) had higher patient-satisfaction levels compared to PGY2/PGY3 residents. The PGY1 level residents were more likely to score in the 90th percentile and this remained constant even after adjusting for confounders. The research was a single-center study and may have been subject to confounding factors such as patient personality types and a survey ceiling effect. The survey's cross-sectional nature may also be a potential limitation. Practical implications - Patient satisfaction varies significantly with PGY status. Though clinical skills may improve with increasing experience, findings imply that interpersonal and humanistic qualities may deteriorate. The study is the first to assess patient satisfaction with PGY status and provides evidence that advanced trainees may need support to keep their communication skills and humanistic qualities from deteriorating as stressors increase to ensure optimal patient satisfaction.

  4. Life satisfaction of people with intellectual disability living in community residences: perceptions of the residents, their parents and staff members. (United States)

    Schwartz, C; Rabinovitz, S


    Within the literature on quality of life (QoL), life satisfaction (LS) has emerged as a key variable by which to measure perceived well-being, which is referred to as subjective QoL. The LS self-reports of 93 residents with intellectual disability (ID) living in community-based residences were compared with reports about their LS completed by their staff and parents. The residents were interviewed on their LS by social workers who did not belong to the staff of the interviewee's residence. The instrument used was the Life Satisfaction Scale (LSS). Staff and parents completed the short version of the LSS. Residents and staff's LS reports were positively correlated. However, significant differences were found between these two groups of informants when the residents were characterized as high functioning, had a low score in challenging behaviour, worked in an integrative employment setting and lived in an apartment. As opposed to staff/resident discrepancies, no differences were found between parents' and residents' LS reports. If residents cannot to be interviewed about their LS, then the parent is the preferred person to respond on behalf of the resident. The current study highlights the importance of including both objective measures (e.g. functional assessment characteristics) and subjective measures (e.g. LS) in order to get a better understanding of the QoL of people with ID.

  5. Incorporating Interpersonal Skills into Otolaryngology Resident Selection and Training. (United States)

    Lu-Myers, Yemeng; Myers, Christopher G


    Increasing attention has been paid to the selection of otolaryngology residents, a highly competitive process but one with room for improvement. A recent commentary in this journal recommended that residency programs more thoroughly incorporate theory and evidence from personnel psychology (part of the broader field of organizational science) in the resident selection process. However, the focus of this recommendation was limited to applicants' cognitive abilities and independent work-oriented traits (eg, conscientiousness). We broaden this perspective to consider critical interpersonal skills and traits that enhance resident effectiveness in interdependent health care organizations and we expand beyond the emphasis on selection to consider how these skills can be honed during residency. We advocate for greater use of standardized team-based care simulations, which can aid in assessing and developing the key interpersonal leadership skills necessary for success as an otolaryngology resident.

  6. Prolonged and tunable residence time using reversible covalent kinase inhibitors. (United States)

    Bradshaw, J Michael; McFarland, Jesse M; Paavilainen, Ville O; Bisconte, Angelina; Tam, Danny; Phan, Vernon T; Romanov, Sergei; Finkle, David; Shu, Jin; Patel, Vaishali; Ton, Tony; Li, Xiaoyan; Loughhead, David G; Nunn, Philip A; Karr, Dane E; Gerritsen, Mary E; Funk, Jens Oliver; Owens, Timothy D; Verner, Erik; Brameld, Ken A; Hill, Ronald J; Goldstein, David M; Taunton, Jack


    Drugs with prolonged on-target residence times often show superior efficacy, yet general strategies for optimizing drug-target residence time are lacking. Here we made progress toward this elusive goal by targeting a noncatalytic cysteine in Bruton's tyrosine kinase (BTK) with reversible covalent inhibitors. Using an inverted orientation of the cysteine-reactive cyanoacrylamide electrophile, we identified potent and selective BTK inhibitors that demonstrated biochemical residence times spanning from minutes to 7 d. An inverted cyanoacrylamide with prolonged residence time in vivo remained bound to BTK for more than 18 h after clearance from the circulation. The inverted cyanoacrylamide strategy was further used to discover fibroblast growth factor receptor (FGFR) kinase inhibitors with residence times of several days, demonstrating the generalizability of the approach. Targeting of noncatalytic cysteines with inverted cyanoacrylamides may serve as a broadly applicable platform that facilitates 'residence time by design', the ability to modulate and improve the duration of target engagement in vivo.

  7. [Knowledge of health care ethics in paediatric residents]. (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


    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.

  8. Residence time determination for adsorbent beds of different configurations

    Energy Technology Data Exchange (ETDEWEB)

    Otermat, J.E.; Wikoff, W.O.; Kovach, J.L.


    The residence time calculations of ASME AG-1 Code, Section FC, currently specify a screen surface area method, that is technically incorrect. Test data has been obtained on Type II adsorber trays of different configurations to establish residence time in the adsorber trays. These data indicate that the air volume/carbon volume ratio or the average screen area are more appropriate for the calculation of the residence time calculation than the currently used, smallest screen area basis.

  9. Resident Career Planning Needs in Internal Medicine: A Qualitative Assessment (United States)

    Garcia, Rina L.; Windish, Donna M.; Rosenbaum, Julie R.


    Background Few residency programs have centralized resources for career planning. As a consequence, little is known about residents' informational needs regarding career planning. Objective To examine career preparation stressors, practical needs, and information that residents wished they were privy to when applying. Methods In 2007 and 2008, we surveyed 163 recent graduates or graduating residents from 10 Yale-based and Yale-affiliated hospitals' internal medicine programs regarding their experiences with applying for positions after residency. We included questions about demographics, mentorship, stress of finding a job or fellowship, and open-ended questions to assess barriers and frustrations. Qualitative data were coded independently and a classification scheme was negotiated by consensus. Results A total of 89 residents or recent graduates responded, and 75% of them found career planning during residency training at least somewhat stressful. Themes regarding the application process included (1) knowledge about the process, (2) knowledge about career paths and opportunities, (3) time factors, (4) importance of adequate personal guidance and mentorship, and (5) self-knowledge regarding priorities and the desired outcome. Residents identified the following advice as most important: (1) start the process as early as possible and with a clear knowledge of the process timeline, (2) be clear about personal goals and priorities, and (3) be well-informed about a prospective employer and what that employer is looking for. Most residents felt career planning should be structured into the curriculum and should occur in the first year or throughout residency. Conclusions This study highlights residents' desire for structured dissemination of information and counseling with regard to career planning during residency. Our data suggest that exposure to such resources may be beneficial as early as the first year of training. PMID:22132271

  10. Resident career planning needs in internal medicine: a qualitative assessment. (United States)

    Garcia, Rina L; Windish, Donna M; Rosenbaum, Julie R


    Few residency programs have centralized resources for career planning. As a consequence, little is known about residents' informational needs regarding career planning. To examine career preparation stressors, practical needs, and information that residents wished they were privy to when applying. In 2007 and 2008, we surveyed 163 recent graduates or graduating residents from 10 Yale-based and Yale-affiliated hospitals' internal medicine programs regarding their experiences with applying for positions after residency. We included questions about demographics, mentorship, stress of finding a job or fellowship, and open-ended questions to assess barriers and frustrations. Qualitative data were coded independently and a classification scheme was negotiated by consensus. A total of 89 residents or recent graduates responded, and 75% of them found career planning during residency training at least somewhat stressful. Themes regarding the application process included (1) knowledge about the process, (2) knowledge about career paths and opportunities, (3) time factors, (4) importance of adequate personal guidance and mentorship, and (5) self-knowledge regarding priorities and the desired outcome. Residents identified the following advice as most important: (1) start the process as early as possible and with a clear knowledge of the process timeline, (2) be clear about personal goals and priorities, and (3) be well-informed about a prospective employer and what that employer is looking for. Most residents felt career planning should be structured into the curriculum and should occur in the first year or throughout residency. This study highlights residents' desire for structured dissemination of information and counseling with regard to career planning during residency. Our data suggest that exposure to such resources may be beneficial as early as the first year of training.

  11. Opinions of Otorhinolaryngology Residents about Their Education Process. (United States)

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


    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.

  12. Choosing family medicine residency programs: what factors infuence residents’ decisions? (United States)

    Lee, Joseph; Alferi, Marg; Patel, Tejal; Lee, Linda


    To describe key determinants for residents' selection of a new community-based, interprofessional site for their family medicine training, and to evaluate residents' satisfaction with their programs. Combined qualitative and quantitative methods using in-depth interviews and a survey. McMaster University, including the new site of the Centre for Family Medicine in Kitchener-Waterloo, Ont, and a long-established site in Hamilton, Ont. Eleven first-year and second-year family medicine residents from the Kitchener-Waterloo site participated in in-depth interviews. Forty-four first-year and second-year family medicine residents completed the survey, 22 in Kitchener-Waterloo and 22 in Hamilton. Kitchener-Waterloo residents participated in in-depth interviews during their residency programs in 2008 to 2009 using a semistructured format to explore their choice of site and the effect of an interprofessional environment on their education. Common themes were established using qualitative analysis techniques; based on these themes, a survey was developed and distributed to residents from both sites to further explore factors influencing site selection, satisfaction, and effects of interprofessional education. Residents identifIed several reasons for selecting a new community-based, interprofessional family medicine residency program. Reasons included preference for the location and opportunities to learn in an interprofessional teaching environment. A less hierarchical structure and greater opportunities for one-on-one teaching also influenced their choices. Perception of poor communication from the well established site was identified as a challenge. Residents at both sites indicated similarly high levels of program satisfaction. Residents selected the new community-based family medicine site for reasons of geographic location and the potential for clinical learning experiences and interprofessional education. High program satisfaction was achieved at both the new and well

  13. Workplace Violence and Harassment Against Emergency Medicine Residents


    Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.


    Introduction: Several studies have shown that workplace violence in the emergency department (ED) iscommon. Residents may be among the most vulnerable staff, as they have the least experience with thesevolatile encounters. The goal for this study was to quantify and describe acts of violence against emergencymedicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at mul...

  14. Results of the American Academy of Neurology resident survey. (United States)

    Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R


    To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

  15. Residence time determination for adsorbent beds of different configurations

    International Nuclear Information System (INIS)

    Otermat, J.E.; Wikoff, W.O.; Kovach, J.L.


    The residence time calculations of ASME AG-1 Code, Section FC, currently specify a screen surface area method, that is technically incorrect. Test data has been obtained on Type II adsorber trays of different configurations to establish residence time in the adsorber trays. These data indicate that the air volume/carbon volume ratio or the average screen area are more appropriate for the calculation of the residence time calculation than the currently used, smallest screen area basis

  16. Documenting resident procedure and diagnostic experience: simplifying the process. (United States)

    Baldor, R A; Broadhurst, J


    The Residency Review Committee (RRC) requires documentation of family practice residents' procedural and diagnostic experiences. Further, hospital privileging is frequently based on documentation of prior clinical experience. Residency programs need a user-friendly (ie, resident-friendly) mechanism for collecting data and generating reports to document these experiences. This paper outlines a simplified, user-friendly method of documenting resident procedural and diagnostic experiences. We developed a pocket-sized, optically scannable card for data input. This is coupled with a computerized database with report generation capability. The system is based on diagnostic clusters to further simplify the data input process. The system's setup costs are about $10,000. Annual maintenance and operational fees are about $5,000. After instituting the system, the number of residents submitting documentation information increased substantially. This system meets both RRC and potential clinical privileging requirements and provides a useful tool for guiding resident evaluation and developing appropriate training opportunities during the latter half of the residency. Simplified, accurate documentation may allow for comparisons among residents at various levels--program, state, and national.

  17. Knowledge and attitudes of residents regarding electroconvulsive therapy

    Directory of Open Access Journals (Sweden)

    Gokay Alpak


    Full Text Available AIM: To determine the knowledge and attitudes of non-psychiatry residents about electroconvulsive therapy (ECT and additionally to make a comparison between residents of medical sciences and surgical sciences. METHODS: The study consisted of 176 medical school graduates in their residency training (119 medical sciences, 57 surgical sciences at a university hospital. All subjects are asked to fill a questionnaire prepared by the authors. RESULTS: Among all, 58 of the medical sciences residents (48.7%, and 32 of the surgical sciences residents (56.1% had reported that they have never observed any ECT session. There was no statistically significant difference between the residents of the two groups in terms of theirs attitudes towards ECT (p>0.05. The residents of surgical sciences differed from the others only in their response to the question that sought answer whether they would agree to have any of their relatives to undergo ECT. They more often disagreed to this statement (p=0.02. CONCLUSIONS: The knowledge and attitudes of residents in medical, and surgical sciences about ECT seemed to be similar. Despite their significant amount of knowledge about ECT the residents showed similar attitudes towards it with the patients and their caregivers that were previously reported in the literature. Additionally, the results also suggest that current training in medical schools need a revision that would eventually improve attitudes of medical graduates towards ECT. [TAF Prev Med Bull 2015; 14(1.000: 33-38

  18. Workplace Violence and Harassment Against Emergency Medicine Residents. (United States)

    Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A


    Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  19. Policies and attitudes toward the pregnant radiology resident

    International Nuclear Information System (INIS)

    Sheth, S.; Freedman, M.T.; Arak, G.


    To evaluate attitudes and policies toward pregnant radiology residents, a questionnaire was sent to the chiefs of radiology residency programs across the country. A return rate of 76.4% and a response rate of 75.4% were achieved. A large majority of the respondents indicated that schedule changes would be made to avoid excessive exposure of a pregnant resident to radiation. The accommodations they suggest are reviewed, and suggestions are made that would help alleviate some of the stress and conflicts that invariably arise when a resident becomes pregnant

  20. 38 CFR 51.90 - Resident behavior and facility practices. (United States)


    ... or physical restraints imposed for purposes of discipline or convenience. When a restraint is applied... providing food and hydration (without physician, resident, or surrogate approval), clothing, medical care...

  1. Global health in general surgery residency: a national survey. (United States)

    Jayaraman, Sudha P; Ayzengart, Alexander L; Goetz, Laura H; Ozgediz, Doruk; Farmer, Diana L


    Interest in global health during postgraduate training is increasing across disciplines. There are limited data from surgery residency programs on their attitudes and scope of activities in this area. This study aims to understand how global health education fits into postgraduate surgical training in the US. In 2007 to 2008, we conducted a nationwide survey of program directors at all 253 US general surgery residencies using a Web-based questionnaire modified from a previously published survey. The goals of global health activities, type of activity (ie, clinical versus research), and challenges to establishing these programs were analyzed. Seventy-three programs responded to the survey (29%). Of the respondents, 23 (33%) offered educational activities in global health and 86% (n = 18) of these offered clinical rotations abroad. The primary goals of these activities were to prepare residents for a career in global health and to improve resident recruitment. The greatest barriers to establishing these activities were time constraints for faculty and residents, lack of approval from the Accreditation Council for Graduate Medical Education and Residency Review Committee, and funding concerns. Lack of interest at the institution level was listed by only 5% of program directors. Of the 47 programs not offering such activities, 57% (n = 27) were interested in establishing them. Few general surgery residency programs currently offer clinical or other educational opportunities in global health. Most residencies that responded to our survey are interested in such activities but face many barriers, including time constraints, Residency Review Committee restrictions, and funding.

  2. Emotional Intelligence as a Predictor of Resident Well-Being. (United States)

    Lin, Dana T; Liebert, Cara A; Tran, Jennifer; Lau, James N; Salles, Arghavan


    There is increasing recognition that physician wellness is critical; it not only benefits the provider, but also influences quality and patient care outcomes. Despite this, resident physicians suffer from a high rate of burnout and personal distress. Individuals with higher emotional intelligence (EI) are thought to perceive, process, and regulate emotions more effectively, which can lead to enhanced well-being and less emotional disturbance. This study sought to understand the relationship between EI and wellness among surgical residents. Residents in a single general surgery residency program were surveyed on a voluntary basis. Emotional intelligence was measured using the Trait Emotional Intelligence Questionnaire-Short Form. Resident wellness was assessed with the Dupuy Psychological General Well-Being Index, Maslach Burnout Inventory, and Beck Depression Inventory-Short Form. Emotional intelligence and wellness parameters were correlated using Pearson coefficients. Multivariate analysis was performed to identify factors predictive of well-being. Seventy-three residents participated in the survey (response rate 63%). Emotional intelligence scores correlated positively with psychological well-being (r = 0.74; p emotional exhaustion (r = -0.69; p emotional exhaustion (β = -0.63; p Emotional intelligence is a strong predictor of resident well-being. Prospectively measuring EI can identify those who are most likely to thrive in surgical residency. Interventions to increase EI can be effective at optimizing the wellness of residents. Copyright © 2016. Published by Elsevier Inc.

  3. Electrocardiographic interpretation skills of cardiology residents: are they competent? (United States)

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


    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.

  4. Competency-Based Medical Education: Can Both Junior Residents and Senior Residents Achieve Competence After a Sports Medicine Training Module? (United States)

    Dwyer, Tim; Wright, Sara; Kulasegaram, Kulamakan M; Theodoropoulos, John; Chahal, Jaskarndip; Wasserstein, David; Ringsted, Charlotte; Hodges, Brian; Ogilvie-Harris, Darrell


    Competency-based medical education as a resident-training format will move postgraduate training away from time-based training, to a model based on observable outcomes. The purpose of this study was to determine whether junior residents and senior residents could demonstrate clinical skills to a similar level, after a sports medicine rotation. All residents undertaking a three-month sports medicine rotation had to pass an Objective Structured Clinical Examination. The stations tested the fundamentals of history-taking, examination, image interpretation, differential diagnosis, informed consent, and clinical decision-making. Performance at each station was assessed with a binary station-specific checklist and an overall global rating scale, in which 1 indicated novice, 2 indicated advanced beginner, 3 indicated competent, 4 indicated proficient, and 5 indicated expert. A global rating scale was also given for each domain of knowledge. Over eighteen months, thirty-nine residents (twenty-one junior residents and eighteen senior residents) and six fellows (for a total of forty-five participants) completed the examination. With regard to junior residents and senior residents, analysis using a two-tailed t test demonstrated a significant difference (p < 0.01) in both total checklist score and overall global rating scale; the mean total checklist score (and standard deviation) was 56.15% ± 10.99% for junior residents and 71.87% ± 8.94% for senior residents, and the mean global rating scale was 2.44 ± 0.55 for junior residents and 3.79 ± 0.49 for senior residents. There was a significant difference between junior residents and senior residents for each knowledge domain, with a significance of p < 0.05 for history-taking and p < 0.01 for the remainder of the domains. Despite intensive teaching within a competency-based medical education model, junior residents were not able to demonstrate knowledge as well as senior residents, suggesting that overall clinical experience

  5. Ethics knowledge of recent paediatric residency graduates: the role of residency ethics curricula. (United States)

    Kesselheim, Jennifer C; Najita, Julie; Morley, Debra; Bair, Elizabeth; Joffe, Steven


    To evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency. We conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006-2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010-2011. This sample was stratified based on residency programme variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation. Among the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect). This study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  6. Facebook Use between College Resident Advisors’ and Their Residents: A Mixed Methods Approach


    Kacvinsky, Lauren E.; Moreno, Megan A.


    Facebook use is nearly ubiquitous among college students. Studies have shown links between Facebook displays of depression or problem drinking and risk of these problems. This project aimed to determine whether Facebook could be used to help Resident Advisors (RAs) identify college students at risk for depression or problem drinking. Interviews were conducted with college freshmen to investigate whether they were Facebook “friends” with their RA. Focus groups were conducted with RAs to determ...

  7. Do changes in residents' fear of crime impact their walking? Longitudinal results from RESIDE. (United States)

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


    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.

  8. Global Women's Health Education in Canadian Obstetrics and Gynaecology Residency Programs: A Survey of Program Directors and Senior Residents. (United States)

    Millar, Heather C; Randle, Elizabeth A; Scott, Heather M; Shaw, Dorothy; Kent, Nancy; Nakajima, Amy K; Spitzer, Rachel F


    To become culturally competent practitioners with the ability to care and advocate for vulnerable populations, residents must be educated in global health priorities. In the field of obstetrics and gynaecology, there is minimal information about global women's health (GWH) education and interest within residency programs. We wished to determine within obstetrics and gynaecology residency programs across Canada: (1) current GWH teaching and support, (2) the importance of GWH to residents and program directors, and (3) the level of interest in a national postgraduate GWH curriculum. We conducted an online survey across Canada of obstetrics and gynaecology residency program directors and senior obstetrics and gynaecology residents. Of 297 residents, 101 (34.0%) responded to the survey and 76 (26%) completed the full survey. Eleven of 16 program directors (68.8%) responded and 10/16 (62.5%) provided complete responses. Four of 11 programs (36.4%) had a GWH curriculum, 2/11 (18.2%) had a GWH budget, and 4/11 (36.4%) had a GWH chairperson. Nine of 10 program directors (90%) and 68/79 residents (86.1%) felt that an understanding of GWH issues is important for all Canadian obstetrics and gynaecology trainees. Only 1/10 program directors (10%) and 11/79 residents (13.9%) felt that their program offered sufficient education in these issues. Of residents in programs with a GWH curriculum, 12/19 (63.2%) felt that residents in their program who did not undertake an international elective would still learn about GWH, versus only 9/50 residents (18.0%) in programs without a curriculum (P education is important for all trainees and is currently insufficient. There is a high level of interest in a national postgraduate GWH educational module.

  9. Influences on the Retention of Residency-Trained and Non-Residency Trained Navy Dental Corps Officers (United States)


    Temporomandibular Dysfunction 14,000 10,000 8, (Advanced C l 12,000 8,000 6,000 12 creditable service”36 or have completed their active duty obligated...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT Influences on the Retention of Residency-Trained and...SUBTITLE: Influences on the Retention of Residency-Trained and Non-Residency Trained Navy Dental Corps Officers 6. AUTHOR(S) Alan B. Christian 5

  10. A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans. (United States)

    Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha


    In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.

  11. Mental health literacy among residents in Shanghai (United States)

    Wang, Jingyi; He, Yanling; Jiang, Qing; Cai, Jun; Wang, Weiling; Zeng, Qingzhi; Miao, Juming; Qi, Xuejun; Chen, Jianxin; Bian, Qian; Cai, Chun; Ma, Ning; Zhu, Ziqing; Zhang, Mingyuan


    Background The recent adoption of China's new national mental health law provides a good opportunity to obtain baseline information about community mental health literacy in the country. Aim Assess knowledge and attitudes about mental disorders among residents in Shanghai. Methods A total of 1953 residents aged 15 or above selected from all 19 districts in Shanghai completed two self-report questionnaires – the Mental Health Knowledge Questionnaire (MHKQ) and the Case Assessment Questionnaire (CAQ). MHKQ total scores range from 0 to 20 (higher scores indicate better mental health literacy). The CAQ presents respondents with five case vignettes and possesses nine questions after each vignette measuring respondents' knowledge and attitudes towards these mental illnesses. Results Correct response rates for the 20 MHKQ items ranged from 26 to 98%, with a mean rate of 72%. The internal consistency (alpha) of the 20 items on the MHKQ was 0.69, but this decreased to 0.59 after removing four items about mental health promotion. A 5-factor model for the 20 items in the MHKQ was identified using exploratory factor analysis on one-half of the surveys, but the model was only partially validated in the confirmatory factor analysis using the second half of the surveys. On the CAQ, rates of correct recognition of mania, depression, schizophrenia with positive symptoms, schizophrenia with negative symptoms and anxiety were 42%, 35%, 30%, 19% and 21%, respectively. Work stress (37.3%), problems with thinking (30.0%) and negative life events (24.4%) were reported to be the three main causes of mental disorders. Seeing a counselor (34.2%) or a psychiatrist (33.3%) were the two most common suggestions for help-seeking. Higher education and younger age were related with better mental health literacy and higher rates of recognition of common mental disorders. Conclusions Mental health literacy in Shanghai appears to be increasing, but the reliability and validity of the instruments

  12. First-Year Residents Outperform Third-Year Residents after Simulation-Based Education in Critical Care Medicine (United States)

    Singer, Benjamin D.; Corbridge, Thomas C.; Schroedl, Clara J.; Wilcox, Jane E.; Cohen, Elaine R.; McGaghie, William C.; Wayne, Diane B.


    Introduction Prior research shows that gaps exist in internal medicine residents’ critical care knowledge and skills. The purpose of this study was to compare the bedside critical care competency of first-year residents who received a simulation-based educational intervention plus clinical training to third-year residents who received clinical training alone. Methods During their first three months of residency, a group of first-year residents completed a simulation-based educational intervention. A group of traditionally-trained third-year residents who did not receive simulation-based training served as a comparison group. Both groups were evaluated using a 20-item clinical skills assessment at the bedside of a patient receiving mechanical ventilation at the end of their medical intensive care unit rotation. Scores on the skills assessment were compared between groups. Results Simulator-trained first-year residents (n=40) scored significantly higher compared to traditionally-trained third-year residents (n=27) on the bedside assessment, 91.3% (95% CI 88.2% to 94.3%) vs. 80.9% (95% CI 76.8% to 85.0%), P = simulation-based educational intervention demonstrated higher clinical competency than third-year residents who did not undergo simulation training. Critical care competency cannot be assumed after clinical ICU rotations; simulation-based curricula can help ensure residents are proficient to care for critically ill patients. PMID:23222546

  13. Resident satisfaction on their residence and environment (case study of Srondol Bumi Indah Housing of Semarang City) (United States)

    Hariyono, Paulus


    A piece of an architecture work will be meaningful if it meets the needs of the residents. Likewise, the design and natural environment of a residence will surely be meaningful if it is able to satisfy the residents. The degree of satisfaction can be referred to the theory of human need hierarchy proposed by Abraham Maslow. Although his theory is an old one, it is still a good one for a reference. Socio economic status (SES)also affects someone in understanding the comfort of his resident. This research has some purpose: 1) to know the satisfaction level of the residents, 2) to know the effects of socio economic status towards the residents, and 3) to know the natural environment aspect to resident satisfaction. The methode analysis used is qualitative analysis. The major finding are: 1)security factor is the main aspect of the human need residents; 2) upper and lowerclass residents have different knowledge and understanding regarding the natural environment satisfaction on the house they live.

  14. A psychological profile of surgeons and surgical residents. (United States)

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


    Approximately 20 percent of general surgery residents never complete their original residency programs. The psychological, programmatic, and financial costs for this attrition are substantial for both the residents, who spend valuable time and money pursuing incompatible career paths, and the residency programs, which also lose valuable time and money invested in these residents. There is a large amount of information in the field about the performance dimensions and skill sets of surgeons and surgical residents. To date, however, no research has been conducted on important process and content dimensions, which are critical in determining good person-job fit. A research team from the Department of Psychology at Arizona State University and Maricopa Medical Center conducted descriptive research to determine the work-related personality and interest variables of attending surgeons and surgical residents. Sixty-three surgical residents and 27 attending/teaching surgeons completed 2 sections (interests and personality scales) of the World of Work Inventory Online (WOWI Online). This multidimensional assessment was offered to all attending/teaching surgeons and surgical residents at Maricopa Medical Center. All members of the Department of Surgery participated in the trial. Based on the attending/teaching and high-performing resident profiles, a stable interest and personality profile emerged, which highlights the unique characteristics necessary to identify those who would be most satisfied with and suitable for work as surgeons. The profiles of the attending/teaching surgeons and the high-performing residents were similar. This contrasted with the interest and personality profiles of low-performing residents. The differences in the 2 groups' profiles provide insight into low performance and possible incompatibility with surgical residency, and possibly with general surgery as a profession choice. The WOWI Online assessment tool provides a stable profile of successful

  15. The ethical education of ophthalmology residents: an experiment. (United States)

    Packer, Samuel


    To demonstrate the effect of ethics education on a resident's ability to answer questions that relate to moral dilemmas and on the clinical evaluations of residents by faculty. The curriculum for the ethics education that was used for this study was designed by the author and consisted of 10 lectures of 1.5 hours each. Five residencies were included in the project. One residency received one lecture, two residencies received three lectures, and two residencies received 10 lectures. To evaluate the moral skills of the residents at the beginning of the course and at the end, the residents were given the Defining Issues Test (DIT-2) developed by James Rest, which involves answering standardized questions about four moral dilemmas. Faculty evaluations were completed before and after the ethics lectures were given. At the beginning of the ethics course, each resident was given a social survey that was designed to assess participation in community, religious, political, and societal activities as well as attitudes about these activities. All residents were also asked demographic information, including their age, gender, and year of residency. The results of the DIT-2 taken before and after the ethics lectures were compared. No correlations were found in faculty evaluations of clinical performance of the residents before and after the course (P = .052). Associations between DIT-2 scores and questions on community and religion in the social survey were noted. The finding that the effect of an ethics course on residents' ability to answer moral dilemmas did not achieve statistical significance should be accepted with the understanding that this was a first attempt at standardization of many variables, especially the format of the curriculum and materials used. The use of faculty evaluations to assess clinical performance needs to be standardized, and the faculty members need additional training to ensure validity of the results. The social survey was also the first attempt

  16. The neighborhood health exchange: developing a community partnership in residency. (United States)

    Tartaglia, Kimberly M; Press, Valerie G; Freed, Benjamin H; Baker, Timothy; Tang, Joyce W; Cohen, Julie C; Laiteerapong, Neda; Alvarez, Kimberly; Schwartz, Mindy; Arora, Vineet M


    The current system of residency training focuses on the hospital setting, and resident exposure to the surrounding community is often limited. However, community interaction can play an important role in ambulatory training and in learning systems-based practice, a residency core competency. The goal of the Neighborhood Health Exchange was to develop a community partnership to provide internal medicine residents with an opportunity to interface with community members through a mutually beneficial educational experience. Internal medicine residents received training during their ambulatory block and participated in a voluntary field practicum designed to engage community members in discussions about their health. Community members participated in education sessions led by resident volunteers. Resident volunteers completed a survey on their experiences. All residents stated that the opportunity to lead an exchange was very useful to their overall residency training. Eight exchanges were held with a total of 61 community participants, who completed a 3-question survey following the session. This survey asked about the level of material, the helpfulness of the exchanges, and opportunities for improvement. We received 46 completed surveys from community members: 91% stated that the material was presented "at the right level" and 93% stated that the presentations were somewhat or very helpful. Eighty percent gave positive and encouraging comments about the exchange. Effective community partnerships involve assessing needs of the stakeholders, anticipating leadership turnover, and adapting the Neighborhood Health Exchange model to different groups. Community outreach can also enhance internal medicine ambulatory training experience, provide residents with patient counseling opportunities, and offer a novel method to enhance resident understanding of systems-based practice, especially within the larger community in which their patients live.

  17. Assessing work-related musculoskeletal symptoms among otolaryngology residents. (United States)

    Wong, Kevin; Grundfast, Kenneth M; Levi, Jessica R

    Previous studies have suggested that musculoskeletal symptoms are common among practicing otolaryngologists. Early training can be the ideal time to foster knowledge of ergonomics and develop safe work habits, however, little data exists regarding musculoskeletal symptoms in residents. The purpose of this study was to identify and characterize musculoskeletal symptoms in a preliminary sample of otolaryngology residents. A cross-sectional survey incorporating the Nordic Musculoskeletal Questionnaire was sent to 30 Otolaryngology-Head and Neck Surgery residencies to examine musculoskeletal symptoms among residents. A two-sample test of proportions was performed to compare symptoms between male and female residents. In total, 141 respondents (response rate=34.7%) completed the survey. Fifty-five percent of survey respondents were male and 45% were female. Musculoskeletal symptoms were most frequently reported in the neck (82.3%), followed by the lower back (56%), upper back (40.4%), and shoulders (40.4%). The most common symptoms were stiffness in the neck (71.6%), pain in the neck (61.7%), and pain in the lower back (48.2%). In total, 6.4% of residents missed work and 16.3% of residents stopped during an operation at some point due to their symptoms. Most residents (88.3%) believed their musculoskeletal symptoms were attributed to their surgical training. Female residents were significantly more likely to experience neck (p<0.0001) and wrist/hand (p=0.019) discomfort compared to male residents. Musculoskeletal symptoms were common among residents, approaching rates similar to those previously identified in practicing otolaryngologists. Increased emphasis on surgical ergonomics is warranted to improve workplace safety and prevent future injury. Copyright © 2017. Published by Elsevier Inc.

  18. Resident Ratings of Communication Skills Using the Kalamazoo Adapted Checklist. (United States)

    Porcerelli, John H; Brennan, Simone; Carty, Jennifer; Ziadni, Maisa; Markova, Tsveti


    The Kalamazoo Essential Elements Communication Checklist-Adapted (KEECC-A) is a well-regarded instrument for evaluating communication and interpersonal skills. To date, little research has been conducted that assesses the accuracy of resident self-ratings of their communication skills. To assess whether residents can accurately self-rate communication skills, using the KEECC-A, during an objective structured clinical examination (OSCE). A group of 104 residents from 8 specialties completed a multistation OSCE as part of an institutional communication skills curriculum conducted at a single institution. Standardized patients (SPs) and observers were trained in rating communication skills using the KEECC-A. Standardized patient ratings and resident self-ratings were completed immediately following each OSCE encounter, and trained observers rated archived videotapes of the encounters. Resident self-ratings and SP ratings using the KEECC-A were significantly correlated (r104  = 0.238, P = .02), as were resident self-ratings and observer ratings (r104  = 0.284, P = .004). The correlation between the SP ratings and observer (r104  = 0.378, P = .001) ratings were larger in magnitude, but not significantly different (P > .05) from resident/SP or resident/observer correlations. The results suggest that residents, with a modicum of training using the KEECC-A, can accurately rate their own communication and interpersonal skills during an OSCE. Using trained observers to rate resident communication skills provides a unique opportunity for evaluating SP and resident self-ratings. Our findings also lend further support for the reliability and validity of the KEECC-A.

  19. Factors affecting orthopedic residency selection: a cross-sectional survey. (United States)

    Strelzow, Jason; Petretta, Robert; Broekhuyse, Henry M


    Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate's choice of orthopedic residency program. We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1-5). The confidential online survey focused on 3 broad categories of program selection: educational, program cohesion and noneducation factors. Questions were graded on a Likert Scale and tailed for mean scores. In total, 139 residents from 11 of 17 Canadian orthopedic programs (49% response rate) and 23 medical student applicants (88% response rate) completed our survey. Orthopedic electives and mandatory rotations were reported by 71% of participants as somewhat or very important to their career choice. Collegiality among residents (4.70 ± 0.6), program being the "right fit" (4.65 ± 0.53) and current resident satisfaction with their chosen program (4.63 ±0.66) were ranked with the highest mean scores on a 5-point Likert scale. There are several modifiable factors that residency programs may use to attract applicants, including early availability of clerkship rotations and a strong mentorship environment emphasizing both resident-resident and resident-staff cohesion. Desirable residency programs should develop early access to surgical and operative skills. These must be balanced with a continued emphasis on top-level orthopedic training.

  20. Potassium concentration in bone of Beijing residents

    International Nuclear Information System (INIS)

    Lin Lianqing


    The author presents the measuring results of K concentration in bone ash samples of 65 residents in Beijing area by atomic absorption spectrum. The results indicate that the K concentrations in bone ash is logarithmic normal distribution, ranging level is 0.75-8.44 g/kg ash, the average and standard deviation is respectively 2.40 and 1.52 g/kg ash. The highest concentration (4.88 g/kg ash) appears in infantile stage (< 1y), the lowest concentration (1.59 g/kg ash) appears in young stage (2-5 y). The lower concentration (1.88 g/kg ash) appears in adolescence (11-20 y). The K concentration in wet bone as a percentage of weight is 0.067%. The specific activities of K-40 in bone is about 22 mBq/g wet bone. The total radioactivity of K-40 in whole bone is 220 Bq. The annual absorbed dose is received in adult bone from K-40 is estimated to be 95 μGy

  1. Advancing resident assessment in graduate medical education. (United States)

    Swing, Susan R; Clyman, Stephen G; Holmboe, Eric S; Williams, Reed G


    The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007-2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008.

  2. Does Rural Residence Affect Access to Prenatal Care in Oregon? (United States)

    Epstein, Beth; Grant, Therese; Schiff, Melissa; Kasehagen, Laurin


    Context: Identifying how maternal residential location affects late initiation of prenatal care is important for policy planning and allocation of resources for intervention. Purpose: To determine how rural residence and other social and demographic characteristics affect late initiation of prenatal care, and how residence status is associated…

  3. Exposure to and Attitudes Regarding Transgender Education Among Urology Residents. (United States)

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


    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.

  4. 42 CFR 413.343 - Resident assessment data. (United States)


    ...; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.343 Resident assessment data. (a) Submission of resident assessment data... such other assessments that are necessary to account for changes in patient care needs. (c...

  5. A Business-Oriented Student Program: Residence Hall Stores. (United States)

    Valerio, Vance R.


    Describes a residence hall store program which provides prepackaged food and snacks to students at Marquette University. Results of a survey of 21 colleges which have residence hall stores revealed primarily informal organizations. Stores can be a successful student development technique which teaches principles of small-business management. (JAC)

  6. The Resident Assistant as Responder to the Seventies. (United States)

    Schell, Robert E.

    The nature of a residence hall program depends more on the values and behavior of the resident assistants than on the principles and structure of the system. To develop a program consistent with the most salient aspects of student development, it is important to select appropriate personnel. Any selection process is based on two assumptions: (1)…

  7. Residents' Perceptions of Property Rating in a Traditional African City

    African Journals Online (AJOL)

    The success of any revenue generation drive by government depends on the support shown by an area's residents. This in turn depends on the latter's perceptions of the revenue. This study examines the influence of residents' perceptions of a property tax in the different residential districts of Ogbomoso, Oyo State, Nigeria.

  8. Involving Students in Residence Halls in Hong Kong (United States)

    Ting, S. Raymond; Chan, Rebecca; Lee, Esther


    This article reports a study based on A. W. Astin's (1984) involvement theory applied in residence halls at a public university in Hong Kong, China. The resident students who were involved as participants or student leaders in this study were found to be better developed in terms of leadership, career development, multicultural experience,…

  9. Predictors of advance directives among nursing home residents with dementia. (United States)

    Huang, Hsiu-Li; Shyu, Yea-Ing Lotus; Weng, Li-Chueh; Chen, Kang-Hua; Hsu, Wen-Chuin


    Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan. Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator. Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation. Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

  10. 8 CFR 204.303 - Determination of habitual residence. (United States)


    ... resident in the United States if the individual: (1) Has his or her domicile in the United States, even if... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Determination of habitual residence. 204... IMMIGRANT PETITIONS Intercountry Adoption of a Convention Adoptee § 204.303 Determination of habitual...

  11. Survey of Sexual Education among Residents from Different Specialties (United States)

    Morreale, Mary K.; Arfken, Cynthia L.; Balon, Richard


    Objective: This study aims to determine how residents are being educated regarding sexual health, and it assesses attitudes toward sexual education and barriers to evaluating patients' sexuality. Methods: An anonymous Internet survey was sent to 195 residents in family practice, internal medicine, obstetrics and gynecology, and psychiatry at a…

  12. Residency training programme in Nigeria- problems and prospects ...

    African Journals Online (AJOL)

    Postgraduate medical training is essential in the development of specialist manpower in health care delivery services. In this paper, postgraduate residency training in Nigeria was examined with highlights on the problems involved and the prospects. Keywords : Postgraduate, Residency, Medical, Nigeria, Training.

  13. Social, recreational and housing habits of residents of Selebi ...

    African Journals Online (AJOL)

    This study presents a survey of the existing status of the social, recreational and housing habits related to the environmental health of residents living within the Selebi-Phikwe Ni-Cu mine area, Botswana. Primary data of residents obtained through the administration of questionnaire and structured interviews was processed ...

  14. Pediatric resident perceptions of shift work in ward rotations. (United States)

    Nomura, Osamu; Mishina, Hiroki; Jasti, Harish; Sakai, Hirokazu; Ishiguro, Akira


    Although the long working hours of physicians are considered to be a social issue, no effective policies such as duty hour regulations have so far been proposed in Japan. We implemented an overnight call shift (OCS) system for ward rotations to improve the working environment for residents in a pediatric residency program. We later conducted a cross-sectional questionnaire asking the residents to compare this system with the traditional overnight call system. Forty-one pediatric residents participated in this survey. The residents felt that the quality of patient care improved (80.4% agreed). Most felt that there was less emphasis on education (26.8%) and more emphasis on service (31.7%). Overall, the residents reported that the OCS was beneficial (90.2%). In conclusion, the pediatric residents considered the OCS system during ward rotations as beneficial. Alternative solutions are vital to balance improvements in resident work conditions with the requirement for a high quality of education. © 2017 Japan Pediatric Society.

  15. Quality of care reported by proxies - Does resident cognition count? (United States)

    Kahanpää, Anja; Noro, Anja; Perälä, Marja-Leena


    Resident self-reports are considered the primary source of quality of care information, but proxy reports by family or staff can also be used to supplement or substitute resident reports. This study analyses how the results of proxy reports vary according to residents' cognition level. The data set used covers proxy reports of family ( n = 558) and staff ( n = 801), divided by the availability of resident self-reports (family yes n = 289, no n = 269; staff yes 393, no = 408). Family and staff proxies assessed residents' quality of care as better when resident self-reports were also available, and quality of care tended to be assessed as poorer among those with higher cognitive decline. The results of this methodological study indicate the importance of using several proxy evaluations; however, these can only supplement resident self-reports, not replace them. The interpretation rules acknowledging dependency between residents' cognition and proxy assessments could be used as a basis for future comparisons of quality improvement in long-term care and for painting a more comprehensive picture of service quality.

  16. Leadership and business education in orthopaedic residency training programs. (United States)

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G


    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

  17. Internal Medicine residents use heuristics to estimate disease probability

    Directory of Open Access Journals (Sweden)

    Sen Phang


    Conclusions: Our findings suggest that despite previous exposure to the use of Bayesian reasoning, residents use heuristics, such as the representative heuristic and anchoring with adjustment, to estimate probabilities. Potential reasons for attribute substitution include the relative cognitive ease of heuristics vs. Bayesian reasoning or perhaps residents in their clinical practice use gist traces rather than precise probability estimates when diagnosing.

  18. Residency and small-scale movement behaviour of three endemic ...

    African Journals Online (AJOL)

    Juvenile zebra displayed the highest degree of residency followed by white musselcracker and blacktail, with re-sightings recorded on 53%, 40% and 10% of observation days, respectively. The high degree of residency by early juvenile sparids renders them vulnerable to localized coastal perturbations and climate change.

  19. Surgical Resident Doctor's Perspective of Their Training in the ...

    African Journals Online (AJOL)

    Background: There are several problems militating against satisfactory residency training in Nigeria. These problems may not be effectively identified and resolved if the opinion of the trainee doctors is ignored. Objectives: To review surgical residents' perspectives of their training program in South-eastern Nigeria, with the ...

  20. Can Emergency Medicine Residents Predict Cost of Diagnostic Testing?

    Directory of Open Access Journals (Sweden)

    Tainter, Christopher R


    Full Text Available Diagnostic testing represents a significant portion of healthcare spending, and cost should be considered when ordering such tests. Needless and excessive spending may occur without an appreciation of the impact on the larger healthcare system. Knowledge regarding the cost of diagnostic testing among emergency medicine (EM residents has not previously been studied. A survey was administered to 20 EM residents from a single ACGME-accredited three-year EM residency program, asking for an estimation of patient charges for 20 commonly ordered laboratory tests and seven radiological exams. We compared responses between residency classes to evaluate whether there was a difference based on level of training. The survey completion rate was 100% (20/20 residents. We noted significant discrepancies between the median resident estimates and actual charge to patient for both laboratory and radiological exams. Nearly all responses were an underestimate of the actual cost. The group median underestimation for laboratory testing was $114, for radiographs $57, and for computed tomography exams was $1,058. There was improvement in accuracy with increasing level of training. This pilot study demonstrates that EM residents have a poor understanding of the charges burdening patients and health insurance providers. In order to make balanced decisions with regard to diagnostic testing, providers must appreciate these factors. Education regarding the cost of providing emergency care is a potential area for improvement of EM residency curricula, and warrants further attention and investigation.

  1. Sleep Practices of University Students Living in Residence (United States)

    Qin, Pei; Brown, Cary A.


    Sleep plays an important role in both students' academic and personal life. Despite widespread sleep problems among young adults, few studies focus on higher education students living in campus residence. This study investigated residence-living students' sleep patterns, sleep promoting practices, sources of help seeking, and preferred ways to…

  2. Attitudes of Portuguese medical residents' towards clinical communication skills. (United States)

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


    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.

  3. Normal versus Pathological Aging: Knowledge of Family Practice Residents. (United States)

    Beall, S. Colleen; And Others


    Family physicians may lack discriminatory ability to differentiate normal aging form disease states. To assess such ability, 53 aging-related indicators or symptoms were presented to 65 physicians in 3 family practice residency programs. Respondents classified each symptom as normal aging or disease. On average, residents classified 73.4% of…

  4. A Self-Assessment Guide for Resident Teaching Experiences. (United States)

    Engle, Janet P; Franks, Amy M; Ashjian, Emily; Bingham, Angela L; Burke, John M; Erstad, Brian L; Haines, Seena L; Hilaire, Michelle L; Rager, Michelle L; Wienbar, Rebecca


    The 2015 American College of Clinical Pharmacy (ACCP) Educational Affairs Committee was charged with developing a self-assessment guide for residency programs to quantitatively and qualitatively evaluate the outcomes of resident teaching curricula. After extensively reviewing the literature, the committee developed assessment rubrics modeled after the 2013 ACCP white paper titled "Guidelines for Resident Teaching Experiences" and the revised American Society of Health-System Pharmacists (ASHP) 2014 accreditation standards for PGY1 residencies, which place greater emphasis on the teaching and learning curriculum (TLC) than the previous accreditation standards. The self-assessment guide developed by the present committee can serve as an assessment tool for both basic and expanded TLCs. It provides the criteria for program goals, mentoring, directed readings with topic discussions, teaching experiences, and assessment methodology. For an expanded TLC, the committee has provided additional guidance on developing a teaching philosophy, becoming involved in interactive seminars, expanding teaching experiences, developing courses, and serving on academic committees. All the guidelines listed in the present paper use the measures "not present," "developing," and "well developed" so that residency program directors can self-assess along the continuum and identify areas of excellence and areas for improvement. Residency program directors should consider using this new assessment tool to measure program quality and outcomes of residency teaching experiences. Results of the assessment will help residency programs focus on areas within the TLC that will potentially benefit from additional attention and possible modification. © 2016 Pharmacotherapy Publications, Inc.

  5. Residence time modeling of hot melt extrusion processes. (United States)

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


    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.

  6. Geographic Region, Size, and Program Type in Family Practice Residencies. (United States)

    Berg, Jolene K.; Garrard, Judith


    Research on residency education in family practice is discussed. Programmatic variables are examined: geographic region, size, and type of program. Definitions of these variables are provided, the current distribution of family practice residency programs across each of these variables is described, and data for use by other researchers is…

  7. evaluation/of surgical resident staff knowledge of cancer pain ...

    African Journals Online (AJOL)

    their management of a hypothetical patient who had severe cancer pain and also asked questions on other issues relating to cancer pain therapy. ' Results: Sixteen resident doctors responded to the questionnaire. Mean number of years spent in residency was 2.1. More than 80% of the respondents had adequate ...

  8. Practical Interventions to Enhance Resident Ownership of Patient Care. (United States)

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


    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.

  9. Teaching the Surgical Craft: Surgery Residents Perception of the ...

    African Journals Online (AJOL)

    Teaching the Surgical Craft: Surgery Residents. Perception of the Operating Theater Educational ... theater. This study investigates the perceptions of residents about the educational environment of the operating theater and .... Mean score. My consultant has a pleasant personality. 4.18. I get on well with my consultant. 4.18.

  10. Tourism practices of Chinese residents in South Africa | Potgieter ...

    African Journals Online (AJOL)

    Chinese consumers are different due to their cultural background and way of life and this necessitates a conversion of the business model and products offered by leisure and tourism service providers. Very little is known about tourism practices of resident Chinese in South Africa. Research was conducted amongst resident ...

  11. Benefits and impact influencing support of participants and residents ...

    African Journals Online (AJOL)

    Benefits and impact influencing support of participants and residents for road race events: a comparative study. ... South African Journal for Research in Sport, Physical Education and Recreation ... However, the impact cognition of road race event of participants and residents was less obvious than benefit cognition.

  12. Prospective analysis of a novel orthopedic residency advocacy education program. (United States)

    Daniels, Alan H; Bariteau, Jason T; Grabel, Zachary; DiGiovanni, Christopher W


    Future physician leaders must be able to critically assess health care policy and patient advocacy issues. Currently, no nationally accepted, standardized curriculum to provide advocacy education during orthopedic residency training exists. We therefore developed an "Advocacy" curriculum for our orthopedic residents designed to direct particular attention to patient advocacy, specialty advocacy, and healthcare policy. Residents were given pre- and post-curriculum questionnaires to gauge their perception of the importance, strengths, and weaknesses of this curriculum. A paired t-test was used to compare pre- and post-curriculum responses. Twenty-one of 24 orthopedic residents completed the pre-curriculum and post-curriculum questionnaire regarding the importance of advocacy education (87.5% response rate). Overall, 85.7% (18/21) of responders ranked the curriculum on orthopedic advocacy as good or excellent. Prior to the advocacy curriculum, 33.3% (7/21) of residents felt that learning about orthopedic advocacy was important to their education, while following the curriculum 100% (21/21) felt so (padvocacy curriculum, 90.5% (19/21) of responders would be interested in getting involved in orthopedic advocacy. This curriculum significantly increased residents' belief in the importance of advocacy issues. Following the curriculum, 100% of responding residents considered orthopedic advocacy education as important. An advocacy curriculum may serve as an integral preparatory educational core component to residency training.

  13. Residence as a Factor in Longevity: A Study of Louisianians. (United States)

    Kwan, Yui-Huen; Bertrand, Alvin L.

    In order to test the hypothesis that the longevity of aged persons differs according to residence and by sex, race, and marital status, data from every third year between 1962 and 1974 in the Louisiana State Bureau of Vital Statistics were examined. Criteria for population inclusion were: people over 65 years of age; Louisiana residents at time of…

  14. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline. (United States)

    Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J


    Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine

  15. Why Are Residents Reluctant to Consult Attending Physicians?

    NARCIS (Netherlands)

    O.H. Swank (Otto)


    textabstractA physician performs two tasks: making diagnoses and determining treatments. To reduce medical error, residents are supposed to consult their supervisors when they face uncommon circumstances. However, recent research shows that residents are reluctant to do so. This paper presents a

  16. Coleadership Among Chief Residents: Exploration of Experiences Across Specialties. (United States)

    Pettit, Jeffrey E


    Many departments have multiple chief residents. How these coleaders relate to each other could affect their performance, the residency program, and the department. This article reports on how co-chiefs work together during the chief year, and what may allow them to be more effective coleaders. A phenomenological research design was used to investigate experiences of outgoing chief residents from 13 specialties at the University of Iowa Hospitals and Clinics over a 2-year period from 2012 through 2013. Thematic analysis of semistructured interviews was conducted to investigate commonalities and recommendations. Face-to-face interviews with 19 chief residents from 13 different specialties identified experiences that helped co-chiefs work effectively with each other in orienting new co-chiefs, setting goals and expectations, making decisions, managing interpersonal conflict, leadership styles, communicating, working with program directors, and providing evaluations and feedback. Although the interviewed chief residents received guidance on how to be an effective chief resident, none had been given advice on how to effectively work with a co-chief, and 26% (5 of 19) of the respondents reported having an ineffective working relationship with their co-chief. Chief residents often colead in carrying out their multiple functions. To successfully function in a multichief environment, chief residents may benefit from a formal co-orientation in which they discuss goals and expectations, agree on a decision-making process, understand each other's leadership style, and receive feedback on their efficacy as leaders.

  17. Coleadership Among Chief Residents: Exploration of Experiences Across Specialties (United States)

    Pettit, Jeffrey E.


    Background Many departments have multiple chief residents. How these coleaders relate to each other could affect their performance, the residency program, and the department. Objective This article reports on how co-chiefs work together during the chief year, and what may allow them to be more effective coleaders. Methods A phenomenological research design was used to investigate experiences of outgoing chief residents from 13 specialties at the University of Iowa Hospitals and Clinics over a 2-year period from 2012 through 2013. Thematic analysis of semistructured interviews was conducted to investigate commonalities and recommendations. Results Face-to-face interviews with 19 chief residents from 13 different specialties identified experiences that helped co-chiefs work effectively with each other in orienting new co-chiefs, setting goals and expectations, making decisions, managing interpersonal conflict, leadership styles, communicating, working with program directors, and providing evaluations and feedback. Although the interviewed chief residents received guidance on how to be an effective chief resident, none had been given advice on how to effectively work with a co-chief, and 26% (5 of 19) of the respondents reported having an ineffective working relationship with their co-chief. Conclusions Chief residents often colead in carrying out their multiple functions. To successfully function in a multichief environment, chief residents may benefit from a formal co-orientation in which they discuss goals and expectations, agree on a decision-making process, understand each other's leadership style, and receive feedback on their efficacy as leaders. PMID:26221435

  18. The residence time of water in the atmosphere revisited

    NARCIS (Netherlands)

    Van Der Ent, Ruud J.; Tuinenburg, Obbe A.


    This paper revisits the knowledge on the residence time of water in the atmosphere. Based on state-of-the-art data of the hydrological cycle we derive a global average residence time of 8.9 ± 0.4 days (uncertainty given as 1 standard deviation). We use two different atmospheric moisture tracking

  19. Markov analysis for estimation of residence time | Agunwamba ...

    African Journals Online (AJOL)

    Accurate estimation of residence time is very useful for the design of water and wastewater treatment plants. Its determination is difficult because it depends on complex interaction among many factors such as geometry, hydrodynamic and environmental factors. In this paper, the estimation of residence time is formulated as ...

  20. Resident burnout: evaluating the role of the learning environment. (United States)

    van Vendeloo, Stefan N; Godderis, Lode; Brand, Paul L P; Verheyen, Kees C P M; Rowell, Suria A; Hoekstra, Harm


    Although burnout is viewed as a syndrome rooted in the working environment and organizational culture, the role of the learning environment in the development of resident burnout remains unclear. We aimed to evaluate the association between burnout and the learning environment in a cohort of Belgian residents. We conducted a cross-sectional online survey among residents in a large university hospital in Belgium. We used the Dutch version of the Maslach Burnout Inventory (UBOS-C) to assess burnout and the Dutch Residency Educational Climate Test (D-RECT) to assess the learning environment. A total of 236 residents (29 specialties) completed the survey (response rate 34.6%), of which 98 (41.5%) met standard criteria for burnout. After multivariate regression analysis adjusting for hours worked per week, quality of life and satisfaction with work-life balance, we found an inverse association between D-RECT scores and the risk of burnout (adjusted odds ratio; 0.47 for each point increase in D-RECT score; 95% CI, 0.23 - 0.95; p = 0.01). Resident burnout is highly prevalent in our cohort of Belgian residents. Our results suggest that the learning environment plays an important role in reducing the risk of burnout among residents.

  1. Risk of aspiration in care home residents and associated factors

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.


    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five

  2. A Curriculum on Care for Complex Patients: Resident Perspectives. (United States)

    Osborn, Justin; Raetz, Jaqueline; Huntington, Jane; Overstreet, Frederica; Ross, Valerie; Charles, Carol; Mauksch, Larry


    Caring for patients with a challenging mix of medical, psychological, and social problems may easily overwhelm residents. We developed a month-long "Care for Complex Patients" curriculum for second-year residents to improve their ability to care for this group of patients by increasing their understanding of why the care is complex and by building communication, teamwork, and resource management skills. Surveys and focus groups were used to assess the impact of the curriculum. Quantitative and qualitative methods were used to evaluate responses. Between 2008 and 2010, 24 residents completed our rotation. Eighty-three percent completed the pre-curriculum and post-curriculum surveys. Residents' self-ratings significantly improved in all 11 complex care management skills, and residents reported increased confidence when working with patients whose care was complex. Residents were surprised to learn about all the community resources and began using these resources when providing care for these patients. Despite rating themselves improved, a large number of residents still rated themselves as not competent in many of the skills. A curriculum for residents focused on education in 11 key skill areas in the care of complex patients led to increased self-confidence and willingness to provide complex care. However, 1 month of training is an insufficient amount of time to help most learners achieve self-assessed ratings of capable and competent in using these key skills when caring for complex patients.

  3. Survey of Threats and Assaults by Patients on Psychiatry Residents (United States)

    Dvir, Yael; Moniwa, Emiko; Crisp-Han, Holly; Levy, Dana; Coverdale, John H.


    Objective: The authors sought to determine the prevalence of threats and assaults by patients on psychiatry residents, their consequences, and the perceived adequacy of supports and institutional responses. Method: Authors conducted an anonymous survey of 519 psychiatry residents in 13 psychiatry programs across the United States. The survey…

  4. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents (United States)

    Rios, Francisco Javier Mesa; Munoz, Maria Del Carmen Lara


    Background: Various rates of alcoholism, drug abuse, mental illness, and suicide among physician have been reported, generally higher than those in the general population. Psychiatry residents, as other specializing physicians, seem to be prone to suffering them. The prevalence of psychological symptoms among psychiatry residents has not been…

  5. Teaching Psychiatry Residents to Teach: A National Survey (United States)

    Crisp-Han, Holly; Chambliss, R. Bryan; Coverdale, John


    Objective: Because there have been no previously published national surveys on teaching psychiatry residents about how to teach, the authors surveyed United States psychiatry program directors on what and how residents are taught about teaching. Methods: All psychiatry training programs across the United States were mailed a semistructured…

  6. An Investigation of Psychiatry Residents' Important Experiences (United States)

    Long, Jody


    This research study was conducted to explore the phenomenon of the third-year experiences of the psychiatry residents. A review of the literature identified themes and subthemes related to the third-year of psychiatry education. The study was conducted at a university health science center. Data were collected from five residents using participant…

  7. Evaluation of Professional Role Competency during Psychiatry Residency (United States)

    Grujich, Nikola N.; Razmy, Ajmal; Zaretsky, Ari; Styra, Rima G.; Sockalingam, Sanjeev


    Objective: The authors sought to determine psychiatry residents' perceptions on the current method of evaluating professional role competency and the use of multi-source feedback (MSF) as an assessment tool. Method: Authors disseminated a structured, anonymous survey to 128 University of Toronto psychiatry residents, evaluating the current mode of…

  8. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina


    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  9. Resident physicians as human information systems: sources yet seekers. (United States)

    Bass, Ellen J; DeVoge, Justin Michael; Waggoner-Fountain, Linda A; Borowitz, Stephen M


    To characterize question types that residents received on overnight shifts and what information sources were used to answer them. Across 30 overnight shifts, questions asked of on-call senior residents, question askers' roles, and residents' responses were documented. External sources were noted. 158 of 397 questions (39.8%) related to the plan of care, 53 (13.4%) to medical knowledge, 48 (12.1%) to taskwork knowledge, and 44 (11.1%) to the current condition of patients. For 351 (88.4%) questions residents provided specific, direct answers or visited the patient. For 16 of these, residents modeled or completed the task. For 216 questions, residents used previous knowledge or their own clinical judgment. Residents solicited external information sources for 118 questions and only a single source for 77 (65.3%) of them. For the 118, most questions concerned either the plan of care or the patient's current condition and were asked by interns and nurses (those with direct patient care responsibilities). Resident physicians serve as an information system and they often specifically answer the question using previous knowledge or their own clinical judgment, suggesting that askers are contacting an appropriately knowledgeable person. However, they do need to access patient information such as the plan of care. They also serve an educator role and answer many knowledge-related questions. As synchronous verbal communications continue to be important pathways for information flow, informaticians need to consider the relationship between such communications and workflow in the development of healthcare support tools.

  10. Men's Identity Development: Issues and Implications for Residence Life (United States)

    Scott, David A.; Livingston, Wade G.; Havice, Pamela A.; Cawthon, Tony W.


    Young men struggle with privilege and oppression in college and university residence halls just as they do in other educational and social contexts. While discussions and research about adolescent and adult identity development continue, little attention has focused on how a male student's identity development can impact residence life cultures on…

  11. Past residence outside of the United States is associated with diet quality in adults currently residing in the United States. (United States)

    Frankenfeld, Cara L; Poudrier, Jill; Waters, Nigel; Gillevet, Patrick M


    To evaluate healthy dietary factors in relation to prior residence outside the United States (US) among university-affiliated individuals currently residing in the US. Current diet information was collected via a 4-day food record and residential history data were collected by in-person interview for 114 individuals. Residence outside of the US at any point during the interviewee's life was associated with higher diet quality (Healthy Eating Index-2005: 50.0 vs. 46.8) and lower added sugar intake (25.8 vs. 34.9 g/d). Concordance of residence as a child (≤12 years of age) and within the prior 5 years was more strongly associated with higher HEI-2005 score (52.7) than if childhood was outside of the US and recent within the US (47.1), compared with individuals who have only resided within the US (46.9). Results were similar when also accounting for self-reported current residence as permanent residence. Current diet quality, food groups, and nutrient intakes differed depending on where in the world region individuals resided as a child. Restricting the analyzes to a subgroup of individuals of younger age and similar education attenuated associations. Lower added sugar intake and higher overall diet quality were most consistently associated with residence outside of the US, and recent residence outside of the US may be more strongly associated than childhood residence. Some of these differences may be explained by demographic or socioeconomic factors. Future studies could evaluate explanatory factors for these observations, including detailed socioeconomic factors, exposure to diverse foods, and accessibility of processed foods. Copyright © 2013 Wiley Periodicals, Inc.

  12. The Urology Residency Program in Israel—Results of a Residents Survey and Insights for the Future

    Directory of Open Access Journals (Sweden)

    Arnon Lavi


    Full Text Available Objective Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents’ perspective on the current residency program in Israel and propose changes in it. Methods A web-based survey was distributed among urology residents. Results 61 residents completed the survey out of 95 to whom it was sent (64% compliance. A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training “hands-on.” Most non-junior residents (post-graduate year 3 and beyond reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship. Conclusion Given the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center, greater out-patient urology clinic exposure, and possible changes in the basic science

  13. Fellows as teachers: a model to enhance pediatric resident education

    Directory of Open Access Journals (Sweden)

    Charles V. Smith


    Full Text Available Pressures on academic faculty to perform beyond their role as educators has stimulated interest in complementary approaches in resident medical education. While fellows are often believed to detract from resident learning and experience, we describe our preliminary investigations utilizing clinical fellows as a positive force in pediatric resident education. Our objectives were to implement a practical approach to engage fellows in resident education, evaluate the impact of a fellow-led education program on pediatric resident and fellow experience, and investigate if growth of a fellowship program detracts from resident procedural experience.This study was conducted in a neonatal intensive care unit (NICU where fellows designed and implemented an education program consisting of daily didactic teaching sessions before morning clinical rounds. The impact of a fellow-led education program on resident satisfaction with their NICU experience was assessed via anonymous student evaluations. The potential value of the program for participating fellows was also evaluated using an anonymous survey.The online evaluation was completed by 105 residents. Scores were markedly higher after the program was implemented in areas of teaching excellence (4.44 out of 5 versus 4.67, p<0.05 and overall resident learning (3.60 out of 5 versus 4.61, p<0.001. Fellows rated the acquisition of teaching skills and enhanced knowledge of neonatal pathophysiology as the most valuable aspects of their participation in the education program. The anonymous survey revealed that 87.5% of participating residents believed that NICU fellows were very important to their overall training and education.While fellows are often believed to be a detracting factor to residency training, we found that pediatric resident attitudes toward the fellows were generally positive. In our experience, in the specialty of neonatology a fellow-led education program can positively contribute to both

  14. Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps

    Directory of Open Access Journals (Sweden)

    Stephen C. Morris, MD, MPH


    Full Text Available Introduction: International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them. Methods: A survey was sent to all U.S. emergency medicine (EM residencies with publicly available e-mail addresses. The survey documents and examines the training and support that emergency medicine residents are offered for international rotations and the frequency of adverse safety events. Results: 72.5% of program director responded that their residents are participating in rotations abroad. However, only 15.4% of programs reported offering training specific to working abroad. The results point to an increased need for specific training and insurance coverage. Conclusion: Oversight of international rotations should be improved to guarantee safety and education benefit.

  15. The role of simulation training in anesthesiology resident education. (United States)

    Yunoki, Kazuma; Sakai, Tetsuro


    An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology. However, it is still unclear what types of simulators should be used or how to incorporate simulation education effectively into education curriculums. Whether simulation training improves patient outcomes has not been fully determined. The goal of this review is to provide an overview of the status of simulation in anesthesiology resident education, encourage more anesthesiologists to get involved in simulation education to propagate its influence, and stimulate future research directed toward improving resident education and patient outcomes.

  16. Nursing home residents and celebrities: a tale of morality. (United States)

    Claessens, Nathalie


    In contemporary Western societies, characterized by global aging and an omnipresent celebrity culture, little is known about the role of celebrities for older adults. This study bridges gerontology and celebrity studies to explore a social role that celebrities can fulfill for nursing home residents: triggering moral discussions. This potential role is examined in four focus groups with 27 nursing home residents in Flanders (Belgium). Here, 20 celebrity pictures are employed to evoke moral discussions, with a focus on adultery and homosexuality. These discussions are subjected to a framing analysis. Results show that celebrities can trigger moral discussions among the nursing home residents. The residents' adultery and homosexuality frames show that they mostly retain dominant values from their youth, often combining them with contemporary dominant values. Further, the residents' frames prove to be relativistic, which can be linked to their multitude of life experiences and complex emotional skills.

  17. [Strategy for educating senior dermatological residents in mycology]. (United States)

    Mochizuki, Takashi; Tsuboi, Ryoji; Sei, Yoshihiro; Hiruma, Masataro; Watanabe, Shinichi; Makimura, Koichi


    To improve the ability of dermatologists to diagnose cutaneous mycoses, we have proposed a list of the minimum mycological knowledge and skills required by senior residents of dermatology. The list includes ability to select the most appropriate sampling method, knowledge of the basic method of potassium hydroxide (KOH) examination and skill in performing fungal cultures and identifying the most prevalent fungal species isolated from skin lesions. It is not possible for the Japanese Society of Medical Mycology to train every senior resident directly, and it is difficult for them to acquire sufficient expertise independently. Consequently, training and advice given by instructors in residents' home institutes is essential. A project of an advanced course for instructors, who are in charge of educating senior residents in their own institute, may be possible. Therefore, we have proposed here a list for instructors of the knowledge and skills required to educate senior residents. Employing this list should realize improved skill in dermatologists.

  18. The Changing Scenario of Obstetrics and Gynecology Residency Training (United States)

    Gupta, Natasha; Dragovic, Kristina; Trester, Richard; Blankstein, Josef


    Background Significant changes have been noted in aspects of obstetrics-gynecology (ob-gyn) training over the last decade, which is reflected in Accreditation Council for Graduate Medical Education (ACGME) operative case logs for graduating ob-gyn residents. Objective We sought to understand the changing trends of ob-gyn residents' experience in obstetric procedures over the past 11 years. Methods We analyzed national ACGME procedure logs for all obstetric procedures recorded by 12 728 ob-gyn residents who graduated between academic years 2002–2003 and 2012–2013. Results The average number of cesarean sections per resident increased from 191.8 in 2002–2003 to 233.4 in 2012–2013 (17%; P obstetric logs demonstrated decreases in volume of vaginal, forceps, and vacuum deliveries, and increases in cesarean and multifetal deliveries. Change in experience may require use of innovative strategies to help improve residents' basic obstetric skills. PMID:26457146

  19. Creating a spirituality curriculum for family practice residents. (United States)

    Silverman, H D


    The purpose of this pilot study was to investigate issues related to the creation of a curriculum to teach spirituality to family practice residents; specifically, (1) to determine whether there was support among family practice residents and faculty to include such teaching in the residency curriculum, and (2) to determine specifically what should be taught and how it should be taught. The hypothesis was that residents and faculty would support such a curriculum and that specific educational methodologies could be identified to implement it. This was accomplished by conducting one-on-one interviews and focus groups and by administering a written curriculum needs assessment to family practice residents and faculty, compiling and interpreting the results, and subsequently writing an integrated curriculum.

  20. Assessing Residents' Confidence in the Context of Pharmacotherapy Competence. (United States)

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


    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.

  1. Training Psychiatry Residents in Psychotherapy: The Role of Manualized Treatments. (United States)

    Pagano, Joshua; Kyle, Brandon N; Johnson, Toni L; Saeed, Sy Atezaz


    Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy. Requirements for resident training in psychotherapy have changed over the years, and treatment manuals offer a simple and straightforward way to meet training requirements. In a search limited to only depression, two treatment manuals emerged with the support of research regarding both clinical practice and resident training. In looking toward the future, it will be important for clinicians to remain updated on further advances in evidence based manualized treatment as a tool for training residents in psychotherapy, including recent developments in online and smartphone based treatments.

  2. Resident Selection Beyond the United States Medical Licensing Examination. (United States)

    Porter, Scott E; Graves, Matt


    The resident application process has matured over the decades to become an efficient system. An unforeseen consequence of this efficiency is the massive number of applications that each orthopaedic surgery residency program must sort through to arrive at a manageable rank list. The most widely used filter in today's application cycle is an applicant's performance on the United States Medical Licensing Examination Step 1. Although no evidence exists to prove that this examination is predictive of any of the potentially defining characteristics of a successful resident, orthopaedic surgery programs historically have had few alternative options. A growing body of literature suggests that a more focused investigation of an applicant's inherent personality traits, as evidenced by his or her past accomplishments, as well as a structured use of questionnaires as part of the application process may improve the ability of orthopaedic surgery residency programs to predict who will be a successful resident.

  3. Residents' Perceptions of Plastic Surgeons as Craniofacial Surgery Specialists. (United States)

    Denadai, Rafael; Muraro, Carlos Alberto Salomão; Raposo-Amaral, Cassio Eduardo


    To assess residents' perceptions of plastic surgeons as craniofacial surgery specialists in Brazil. Brazilian residents were asked to choose 1 or 2 specialists that they perceived to be an expert for 14 craniofacial surgery-related scenarios. Both an overall analysis (all 14 scenarios) and subanalysis (each scenario separately) were performed. Response patterns were distributed as "plastic surgeons alone," "plastic surgeons combined with other specialists," or "without plastic surgeons." Overall, plastic surgeons were chosen more (all P plastic surgeons were chosen more (all P surgery-related scenarios and also demonstrated that "plastic surgeons alone" and "without plastic surgeons" were selected more (all P surgery residents and male residents chose more (all P plastic surgeons as experts than their peers. Residents' perceptions of plastic surgeons as craniofacial surgery specialists are limited in Brazil.

  4. Length and content of family practice residency training. (United States)

    Duane, Marguerite; Green, Larry A; Dovey, Susan; Lai, Sandy; Graham, Robert; Fryer, George E


    Family practice residency programs are based largely on a model implemented more than 30 years ago. Substantial changes in medical practice, technology, and knowledge necessitate reassessment of how family physicians are prepared for practice. We simultaneously surveyed samples of family practice residency directors, first-year residents, and family physicians due for their first board recertification examination to determine, using both quantitative and qualitative methods, their opinions about the length and content of family practice residencies in the United States. Twenty-seven percent of residency directors, 32% of residents, and 28% of family physicians favored extending family practice residency to 4 years; very few favored 2- or 5-year programs. There was dispersion of opinions about possible changes within each group and among the three groups. Most in all three groups would be willing to extend residency for more training in office-based procedures and sports medicine, but many were unwilling to extend residency for more training in surgery or hospital-based care. Residents expressed more willingness than program directors or family physicians to change training. Barriers to change included disagreement about the need to change; program financing and opportunity costs, such as loss of income and delay in debt repayment; and potential negative impact on student recruitment. Most respondents support the current 3-year model of training. There is considerable interest in changing both the length and content of family practice training. Lack of consensus suggests that a period of elective experimentation might be needed to assure family physicians are prepared to meet the needs and expectations of their patients.

  5. Menopause education: needs assessment of American obstetrics and gynecology residents. (United States)

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen


    This study aims to understand the current teaching of menopause medicine in American obstetrics and gynecology residency programs. A Web-based survey was e-mailed to all American obstetrics and gynecology residency directors, with a request that they forward it to their residents. Of 258 residency program directors contacted, 79 (30.6%) confirmed forwarding the survey. In all, 1,799 people received the survey, with 510 completions, for a response rate of 28.3%. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine: pathophysiology of menopause symptoms (67.1%), hormone therapy (68.1%), nonhormone therapy (79.0%), bone health (66.1%), cardiovascular disease (71.7%), and metabolic syndrome (69.5%). Among fourth-year residents who will be entering clinical practice soon, a large proportion also reported a need to learn more in these areas: pathophysiology of menopause symptoms (45.9%), hormone therapy (54.2%), nonhormone therapy (69.4%), bone health (54.2%), cardiovascular disease (64.3%), and metabolic syndrome (63.8%). When asked to rate the most preferred modalities for learning about menopause, the top choice was supervised clinics (53.2%), followed by case presentations (22.2%), formal lectures (21.3%), small groups (14.7%), Web-based learning (7.8%), and independent reading (5.2%). Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency. It seems that some American residency programs do not fulfill the educational goals of their residents in menopause medicine. A curriculum would be beneficial for increasing knowledge and clinical experience on menopause issues.

  6. Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum. (United States)

    Potts, Stacy; Shields, Sara; Upshur, Carole


    The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of quality improvement (QI) training and requires that accredited residencies in all specialties demonstrate that residents are "integrated and actively participate in interdisciplinary clinical quality improvement and patient safety activities." However, competing demands in residency training may make this difficult to accomplish. The study's objective is to develop and evaluate a longitudinal curriculum that meets the ACGME requirement for QI and patient safety training and links to patient-centered medical home (PCMH) practices. Residents in the Worcester Family Medicine Residency (WFMR) participated in a faculty-developed quality improvement curriculum that included web-based tutorials, quality improvement projects, and small-group sessions across all 3 years of residency. They completed self-evaluations of knowledge and use of curricular activities annually and at graduation, and comparisons were made between two graduating classes, as well as comparison of end of PGY2 to end of PGY3 for one class. Graduating residents who completed the full 3 years of the curriculum rated themselves as significantly more skilled in nine of 15 areas assessed at end of residency compared to after PGY2 and reported confidence in providing future leadership in a focus group. Five areas were also rated significantly higher than prior-year residents. Involving family medicine residents in a longitudinal curriculum with hands-on practice in implementing QI, patient safety, and chronic illness management activities that are inclusive of PCMH goals increased their self-perceived skills and leadership ability to implement these new and emerging evidence-based practices in primary care.

  7. Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents. (United States)

    Peterson, Eleanor B; Boland, Kimberly A; Bryant, Kristina A; McKinley, Tara F; Porter, Melissa B; Potter, Katherine E; Calhoun, Aaron W


    Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies. The result was a cohesive curriculum that incorporates didactic, role play, and real-life experiences over the course of the entire training period. Methods to assess curricular outcomes included self-reporting, surveys, and periodic faculty evaluations of the residents. Curricular components have been highly rated by residents (3.95-3.97 based on a 4-point Likert scale), and residents' self-reported communication skills demonstrated an improvement over the course of residency in the domains of requesting a consultation, providing effective handoffs, handling conflict, and having difficult conversations (intern median 3.0, graduate median 4.0 based on a 5-point Likert scale, P  ≤ .002). Faculty evaluations of residents have also demonstrated improvement over time (intern median 3.0, graduate median 4.5 based on a 5-point Likert scale, P  communication skills curriculum for pediatrics residents was implemented, with a multistep evaluative process showing improvement in skills over the course of the residency program. Positive resident evaluations and informal comments from faculty support its general acceptance. The use of existing resources makes this curriculum feasible.

  8. Exit Survey of Senior Residents: Cost Conscious but Uninformed. (United States)

    Long, Theodore; Silvestri, Mark T; Dashevsky, Meir; Halim, Andrea; Fogerty, Robert L


    Background Cost awareness, to ensure physician stewardship of limited resources, is increasingly recognized as an important skill for physicians. The Accreditation Council for Graduate Medical Education has made cost awareness part of systems-based practice, a core competency of resident education. However, little is known about resident cost awareness. Objective We sought to assess senior resident self-perceived cost awareness and cost knowledge. Methods In March 2014, we conducted a cross-sectional survey of all emergency medicine, internal medicine, obstetrics and gynecology, orthopaedic surgery pediatrics, and medicine-pediatrics residents in their final year at Yale-New Haven Hospital. The survey examined attitudes toward health care costs and residents' estimates of order prices. We considered resident price estimates to be accurate if they were between 50% and 200% of the Connecticut-specific Medicare price. Results We sent the survey to 84 residents and received 47 completed surveys (56% response rate). Although more than 95% (45 of 47) felt that containing costs is the responsibility of every clinician, and 49% (23 of 47) agreed that cost influenced their decision when ordering, only 4% (2 of 47) agreed that they knew the cost of tests being ordered. No residents accurately estimated the price of a complete blood count with differential, and only 2.1% (1 of 47) were accurate for a basic metabolic panel. The overall accuracy of all resident responses was 25%. Conclusions In our study, many trainees exit residency with self-identified deficiencies in knowledge about costs. The findings show the need for educational approaches to improve cost awareness among trainees.

  9. Attitudes toward the use of gender-inclusive language among residency trainees. The McMaster Residency Training Program Directors. (United States)

    Guyatt, G H; Cook, D J; Griffith, L; Walter, S D; Risdon, C; Liutkus, J


    To explore postgraduate medical trainees' attitudes toward the use of gender-inclusive language. Self-administered questionnaire. Seven residency training programs at McMaster University, Hamilton, Ont., from July 1993 to June 1994. Of 225 residents in the programs, 186 responded to the survey, for a response rate of 82.7%. Men and women were equally represented among the respondents. Categorization of attitudes about the use of language as gender-inclusive or gender-exclusive; characteristics predicting a gender-inclusive attitude. Factor analysis and Cronbach's alpha (0.90) supported the existence of a construct related to attitudes about language use, the poles of which were categorized as gender-inclusive and gender-exclusive. The authors classified residents with respect to their attitudes to language use from their responses to the questionnaire. In univariate analyses, sex, residency program and country of graduation significantly predicted a gender-inclusive attitude (p < 0.01). Only the first 2 variables were significant in a multivariate model; residency program explained 18% of the variance and sex 3%. Residents in obstetrics and gynecology and psychiatry had the most gender-inclusive attitudes, whereas residents in surgery and anesthesia had the most gender-exclusive attitudes. Residents' values are reflected in the language they choose to use. Language use may provide an index of underlying attitudes that may create hostile environments for female trainees.

  10. Need fulfillment in the nursing home: resident and observer perspectives in relation to resident well-being

    NARCIS (Netherlands)

    Custers, Annette F.J.; Westerhof, Gerben Johan; Kuin, Y.; Gerritsen, D.L.; Riksen-Walraven, J.M.


    Self-reports in nursing homes generally show highly satisfied residents, whereas observational studies provide more nuanced results. In this study, which is based on self-determination theory, the perspective of nursing home residents (self-reports) is compared to the perspective of trained

  11. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows. (United States)

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M


    Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

  12. Embracing the new paradigm of assessment in residency training: an assessment programme for first-year residency training in anaesthesiology

    DEFF Research Database (Denmark)

    Ringsted, C; Østergaard, D; Scherpbier, A


    is to specify the evaluation situations and develop appropriate methods. This paper describes the intrinsic rational validation process in outlining an assessment programme for first-year anaesthesiology residency training according to the new paradigm. The applicability to other residency programmes and higher......-level training in anaesthesiology is discussed. Udgivelsesdato: 2003-Jan...

  13. The Preferred Learning Styles of Neurosurgeons, Neurosurgery Residents, and Neurology Residents: Implications in the Neurosurgical Field. (United States)

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


    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.

  14. Residência Médica no Brasil / Medical Residency in Brazil

    Directory of Open Access Journals (Sweden)

    Tania Maria Marcial


    Full Text Available Talvez não exista na história da ciência médica nos últimos cem anos nada mais fascinante do que a vida do Dr.William Stewart Halsted, considerado o mais inovador e influente cirurgião que os Estados Unidos já teve. O número e a magnitude de suas contribuições são surpreendentes. No entanto, a mais importante delas foi a criação da residência médica. Até a abertura do hospital John’s Hopkins em 1889, não havia um sistema formal para treinar cirurgiões nos Estados Unidos. Halsted introduziu um sistema em que médicos formados nas universidades ingressavam em um programa cirúrgico de base hospitalar, ao longo de um período de vários anos, com aumento progressivo de responsabilidades, culminando no último período em independência e autonomia dos jovens médicos. Esse sistema de treinamento se espalhou lentamente em todo o país. Este método de formação foi responsável mais do que qualquer outro fator, pela incrível produtividade que colocou os Estados Unidos na vanguarda da ciência cirúrgica em todo o mundo.1 Em 1890, também na Universidade John’s Hopkins, Willian Osler implantou o sistema de residência médica para a especialização em Clínica Médica. Em 1917, a Associação Médica Americana reconheceu a importância da residência médica e dez anos mais tarde, teve início o credenciamento dos primeiros programas. A partir de 1933, a obtenção de certificado de residência médica passou a ser exigência para o exercício da medicina naquele país.

  15. Residents' views about family medicine specialty education in Turkey

    Directory of Open Access Journals (Sweden)

    Uzuner Arzu


    Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

  16. Residents' views about family medicine specialty education in Turkey. (United States)

    Uzuner, Arzu; Topsever, Pinar; Unluoglu, Ilhami; Caylan, Ayse; Dagdeviren, Nezih; Uncu, Yesim; Mazicioğlu, Mumtaz; Ozçakir, Alis; Ozdemir, Hakan; Ersoy, Fusun


    Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27) and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11) by e-mail and by personal contact. A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%). Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e-learning. Participation in courses and congresses was considered

  17. Canadian pharmacy practice residents' projects: publication rates and study characteristics. (United States)

    Hung, Michelle; Duffett, Mark


    Research projects are a key component of pharmacy residents' education. Projects represent both a large investment of effort for each resident (up to 10 weeks over the residency year) and a large body of research (given that there are currently over 150 residency positions in Canada annually). Publication of results is a vital part of the dissemination of information gleaned from these projects. To determine the publication rate for research projects performed under the auspices of accredited English-language hospital pharmacy residency programs in Canada and to describe the study characteristics of residency projects performed in Ontario from 1999/2000 to 2008/2009. Lists of residents and project titles for the period of interest were obtained from residency coordinators. PubMed, CINAHL, the Canadian Journal of Hospital Pharmacy, and Google were searched for evidence of publication of each project identified, as an abstract or presentation at a meeting, a letter to the editor, or a full-text manuscript. The library holdings of the University of Toronto were reviewed to determine study characteristics of the Ontario residency projects. For the objective of this study relating to publication rate, 518 projects were included. The overall publication rate was 32.2% (60 [35.9%] as abstracts and 107 [64.1%] as full-text manuscripts). Publication in pharmacy-specific journals (66 [61.7%] of 107 full-text manuscripts) was more frequent than publication in non-pharmacy-specific journals. The publication rate of projects as full-text manuscripts remained stable over time. Of the 202 Ontario residency projects archived in the University of Toronto's library, most were cohort studies (83 [41.1%]), and the most common topic was efficacy and/or safety of a medication (46 [22.8%]). Most hospital pharmacy residents' projects were unpublished, and the publication rate of projects as full-text manuscripts has not increased over time. Most projects were observational studies

  18. Are All Competencies Equal in the Eyes of Residents? A Multicenter Study of Emergency Medicine Residents' Interest in Feedback. (United States)

    Bentley, Suzanne; Hu, Kevin; Messman, Anne; Moadel, Tiffany; Khandelwal, Sorabh; Streich, Heather; Noelker, Joan


    Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three four-year training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents' perceived importance of competencies/sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies.

  19. Effect of the Learning Climate of Residency Programs on Faculty’s Teaching Performance as Evaluated by Residents (United States)

    Lombarts, Kiki M. J. M. H.; Heineman, Maas Jan; Scherpbier, Albert J. J. A.; Arah, Onyebuchi A.


    Background To understand teaching performance of individual faculty, the climate in which residents’ learning takes place, the learning climate, may be important. There is emerging evidence that specific climates do predict specific outcomes. Until now, the effect of learning climate on the performance of the individual faculty who actually do the teaching was unknown. Objectives This study: (i) tested the hypothesis that a positive learning climate was associated with better teaching performance of individual faculty as evaluated by residents, and (ii) explored which dimensions of learning climate were associated with faculty’s teaching performance. Methods and Materials We conducted two cross-sectional questionnaire surveys amongst residents from 45 residency training programs and multiple specialties in 17 hospitals in the Netherlands. Residents evaluated the teaching performance of individual faculty using the robust System for Evaluating Teaching Qualities (SETQ) and evaluated the learning climate of residency programs using the Dutch Residency Educational Climate Test (D-RECT). The validated D-RECT questionnaire consisted of 11 subscales of learning climate. Main outcome measure was faculty’s overall teaching (SETQ) score. We used multivariable adjusted linear mixed models to estimate the separate associations of overall learning climate and each of its subscales with faculty’s teaching performance. Results In total 451 residents completed 3569 SETQ evaluations of 502 faculty. Residents also evaluated the learning climate of 45 residency programs in 17 hospitals in the Netherlands. Overall learning climate was positively associated with faculty’s teaching performance (regression coefficient 0.54, 95% confidence interval: 0.37 to 0.71; Pteaching performance: ‘coaching and assessment’, ‘work is adapted to residents’ competence’, and ‘formal education’. Conclusions Individual faculty’s teaching performance evaluations are positively

  20. Global health training in US obstetrics and gynaecology residency programmes: perspectives of students, residents and programme directors. (United States)

    Nathan, Lisa M; Banks, Erika H; Conroy, Erin M; McGinn, Aileen P; Ghartey, Jeny P; Wagner, Sarah A; Merkatz, Irwin R


    Benefits of exposure to global health training during medical education are well documented and residents' demand for this training is increasing. Despite this, it is offered by few US obstetrics and gynaecology (OBGYN) residency training programmes. To evaluate interest, perceived importance, predictors of global health interest and barriers to offering global health training among prospective OBGYN residents, current OBGYN residents and US OGBYN residency directors. We designed two questionnaires using Likert scale questions to assess perceived importance of global health training. The first was distributed to current and prospective OBGYN residents interviewing at a US residency programme during 2012-2013. The second questionnaire distributed to US OBGYN programme directors assessed for existing global health programmes and global health training barriers. A composite Global Health Interest/Importance score was tabulated from the Likert scores. Multivariable linear regression was performed to assess for predictors of Global Health Interest/Importance. A total of 159 trainees (77%; 129 prospective OBGYN residents and 30 residents) and 69 (28%) programme directors completed the questionnaires. Median Global Health Interest/Importance score was 7 (IQR 4-9). Prior volunteer experience was predictive of a 5-point increase in Global Health Interest/Importance score (95% CI -0.19 to 9.85; p=0.02). The most commonly cited barriers were cost and time. Interest and perceived importance of global health training in US OBGYN residency programmes is evident among trainees and programme directors; however, significant financial and time barriers prevent many programmes from offering opportunities to their trainees. Prior volunteer experience predicts global health interest. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  1. Practice gaps in patient safety among dermatology residents and their teachers: a survey study of dermatology residents. (United States)

    Swary, Jillian Havey; Stratman, Erik J


    Curriculum and role modeling adjustments are necessary to address patient safety gaps occurring during dermatology residency. To identify the source of clinical practices among dermatology residents that affect patient safety and determine the best approach for overcoming gaps in knowledge and practice patterns that contribute to these practices. A survey-based study, performed at a national medical dermatology meeting in Itasca, Illinois, in 2012, included 142 dermatology residents from 44 residency programs in the United States and Canada. Self-reported rates of dermatology residents committing errors, identifying local systems errors, and identifying poor patient safety role modeling. Of surveyed dermatology residents, 45.2% have failed to report needle-stick injuries incurred during procedures, 82.8% reported cutting and pasting a previous author's patient history information into a medical record without confirming its validity, 96.7% reported right-left body part mislabeling during examination or biopsy, and 29.4% reported not incorporating clinical photographs of lesions sampled for biopsy in the medical record at their institution. Residents variably perform a purposeful pause ("time-out") when indicated to confirm patient, procedure, and site before biopsy, with 20.0% always doing so. In addition, 59.7% of residents work with at least 1 attending physician who intimidates the residents, reducing the likelihood of reporting safety issues they witness. Finally, 78.3% have witnessed attending physicians purposefully disregarding required safety steps. Our data reinforce the need for modified curricula, systems, and teacher development to reduce injuries, improve communication with patients and between physicians, residents, and other members of the health care team, and create an environment free of intimidation.

  2. E-conferencing for delivery of residency didactics. (United States)

    Markova, Tsveti; Roth, Linda M


    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

  3. Five Key Leadership Actions Needed to Redesign Family Medicine Residencies. (United States)

    Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A


    New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

  4. Personal characteristics of residents may predict competency improvement. (United States)

    Park, EunMi; Ha, Patrick K; Eisele, David W; Francis, Howard W; Kim, Young J


    We hypothesized that personal characteristics of residents may affect how well competency is attained in a surgical residency. To this end, we examined two concepts of global trait emotional intelligence and learner autonomy profile and their factor relationship with competency outcomes in a residency program in otolaryngology-head and neck surgery. A cohort study prospectively gathered competency change scores for 1 year and retrospectively analyzed the factor associations. We measured two personal characteristics using the Trait Emotional Intelligence Questionnaire-Short Form and Learner Autonomy Profile-Short Form between 2013 and 2014 in a tertiary otolaryngology-head and neck residency program. We prospectively examined faculty-rated resident competency scores monitored in the same time period and correlated the personal attributes with cumulative competency improvement scores. Statistical analyses included factor correlations and univariate regression. With a response rate of 64% (N = 16/25), we identified two statically significant predictors of competency improvement outcome attained by the end of the year. Regression analyses showed that emotionality factor of global trait emotional intelligence (P = .04) and learner autonomy profile (P < .01) were significant predictors for the higher improvement of aggregate competency outcome. Personal factors of individual residents can affect their improvement of overall competency. Practicing competency-based education should, therefore, include assessing individual resident factors as well as teaching clinical knowledge and technical skills. NA Laryngoscope, 126:1746-1752, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Mixed reality ventriculostomy simulation: experience in neurosurgical residency. (United States)

    Hooten, Kristopher G; Lister, J Richard; Lombard, Gwen; Lizdas, David E; Lampotang, Samsun; Rajon, Didier A; Bova, Frank; Murad, Gregory J A


    Medicine and surgery are turning toward simulation to improve on limited patient interaction during residency training. Many simulators today use virtual reality with augmented haptic feedback with little to no physical elements. In a collaborative effort, the University of Florida Department of Neurosurgery and the Center for Safety, Simulation & Advanced Learning Technologies created a novel "mixed" physical and virtual simulator to mimic the ventriculostomy procedure. The simulator contains all the physical components encountered for the procedure with superimposed 3-D virtual elements for the neuroanatomical structures. To introduce the ventriculostomy simulator and its validation as a necessary training tool in neurosurgical residency. We tested the simulator in more than 260 residents. An algorithm combining time and accuracy was used to grade performance. Voluntary postperformance surveys were used to evaluate the experience. Results demonstrate that more experienced residents have statistically significant better scores and completed the procedure in less time than inexperienced residents. Survey results revealed that most residents agreed that practice on the simulator would help with future ventriculostomies. This mixed reality simulator provides a real-life experience, and will be an instrumental tool in training the next generation of neurosurgeons. We have now implemented a standard where incoming residents must prove efficiency and skill on the simulator before their first interaction with a patient.

  6. ACGME proposes dropping the 16 hour resident shift limit

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. The Accreditation Council for Graduate Medical Education (ACGME is proposing that first-year residents would no longer be limited to 16-hour shifts during the 2017-2018 academic year under a controversial proposal released today (1. Instead, individual residency programs could assign first-year trainees to shifts as long as 28 hours, the current limit for all other residents. The 28-hour maximum includes 4 transitional hours that's designed in part to help residents improve continuity of care. The plan to revise training requirements does not change other rules designed to protect all residents from overwork. including the maximum80 hours per week. The ACGME capped the shifts of first-year residents at 16 hours in 2011 as a part of an ongoing effort to make trainee schedules more humane and avoid clinical errors caused by sleep deprivation. ACGME CEO Thomas Nasca, MD, told Medscape Medical News that the problem arises largely from first-year residents not being ...

  7. A patient safety education program in a medical physics residency. (United States)

    Ford, Eric C; Nyflot, Matthew; Spraker, Matthew B; Kane, Gabrielle; Hendrickson, Kristi R G


    Education in patient safety and quality of care is a requirement for radiation oncology residency programs according to accrediting agencies. However, recent surveys indicate that most programs lack a formal program to support this learning. The aim of this report was to address this gap and share experiences with a structured educational program on quality and safety designed specifically for medical physics therapy residencies. Five key topic areas were identified, drawn from published recommendations on safety and quality. A didactic component was developed, which includes an extensive reading list supported by a series of lectures. This was coupled with practice-based learning which includes one project, for example, failure modes and effect analysis exercise, and also continued participation in the departmental incident learning system including a root-cause analysis exercise. Performance was evaluated through quizzes, presentations, and reports. Over the period of 2014-2016, five medical physics residents successfully completed the program. Evaluations indicated that the residents had a positive experience. In addition to educating physics residents this program may be adapted for medical physics graduate programs or certificate programs, radiation oncology residencies, or as a self-directed educational project for practicing physicists. Future directions might include a system that coordinates between medical training centers such as a resident exchange program. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  8. Factors associated with primary care residents' satisfaction with their training. (United States)

    Randall, C S; Bergus, G R; Schlechte, J A; McGuinness, G; Mueller, C W


    Satisfaction is known to impact work performance, learning, recruitment, and retention. This study identifies the factors associated with primary care residents' satisfaction with their training. We used a cross-sectional survey based on the Price-Mueller model of job satisfaction. The model included 14 job characteristics, four personal characteristics, and four demographic factors. Data were collected in February and March 1996 from residents in three primary care training programs (family practice, pediatrics, and internal medicine) at a large academic medical center. The same standardized, self-administered questionnaires were used in all three departments. Seventy-five percent (n = 119) of the residents returned questionnaires. Five job characteristics were positively associated with resident satisfaction: continuity of care, autonomy, collegiality, work that encourages professional growth, and work group loyalty. Role conflict, a sixth job characteristic, was negatively associated with satisfaction. The personal characteristic of having an optimistic outlook on life was also positively associated with satisfaction. The model explained 66% of the variation in self-reported satisfaction. The satisfaction of the residents was significantly associated with six job characteristics and one personal factor. Interventions based on these job characteristics may increase resident satisfaction and may lead to better patient outcomes, better work performance, greater patient satisfaction, and more success in recruiting top students into a residency.

  9. Does rural residence impact total ankle arthroplasty utilization and outcomes? (United States)

    Singh, Jasvinder A; Ramachandaran, Rekha


    The objective of this study was to compare total ankle arthroplasty (TAA) utilization and outcomes by patient residence. We used the Nationwide Inpatient Sample (NIS) from 2003 to 2011 to compare utilization and outcomes (post-arthroplasty discharge disposition, length of hospitalization, and mortality) by rural vs. urban residence. Ten thousand eight hundred thirty-three patients in urban and 3,324 patients in rural area underwent TAA. Compared to rural residents, urban residents had: lower mean age, 62.4 vs. 61.8 years (p residence: (1) 11.3 % rural vs. 14.2 % urban residents were discharged to an inpatient facility (p = 0.098); (2) length of hospital stay above the median stay, was 44.8 vs. 42.2 % (p = 0.30); and (3) mortality was 0.2 vs. 0.1 %, respectively (p = 0.81). Multivariable-adjusted logistic regression models did not show any significant differences in discharge to home, length of stay, or mortality, by residence. Our study demonstrated an absence of any evidence of rural-urban differences in TAA outcomes. The rural-urban differences in TAA utilization noted in 2003 were no longer significant in 2011.

  10. DNA residence time is a regulatory factor of transcription repression. (United States)

    Clauß, Karen; Popp, Achim P; Schulze, Lena; Hettich, Johannes; Reisser, Matthias; Escoter Torres, Laura; Uhlenhaut, N Henriette; Gebhardt, J Christof M


    Transcription comprises a highly regulated sequence of intrinsically stochastic processes, resulting in bursts of transcription intermitted by quiescence. In transcription activation or repression, a transcription factor binds dynamically to DNA, with a residence time unique to each factor. Whether the DNA residence time is important in the transcription process is unclear. Here, we designed a series of transcription repressors differing in their DNA residence time by utilizing the modular DNA binding domain of transcription activator-like effectors (TALEs) and varying the number of nucleotide-recognizing repeat domains. We characterized the DNA residence times of our repressors in living cells using single molecule tracking. The residence times depended non-linearly on the number of repeat domains and differed by more than a factor of six. The factors provoked a residence time-dependent decrease in transcript level of the glucocorticoid receptor-activated gene SGK1. Down regulation of transcription was due to a lower burst frequency in the presence of long binding repressors and is in accordance with a model of competitive inhibition of endogenous activator binding. Our single molecule experiments reveal transcription factor DNA residence time as a regulatory factor controlling transcription repression and establish TALE-DNA binding domains as tools for the temporal dissection of transcription regulation. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  11. Experimental determination of residence time distribution in continuous dry granulation. (United States)

    Mangal, Haress; Kleinebudde, Peter


    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.

  12. Residents' leadership styles and effectiveness as perceived by nurses. (United States)

    McCue, J D; Magrinat, G; Hansen, C J; Bailey, R S


    Although physicians are required to act as leaders in a variety of situations, leadership ability and leadership training have been largely ignored by medical educators. The leadership styles and leadership effectiveness of 17 residents in a community hospital were studied as part of a leadership training seminar. Self-ratings and ratings of the residents by nurses who had worked with them were used to assess the residents' leadership style and the nurses' perceptions of the effectiveness of those styles. Styles that emphasized relationships with co-workers (encouraging and coaching styles) predominated over low relationship-oriented styles (delegating and structuring). The nurses perceived individual residents who exhibited encouraging and coaching leadership styles as being distinctly more effective leaders than the residents who exhibited structuring and delegating styles. The residents, however, rated all four styles as similarly effective. Leadership training programs and studies of the type reported here may provide an opportunity for faculty members to help residents learn more appropriate and productive styles of leadership.

  13. Incorporating population medicine into primary care residency training. (United States)

    Dysinger, Wayne S; King, Valerie; Foster, Tina C; Geffken, Dominic


    Expanded competencies in population health and systems-based medicine have been identified as a need for primary care physicians. Incorporating formal training in preventive medicine is one method of accomplishing this objective. We identified three family medicine residencies that have developed formal integrated pathways for residents to also complete preventive medicine residency requirements during their training period. Although there are differences, each pathway incorporates a structured approach to dual residency training and includes formal curriculum that expands resident competencies in population health and systems-based medicine. A total of 26 graduates have completed the formally combined family and preventive medicine residencies. All are board certified in family medicine, and 22 are board certified in preventive medicine. Graduates work in a variety of academic, quality improvement, community, and international settings utilizing their clinical skills as well as their population medicine competencies. Dual training has been beneficial in job acquisition and satisfaction. Incorporation of formal preventive medicine training into family medicine education is a viable way to use a structured format to expand competencies in population medicine for primary care physicians. This type of training, or modifications of it, should be part of the debate in primary care residency redesign.

  14. A set of principles, developed by residents, to guide Canadian residency education. (United States)

    Maniate, Jerry M; Karimuddin, Ahmer


    With so much invested in the clinical competency of physicians, adequate and appropriate mechanisms are needed to ensure that educational systems provide the highest-quality training possible and are responsive both to the changing demands of the patient population and to changing technologies and research. After a literature review, the authors concluded that there are no established criteria or principles, from a learners' perspective, that set out goals for the delivery and evaluation in Canada of quality postgraduate medical education. The authors initiated the process of developing a set of principles of medical education based on residents' perspectives by compiling a list of issues and concepts that were felt to be important to creating the "ideal" postgraduate medical education system. This list of issues was divided into broad categories before presentation by the authors for Canada-wide discussion, reflection, and further refinement of concepts and issues across a nine-month period. The process eventually resulted in the final consensus-driven and iterative development of the main categories and the final principles that were adopted by the Canadian Association of Internes and Residents (CAIR). The authors present this set of principles and propose that they be used as a template to guide postgraduate medical education and against which changes to the system can be evaluated. CAIR will use these principles in a number of ways, including evaluation, education, and quality assurance.

  15. Residency Training: The need for an integrated diversity curriculum for neurology residency. (United States)

    Rosendale, Nicole; Josephson, S Andrew


    Providing culturally responsive care to an increasingly multicultural population is essential and requires formal cultural humility training for residents. We sought to understand the current prevalence and need for this type of training within neurology programs and to pilot an integrated curriculum locally. We surveyed via email all program directors of academic neurology programs nationally regarding the prevalence of and need for formal cultural responsiveness training. Forty-seven program directors (36%) responded to the survey. The majority of respondents did not have a formalized diversity curriculum in their program (65%), but most (85%) believed that training in cultural responsiveness was important. We developed locally an integrated diversity curriculum as a proof of concept. The curriculum covered topics of diversity in language, religion, sexual orientation, gender identity/expression, and socioeconomic status designed to focus on the needs of the local community. Program evaluation included a pre and post survey of the learner attitudes toward cultural diversity. There is an unmet need for cultural responsiveness training within neurology residencies, and integrating this curriculum is both feasible and efficacious. When adapted to address cultural issues of the local community, this curriculum can be generalizable to both academic and community organizations. © 2017 American Academy of Neurology.

  16. Family medicine residents' practice intentions: Theory of planned behaviour evaluation. (United States)

    Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W


    To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

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


    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.

  18. Perceptual Assessment of Velopharyngeal Dysfunction by Otolaryngology Residents. (United States)

    Butts, Sydney C; Truong, Alan; Forde, Christina; Stefanov, Dimitre G; Marrinan, Eileen


    To assess the ability of otolaryngology residents to rate the hypernasal resonance of patients with velopharyngeal dysfunction. We hypothesize that experience (postgraduate year [PGY] level) and training will result in improved ratings of speech samples. Prospective cohort study. Otolaryngology training programs at 2 academic medical centers. Thirty otolaryngology residents (PGY 1-5) were enrolled in the study. All residents rated 30 speech samples at 2 separate times. Half the residents completed a training module between the rating exercises, with the other half serving as a control group. Percentage agreement with the expert rating of each speech sample and intrarater reliability were calculated for each resident. Analysis of covariance was used to model accuracy at session 2. The median percentage agreement at session 1 was 53.3% for all residents. At the second session, the median scores were 53.3% for the control group and 60% for the training group, but this difference was not statistically significant. Intrarater reliability was moderate for both groups. Residents were more accurate in their ratings of normal and severely hypernasal speech. There was no correlation between rating accuracy and PGY level. Score at session 1 positively correlated with score at session 2. Perceptual training of otolaryngology residents has the potential to improve their ratings of hypernasal speech. Length of time in residency may not be best predictor of perceptual skill. Training modalities incorporating practice with hypernasal speech samples could improve rater skills and should be studied more extensively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. Management training for pathology residents: a regional approach. (United States)

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


    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.

  20. Modeling Hourly Resident Productivity in the Emergency Department. (United States)

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


    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.

  1. Money matters: a resident curriculum for financial management. (United States)

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


    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.

  2. Workplace Violence and Harassment Against Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Benjamin H. Schnapp


    Full Text Available Introduction: Several studies have shown that workplace violence in the emergency department (ED is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results: A majority of residents (66%, 78/119 reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119 experienced verbal harassment, 78% (93/119 had experienced verbal threats, and 52% (62/119 reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion: Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  3. The use of error analysis to assess resident performance. (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


    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.

  4. Board review course effect on resident in-training examination. (United States)

    Cheng, David


    The in-training examination is a national and yearly exam administered by the American Board of Emergency Medicine to all emergency medicine residents in the USA. The purpose of the examination is to evaluate a resident's progress toward obtaining the fundamental knowledge to practice independent emergency medicine. The purpose of this study was to determine the effects of a 40 hour board review lecture course on the resident in-training examination in emergency medicine. A 40 hour board review lecture course was designed and implemented during the weekly 5 hour long resident conferences during the 8 weeks preceding the in-training examination date in 2006. Attendance was mandatory at the Accreditation Council for Graduate Medical Education (ACGME) standard of 70% or greater. A positive result was considered to be a 10% increase or greater in the resident's individual national class percentile ranking among their national peers for their class year for the emergency medicine in-training examination. A resident was excluded from the study if there was no 2005 in-training examination score for self-comparison. The 95% confidence intervals (CI) were used to analyze the results. Of 16 residents, 1 (6.25%; 95% CI: 0-18%) showed a positive result of increasing their national class percentile ranking by 10% or greater. For the PGY2, one of the eight had a positive result (12.5%; 95% CI: 0-35.4%). For PGY3, no resident (0%; 95% CI: 0-35.4%) had a positive result. A 40 hour board review lecture course has no positive effect on improving a resident's in-training examination score.

  5. The Impact of Resident Training on Communication with Families in the Intensive Care Unit. Resident and Family Outcomes. (United States)

    Sullivan, Amy M; Rock, Laura K; Gadmer, Nina M; Norwich, Diana E; Schwartzstein, Richard M


    In high-acuity settings such as intensive care units (ICUs), the quality of communication with patients' families is a particularly important component of care. Evidence shows that ICU communication is often inadequate and can negatively impact family outcomes. To assess the impact of a communication training program on resident skills in communicating with families in an ICU and on family outcomes. We conducted a prospective, single-site educational intervention study. The intervention featured a weekly required communication training program (4 h total) during the ICU rotation, which included interactive discussion, and role play with immediate feedback from simulated family members. All internal medicine residents on ICU rotation between July 2012 and July 2014 were invited to participate in the study. Family members who had a meeting with an enrolled resident were approached for a survey or interview. The primary outcome was family ratings of how well residents met their informational and emotional needs. The response rate for the resident baseline survey was 93% (n = 149 of 160), and it was 90% at postcourse and 84% at 3-month follow-up. Of 303 family members approached, 237 were enrolled. Enrolled family members who had a confirmed meeting with a resident were eligible to complete a survey or interview. The completion rate was 86% (n = 82 of 95). Family members were more likely to describe residents as having "fully met" (average rating of 10/10 on 0-10 scale) their informational and emotional needs when the resident had completed two or three course sessions (84% of family members said conversation with these residents "fully met" their needs), as compared with residents who had taken one session or no sessions (25% of family members said needs were "fully met") (P training program designed for integration into medical residency programs was associated with strongly positive family member outcomes and significant improvements in residents' perceived skills

  6. Evolving Perceptions of the Plastic Surgery Integrated Residency Training Program. (United States)

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


    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 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 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

  7. A basic residency curriculum concerning the chronically mentally ill. (United States)

    Faulkner, L R; Cutler, D L; Krohn, D D; Factor, R M; Goldfinger, S M; Goldman, C R; Lamb, H R; Lefley, H; Minkoff, K; Schwartz, S R


    In this paper a group of knowledgeable individuals with expertise in psychiatric education present their recommendations for a basic psychiatric residency curriculum concerning the chronically mentally ill. The proposed curriculum consists of knowledge, skill, and attitude educational objectives, as well as clinical experiences, faculty supervision, didactics and seminars, and evaluation mechanisms. Recommendations are also made concerning changes in the Accreditation Council for Graduate Medical Education's Special Requirements for Residency Training in Psychiatry, which would require residency programs to place more emphasis on training to meet the needs of the chronically mentally ill. Obstacles to the implementation of the proposed recommendations are presented and possible solutions are discussed.

  8. Workplace bullying of general surgery residents by nurses. (United States)

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


    Workplace bullying is at the forefront of social behavior research, garnering significant media attention. Most of the medical research has addressed bullying of nurses by physicians and demonstrates that patient care and outcomes may suffer. The intent of this study was to determine if general surgery residents are bullied by nurses. A survey instrument previously validated (Negative Acts Questionnaire-Revised) to evaluate for workplace bullying was modified to reflect the resident-nurse relationship. After institutional review board approval, the piloted online survey was sent to general surgery program directors to forward to general surgery residents. Demographic data are presented as percentages, and for negative acts, percentages of daily, weekly, and monthly frequencies are combined. Allopathic general surgery residencies in the United States. General surgery residents. The response rate was 22.1% (n = 452). Most respondents were men (55%) and had a mean age of 29 years (standard deviation = 7). Although 27.0% of the respondents were interns, the remaining classes were equally represented (12%-18% of responses/class). The respondents were primarily from medium-sized residency programs (45%), in the Midwest (28%), training in university programs (72%), and rotating primarily in a combined private and county hospital that serves both insured and indigent patients (59%). The residents had experienced each of the 22 negative acts (11.5%-82.5%). Work-related bullying occurs more than person-related bullying and physical intimidation. Ignoring of recommendations or orders by nurses occurs on a daily, weekly, or monthly basis for 30.2% of residents (work-related bullying). The most frequent person-related bullying act is ignoring the resident when they approach or reacting in a hostile manner (18.0%), followed by ignoring or excluding the resident (17.1%). Workplace bullying of general surgery residents by nurses is prominent. Future research is needed to determine

  9. Types of tourism and residents' attitudes: the case of Ibiza


    José Ramón Cardona


    The types and forms of tourism and, above all, perception and attitude of tourists influence how evolving attitudes of residents. But the vast majority of studies of residents' attitudes discussed the tourism sector as a whole, with few cases that focus on a particular type of supply. The aim of this paper is to analyze whether tourism products with worse or better rating. The main difference between the two surveys used is that effects of the economic crisis are expected in 2011. Residents c...

  10. Primary group interaction of residents in a retirement hotel. (United States)

    Hampe, G D; Blevins, A L


    The interaction patterns of sixty-three residents age 55 and over living in a retirement hotel for three types of primary groups-kin, friends, and neighbors-were studied. Almost all residents voiced high housing satisfaction and were involved to various degrees in their primary group network. The relative with whom visited the most, usually the adult child, influences the primary group interaction the most, but at the same time may contribute to feelings of uselessness on the part of the retired residents of the apartment complex.

  11. 41 CFR 302-11.5 - To be reimbursed for expenses incurred in my residence transactions, must I occupy the residence... (United States)


    ... expenses incurred in my residence transactions, must I occupy the residence at the time I am notified of my... System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules § 302-11.5 To be reimbursed for expenses incurred in my...

  12. Long residence times - bad tracer tests? (United States)

    Ghergut, Julia; Behrens, Horst; Sauter, Martin


    Tracer tests conducted at geothermal well doublets or triplets in the Upper Rhine Rift Valley [1] all face, with very few exceptions so far, one common issue: lack of conclusive tracer test results, or tracer signals still undetectable for longer than one or two years after tracer injection. While the reasons for this surely differ from site to site (Riehen, Landau, Insheim, Bruchsal, ...), its effects on how the usefulness of tracer tests is perceived by the non-tracer community are pretty much the same. The 'poor-signal' frustration keeps nourishing two major 'alternative' endeavours : (I) design and execute tracer tests in single-well injection-withdrawal (push-pull), 'instead of' inter-well flow-path tracing configurations; (II) use 'novel' tracer substances instead of the 'old' ones which have 'obviously failed'. Frustration experienced with most inter-well tracer tests in the Upper Rhine Rift Valley has also made them be regarded as 'maybe useful for EGS' ('enhanced', or 'engineered' geothermal systems, whose fluid RTD typically include a major share of values below one year), but 'no longer worthwhile a follow-up sampling' in natural, large-scale hydrothermal reservoirs. We illustrate some of these arguments with the ongoing Bruchsal case [2]. The inter-well tracer test conducted at Bruchsal was (and still is!) aimed at assessing inter-well connectivity, fluid residence times, and characterizing the reservoir structure [3]. Fluid samples taken at the geothermal production well after reaching a fluid turnover of about 700,000 m3 showed tracer concentrations in the range of 10-8 Minj per m3, in the liquid phase of each sample (Minj being the total quantity of tracer injected as a short pulse at the geothermal re-injection well). Tracer signals might actually be higher, owing to tracer amounts co-precipitated and/or adsorbed onto the solid phase whose accumulation in the samples was unavoidable (due to pressure relief and degassing during the very sampling

  13. Family medicine residents' perceived level of comfort in treating common sports injuries across residency programs in the United States. (United States)

    Amoako, Adae O; Amoako, Agyenim B; Pujalte, George Ga


    Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7%) compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8%) respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively). Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, sports medicine contribute to residents' knowledge and comfort level in treatment of common sports injuries.

  14. Development of a Night Float Call Model for Obstetrics and Gynaecology Residency: The Process and Residents' Perceptions. (United States)

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


    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.

  15. Change in residents' perceptions of teaching: following a one day "Residents as Teachers" (RasT) workshop. (United States)

    Aiyer, Meenakshy; Woods, Gordon; Lombard, Gwen; Meyer, Lynne; Vanka, Anita


    The objective of this study was to assess the perceptions and attitudes of resident physicians toward teaching before and after participation in a mandatory "Residents as Teachers" (RasT) workshop in four domains: (1) setting goals and expectations, (2) use of clinical microskills in teaching, (3) evaluation and feedback, and (4) enthusiasm and preparedness toward teaching. Pre- and postintervention questionnaires were utilized. Data were analyzed for all respondents. Subgroup analyses were performed for each academic year and for primary care versus nonprimary care specialties. Over a 5-year period, 15 RasT workshops were presented to 276 residents from 10 different residency programs. Eighty-six percent completed the questionnaire before participation in the workshop, and 88% completed the questionnaire immediately after participation. The difference between the mean post-RasT and pre-RasT ratings on each item was used to measure the change in that item resulting from participation in the workshop. Overall, residents' self-assessed ratings of their attitudes toward teaching were positively impacted by participation in a RasT workshop. Further subanalysis showed that residents in primary care specialties showed a significantly greater increase in their ratings than residents in nonprimary care specialties.

  16. Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance. (United States)

    Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y


    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P general surgery patient outcomes or differences in resident examination performance. The implications of these findings should be considered when evaluating the merit of the 2011 ACGME duty hour reform and revising related policies in the future.

  17. Uncertainty and decision making for residents with dementia. (United States)

    Lopez, Ruth Palan; Guarino, A J


    Uncertainty is a significant barrier confronting surrogate decision makers(SDMs) who make treatment decisions for nursing home (NH) residents with dementia. The study purpose is to describe uncertainty among SDMs of NH residents with dementia and to identify factors associated with greater Uncertainty. We employed a nonexperimental, cross-sectional design using mailed survey and recruited 155 SDM participants from eight NHs in New England. The survey contained the Mishel Uncertainty in Illness Scale For Family Members. Independent variables included resident and SDM sociodemographic characteristics, Advance Directives, Credible Authority, Social Support, and Perceived Self-Efficacy for Surrogate Decision Making. Results of a simultaneous multiple regression analysis identified Perceived Self-Efficacy,Social Support, and Close Relative explained 22% of the Uncertainty variance.These findings suggest that close family relatives who serve as SDMs for NH residents with dementia may benefit from increasing social support and enhancing SDMs’ self-efficacy for decision making.

  18. Training Psychiatry Residents in Professionalism in the Digital World. (United States)

    John, Nadyah Janine; Shelton, P G; Lang, Michael C; Ingersoll, Jennifer


    Professionalism is an abstract concept which makes it difficult to define, assess and teach. An additional layer of complexity is added when discussing professionalism in the context of digital technology, the internet and social media - the digital world. Current physicians-in-training (residents and fellows) are digital natives having been raised in a digital, media saturated world. Consequently, their use of digital technology and social media has been unconstrained - a reflection of it being integral to their social construct and identity. Cultivating the professional identity and therefore professionalism is the charge of residency training programs. Residents have shown negative and hostile attitudes to formalized professionalism curricula in training. Approaches to these curricula need to consider the learning style of Millennials and incorporate more active learning techniques that utilize technology. Reviewing landmark position papers, guidelines and scholarly work can therefore be augmented with use of vignettes and technology that are available to residency training programs for use with their Millennial learners.

  19. Resident Assessment Instrument/Minimum Data Set (RAI/MDS) (United States)

    Department of Veterans Affairs — The Resident Assessment Instrument/Minimum Data Set (RAI/MDS) is a comprehensive assessment and care planning process used by the nursing home industry since 1990 as...

  20. Endoscopy training in Canadian general surgery residency programs. (United States)

    Bradley, Nori L; Bazzerelli, Amy; Lim, Jenny; Wu Chao Ying, Valerie; Steigerwald, Sarah; Strickland, Matt


    Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met.

  1. Taking it Global: Structuring Global Health Education in Residency Training. (United States)

    Arora, Gitanjli; Ripp, Jonathan; Evert, Jessica; Rabin, Tracy; Tupesis, Janis P; Hudspeth, James


    To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U.S. and international partners. This article provides guidance for incorporating GH education into U.S. residency programs in an ethically sound and sustainable manner, and gives examples and solutions for common challenges encountered when developing GH education programs.

  2. Socio-economic Factors and Residents' Health in Nigeria Urban ...

    African Journals Online (AJOL)

    The study then suggested the introduction of standard yardstick policy, which could be used to measure socio-economic status of residents in relation to their health status determinants in this country. African Research Review Vol. 2 (3) 2008: pp.

  3. Resident participation in neighbourhood audit tools - a scoping review.

    NARCIS (Netherlands)

    Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea


    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

  4. Resident participation in neighbourhood audit tools : a scoping review

    NARCIS (Netherlands)

    Hofland, Aafke C.L.; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea


    Background: 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

  5. Factors associated with the satisfaction of millennial generation dental residents. (United States)

    Lam, Hwai-Tai C; O'Toole, Terry G; Arola, Patricia E; Kashner, T Michael; Chang, Barbara K


    Data from the 2010 Learners' Perceptions Survey (LPS) administered through the Office of Academic Affiliations, Department of Veterans Affairs (VA) were analyzed to identify factors associated with dental residents' satisfaction with the VA as a clinical training environment. Satisfaction scores were linked to clinic workloads, dental procedure complexity levels, staffing patterns, and facility infrastructure data to explore conditions that may improve residents' satisfaction. Findings supported the construct validity of the LPS survey data and underscored the importance of maintaining optimal ratios of attending dentists, dental assistants, and administrative staff to residents so that each trainee will have opportunities to perform an adequate level of dental workload. As programs strive to improve the quality of graduate dental education, findings from this study are vital for setting curriculum design guidelines and for providing infrastructure support for dental resident education.

  6. Enhancing resident morning report with "daily learning packages". (United States)

    Weaver, Debbie


    The daily "Morning Report" is a fixture in many residency programs. In the past, librarians have attended this meeting and, in various ways, worked to enhance the resident learning experience. At the academic children's hospital discussed in this study, the concept was taken a step further. Together with the chief residents, the librarian provided a complete "learning package" consisting of the case write-up along with relevant, librarian-filtered, evidence-based information. The learning package was then e-mailed to all residents and some of the attending physicians. This program led to a huge increase in the use of library resources and services as well as a renewed recognition of the value of the library and the librarians.

  7. Resident training in a new robotic thoracic surgery program. (United States)

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


    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.

  8. Gaps in nurse staffng and nursing home resident needs. (United States)

    Zhang, Ning Jackie; Unruh, Lynn; Wan, Thomas T H


    Trends in nurse staffing levels in nursing homes from 1997 to 2011 varied across the category of nurse and the type of nursing home. The gaps found in this study are important to consider because nurses may become overworked and this may negatively affect the quality of services and jeopardize resident safety. Nursing home administrators should consider improving staffing strategically. Staffing should be based not only on the number of resident days, but also allocated according to particular resident needs. As the demand for nursing home care grows, bridging the gap between nurse staffing and resident nursing care needs will be especially important in light of the evidence linking nurse staffing to the quality of nursing home care. Until more efficient nursing care delivery exits, there may be no other way to safeguard quality except to increase nurse staffing in nursing homes.

  9. Challenges to neurology residency education in today's health care environment. (United States)

    Bega, Danny; Krainc, Dimitri


    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  10. Prediction of residence time distributions in food processing machinery

    DEFF Research Database (Denmark)

    Karlson, Torben; Friis, Alan; Szabo, Peter


    The velocity field in a co-rotating disc scraped surface heat exchanger (CDHE) is calculated using a finite element method. The residence time distribution for the CDHE is then obtained by tracing particles introduced in the inlet....

  11. Improving Surgical Skills of OBGYN Residents through Partnership ...

    African Journals Online (AJOL)

    Improving Surgical Skills of OBGYN Residents through Partnership with Rural Hospitals: Experience from Southeast Nigeria. Odidika Ugochukwu Joannes Umeora, Azubuike Kanario Onyebuchi, Nkechi Bridget Emma-Echiegu, Justus Ndulue Eze, Paul Olisaemeka Ezeonu ...

  12. MDS 2.0 Public Quality Indicator and Resident Reports (United States)

    U.S. Department of Health & Human Services — The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This...

  13. P270: Factors associated with fall rate in psychogeriatric residents

    NARCIS (Netherlands)

    Kosse, N.M.; de Groot, Maartje H; Hortobágyi, T.; Lamoth, C.J.C.


    Introduction: Falls in psychogeriatric residents represent a costly but unresolved safety issue. Identifying fall risk factors and their inter-relationship may help to individualize prevention programs and increase the effectiveness. Therefore, we aimed to examine the relationship between patient

  14. Doll therapy: an intervention for nursing home residents with dementia. (United States)

    Shin, Juh Hyun


    The use of dolls as a therapeutic intervention for nursing home residents with dementia is relatively new. The current article describes a research study implemented with nursing home residents in Korea to examine the effects of doll therapy on their mood, behavior, and social interactions. A one-group, pretest-posttest design was used to measure the impact of doll therapy on 51 residents with dementia. Linear regression demonstrated statistically significant differences in aggression, obsessive behaviors, wandering, negative verbalization, negative mood, and negative physical appearance after introduction of the doll therapy intervention. Interactions with other individuals also increased over time. Findings support the benefits of doll therapy for nursing home residents with dementia; however, further research is needed to provide more empirical evidence and explore ethical considerations in the use of doll therapy in this vulnerable population. Copyright 2015, SLACK Incorporated.

  15. U.S. Lawful Permanent Residents: Fiscal Year 2014 (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs), also known as “green card” holders, are non-citizens who are lawfully authorized to live permanently within the United States.

  16. Children's postdivorce residence arrangements and parental experienced time pressure

    NARCIS (Netherlands)

    van der Heijden, Franciëlla; Poortman, Anne Rigt; van der Lippe, Tanja


    Although the rise in postdivorce joint physical custody has fueled scholarly interest in its impact on children, consequences for parents remain understudied. Because children's residence arrangements determine time and coordination demands associated with child care, this study investigated the

  17. Estimates of the Legal Permanent Resident Population: 2011 (United States)

    Department of Homeland Security — This report presents estimates of the legal permanent resident (LPR) population living in the United States on January 1, 2011. The LPR population includes persons...

  18. U.S. Legal Permanent Residents: Fiscal Year 2006 (United States)

    Department of Homeland Security — Every year, hundreds of thousands of persons become legal permanent residents (LPRs) or “green card” recipients of the United States. LPRs, as defined by immigration...

  19. A review of teaching methods and outcomes of resident phacoemulsification. (United States)

    Kaplowitz, Kevin; Yazdanie, Mohammad; Abazari, Azin

    Cataract surgery with phacoemulsification is a challenging procedure for surgeons in training to learn to perform safely, efficiently, and effectively. We review the auxiliary learning tools outside the operating room that residency programs have incorporated into their curriculum to improve surgical skills, including wet laboratory and surgical simulators. We then discuss different methods of teaching cataract surgery in the operating room. Our goal is to define a learning curve for cataract surgery. We demonstrate that complication rates decline significantly after a resident performs an average of 70 cases. We summarize the reported incidence and risk factors for complications in resident-performed cataract surgery to help identify cases that require a higher level of skill to improve visual outcomes. We suggest that future studies include details on preoperative comorbidities, risk stratification, resident skill level, and frequency of takeover by attending. Published by Elsevier Inc.

  20. Outcomes of the first Family Practice Chief Resident Leadership Conference. (United States)

    Mygdal, W K; Monteiro, M; Hitchcock, M; Featherston, W; Conard, S


    In June 1989 the first Family Practice Chief Resident Leadership Conference was presented to 27 Texas second-year residents who had been selected to serve as chief residents during their third year. The objectives of the conference were to assist these emerging leaders to develop better stress management and leadership skills and to strengthen their ties with the Texas Academy of Family Physicians. The conference featured two major workshops on stress management and leadership skills, and included plenary speeches and large and small group discussions. This article reports the outcomes of the conference as measured by the evaluation instrument completed by participants. Analysis of the results indicated that the conference had a positive effect on the residents.