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Sample records for residents reported substandard

  1. Identification of Substandard Medicines via Disproportionality Analysis of Individual Case Safety Reports.

    Science.gov (United States)

    Trippe, Zahra Anita; Brendani, Bruno; Meier, Christoph; Lewis, David

    2017-04-01

    The distribution and use of substandard medicines (SSMs) is a public health concern worldwide. The detection of SSMs is currently limited to expensive large-scale assay techniques such as high-performance liquid chromatography (HPLC). Since 2013, the Pharmacovigilance Department at Novartis Pharma AG has been analyzing drug-associated adverse events related to 'product quality issues' with the aim of detecting defective medicines using spontaneous reporting. The method of identifying SSMs with spontaneous reporting was pioneered by the Monitoring Medicines project in 2011. This retrospective review was based on data from the World Health Organization (WHO) Global individual case safety report (ICSR) database VigiBase ® collected from January 2001 to December 2014. We conducted three different stratification analyses using the Multi-item Gamma Poisson Shrinker (MGPS) algorithm through the Oracle Empirica data-mining software. In total, 24 preferred terms (PTs) from the Medical Dictionary for Regulatory Activities (MedDRA ® ) were used to identify poor-quality medicines. To identify potential SSMs for further evaluation, a cutoff of 2.0 for EB05, the lower 95% interval of the empirical Bayes geometric mean (EBGM) was applied. We carried out a literature search for advisory letters related to defective medicinal products to validate our findings. Furthermore, we aimed to assess whether we could confirm two SSMs first identified by the Uppsala Monitoring Centre (UMC) with our stratification method. The analysis of ICSRs based on the specified selection criteria and threshold yielded 2506 hits including medicinal products with an excess of reports of product quality defects relative to other medicines in the database. Further investigations and a pilot study in five authorized medicinal products (proprietary and generic) licensed by a single marketing authorization holder, containing valsartan, methylphenidate, rivastigmine, clozapine, or carbamazepine, were performed

  2. Resident Characteristics Report

    Data.gov (United States)

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

  3. Substandard/counterfeit antimicrobial drugs.

    Science.gov (United States)

    Kelesidis, Theodoros; Falagas, Matthew E

    2015-04-01

    Substandard/counterfeit antimicrobial drugs are a growing global problem. The most common substandard/counterfeit antimicrobials include beta-lactams (among antibiotics) and chloroquine and artemisin derivatives (among antimalarials). The most common type of substandard/counterfeit antimicrobial drugs have a reduced amount of the active drug, and the majority of them are manufactured in Southeast Asia and Africa. Counterfeit antimicrobial drugs may cause increased mortality and morbidity and pose a danger to patients. Here we review the literature with regard to the issue of substandard/counterfeit antimicrobials and describe the prevalence of this problem, the different types of substandard/counterfeit antimicrobial drugs, and the consequences for the individuals and global public health. Local, national, and international initiatives are required to combat this very important public health issue. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

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

  5. 7 CFR 983.30 - Substandard pistachios.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Substandard pistachios. 983.30 Section 983.30 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing..., ARIZONA, AND NEW MEXICO Definitions § 983.30 Substandard pistachios. Substandard pistachios means...

  6. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

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

  7. 7 CFR 983.57 - Substandard pistachios.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Substandard pistachios. 983.57 Section 983.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing..., ARIZONA, AND NEW MEXICO Regulations § 983.57 Substandard pistachios. The committee shall, with the...

  8. 20th Annual Residence Hall Construction Report

    Science.gov (United States)

    Agron, Joe

    2009-01-01

    Even in difficult economic times, colleges and universities continue to invest in residence hall construction projects as a way to attract new students and keep existing ones on campus. According to data from "American School & University"'s 20th annual Residence Hall Construction Report, the median new project completed in 2008 was…

  9. 7 CFR 989.212 - Substandard dockage.

    Science.gov (United States)

    2010-01-01

    .... Percent substandard Dockage factor 5.0 or less (1) 5.1 .999 5.2 .998 5.3 .997 5.4 .996 5.5 .995 1 No... substandard Dockage factor 12.0 or less (1) 12.1 .999 12.2 .998 12.3 .997 12.4 .996 12.5 .995 1 No dockage... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

  10. Assessment of the incidence of substandard drugs in developing countries.

    Science.gov (United States)

    Shakoor, O; Taylor, R B; Behrens, R H

    1997-09-01

    In a number of developing countries there is reportedly a high incidence of the availability of substandard drugs. The majority of these reports do not contain quantitative data to support these claims, nor do they describe the methodology employed for the quality assessment. Many assume counterfeiting as the reason for the poor quality and in some cases this is not justified. We collected 96 samples of chloroquine and selected antibacterials from Nigeria and Thailand in a controlled and methodical manner and analysed them using appropriately validated methods based on high-performance liquid chromatography capable of detecting drug-related impurities and quantifying active drug(s). The results indicate that 36.5% of the samples were substandard with respect to pharmacopoeial limits. Decomposition was the cause of poor quality in a number of the samples but overall, poor manufacturing appeared to be prevalent. The analyses generated little evidence to indicate fraudulent manufacturing. Treatment failure and drug-resistance are possible consequences of the use of substandard drugs.

  11. Adverse Event Reporting: Harnessing Residents to Improve Patient Safety.

    Science.gov (United States)

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

    2017-10-13

    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.

  12. Safeguarding against substandard/counterfeit drugs: mitigating a macroeconomic pandemic.

    Science.gov (United States)

    Wertheimer, Albert I; Norris, Jeremiah

    2009-03-01

    Counterfeiting and the sale of substandard pharmaceutical products can no longer be ignored. At 10% of global trade, counterfeiting is affecting many countries, causing serious downstream expenses and resource shortages. To describe the nature and impact of drug product counterfeiting and substandard product sale and to present strategies that may have value in ameliorating these phenomena. A literature review was conducted, supplemented by interviews of key leaders/experts in the field and the search of relevant web sites. All of the data were combined, integrated, and coordinated to present the complete picture of this problem. In addition to known corruption in some of the least developed countries, the trail through developed countries was detected. This report identifies means to detect faulty products and describes efforts toward resisting and ending these corrupt practices. Counterfeit drugs, if not stopped, can be responsible for a macroeconomic pandemic where major portions of some populations may be too ill to work and where the health sector resources are completely overwhelmed, as with the case of HIV/AIDS.

  13. Tailoring Morning Reports to an Internal Medicine Residency in Qatar.

    Science.gov (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

    2014-12-01

    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.

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

    Science.gov (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

    2009-12-01

    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.

  15. Quality of care reported by proxies - Does resident cognition count?

    Science.gov (United States)

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

    2018-01-01

    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. Improving Patient Safety Event Reporting Among Residents and Teaching Faculty.

    Science.gov (United States)

    Louis, Michelle Y; Hussain, Lala R; Dhanraj, David N; Khan, Bilal S; Jung, Steven R; Quiles, Wendy R; Stephens, Lorraine A; Broering, Mark J; Schrand, Kevin V; Klarquist, Lori J

    2016-01-01

    A June 2012 site visit report from the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review revealed that residents and physicians at TriHealth, Inc., a large, nonprofit independent academic medical center serving the Greater Cincinnati area in Ohio, had an opportunity to improve their awareness and understanding of the hospital's system for reporting patient safety concerns in 3 areas: (1) what constitutes a reportable patient safety event, (2) who is responsible for reporting, and (3) how to use the hospital's current reporting system. To improve the culture of patient safety, we designed a quality improvement project with the goal to increase patient safety event reporting among residents and teaching faculty. An anonymous questionnaire assessed physicians' and residents' attitudes and experience regarding patient safety event reporting. An educational intervention was provided in each graduate medical education program to improve knowledge and skills related to patient safety event reporting, and the anonymous questionnaire was distributed after the intervention. We compared the responses to the preintervention and postintervention questionnaires and tracked monthly patient safety event reports for 1 year postintervention. The number of patient safety event reports increased following the educational intervention; however, we saw wide variability in reporting per month. On the postintervention questionnaire, participants demonstrated improved knowledge and attitudes toward patient safety event reporting. The goal of this unique project was to increase patient safety event reporting by both residents and teaching faculty in 6 residency programs through education. We achieved this goal through an educational intervention tailored to the institution's new event reporting system delivered to each residency program. We clearly understand that improvements in quality and patient safety require ongoing effort. The keys to ongoing

  17. Counterfeit and substandard antimalarial drugs in Cambodia.

    Science.gov (United States)

    Lon, C T; Tsuyuoka, R; Phanouvong, S; Nivanna, N; Socheat, D; Sokhan, C; Blum, N; Christophel, E M; Smine, A

    2006-11-01

    Counterfeit and substandard antimalarial drugs can cause death and contribute to the growing malaria drug resistance problem, particularly in Southeast Asia. Since 2003 in Cambodia the quality of antimalarial drugs both in the public and private health sector is regularly monitored in sentinel sites. We surveyed 34% of all 498 known facilities and drug outlets in four provinces. We collected 451 drug samples; 79% of these were not registered at the Cambodia Department of Drugs and Food (DDF). Twenty-seven percent of the samples failed the thin layer chromatography and disintegration tests; all of them were unregistered products. Immediate action against counterfeit drugs was taken by the National Malaria Control Program (NMCP) and the DDF. They communicated with the Provincial Health Department about the presence of counterfeit antimalarial drugs through alert letters, a manual, annual malaria conferencing and other training occasions. Television campaigns to alert the population about counterfeit drugs were conducted. Moreover, the NMCP has been promoting the use of good quality antimalarial drugs of a blister co-packaged combination of artesunate and mefloquine in public and private sectors. Appropriate strategies need to be developed and implemented by relevant government agencies and stakeholders to strengthen drug quality assurance and control systems in the country.

  18. Problems Associated With Substandard And Counterfeit Drugs In ...

    African Journals Online (AJOL)

    Problems Associated With Substandard And Counterfeit Drugs In Developing Countries: A Review Article On Global Implications Of Counterfeit Drugs In The Era Of Anti-Retroviral (ARVS) Drugs In A Free Market Economy.

  19. A systematic review of counterfeit and substandard medicines in field quality surveys

    Directory of Open Access Journals (Sweden)

    Alghannam AFA

    2014-09-01

    Full Text Available Abdulaziz Fahad Abdulaziz Alghannam, Zoe Aslanpour, Sara Evans, Fabrizio Schifano Department of Pharmacy, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom Objectives: Counterfeit and substandard medicines pose a great threat to public health and the economy worldwide. Reports suggest their prevalence is increasing and can no longer be ignored. A detailed account on the current nature of the problem and identification of knowledge limitations in terms of geographical location, medicine classes, and type of medicine analysis performed is not available. Our objective was to systematically review articles that have reported investigations of counterfeit and substandard medicines. Design: Systematic review. Data sources: PubMed, Scopus, and ISI Web of Knowledge. Data Selection: Prospective field quality surveys on counterfeit and substandard medicines were selected from all available records within the selected databases up to December 31, 2013. All prospective studies performing chemical analysis on medicine samples were identified using the key search terms “counterfeit” or “substandard” and “medicine” or “drug” or “pharmaceutical.” The title, abstract, and/or full articles were reviewed for relevance according to a predetermined set of inclusion and exclusion criteria. Medicines procured from the Internet are beyond the scope of this review. Results: Sixty-six research articles were found that fulfilled our inclusion criteria. The majority of medicine quality surveys were conducted in specific areas of Africa and Asia. Within these two continents, medicine quality reports covering the Northern part of Africa and the Western part of Asia in the Middle East are extremely scarce. Other continents such as North or South America and Europe were covered in limited articles, whereas the Australian continent had no reports. Moreover, most studies examined medicines that treat infectious diseases; very few articles

  20. Cooperative learning as applied to resident instruction in radiology reporting.

    Science.gov (United States)

    Mueller, Donald; Georges, Alexandra; Vaslow, Dale

    2007-12-01

    The study is designed to evaluate the effectiveness of an active form of resident instruction, cooperative learning, and the residents' response to that form of instruction. The residents dictated three sets of reports both before and after instruction in radiology reporting using the cooperative learning method. The reports were evaluated for word count, Flesch-Kincaid grade level, advancement on clinical spectrum, clarity, and comparison to prior reports. The reports were evaluated for changes in performance characteristics between the pre- and postinstruction dictations. The residents' response to this form of instruction was evaluated by means of a questionnaire. The instruction was effective in changing the resident dictations. The results became shorter (Pcooperative learning activities. The least positive responses related to the amount of time devoted to the project. Sixty-three percent of respondents stated that the time devoted to the project was appropriate. Cooperative learning can be an effective tool in the setting of the radiology residency. Instructional time requirements must be strongly considered in designing a cooperative learning program.

  1. A systematic review of counterfeit and substandard medicines in field quality surveys

    OpenAIRE

    Alghannam, Abdulaziz; Evans,Sara; Schifano,Fabrizio; Aslanpour,Zoe

    2014-01-01

    Abdulaziz Fahad Abdulaziz Alghannam, Zoe Aslanpour, Sara Evans, Fabrizio Schifano Department of Pharmacy, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom Objectives: Counterfeit and substandard medicines pose a great threat to public health and the economy worldwide. Reports suggest their prevalence is increasing and can no longer be ignored. A detailed account on the current nature of the problem and identification of knowledge limitations in terms of geographical locat...

  2. Substandard and counterfeit medicines: a systematic review of the literature

    Science.gov (United States)

    Almuzaini, Tariq; Choonara, Imti; Sammons, Helen

    2013-01-01

    Objective To explore the evidence available of poor-quality (counterfeit and substandard) medicines in the literature. Design Systematic review. Data sources Databases used were EMBASE, MEDLINE, PubMed and the International Pharmaceutical Abstracts, including articles published till January 2013. Eligibility criteria Prevalence studies containing original data. WHO definitions (1992) used for counterfeit and substandard medicines. Study appraisal and synthesis Two reviewers independently scored study methodology against recommendations from the MEDQUARG Checklist. Studies were classified according to the World Bank classification of countries by income. Data extraction Data extracted: place of study; type of drugs sampled; sample size; percentage of substandard/counterfeit medicines; formulations included; origin of the drugs; chemical analysis and stated issues of counterfeit/substandard medicines. Results 44 prevalence studies were identified, 15 had good methodological quality. They were conducted in 25 different countries; the majority were in low-income countries (11) and/or lower middle-income countries (10). The median prevalence of substandard/counterfeit medicines was 28.5% (range 11–48%). Only two studies differentiated between substandard and counterfeit medicines. Prevalence data were limited to antimicrobial drugs (all 15 studies). 13 studies involved antimalarials, 6 antibiotics and 2 other medications. The majority of studies (93%) contained samples with inadequate amounts of active ingredients. The prevalence of substandard/counterfeit antimicrobials was significantly higher when purchased from unlicensed outlets (pcounterfeit medicines. Most studies assessed only a single therapeutic class of antimicrobials. Conclusions The prevalence of poor-quality antimicrobial medicines is widespread throughout Africa and Asia in lower income countries and lower middle-income countries . The main problem identified was inadequate amounts of the active

  3. Possible solutions for barriers in incident reporting by residents

    NARCIS (Netherlands)

    Martowirono, K.; Jansma, J.D.; van Luijk, S.J.; Wagner, C.; Bijnen, A.B.

    2012-01-01

    Rationale, aims and objectives: Incident reporting can contribute to safer health care. Since the rate of reporting by residents is low, it is useful to investigate which barriers exist and how these can be solved. Methods: Data were collected in a large teaching hospital in the Netherlands. The

  4. Enhancing resident morning report with "daily learning packages".

    Science.gov (United States)

    Weaver, Debbie

    2011-01-01

    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.

  5. IN IDENTIFYING FAKE AND SUBSTANDARD DRUGS IN NIGERIA ...

    African Journals Online (AJOL)

    user

    2017-07-01

    Jul 1, 2017 ... Abstract. This study examines the level of audience awareness of, and determining the effectiveness of the. National Agency for Food and Drug Administration and Control (NAFDAC)'s use of, the. Mobile Authentication Service (MAS) in identifying fake and substandard drugs in Nigeria. The study, anchored ...

  6. Substandard drugs: a potential crisis for public health.

    Science.gov (United States)

    Johnston, Atholl; Holt, David W

    2014-08-01

    Poor-quality medicines present a serious public health problem, particularly in emerging economies and developing countries, and may have a significant impact on the national clinical and economic burden. Attention has largely focused on the increasing availability of deliberately falsified drugs, but substandard medicines are also reaching patients because of poor manufacturing and quality-control practices in the production of genuine drugs (either branded or generic). Substandard medicines are widespread and represent a threat to health because they can inadvertently lead to healthcare failures, such as antibiotic resistance and the spread of disease within a community, as well as death or additional illness in individuals. This article reviews the different aspects of substandard drug formulation that can occur (for example, pharmacological variability between drug batches or between generic and originator drugs, incorrect drug quantity and presence of impurities). The possible means of addressing substandard manufacturing practices are also discussed. A concerted effort is required on the part of governments, drug manufacturers, charities and healthcare providers to ensure that only drugs of acceptable quality reach the patient. © 2013 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of The British Pharmacological Society.

  7. Substandard drugs: a potential crisis for public health

    Science.gov (United States)

    Johnston, Atholl; Holt, David W

    2014-01-01

    Poor-quality medicines present a serious public health problem, particularly in emerging economies and developing countries, and may have a significant impact on the national clinical and economic burden. Attention has largely focused on the increasing availability of deliberately falsified drugs, but substandard medicines are also reaching patients because of poor manufacturing and quality-control practices in the production of genuine drugs (either branded or generic). Substandard medicines are widespread and represent a threat to health because they can inadvertently lead to healthcare failures, such as antibiotic resistance and the spread of disease within a community, as well as death or additional illness in individuals. This article reviews the different aspects of substandard drug formulation that can occur (for example, pharmacological variability between drug batches or between generic and originator drugs, incorrect drug quantity and presence of impurities). The possible means of addressing substandard manufacturing practices are also discussed. A concerted effort is required on the part of governments, drug manufacturers, charities and healthcare providers to ensure that only drugs of acceptable quality reach the patient. PMID:24286459

  8. 7 CFR 984.464 - Disposition of substandard walnuts.

    Science.gov (United States)

    2010-01-01

    .... (a) Whenever free and reserve percentages are in effect during a marketing year substandard walnuts... maintain a list of approved crushers, livestock feed manufacturers and livestock feeders, and of the... walnuts disposed of to an approved crusher, livestock feed manufacturer, or livestock feeder, may only be...

  9. Social survey of Three Mile Island area residents. Final report

    International Nuclear Information System (INIS)

    Brunn, S.D.; Johnson, J.H. Jr; Zeigler, D.J.

    1979-08-01

    Recognizing that there is concern among government officials, utility company officials, engineers, physical, social, and behavioral scientists, and the general public about the consequences of the Three Mile Island accident, the overall objective of this report is to examine how the accident affected TMI area residents. This final report is a detailed analysis and description of the summary results published previously. A questionnaire was mailed to a sample of residents in the Three Mile Island area within one month of the accident. The survey instrument and sampling design are discussed in a subsequent chapter. Because of the nature of the accident and individual memories about dates, places, and events, it was necessary to conduct a survey as soon as possible after the accident. Area residents were asked a variety of questions including: (1) when and how they learned about the accident; (2) where they evacuated and why; (3) what confidence they placed in reports by the government and utility companies; (4) how their attitudes toward nuclear power have changed as a result of the accident; and (5) what impact the accident is likely to have on themselves and the Three Mile Island area. These questions and others are examined in this report. The results are analyzed in light of a number of social, economic, and political characteristics. Both statistical tests and a graphical presentation of the results are included

  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.

    2009-01-01

    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. Substandard anti-malarial drugs in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Sie Ali

    2008-05-01

    Full Text Available Abstract Background There is concern about an increasing infiltration of markets by substandard and fake medications against life-threatening diseases in developing countries. This is particularly worrying with regard to the increasing resistance development of Plasmodium falciparum against affordable anti-malarial medications, which has led to a change to more expensive drugs in most endemic countries. Methods A representative sample of modern anti-malarial medications from licensed (public and private pharmacies, community health workers and illicit (market and street vendors, shops sources has been collected in the Nouna Health District in north-western Burkina Faso in 2006. All drugs were tested for their quality with the standard procedures of the German Pharma Health Fund-Minilab. Detected low standard drugs were re-tested with European Pharmacopoeia 2.9.1 standards for disintegration and ultraviolet-visible spectroscopy at the laboratory of the Heidelberg University for confirmation. Results Overall, 86 anti-malarial drug samples were collected, of which 77 samples have been included in the final analysis. The sample consisted of 39/77 (50% chloroquine, 10/77 (13% pyrimethamine-sulphadoxine, 9/77 (12% quinine, 6/77 (8% amodiaquine, 9/77 (12% artesunate, and 4/77 (5% artemether-lumefantrine. 32/77 (42% drug samples were found to be of poor quality, of which 28 samples failed the visual inspection, nine samples had substandard concentrations of the active ingredient, four samples showed poor disintegration, and one sample contained non of the stated active ingredient. The licensed and the illicit market contributed 5/47 (10.6% and 27/30 (90.0% samples of substandard drugs respectively. Conclusion These findings provide further evidence for the wide-spread existence of substandard anti-malarial medications in Africa and call for strengthening of the regulatory and quality control capacity of affected countries, particularly in view of the

  12. Are psychiatric residents still interested in psychoanalysis? A brief report.

    Science.gov (United States)

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

    2010-12-01

    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.

  13. Fighting trafficking of falsified and substandard medicinal products in Russia.

    Science.gov (United States)

    Fayzrakhmanov, N F

    2015-01-01

    The trafficking of falsified and substandard medicinal products is a global socio-economic problem, which poses a serious threat to economy and health of populations of most countries, including the Russian Federation. To identify the main achievements and challenges in the fight against trafficking of falsified and substandard medicinal products in the Russian Federation, to formulate possible solutions to these problems. The study of criminal cases and statistical information about the level of crime in the Russian Federation; legal analysis of regulatory legal acts in the sphere of criminal law and turnover of medicinal products; review of scientific and practical publications. The problem of trafficking of falsified and substandard medicinal products in the Russian Federation was publicly discussed in the late 1990s - early 2000-ies, first in the media and special editions, later this phenomenon was the subject of extensive discussions at international conferences, in public authorities and public circles. However, the most significant results in tackling this problem were achieved only in the last 5 years.Thus, in 2010, the Russian Federation first joined the annual international police operation under the code name Pangaea, held since 2008 on the initiative of Interpol and the Medicines and Healthcare products Regulatory Agency of the World Health Organization (MHRA WHO). From year to year, the special operation Pangea unites the efforts of many countries from different continents and aims to eliminate transnational criminal groups operating through a global network the Internet. In 2010, as a result of large-scale international inspections 1 200 Internet sites were revealed, through which the fake medicines were spread and 10,000 boxes of medicines were seized, making more than a million falsified tablets in the amount of 2.6 million USA dollars. In 2011, in a special operation Pangea IV was attended by 165 different organizations from 81 countries

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

    Science.gov (United States)

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

    2015-01-01

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

  15. The Influence of Standard and Substandard Dutch on Gender Assignment in Second Language German

    Science.gov (United States)

    Vanhove, Jan

    2017-01-01

    This study investigated how standard and substandard varieties of first language (L1) Dutch affect grammatical gender assignments to nouns in second language (L2) German. While German distinguishes between masculine, feminine, and neuter gender, the masculine--feminine distinction has nearly disappeared in Standard Dutch. Many substandard Belgian…

  16. MDS 2.0 Public Quality Indicator and Resident Reports

    Data.gov (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...

  17. Challenges Facing Medical Residents' Satisfaction in the Middle East: A Report From United Arab Emirates.

    Science.gov (United States)

    Abdulrahman, Mahera; Qayed, Khalil I; AlHammadi, Hisham H; Julfar, Adnan; Griffiths, Jane L; Carrick, Frederick R

    2015-01-01

    PHENOMENON: Medical residents' satisfaction with the quality of training for medical residency training specialists is one of the core measures of training program success. It will also therefore contribute to the integrity of healthcare in the long run. Yet there is a paucity of research describing medical residents' satisfaction in the Middle East, and there are no published studies that measure the satisfaction of medical residents trained within the United Arab Emirates (UAE). This makes it difficult to develop a quality residency training program that might meet the needs of both physicians and society. The authors designed a questionnaire to assess medical residents' satisfaction with the Dubai residency training program in order to identify insufficiencies in the training, clinical, and educational aspects. The survey was a self-report questionnaire composed of different subscales covering sociodemographic and educational/academic profile of the residents along with their overall satisfaction of their training, curriculum, work environment, peer teamwork, and their personal opinion on their medical career. Respondents showed a substantial level of satisfaction with the residency training. The vast majority of residents (80%, N = 88) believe that their residency program curriculum and rotation was "good," "very good," or "excellent." Areas of dissatisfaction included salary, excessive paperwork during rotations, and harassment. INSIGHTS: This is the first report that studies the satisfaction of medical residents in all specialties in Dubai, UAE. Our findings provide preliminary evidence on the efficiency of different modifications applied to the residency program in UAE. To our knowledge, there has not been any previous study in the Middle East that has analyzed this aspect of medical residents from different specialties. The authors believe that this report can be used as a baseline to monitor the effectiveness of interventions applied in the future toward

  18. Vacuum and forceps training in residency: experience and self-reported competency.

    Science.gov (United States)

    Powell, J; Gilo, N; Foote, M; Gil, K; Lavin, J P

    2007-06-01

    Determine chief residents' experience with vacuum and forceps deliveries and self-perceived competencies with the procedures. Study 1: A written questionnaire was mailed to all fourth year residents in US RRC approved Ob/Gyn programs. Study 2: The study was replicated using a web-based survey the following year. Data were analyzed with chi (2) and Wilcoxon Signed Rank tests using SPSS. Surveys were received from 238 residents (20%) in Study 1 and 269 residents in Study 2 (23%, representing 50% of all residency programs). In both studies, residents reported performing significantly less forceps than vacuum deliveries. Virtually all residents wanted to learn to perform both deliveries, indicated attendings were willing to teach both, and felt competent to perform vacuum deliveries (Study 1, 94.5%; Study 2, 98.5%); only half felt competent to perform forceps deliveries (Study 1, 57.6%; Study 2, 55.0%). The majority of residents who felt competent to perform forceps deliveries reported that they would predominately use forceps or both methods of deliveries in their practice (Study 1, 75.8%; Study 2, 64.6%). The majority of residents who reported that they did not feel competent to perform forceps deliveries reported that they would predominately use vacuum deliveries in their practice (Study 1, 86.1%; Study 2, 84.2%). Current training results in a substantial portion of residents graduating who do not feel competent to perform forceps deliveries. Perceived competency affected future operative delivery plans.

  19. Medicines informal market in Congo, Burundi and Angola: counterfeit and sub-standard antimalarials

    Directory of Open Access Journals (Sweden)

    Bertocchi Paola

    2007-02-01

    Full Text Available Abstract Background The presence of counterfeits and sub-standards in African medicines market is a dramatic problem that causes many deaths each year. The increase of the phenomenon of pharmaceutical counterfeiting is due to the rise of the illegal market and to the impossibility to purchase branded high cost medicines. Methods In this paper the results of a quality control on antimalarial tablet samples purchased in the informal market in Congo, Burundi and Angola are reported. The quality control consisted in the assay of active substance by means of validated liquid chromatographic methods, uniformity of mass determination, disintegration and dissolution tests. Moreover, a general evaluation on label and packaging characteristics was performed. Results The results obtained on thirty antimalarial tablet samples containing chloroquine, quinine, mefloquine, sulphadoxine and pyrimethamine showed the presence of different kinds of problems: a general problem concerning the packaging (loose tablets, packaging without Producer name, Producer Country and sometimes without expiry date; low content of active substance (in one sample; different, non-declared, active substance (in one sample; sub-standard technological properties and very low dissolution profiles (in about 50% of samples. This last property could affect the bioavailability and bioequivalence in comparison with branded products and could be related to the use of different excipients in formulation or bad storage conditions. Conclusion This paper evidences that the most common quality problem in the analysed samples appears to be the low dissolution profile. Here it is remarked that the presence of the right active substance in the right quantity is not a sufficient condition for a good quality drug. Dissolution test is not less important in a quality control and often evidences in vitro possible differences in therapeutic efficacy among drugs with the same active content. Dissolution

  20. Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

    Science.gov (United States)

    O'Connell, Timothy; Chang, Debra

    2012-01-01

    While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

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

    Directory of Open Access Journals (Sweden)

    Fok Mark C

    2010-11-01

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

  2. Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Elsass, Peter; Nielsen, Brigitte Bruun

    2010-01-01

    for major substandard care. Hospital based maternal deaths between 2006 and 2008 (35 months) were included. Of 68 registered maternal deaths sufficient information for reviewing was retrieved for 62 cases (91%). As a supplement, in-depth interviews with staff about the underlying causes of substandard care...... in 46 (74%) of the 62 cases reviewed. During the same time period MDA identified substandard care in 18 cases. Staff perceived poor organization of work and lack of training as important causes for substandard care. Local MDA was considered useful although time-consuming and sometimes threatening......, and staff dedication to the process was questioned. CONCLUSION: Quality assurance of emergency obstetric care might be strengthened by supplementing internal MDA with external CE....

  3. Leadership in the clinical workplace: what residents report to observe and supervisors report to display: an exploratory questionnaire study

    OpenAIRE

    van der Wal, Martha A.; Scheele, Fedde; Sch?nrock-Adema, Johanna; Jaarsma, A. Debbie C.; Cohen-Schotanus, Janke

    2015-01-01

    Background: Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to learn? In the current study we investigate which leadership behaviours residents observe throughout their training, which behaviours supervisors report to display and whether residents and supervisor...

  4. Leadership in the clinical workplace: what residents report to observe and supervisors report to display: an exploratory questionnaire study.

    Science.gov (United States)

    van der Wal, Martha A; Scheele, Fedde; Schönrock-Adema, Johanna; Jaarsma, A Debbie C; Cohen-Schotanus, Janke

    2015-11-02

    Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to learn? In the current study we investigate which leadership behaviours residents observe throughout their training, which behaviours supervisors report to display and whether residents and supervisors have a need for more formal training. We performed two questionnaire studies. Study 1: Residents (n = 117) answered questions about the extent to which they observed four basic and observable Situational Leadership behaviours in their supervisors. Study 2: Supervisors (n = 201) answered questions about the extent to which they perceived to display these Situational Leadership behaviours in medical practice. We asked both groups of participants whether they experienced a need for formal leadership training. One-third of the residents did not observe the four basic Situational Leadership behaviours. The same pattern was found among starting, intermediate and experienced residents. Moreover, not all supervisors showed these 4 leadership behaviours. Both supervisors and residents expressed a need for formal leadership training. Both findings together suggest that current practice does not offer residents enough opportunities to acquire these leadership behaviours by solely observing their supervisors. Moreover, residents and supervisors both express a need for more formal leadership training. More explicit attention should be paid to leadership development, for example by providing formal leadership training for supervisors and residents.

  5. Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

    Science.gov (United States)

    Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

    2017-08-01

    Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  6. Columbia Basin residents' view on water : final report

    International Nuclear Information System (INIS)

    Ronalds, L.

    2005-01-01

    Currently, there is no strategic plan for water management in the Columbia Basin to ensure that long-term water quality and quantity issues are addressed according to residents' values and views. The Columbia Basin Trust was therefore created to address water management issues. It devised a comprehensive water information questionnaire and sent it to a broad range of respondents that fell within the Canadian portion of the Columbia Basin. These included municipal, regional, provincial and federal government agencies; community and watershed groups; industry and agriculture groups; recreation and tourism groups; and, First Nations groups. The most prevalent concern among the respondents pertained to issues surrounding domestic water consumption, and the most widespread water issue in the Columbia Basin was that of water conservation. The state of aquatic ecosystems was also of significant importance to respondents. Respondents also expressed concern for the cost of providing potable water and for the sustainability of rivers and their tributaries within the Basin. The survey also found a concern for the fluctuating reservoir levels within the Basin and the protection of drinking water from contamination. In order to address the wide range of water related issues, respondents indicated that an education program should be implemented to address the general nature of the hydrologic cycle; how much water is being used for toilets, lawn watering, and showers; the cost of potable water; the importance of water on a local and global level; the importance and nature of watersheds; the ways people influence and pollute water; the challenges of cleaning up contaminated water sources; the community's water sources; the role of water in sustaining food growth; and, challenges and consequences of other communities that experience severe water quality and quantity issues. It was suggested that the education program should address a water conservation plan, including conservation

  7. Does operative experience during residency correlate with reported competency of recent general surgery graduates?

    Science.gov (United States)

    Safavi, Arash; Lai, Sarah; Butterworth, Sonia; Hameed, Morad; Schiller, Dan; Skarsgard, Erik

    2012-01-01

    Background Identification of attributes of residency training that predict competency would improve surgical education. We hypothesized that case experience during residency would correlate with self-reported competency of recent graduates. Methods Aggregate case log data of residents enrolled in 2 general surgery programs were collected over a 12-month period and stratified into Surgical Council on Resident Education (SCORE) categories. We surveyed recent (surgery (4, 0.04%), and the least common EU procedure was abdomen–spleen (1, 0.1%). The questionnaire response rate was 45%. For EC procedures, self-reported competency was highest in skin and soft tissue, thoracic and head and neck (each 100%) and lowest in vascular–venous (54%), whereas for EU procedures it was highest in abdomen–general (100%) and lowest in vascular–arterial (62%). The correlation between case volume and self-reported competency was poor (R = 0.2 for EC procedures). Conclusion Self-reported competency correlates poorly with operative case experience during residency. Other curriculum factors, including specific rotations and timing, balance between inpatient and outpatient surgical experience and competition for cases, may contribute to procedural competency acquisition during residency. PMID:22854144

  8. Role of the resid solvent in catalytic coprocessing with finely divided catalysts. Quarterly report, January--March 1995

    Energy Technology Data Exchange (ETDEWEB)

    Curtis, C.W.

    1995-07-01

    The research reported in this progress report describes the continuation of coal-resid coprocessing reactions that were discussed in the July to September 1994 Quarterly Report. During previous quarters, Maya and FHC-623 resids were evaluated in noncatalytic and catalytic reactions at 400{degrees}C with Pittsburgh No. 8 and DECS-17 Blind Canyon coals. From the complete reaction matrix containing the two coals and two resids, it was found that the influence of resids on coprocessing depended on the type of coal used; for example, under catalytic reaction conditions, the hexane solubles of Maya resid increased coal conversion of Pittsburgh No. 8 coal but decreased that of DECS-17. In order to observe the intrinsic behavior of resids during coprocessing, another resid, Manji, and another coal, Illinois No. 6, are being tested. These reactions were begun this quarter. The results obtained are reported in this report.

  9. Increasing the Number of Adverse Drug Reactions Reporting: the Role of Clinical Pharmacy Residents

    Science.gov (United States)

    Baniasadi, Shadi; Habibi, Maryam; Haghgoo, Roodabeh; Karimi Gamishan, Masoumeh; Dabaghzadeh, Fatemeh; Farasatinasab, Maryam; Farsaei, Shadi; Gharekhani, Afshin; Kafi, Hamidreza; Karimzadeh, Iman; Kharazmkia, Ali; Najmeddin, Farhad; Nikvarz, Naemeh; Oghazian, Mohammad Bagher; Rezaee, Haleh; Sadeghi, Kourosh; Tafazzoli, Ali; Shahsavari, Nahid; Fahimi, Fanak

    2014-01-01

    Detection of adverse drug reactions (ADRs) in hospitals provides an important measure of the burden of drug related morbidity on the healthcare system. Spontaneous reporting of ADRs is scare and several obstacles to such reporting have been identified formerly. This study aimed to determine the role of clinical pharmacy residents in ADR reporting within a hospital setting. Clinical pharmacy residents were trained to report all suspected ADRs through ADR-reporting yellow cards. The incidence, pattern, seriousness, and preventability of the reported ADRs were analyzed. During the period of 12 months, for 8559 patients, 202 ADR reports were received. The most frequently reported reactions were due to anti-infective agents (38.38%). Rifampin accounted for the highest number of the reported ADRs among anti-infective agents. The gastro-intestinal system was the most frequently affected system (21.56%) of all reactions. Fifty four of the ADRs were reported as serious reactions. Eighteen of the ADRs were classified as preventable. Clinical pharmacy residents' involvement in the ADR reporting program could improve the ADR reporting system. PMID:24734083

  10. ASSOCIATION BETWEEN BURNOUT SYNDROME IN INTERNAL MEDICINE RESIDENTS, THEIR REPORT OF THE SUBOPTIMAL CARE PRACTICES AND PATIENTS’ REPORT

    Directory of Open Access Journals (Sweden)

    ISABEL CASTAÑO

    2006-10-01

    Full Text Available This investigation pretended to establish the association between the Burnout Syndrome in internal medicine residents,the report of their sub optimal medical practices and the report of their hospitalized patients in charge, by using amultitrait-multimethod with a concurrent design that allows the research of two objects in the same investigation withconvergent results. The translated version by Moreno (2004 of the Maslach Burnout Inventory (MBI and the semistructured interview were used in medical residents, and a questionnaire to patients based on the scales proposed byMcKinley, Manku-Scott, Hastings, French and Baker (1997 in their research. The results showed no associationbetween the Burnout Syndrome and the report of the sub optimal practices from residents and patients. On thecontrary, it was found a significant association between the communication category and the report of patients. Finally,suggestions are formulated for improvements of these sub optimal practices and complementary studiesare proposed.

  11. Duck Valley Resident Fish Stocking Program, 2000 Final Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Dodson, Guy; Pero, Vincent

    2002-01-01

    The Shoshone-Paiute Tribes fish-stocking program was begun in 1988 and is intended to provide a subsistence fishery for the tribal members. The program stocks catchable and fingerling size trout in Mt. View and Sheep Creek Reservoirs. Rainbow trout are purchased from only certified disease-free facilities to be stocked in our reservoirs. This project will help restore a fishery for tribal members that historically depended on wild salmon and steelhead in the Owyhee and Bruneau Rivers and their tributaries for their culture as well as for subsistence. This project is partial substitution for loss of anadromous fish production due to construction and operation of hydroelectric dams on the Columbia and Snake Rivers. Until anadromous fish can be returned to the Owyhee and Bruneau Rivers this project will continue indefinitely. As part of this project the Shoshone-Paiute Tribes will also receive income in the form of fees from non-tribal members who come to fish these reservoirs. Regular monitoring and evaluation of the fishery will include sampling for length/weight/condition and for signs of disease. A detailed Monitoring and evaluation plan has been put in place for this project. However due to budget limitations on this project only the fishery surveys and limited water quality work can be completed. A creel survey was initiated in 1998 and we are following the monitoring and evaluation schedule for this program (as budget allows) as well as managing the budget and personnel. This program has been very successful in the past decade and has provided enjoyment and sustenance for both tribal and non-tribal members. All biological data and stocking rates will be including in the Annual reports to Bonneville Power Administration (BPA).

  12. Posterior hip instability relocation testing: a resident's case report.

    Science.gov (United States)

    Maas, Rich; Wallentine, Scott; Gerke, Dale; Crager, Sam; Stewart, Jessica

    2017-09-01

    Micro-instability (non-radiographic clinical instability) continues to gain recognition as a problem at the hip. Although most research has been directed to anterior hip instability, posterior hip instability (PHI) has also garnered attention. PHI is under recognized, difficult to identify, and confused with other hip pathologies such as a simple sprain or strain. A novel clinical test is introduced that may have helped identify PHI in this patient. Additionally, a conservative rehabilitation approach emphasizing stabilization exercises is described. A 29-year-old female presented with complaints of posterior lateral and anterior hip pain of 1.5 years duration. Upon initiating an aggressive stretching program, her pain worsened. Examination revealed limited and painful hip flexion, and positive anterior impingement testing for femoroacetabular impingement. Both tests were significantly less painful with more motion when retested with manual repositioning of the femoral head from posterior to anterior, referred to as posterior relocation testing. The patient was instructed to discontinue stretching. A stabilization plan was established including strengthening of the deep external rotators with trunk and lower quarter neuromuscular re-education. The patient completed 12 appointments over 2.5 months. At discharge, the patient reported improvements with pain and function. The Lower Extremity Functional Scale improved from 64/80 to 77/80 and Oswestry Disability Questionnaire improved from 8 to 0%. PHI may have contributed to this patient's symptoms. The posterior relocation test may assist clinicians with identification of PHI, thus directing treatment toward stabilization and neuromuscular control rather than interventions designed to increase mobility. 4.

  13. Role of the resid solvent in catalytic coprocessing with finely divided catalysts. Quarterly report, April 1995--June 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    The research reported in this progress report describes the continuation of coal-resid coprocessing reactions that were discussed in the January to March 1995 Quarterly Report. During previous quarters, Maya and FHC-623 resids were evaluated in non-catalytic and catalytic reactions at 400{degrees}C with Pittsburgh No. 8 and DECS-17 Blind Canyon coals. From the complete reaction matrix containing the two coals and two resids, it was found that the influence of resids on coprocessing depended on the type of coal used; for example, under catalytic reaction conditions, the hexane solubles of Maya resid increased coal conversion of Pittsburgh No. 8 coal but decreased that of DECS-17. In order to observe the intrinsic behavior of resids during coprocessing, another resid, Manjii, and another coal, Illinois No. 6, are being tested. These reactions were begun this quarter. The results are reported herein. In order to evaluate the role of the different components in resids, the resids were separated into hexane soluble materials and hexane insoluble materials. The hexane solubles, which should contain the naphthenes present in the resid, and the untreated whole resids were reacted with coal at equivalent liquefaction conditions and at the same conditions as when the resids were reacted individually.

  14. Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands

    NARCIS (Netherlands)

    Schutte, J. M.; Schuitemaker, N. W. E.; van Roosmalen, J.; Steegers, E. A. P.

    Objective To review the standard of care in cases of maternal mortality due to hypertensive diseases in pregnancy and to make recommendations for its improvement. Design Care given to women with hypertensive disease in pregnancy was audited and substandard care factors identified. Setting

  15. Preliminary reports in the emergency department: is a subspecialist radiologist more accurate than a radiology resident?

    Science.gov (United States)

    Branstetter, Barton F; Morgan, Matthew B; Nesbit, Chadd E; Phillips, Jinnah A; Lionetti, David M; Chang, Paul J; Towers, Jeffrey D

    2007-02-01

    To determine whether emergency department (ED) preliminary reports rendered by subspecialist attending radiologists who are reading outside their field of expertise are more accurate than reports rendered by radiology residents, and to compare error rates between radiologists and nonradiologists in the ED setting. The study was performed at a large academic medical center with a busy ED. An electronic preliminary report generator was used in the ED to capture preliminary interpretations rendered in a clinical setting by radiology residents, junior attendings (within 2 years of taking their oral boards), senior attendings, and ED clinicians between August 1999 and November 2004. Each preliminary report was later reviewed by a final interpreting radiologist, and the preliminary interpretation was adjudicated for the presence of substantial discordances, defined as a difference in interpretation that might immediately impact the care of the patient. Of the 612,890 preliminary reports in the database, 65,780 (11%) met inclusion criteria for this study. A log-linear analysis was used to assess the effects of modality and type of author on preliminary report error rates. ED clinicians had significantly higher error rates when compared with any type of radiologist, regardless of modality. Within the radiologists, residents and junior attendings had lower error rates than did senior attendings, but the differences were not statistically significant. Subspecialized attending radiologists who interpret ED examinations outside their area of expertise have error rates similar to those of radiology residents. Nonradiologists have significantly higher error rates than radiologists and radiology residents when interpreting examinations in the ED.

  16. Effects on incident reporting after educating residents in patient safety: a controlled trial.

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Kate, R.W. ten; Bijnen, A.B.

    2011-01-01

    Background: Medical residents are key figures in delivering health care and an important target group for patient safety education. Reporting incidents is an important patient safety domain, as awareness of vulnerabilities could be a starting point for improvements. This study examined effects of

  17. Effects on incident reporting after educating residents in patient safety: a controlled study

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; ten Kate, R.W.; Bijnen, A.B.

    2011-01-01

    Background: Medical residents are key figures in delivering health care and an important target group for patient safety education. Reporting incidents is an important patient safety domain, as awareness of vulnerabilities could be a starting point for improvements. This study examined effects of

  18. Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

    Science.gov (United States)

    Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

    2014-03-01

    To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  19. General surgery morning report: a competency-based conference that enhances patient care and resident education.

    Science.gov (United States)

    Stiles, Brendon M; Reece, T Brett; Hedrick, Traci L; Garwood, Robert A; Hughes, Michael G; Dubose, Joseph J; Adams, Reid B; Schirmer, Bruce D; Sanfey, Hilary A; Sawyer, Robert G

    2006-01-01

    After adopting a night float system, the residency program at the University of Virginia Health System Department of Surgery initiated a daily morning report (MR). The conference was originated to sign out new admissions and consults from the previous day to the services that would assume care. Although initially oriented toward transfer of patient information, MR is also hypothesized to serve as a competency-based resident education tool. An anonymous survey was distributed to on-service residents (n = 25). Questions were asked on a 5-point Likert scale. Respondents also ranked the weekly conferences, including MR, in terms of educational benefit derived. Most residents agreed that MR is an efficient method to sign-out patient care [84% stongly agree (SA) or agree (A)] and that it provides an excellent educational experience (88% SA or A). They agreed that it is presented in an evidence-based format (88% SA or A). Regarding the core competencies, residents all asserted that MR addresses "patient care" (100% SA or A) and "medical knowledge" (100% SA or A). Most agreed that it addresses "professionalism" (60% SA or A), "interpersonal skills and communication" (76% SA or A), and "practice-based learning and improvement" (92% SA or A). The 4 most important components identified with respect to continuing to improve both patient care and resident education were the presence of the on-call attending, a review of relevant radiology, provision of follow-up on select cases, and critical review of the literature. On average, MR was seen as the most educational conference, with 52% of residents ranking it first. Although MR is ubiquitous in most primary care residency programs, such a conference has not typically been held on surgical services. The MR was developed at the University of Virginia Health System Department of Surgery as a necessity for patient sign-out. As this conference has continued to evolve, it has become an excellent tool for resident education. It now

  20. Factors influencing residents' evaluations of clinical faculty member teaching qualities and role model status

    NARCIS (Netherlands)

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

    2012-01-01

    OBJECTIVES Evaluations of faculty members are widely used to identify excellent or substandard teaching performance. In order to enable such evaluations to be properly interpreted and used in faculty development, it is essential to understand the factors that influence resident doctors' (residents)

  1. Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

    Science.gov (United States)

    Kuperman, Ethan F; Tobin, Kristen; Kraschnewski, Jennifer L

    2014-12-01

    Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. During the 2010-2011 academic year, second- and third-year internal medicine residents at a single, university hospital-based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance.

  2. Comparison of Student Self-Reported and Administrative Data regarding Intercession into Alcohol Misuse among College Freshmen Dormitory Residents

    Science.gov (United States)

    Novik, Melinda G.; Boekeloo, Bradley O.

    2013-01-01

    Intercession into collegiate alcohol misuse by the Department of Resident Life (DRL) in freshmen dormitories at one large Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers (n = 357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that…

  3. A report that Fukushima residents are concerned about radiation from Land, Food and Radon

    International Nuclear Information System (INIS)

    Tamari, Yuki; Kuroda, Yujiro; Miyagawa, Ryu; Nawa, Kanabu; Sakumi, Akira; Sakata, Naoko; Mizushima, Nozomi; Sakura, Osamu; Iwamitsu, Yumi; Takemura, Kazuhisa; Nakagawa, Keiichi

    2016-01-01

    The Great East Japan Earthquake and subsequent TEPCO Fukushima Daiichi nuclear disaster occurred on 11 March 2011, which caused the leakage of radioactive materials into the environment. In this study, we report public concerns about radiation in Fukushima and Tokyo almost one year after the nuclear disaster. We examined the public concerns by analyzing the data from 1022 participants, 555 in Fukushima and 467 in Tokyo. They were asked whether they were concerned about radiation from some of six different types of sources, which could be answered in a binary way, ‘yes’ or ‘no’. We found not only similarities, but also significant differences in the degrees of concerns between Fukushima residents and Tokyo ones. Fukushima residents more concerned about radiation from land, food and radon in larger rate than that of Tokyo ones, while Tokyo residents were concerned about radiation from medical care. Residents in neither location were concerned about radiation from space. Our results suggested that careful risk communication should be undertaken, adaptively organized depending on location and other factors, e.g. comprehension about radiation, presence of the experience of evacuation, and also age and gender of the people

  4. Technologies for detecting falsified and substandard drugs in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Stephanie Kovacs

    Full Text Available Falsified and substandard drugs are a global health problem, particularly in low- and middle-income countries (LMIC that have weak pharmacovigilance and drug regulatory systems. Poor quality medicines have important health consequences, including the potential for treatment failure, development of antimicrobial resistance, and serious adverse drug reactions, increasing healthcare costs and undermining the public's confidence in healthcare systems. This article presents a review of the methods employed for the analysis of pharmaceutical formulations. Technologies for detecting substandard and falsified drugs were identified primarily through literature reviews. Key-informant interviews with experts augmented our methods when warranted. In order to aid comparisons, technologies were assigned a suitability score for use in LMIC ranging from 0-8. Scores measured the need for electricity, need for sample preparation, need for reagents, portability, level of training required, and speed of analysis. Technologies with higher scores were deemed the most feasible in LMICs. We categorized technologies that cost $10,000 USD or less as low cost, $10,000-100,000 USD as medium cost and those greater than $100,000 USD as high cost technologies (all prices are 2013 USD. This search strategy yielded information on 42 unique technologies. Five technologies were deemed both low cost and had feasibility scores between 6-8, and an additional four technologies had medium cost and high feasibility. Twelve technologies were deemed portable and therefore could be used in the field. Many technologies can aid in the detection of substandard and falsified drugs that vary from the simplest of checklists for packaging to the most complex mass spectrometry analyses. Although there is no single technology that can serve all the requirements of detecting falsified and substandard drugs, there is an opportunity to bifurcate the technologies into specific niches to address

  5. The Economic Cost of Environmental Factors Among North Carolina Children Living in Substandard Housing

    Science.gov (United States)

    Estes, Chris; Lee, Christopher

    2009-01-01

    Objectives. We quantified the economic cost of selected environmental factors among North Carolina children living in substandard housing. Methods. We gathered data on direct medical care costs for specific childhood medical conditions associated with environmental factors commonly found in substandard housing. Medical claims data for 2006 and 2007 were obtained from BlueCross BlueShield of North Carolina and the North Carolina Department of Health and Human Services. Indirect costs were based in part on nonmedical data obtained from several previous studies. Results. Total (direct and indirect) costs for the conditions assessed exceeded $92 million in 2006 and $108 million in 2007. Neurobehavioral conditions contributed to more than 52% of all costs, followed by lead poisoning (20%) and respiratory conditions (12%). Neurobehavioral conditions were the largest contributor to direct medical costs (44%), followed by respiratory conditions (38%) and accidental burns and falls (10%). Conclusions. Direct and indirect costs associated with environmental factors appear to be increasing at about twice the rate of medical inflation. More aggressive policies and funding are needed to reduce the substantial financial impact of childhood illnesses associated with substandard housing in North Carolina. PMID:19890173

  6. [Preparation of sub-standard samples and XRF analytical method of powder non-metallic minerals].

    Science.gov (United States)

    Kong, Qin; Chen, Lei; Wang, Ling

    2012-05-01

    In order to solve the problem that standard samples of non-metallic minerals are not satisfactory in practical work by X-ray fluorescence spectrometer (XRF) analysis with pressed powder pellet, a method was studied how to make sub-standard samples according to standard samples of non-metallic minerals and to determine how they can adapt to analysis of mineral powder samples, taking the K-feldspar ore in Ebian-Wudu, Sichuan as an example. Based on the characteristic analysis of K-feldspar ore and the standard samples by X-ray diffraction (XRD) and chemical methods, combined with the principle of the same or similar between the sub-standard samples and unknown samples, the experiment developed the method of preparation of sub-standard samples: both of the two samples above mentioned should have the same kind of minerals and the similar chemical components, adapt mineral processing, and benefit making working curve. Under the optimum experimental conditions, a method for determination of SiO2, Al2O3, Fe2O3, TiO2, CaO, MgO, K2O and Na2O of K-feldspar ore by XRF was established. Thedetermination results are in good agreement with classical chemical methods, which indicates that this method was accurate.

  7. Seismic Behavior of Substandard RC Columns Retrofitted with Embedded Aramid Fiber Reinforced Polymer (AFRP Reinforcement

    Directory of Open Access Journals (Sweden)

    Engin C. Seyhan

    2015-12-01

    Full Text Available Many existing reinforced concrete structures were constructed with substandard characteristics. Low quality concrete, poor transverse reinforcement details and insufficient flexural strength are among the most common deficiencies. While substandard structures are in need of retrofitting, particularly in seismic areas, problems such as high costs and disturbance to occupants are major obstacles for retrofit interventions. Fiber reinforced polymers can provide feasible retrofit solutions with minimum disturbance to occupants. In this study, the basic aim is to investigate the flexural seismic performance of substandard reinforced concrete columns retrofitted with embedded longitudinal fiber reinforced polymer reinforcement without increasing the original dimensions of the columns. In the experimental study, the reference and retrofitted columns were tested under constant vertical and reversed cyclic lateral loads. Three different connection methods of aramid fiber reinforced polymer reinforcement to the footing were investigated experimentally. A significant enhancement was obtained in lateral flexural strength through the proposed retrofitting method. Furthermore, it was observed that the cyclic lateral drift capacities of the retrofitted columns were as high as 3%, which can be deemed as quite satisfactory against seismic actions. The comparison of the experimental data with analytical calculations revealed that a conventional design approach assuming composite action between concrete and fiber reinforced polymer reinforcement can be used for flexural retrofit design. Experimental results also demonstrated that strain limit for longitudinal fiber reinforced polymer (FRP reinforcement should be remarkably lower in case of reversed cyclic loading conditions.

  8. She said, he said: Comparing mothers' and fathers' reports on the non-resident father's contact with his children

    Directory of Open Access Journals (Sweden)

    Ragni Hege Kitterød

    2014-03-01

    Full Text Available Background: Analyses of contact frequency between non-resident fathers and children have often been based on samples of non-resident fathers or resident mothers only. It is well established that non-resident fathers tend to report more contact than the resident mothers do, but it is less clear if it matters which parent we ask, when the aim is to explore predictors of father-child contact. Objective: We wish to add to the literature on predictors of father-child contact, especially if it matters whether we rely on the resident mothers' or the non-resident fathers' answers. Methods: Analyzing a high-quality Norwegian survey from 2004 of ex-couple-parents living apart, we ran separate OLS regressions estimating the predictors of number of contact days and nights, based on the mothers' and the fathers' answers, respectively. Results: Father-child contact is largely associated with the same independent variables, whether we use the non-resident fathers' or the resident mothers' answers, but some differences do appear. We observe more significant associations between father-child contact days and the independent variables based on the resident mothers' than the non-resident fathers' reporting. The mother's educational attainment and whether the father has children with more former partners have significant effects in the subsample of resident mothers, but not in the subsample of non-resident fathers. Conclusions: Future surveys should collect information from both parents. Using information from one parent only should be a last resort, if more adequate data cannot be obtained.

  9. A Comparison of Self-Reported Hearing Handicap and Audiometric Thresholds in Nursing Home Residents

    Directory of Open Access Journals (Sweden)

    Nematolla Rouhbakhsh

    2007-12-01

    Full Text Available Background and Aim: Self-reported and questionaire method for hearing impairment assessment allow us to study and to detect the invisible related issues, while They can not be done by traditional audiometry procedures. The purpose of this study is to compare measurement of hearing handicap using self-reported and staff version of NHHI and hearing thresholds in nursing home residents. Materials and Method: The study participants were 43 individuals, 23 males and 20 females, aged 45-95 years. Pure tone average were calculated after conventional Pure tone audiometry . the self- and staff- reported questionnaire were also fulfilled. Results: Nine (20.9% individuals have normal hearing, 6 (14% have slight, 10 (23.3% mild, 7 (16.3% moderate, 6 (16.3% moderate to severe, 4 (9.3% severe, and 1 (2.3% profound hearing loss. Mean score of self and of staff reported versions were 32.22 % +29.31 and 32.67% +30.98, respectively. According to Kruskal-wallis test, there were significant correlation between self-reported and hearing level and between staff-reported and hearing level. The Pierson coefficient variation test between self and staff-reported, and self-reported and hearing level, staff-reported and hearing level showed significant correlation. Conclusion: The NHHI self assessment associated with other equipments significantly improved the identification and assessment of adults and elderly hearing handicap in nursing home residents. According to the study condition, it may be concluded that the self and staff version of NHHI questionnaire are significantly identical and can be used instead.

  10. [The morning report - an important item in the training of psychiatrists in residence at psychiatric hospitals].

    Science.gov (United States)

    Con, D; Goethals, K

    2015-01-01

    In this article we focus on the role, function and composition of the morning report in the training of psychiatrists in residence at psychiatric hospitals. We also pay attention to the way in which the case should be presented in the morning report. To make some proposals regarding ways in which the efficiency of the morning report and the case presented in that report can be improved. We studied currently available literature and publications about the morning report and we also drew on our own experience with the morning report. We found very few publications that dealt specifically with morning report in the psychiatric teaching hospital. However, our studies have shown that the morning report should not be regarded purely as an instrument for passing on care details about the patient; it should also be seen as an essential link in the chain of instruction required by trainee psychiatrist. On the basis of rhetoric, constructivism and social-constructionism, we present a model for case presentation. Making improvements in the quality of the morning report is an important way of contributing to the learning process of trainee psychiatrists and staff members and should therefore enhance the status of the psychiatric hospital as a teaching community.

  11. Substandard, Spurious, Falsely-Labelled, Falsified and Counterfeit (SSFFC Drugs: Time to Take a Bitter Pill

    Directory of Open Access Journals (Sweden)

    Geetha Mani

    2016-10-01

    Full Text Available Substandard, Spurious, Falsely-Labelled, Falsified and Counterfeit (SSFFC drugs are an emerging public health concern in India. With one of the huge pharmaceutical sectors in the world, India has a varied prevalence of SSSFC drugs ranging from 0.04% to 34% according to various studies. Apart from severe health consequences, SSSFC drugs also weaken community's trust in the health care system. India is tackling the epidemic of SSSFC drugs through various existing and new regulatory measures. Considering the calamitous consequences of this silent epidemic, it is time to prescribe a bitter pill.

  12. Poverty, disability and self-reported health amongst residents and migrants in Gauteng, South Africa.

    Science.gov (United States)

    Ellison, George T H; de Wet, Thea

    2016-01-01

    The aim of the present study was to assess the relative importance of individual- and household-level indicators of poverty to the self-reported health of residents and recent migrants in South Africa's most urbanised province (Gauteng). Univariate and multivariable statistical analyses were undertaken on data from the 2014 Quality of Life household survey undertaken by the Gauteng City Regional Observatory. The survey generated data on a representative sample of n = 27 490 respondents. At the individual-level the odds for disability or health-limiting work/social activities was significantly lower amongst younger, better educated and employed respondents, and amongst both transnational and internal migrants. At the household-level, the absence of some basic services and household assets (particularly mains electricity, telecommunications and a television) were significantly associated with a lower odds of health-limiting work/social activities. Variation in sociodemographic and economic predictors of self-reported health at the individual- and household-level partly explain the lower odds of disability and health-limiting work/social activities of migrants, since migrants were less likely to be disabled and tended to be younger, with higher educational attainment and better employment status than residents, yet were also more likely to be living in households with fewer services and assets.

  13. Reporting Achievement of Medical Student Milestones to Residency Program Directors: An Educational Handover.

    Science.gov (United States)

    Sozener, Cemal B; Lypson, Monica L; House, Joseph B; Hopson, Laura R; Dooley-Hash, Suzanne L; Hauff, Samantha; Eddy, Mary; Fischer, Jonathan P; Santen, Sally A

    2016-05-01

    Competency-based education, including assessment of specialty-specific milestones, has become the dominant medical education paradigm; however, how to determine baseline competency of entering interns is unclear-as is to whom this responsibility falls. Medical schools should take responsibility for providing residency programs with accurate, competency-based assessments of their graduates. A University of Michigan ad hoc committee developed (spring 2013) a post-Match, milestone-based medical student performance evaluation for seven students matched into emergency medicine (EM) residencies. The committee determined EM milestone levels for each student based on assessments from the EM clerkship, end-of-third-year multistation standardized patient exam, EM boot camp elective, and other medical school data. In this feasibility study, the committee assessed nearly all 23 EM milestones for all seven graduates, shared these performance evaluations with the program director (PD) where each student matched, and subsequently surveyed the PDs regarding this pilot. Of the five responding PDs, none reported using the traditional medical student performance evaluation to customize training, four (80%) indicated that the proposed assessment provided novel information, and 100% answered that the assessment would be useful for all incoming trainees. An EM milestone-based, post-Match assessment that uses existing assessment data is feasible and may be effective for communicating competency-based information about medical school graduates to receiving residency programs. Next steps include further aligning assessments with competencies, determining the benefit of such an assessment for other specialties, and articulating the national need for an effective educational handover tool between undergraduate and graduate medical education institutions.

  14. Validity of Self-Reported Tobacco Smoke Exposure among Non-Smoking Adult Public Housing Residents.

    Directory of Open Access Journals (Sweden)

    Shona C Fang

    Full Text Available Tobacco smoke exposure (TSE in public multi-unit housing (MUH is of concern. However, the validity of self-reports for determining TSE among non-smoking residents in such housing is unclear.We analyzed data from 285 non-smoking public MUH residents living in non-smoking households in the Boston area. Participants were interviewed about personal TSE in various locations in the past 7 days and completed a diary of home TSE for 7 days. Self-reported TSE was validated against measurable saliva cotinine (lower limit of detection (LOD 0.02 ng/ml and airborne apartment nicotine (LOD 5 ng. Correlations, estimates of inter-measure agreement, and logistic regression assessed associations between self-reported TSE items and measurable cotinine and nicotine.Cotinine and nicotine levels were low in this sample (median = 0.026 ng/ml and 0.022 μg/m3, respectively. Prevalence of detectable personal TSE was 66.3% via self-report and 57.0% via measurable cotinine (median concentration among those with cotinine>LOD: 0.057 ng/ml, with poor agreement (kappa = 0.06; sensitivity = 68.9%; specificity = 37.1%. TSE in the home, car, and other peoples' homes was weakly associated with cotinine levels (Spearman correlations rs = 0.15-0.25, while TSE in public places was not associated with cotinine. Among those with airborne nicotine and daily diary data (n = 161, a smaller proportion had household TSE via self-report (41.6% compared with measurable airborne nicotine (53.4% (median concentration among those with nicotine>LOD: 0.04 μg/m3 (kappa = 0.09, sensitivity = 46.5%, specificity = 62.7%.Self-report alone was not adequate to identify individuals with TSE, as 31% with measurable cotinine and 53% with measurable nicotine did not report TSE. Self-report of TSE in private indoor spaces outside the home was most associated with measurable cotinine in this low-income non-smoking population.

  15. Substandard and falsified anti-tuberculosis drugs: a preliminary field analysis.

    Science.gov (United States)

    Bate, R; Jensen, P; Hess, K; Mooney, L; Milligan, J

    2013-03-01

    Pharmacies in 19 cities in Angola, Brazil, China, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, India (n = 3), Kenya, Nigeria, Russia, Rwanda, Thailand, Turkey, Uganda, United Republic of Tanzania and Zambia. To assess the quality of the two main first-line anti-tuberculosis medicines, isoniazid and rifampicin, procured from private-sector pharmacies, to determine if substandard and falsified medicines are available and if they potentially contribute to drug resistance in cities in low- and middle-income countries. Local nationals procured 713 treatment packs from a selection of pharmacies in 19 cities. These samples were tested for quality using 1) thin-layer chromatography to analyze levels of active pharmaceutical ingredient (API), and 2) disintegration testing. Of 713 samples tested, 9.1% failed basic quality testing for requisite levels of API or disintegration. The failure rate was 16.6% in Africa, 10.1% in India, and 3.9% in other middle-income countries. Substandard and falsified drugs are readily available in the private marketplace and probably contribute to anti-tuberculosis drug resistance in low- and middle-income countries. This issue warrants further investigation through large-scale studies of drug quality in all markets.

  16. Clinical implications for substandard, nonproprietary medicines in multiple sclerosis: focus on fingolimod

    Directory of Open Access Journals (Sweden)

    Correale J

    2016-06-01

    Full Text Available Jorge Correale,1 Erwin Chiquete,2 Alexey Boyko,3 Roy G Beran,4–6 Jorge Barahona Strauch,7,8 Snezana Milojevic,9 Nadina Frider101Department of Neurology, Raúl Carrea Institute for Neurological Research, Foundation for the Fight against Infant Neurological Illnesses (FLENI, Buenos Aires, Argentina; 2Department of Neurology and Psychiatry, Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; 3Clinical and Research Center “MS and Other Demyelinating Diseases” at the Neuroclinical Hospital, Department of Neurology, Neurosurgery and Medical Genetics of the Pirogov Russian National Research Medical University, Moscow, Russia; 4South Western Clinical School, University of New South Wales, Liverpool, 5Department of Neurology, Liverpool Hospital, Sydney, NSW, 6School of Medicine, Griffith University, Southport, QLD, Australia; 7Department of Neurology, Clínica Alemana de Santiago, 8School of Medicine, Universidad del Desarrollo, Santiago, Chile; 9Novartis Pharma AG, Basel, Switzerland; 10Novartis Latin America and Canada Region, Buenos Aires, ArgentinaAbstract: Both proprietary and nonproprietary medicines are expected to undergo rigorous preapproval testing and both should meet stringent health authority regulatory requirements related to quality to obtain approval. Nonproprietary (also known as copy, or generic medicines, which base their authorization and use on the proprietary documentation and label, are often viewed as a means to help lower the cost and, thus, increase patient access. If these medicines fail to meet quality standards, such as good manufacturing practice and bioequivalence (in humans, they are then defined as substandard copies and can pose serious risks to patients in terms of safety and efficacy. Potentially noncontrolled or different manufacturing process and excipients in nonproprietary medicines may result in poor batch-to-batch reproducibility (accurate and consistent quantity of

  17. Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey

    Science.gov (United States)

    Yeh, James S.; Austad, Kirsten E.; Franklin, Jessica M.; Chimonas, Susan; Campbell, Eric G.; Avorn, Jerry; Kesselheim, Aaron S.

    2015-01-01

    Background Medical students attending schools with policies limiting industry/student interactions report fewer relationships with pharmaceutical representatives. Objective To investigate whether associations between students' medical school policies and their more limited industry interaction behaviors persist into residency. Methods We randomly sampled 1800 third-year residents who graduated from 120 allopathic US-based medical schools, using the American Medical Association Physician Masterfile. We surveyed them in 2011 to determine self-reported behavior and preferences for brand-name prescriptions, and we calculated the strength of their medical schools' industry interaction policies using the 2008 American Medical Student Association and Institute on Medicine as a Profession databases. We used logistic regression to estimate the association between strength of school policies and residents' behaviors with adjustments for class size, postresidency career plan, and concern about medical school debt. Results We achieved a 44% survey response rate (n = 739). Residents who graduated from schools with restrictive policies were no more or less likely to accept industry gifts or industry-sponsored meals, speak with marketing representative about drug products, attend industry-sponsored lectures, or prefer brand-name medications than residents who graduated from schools with less restrictive policies. Residents who correctly answered evidence-based prescription questions were about 30% less likely to have attended industry-sponsored lectures (OR = 0.72, 95% CI 0.56–0.98). Conclusions Any effect that medical school industry interaction policies had on insulating students from pharmaceutical marketing did not persist in the behavior of residents in our sample. This suggests that residency training environments are important in influencing behavior. PMID:26692972

  18. Self-assessment on the competencies and reported improvement priorities for pediatrics residents.

    Science.gov (United States)

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

    2012-12-01

    Self-assessment and self-directed learning are essential to becoming an effective physician. To identify factors associated with resident self-assessment on the competencies, and to determine whether residents chose areas of self-assessed relative weakness as areas for improvement in their Individualized Learning Plan (ILP). We performed a cross-sectional analysis of the American Academy of Pediatrics' PediaLink ILP database. Pediatrics residents self-assessed their competency in the 6 Accreditation Council for Graduate Medical Education competencies using a color-coded slider scale with end anchors "novice" and "proficient" (0-100), and then chose at least 1 competency to improve. Multivariate regression explored the relationship between overall confidence in core competencies, sex, level of training, and degree (MD or DO) status. Correlation examined whether residents chose to improve competencies in which they rated themselves as lower. A total of 4167 residents completed an ILP in academic year 2009-2010, with residents' ratings improving from advanced beginner (48 on a 0-100 scale) in postgraduate year-1 residents (PGY-1s) to competent (75) in PGY-3s. Residents rated themselves as most competent in professionalism (mean, 75.3) and least competent in medical knowledge (mean, 55.8) and systems-based practice (mean, 55.2). In the adjusted regression model, residents' competency ratings increased by level of training and whether they were men. In PGY-3s, there was no difference between men and women. Residents selected areas for improvement that correlated to competencies where they had rated themselves lower (P self-assessment of their competencies increased by level of training, although residents rated themselves as least competent in medical knowledge and systems-based practice, even as PGY-3s. Residents tended to choose subcompetencies, which they rated as lower to focus on improving.

  19. Current scenario of spurious and substandard medicines in India: a systematic review.

    Science.gov (United States)

    Khan, A N; Khar, R K

    2015-01-01

    Globally, every country is the victim of substandard or spurious drugs, which result in life threatening issues, financial loss of consumer and manufacturer and loss in trust on health system. The aim of this enumerative review was to probe the extent on poor quality drugs with their consequences on public health and the preventive measures taken by the Indian pharmaceutical regulatory system. Government and non-government studies, literature and news were gathered from journals and authentic websites. All data from 2000 to 2013 were compiled and interpreted to reveal the real story of poor quality drugs in India. For minimizing spurious/falsely-labelled/falsified/counterfeit drugs or not of standard quality drugs, there is urgent requirement of more stringent regulation and legal action against the problem. However, India has taken some preventive steps in the country to fight against the poor quality drugs for protecting and promoting the public health.

  20. Giardia duodenalis infection: risk factors for children living in sub-standard settlements in Brazil

    Directory of Open Access Journals (Sweden)

    Júlio César Teixeira

    2007-06-01

    Full Text Available The objective of the present study was to characterize Giardia duodenalis infection among children living in sub-standard settlement areas in the municipality of Juiz de Fora, Minas Gerais State, Brazil. The cross-sectional epidemiological study included 590 children from 1 to 5 years of age. Data were collected from one child per selected family through home interviews with the parent or guardian and parasitological examination of stool samples. Thirty-one putative risk factors concerning family structure, socioeconomic status, and environmental factors were analyzed by multivariate logistic regression. Prevalence of G. duodenalis infection was 18% (106 children. Four potential risk factors were heavily associated with G. duodenalis infection: number of under-five children in the same household, index child's birth order, existence of a bathroom in the home, and drinking water source.

  1. Staff and Institutional Factors Associated with Substandard Care in the Management of Postpartum Hemorrhage.

    Directory of Open Access Journals (Sweden)

    A Rousseau

    Full Text Available to identify staff and institutional factors associated with substandard care by midwives managing postpartum hemorrhage (PPH.A multicenter vignette-based study was e-mailed to a random sample of midwives at 145 French maternity units that belonged to 15 randomly selected perinatal networks. Midwives were asked to describe how they would manage two case-vignettes about PPH and to complete a short questionnaire about their individual (e.g., age, experience, and full- vs. part-time practice and institutional (private or public status and level of care characteristics. These previously validated case-vignettes described two different scenarios: vignette 1, a typical immediate, severe PPH, and vignette 2, a severe but gradual hemorrhage. Experts consensually defined 14 criteria to judge adherence to guidelines. The number of errors (possible range: 0 to 14 for the 14 criteria quantified PPH guideline adherence, separately for each vignette.450 midwives from 87 maternity units provided complete responses. Perfect adherence (no error for any of the 14 criteria was low: 25.1% for vignette 1 and 4.2% for vignette 2. After multivariate analysis, midwives' age remained significantly associated with a greater risk of error in guideline adherence in both vignettes (IRR 1.19 [1.09; 1.29] for vignette 1, and IRR 1.11 [1.05; 1.18] for vignette 2, and the practice of mortality and morbidity reviews in the unit with a lower risk (IRR 0.80 [0.64; 0.99], IRR 0.78 [0.66; 0.93] respectively. Risk-taking scores (IRR 1.41 [1.19; 1.67] and full-time practice (IRR 0.83 [0.71; 0.97] were significantly associated with adherence only in vignette 1.Both staff and institutional factors may be associated with substandard care in midwives' PPH management.

  2. Acetone-butanol-ethanol production from substandard and surplus dates by Egyptian native Clostridium strains.

    Science.gov (United States)

    Abd-Alla, Mohamed Hemida; Zohri, Abdel-Naser Ahmed; El-Enany, Abdel-Wahab Elsadek; Ali, Shimaa Mohamed

    2015-04-01

    One hundred and seven mesophilic isolates of Clostridium were isolated from agricultural soils cultivated with different plants in Assuit Governorate, Egypt. Eighty isolates (out of 107) showed the ability to produce ABE (Acetone, butanol and ethanol) on T6 medium ranging from 0.036 to 31.89 g/L. The highest numbers of ABE producing isolates were obtained from soil samples of potato contributing 27 isolates, followed by 18 isolates from wheat and 10 isolates from onion. On the other hand, there were three native isolates that produced ABE more than those produced by the reference isolate Clostridium acetobutylicum ATCC 824 (11.543 g/L). The three isolates were identified based on phenotypic and gene encoding 16S rRNA as Clostridium beijerinckii ASU10 (KF372577), Clostridium chauvoei ASU55 (KF372580) and Clostridium roseum ASU58 (KF372581). The highest ABE level from substandard and surplus dates was produced by C. beijerinckii ASU10 (24.07 g/L) comprising butanol 67.15% (16.16 g/L), acetone 30.73% (7.4 g/L) and ethanol 2.12% (0.51 g/L), while C. roseum ASU58 and C. chauvoei ASU55 produced ABE contributing 20.20 and 13.79 g/L, respectively. ABE production by C. acetobutylicum ATCC 824 was 15.01 g/L. This study proved that the native strains C. beijerinckii ASU10 and C. roseum ASU58 have high competitive efficacy on ABE production from economical substrate as substandard and surplus date fruits. Additionally, using this substrate without any nutritional components is considered to be a commercial substrate for desired ABE production. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Stating Values through Denial of Substance: Implementation of One Cognitive Mechanism in the Russian Substandard

    Directory of Open Access Journals (Sweden)

    Tatiana V. Ukhanova

    2017-11-01

    Full Text Available The article is devoted to the study of objectification in the substandard forms of Russian language concerning the conceptual norm of possession, which represents the axiological aspect of the world picture by sociolect holders. The relevance of the work is determined by the belonging of the indicated problem to the field of the interest intersection from the theory of nomination, cognitive linguistics and social linguistics, and at the same time, by an insufficient knowledge of the implementation means in the mechanism language of value marking concerning socially separate groups of Russian mentality bearers. In Russian language, the cognitive mechanism of value assertion through the negation of a substance is realized through the word-formation category "an attribute for the lack of substance", which belongs to the number of productive nominative categories. Our task was a complex structural and functional description of sub-standard derivatives of this category with the aim to their further comprehension from onomasiologic and cognitive positions. This conditioned the use of word-formation and component analysis methods. Basing on the works by E.S. Kubryakova and N.D. Arutunova, we determined the essence of the Russian mental norm of possession. The model of field organization proposed by us concerning the mental norm of possession made it possible to draw the conclusion about the complexity of the value basis organization concerning the Russian national worldview, determining the role in which the spiritual and moral guidelines play an important role, and the material values located on the periphery are less significant. The results of the research can be applied in the field of linguistic didactics, especially in the practice of teaching Russian as a foreign language, as well as in the organization of associative and social linguistic experiments.

  4. Radiology residents' comprehension of the breast imaging reporting and data system: The ultrasound lexicon and final assessment category

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Hye; Lee, Eun Hye [Bucheon Hospital, Bucheon (Korea, Republic of); Roh, Yun Ho; Kim, Min Jung; Youk, Ji Hyun [Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoon, Jung Hyun; Kim, Sung Hun [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, You Me [Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2017-07-15

    To evaluate radiology residents' performance in interpretation and comprehension of breast ultrasonographic descriptors in the Breast Imaging Reporting and Data System (BI-RADS) to suggest the adequate duration of training in breast ultrasonography. A total of 102 radiology residents working in the Department of Radiology were included in this study. They were asked to answer 16 questions about the ultrasonographic lexicon and 11 questions about the BI-RADS category. We analyzed the proportion of correct answers according to the radiology residents’ year of training and duration of breast imaging training. With respect to the duration of breast imaging training, the proportion of correct answers for lexicon descriptors ranged from 77.2% to 81.3% (p = 0.368) and the proportion of correct answers for the BI-RADS category was highest after three-four months of training compared with after one month of training (p = 0.033). The proportion of correct answers for lexicon descriptors and BI-RADS category did not differ significantly according to the year of residency training. Radiology residents' comprehension of the BI-RADS category on breast ultrasonography was not associated with their year of residency training. Based on our findings, radiology residents' assessment of the BI-RADS category was significantly improved with three-four months of training compared with one month of training.

  5. Ohio osteopathic residency directors' self-reported administrative knowledge and skills before and after participation in an administrative training program.

    Science.gov (United States)

    Sheehan, Olivia Ojano; Brannan, Grace

    2013-04-01

    Residency directors require myriad skills to perform their jobs efficiently. However, many residency directors receive no training prior to obtaining their positions. To determine the effectiveness of the Residency Directors Residency Administration Program (RD RAP)--a 1-year fellowship training program for Ohio osteopathic residency directors sponsored by the Ohio University Heritage College of Osteopathic Medicine/Centers for Osteopathic Research and Education--by measuring the administrative knowledge and skills of Ohio osteopathic residency directors before and after completion of the program. The authors administered a 54-item self-assessment instrument to RD RAP participants before and after the 2009-2010 and 2010-2011 programs. The assessment asked participants to rank their knowledge and skills in administration on a 5-point Likert scale, with lower values indicating higher knowledge and skills. We analyzed data from the pre- and postprogram assessments by using the Wilcoxon signed rank nonparametric test. The 54 assessment items were categorized into 10 content domains. Ten RD RAP participants completed the assessments. Median scores were statistically significantly lower for each of the 10 content domains after the RD RAP program. The content domain with the greatest change between pre- and postprogram assessment Likert scale scores was Legal Issues in Residency Training, with a median change of 1.7 (P=.007). Role of Program Directors, Personality, and Professional Development had the smallest change in pre- and postprogram assessment Likert scores, with a median change of 0.8 (P=.011). Statistically significant improvements were found in the osteopathic residency directors' self-reported administrative knowledge and skills after participation in the RD RAP.

  6. Essentials and guidelines for clinical medical physics residency training programs: executive summary of AAPM Report Number 249.

    Science.gov (United States)

    Prisciandaro, Joann I; Willis, Charles E; Burmeister, Jay W; Clarke, Geoffrey D; Das, Rupak K; Esthappan, Jacqueline; Gerbi, Bruce J; Harkness, Beth A; Patton, James A; Peck, Donald J; Pizzutiello, Robert J; Sandison, George A; White, Sharon L; Wichman, Brian D; Ibbott, Geoffrey S; Both, Stefan

    2014-05-08

    There is a clear need for established standards for medical physics residency training. The complexity of techniques in imaging, nuclear medicine, and radiation oncology continues to increase with each passing year. It is therefore imperative that training requirements and competencies are routinely reviewed and updated to reflect the changing environment in hospitals and clinics across the country. In 2010, the AAPM Work Group on Periodic Review of Medical Physics Residency Training was formed and charged with updating AAPM Report Number 90. This work group includes AAPM members with extensive experience in clinical, professional, and educational aspects of medical physics. The resulting report, AAPM Report Number 249, concentrates on the clinical and professional knowledge needed to function independently as a practicing medical physicist in the areas of radiation oncology, imaging, and nuclear medicine, and constitutes a revision to AAPM Report Number 90. This manuscript presents an executive summary of AAPM Report Number 249.

  7. Explaining reported puma-related behaviors and behavioral intentions among northern Arizona residents

    Science.gov (United States)

    Mattson, David J.; Ruther, Elizabeth J.

    2012-01-01

    Management of pumas in the American West is typified by conflict among stakeholders plausibly rooted in life experiences and worldviews. We used a mail questionnaire to assess demographics, nature-views, puma-related life experiences and behaviors, and support for puma-related policies among residents of northern Arizona. Data from the questionnaire (n = 693 respondents) were used to model behaviors and support for policies. Compared to models based on nature-views and life experiences, those based on demographics had virtually no support from the data. The Utilitarian/Dominionistic nature-view had the strongest effect of any variable in six of seven models, and was associated with firearms and opposition to policies that would limit killing pumas. The Humanistic/Moralistic nature-view was positively associated with non-lethal behaviors and policies in five models. Gender had the strongest effect of any demographic variable. Compared to demographics alone, our results suggest that worldviews provide a more meaningful explanation of reported human behaviors and behavioral intentions regarding pumas.

  8. Increased error rates in preliminary reports issued by radiology residents working more than 10 consecutive hours overnight.

    Science.gov (United States)

    Ruutiainen, Alexander T; Durand, Daniel J; Scanlon, Mary H; Itri, Jason N

    2013-03-01

    To determine if the rate of major discrepancies between resident preliminary reports and faculty final reports increases during the final hours of consecutive 12-hour overnight call shifts. Institutional review board exemption status was obtained for this study. All overnight radiology reports interpreted by residents on-call between January 2010 and June 2010 were reviewed by board-certified faculty and categorized as major discrepancies if they contained a change in interpretation with the potential to impact patient management or outcome. Initial determination of a major discrepancy was at the discretion of individual faculty radiologists based on this general definition. Studies categorized as major discrepancies were secondarily reviewed by the residency program director (M.H.S.) to ensure consistent application of the major discrepancy designation. Multiple variables associated with each report were collected and analyzed, including the time of preliminary interpretation, time into shift study was interpreted, volume of studies interpreted during each shift, day of the week, patient location (inpatient or emergency department), block of shift (2-hour blocks for 12-hour shifts), imaging modality, patient age and gender, resident identification, and faculty identification. Univariate risk factor analysis was performed to determine the optimal data format of each variable (ie, continuous versus categorical). A multivariate logistic regression model was then constructed to account for confounding between variables and identify independent risk factors for major discrepancies. We analyzed 8062 preliminary resident reports with 79 major discrepancies (1.0%). There was a statistically significant increase in major discrepancy rate during the final 2 hours of consecutive 12-hour call shifts. Multivariate analysis confirmed that interpretation during the last 2 hours of 12-hour call shifts (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.18-3.21), cross

  9. Surveillance for falsified and substandard medicines in Africa and Asia by local organizations using the low-cost GPHF Minilab

    Science.gov (United States)

    Petersen, Albert; Held, Nadja

    2017-01-01

    Background Substandard and falsified medical products present a serious threat to public health, especially in low- and middle-income countries. Their identification using pharmacopeial analysis is expensive and requires sophisticated equipment and highly trained personnel. Simple, low-cost technologies are required in addition to full pharmacopeial analysis in order to accomplish widespread routine surveillance for poor-quality medicines in low- and middle-income countries. Methods Ten faith-based drug supply organizations in seven countries of Africa and Asia were each equipped with a Minilab of the Global Pharma Health Fund (GPHF, Frankfurt, Germany), suitable for the analysis of about 85 different essential medicines by thin-layer chromatography. Each organization was asked to collect approximately 100 medicine samples from private local medicine outlets, especially from the informal sector. The medicine samples were tested locally according to the Minilab protocols. Medicines which failed Minilab testing were subjected to confirmatory analysis in a WHO-prequalified medicine quality control laboratory in Kenya. Results Out of 869 medicine samples, 21 were confirmed to be substandard or falsified medical products. Twelve did not contain the stated active pharmaceutical ingredient (API), six contained insufficient amounts of the API, and three showed insufficient dissolution of the API. The highest proportion of substandard and falsified medicines was found in Cameroon (7.1%), followed by the Democratic Republic of Congo (2.7%) and Nigeria (1.1%). Antimalarial medicines were most frequently found to be substandard or falsified (9.5% of all antimalarials). Thin-layer chromatography according to the Minilab protocols was found to be specific and reproducible in the identification of medicines which did not contain the stated API. Since only samples which failed Minilab testing were subjected to confirmatory testing using pharmacopeial methods, this study did not

  10. Leadership in the clinical workplace : what residents report to observe and supervisors report to display: an exploratory questionnaire study

    NARCIS (Netherlands)

    van der Wal, Martha A.; Scheele, Fedde; Schonrock-Adema, Johanna; Jaarsma, A. Debbie C.; Cohen-Schotanus, Janke

    2015-01-01

    Background: Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to

  11. Leadership in the clinical workplace: what residents report to observe and supervisors report to display: an exploratory questionnaire study

    NARCIS (Netherlands)

    van der Wal, M.A.; Scheele, F.; Schonrock-Adema, J.; Jaarsma, A.D.C.; Cohen-Schotanus, J.

    2015-01-01

    Background: Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to

  12. Self-Reported Emergency Medicine Residency Applicant Attitudes Towards a Procedural Cadaver Laboratory Curriculum

    Directory of Open Access Journals (Sweden)

    Hoffman, Lance

    2008-08-01

    Full Text Available OBJECTIVE: Residency applicants consider a variety of factors when ranking emergency medicine (EM programs for their NRMP match list. A human cadaver emergency procedure lab curriculum is uncommon. We hypothesized that the presence this curriculum would positively impact the ranking of an EM residency program.METHODS: The EM residency at Nebraska Medical Center is an urban, university-based program with a PGY I-III format. Residency applicants during the interview for a position in the PGY I class of 2006 were surveyed by three weekly electronic mailings. The survey was distributed in March 2006 after the final NRMP match results were released. The survey explored learner preferences and methodological commonality of models of emergency procedural training, as well as the impact of a procedural cadaver lab curriculum on residency ranking. ANOVA of ranks was used to compare responses to ranking questions.RESULTS: Of the 73 potential subjects, 54 (74% completed the survey. Respondents ranked methods of procedural instruction from 1 (most preferred or most common technique to 4 (least preferred or least common technique. Response averages and 95% confidence intervals for the preferred means of learning a new procedure are as follows: textbook (3.69; 3.51-3.87, mannequin (2.83; 2.64-3.02, human cadaver (1.93; 1.72-2.14, and living patient (1.56; 1.33-1.79. Response averages for the commonality of means used to teach a new procedure are as follows: human cadaver (3.63; 3.46-3.80, mannequin (2.70; 2.50-2.90, living patient (2.09; 1.85-2.33, and textbook (1.57; 1.32-1.82. When asked if the University of Nebraska Medical Center residency ranked higher in the individual's match list because of its procedural cadaver lab, 14.8% strongly disagreed, 14.8% disagreed, 40.7% were neutral, 14.8% agreed, and 14.8% strongly agreed.CONCLUSION: We conclude that, although cadaveric procedural training is viewed by senior medical student learners as a desirable means

  13. Effect of pregnancy-lactation overlap on the current pregnancy outcome in women with substandard nutrition: a prospective cohort study

    OpenAIRE

    Shaaban, OM; Abbas, AM; Abdel Hafiz, HA; Abdelrahman, AS; Rashwan, M; Othman, ER

    2016-01-01

    Background Pregnancy during lactation is common in Egypt and is often unplanned. Overlap between pregnancy and lactation could be associated with an increased risk for the pregnant mother, her fetus as well as her nursing child. Aim of the study The current study aims to compare the maternal and perinatal outcome of pregnancies occurred during lactation with those occurred after weaning in women with substandard nutrition. Materials and methods A prospective-cohort study was carried out in si...

  14. Modelling the effects of transglutaminase and L-ascorbic acid on substandard quality wheat flour by response surface methodology

    Directory of Open Access Journals (Sweden)

    Šimurina Olivera D.

    2014-01-01

    Full Text Available In recent decade, there have been observed extreme variations in climatic conditions which in combination with inadequate agro techniques lead to decreased quality of mercantile wheat, actally flour. The application of improvers can optimise the quality of substandard wheat flour. This paper focuses to systematic analysis of individual and interaction effects of ascorbic acid and transglutaminase as dough strengthening improvers. The effects were investigated using the Response Surface Methodology. Transglutaminase had much higher linear effect on the rheological and fermentative properties of dough from substandard flour than L-ascorbic acid. Both transglutaminase and L-ascorbic acid additions had a significant linear effect on the increase of bread specific volume. Effects of transglutaminase and ascorbic acid are dependent on the applied concentrations and it is necessary to determine the optimal concentration in order to achieve the maximum quality of the dough and bread. Optimal levels of tested improvers were determined using appropriate statistical techniques which applied the desirability function. It was found that the combination of 30 mg/kg of transglutaminase and 75.8 mg/kg of L-ascorbic acid achieved positive synergistic effect on rheological and fermentative wheat dough properties, as well on textural properties and specific volume of bread made from substandard quality flour.

  15. Resident fish stock status above Chief Joseph and Grand Coulee dams : 2000 annual report; ANNUAL

    International Nuclear Information System (INIS)

    Lockwood, N.; McLellan, J.; Crossley, B.

    2001-01-01

    The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, commonly known as the Joint Stock Assessment Project (JSAP) is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (blocked area). The three-phase approach of this project will enhance the fisheries resources of the blocked area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information housed in a central location will allow managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP (NWPPC program measure 10.8B.26) is designed and guided jointly by fisheries managers in the blocked area and the Columbia Basin blocked area management plan (1998). The initial year of the project (1997) identified the need for a central data storage and analysis facility, coordination with the StreamNet project, compilation of blocked area fisheries information, and a report on the ecological condition of the Spokane River System. These needs were addressed in 1998 by acquiring a central location with a data storage and analysis system, coordinating a pilot project with StreamNet, compiling fisheries distribution data throughout the blocked area, identifying data gaps based on compiled information, and researching the ecological condition of the Spokane River. In order to ensure that any additional information collected throughout the life of this project will be easily stored and manipulated by the central storage facility, it was necessary to develop standardized methodologies between the JSAP fisheries managers. The use of common collection and analytical tools is essential to the process of streamlining joint management decisions. In 1999 and 2000 the project

  16. Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams; 2000 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Lockwood, Jr., Neil [Kalispel Tribe of Indians, Usk, WA (United States); McLellan, Jason G [Washington Department of Fish and Wildlife, Spokane, WA (United States); Crossley, Brian [Spokane Tribe of Indians, Department of Natural Resources, Wellpinit, WA (United States); O' Connor, Dick

    2001-01-01

    The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, commonly known as the Joint Stock Assessment Project (JSAP) is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (blocked area). The three-phase approach of this project will enhance the fisheries resources of the blocked area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information housed in a central location will allow managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP (NWPPC program measure 10.8B.26) is designed and guided jointly by fisheries managers in the blocked area and the Columbia Basin blocked area management plan (1998). The initial year of the project (1997) identified the need for a central data storage and analysis facility, coordination with the StreamNet project, compilation of blocked area fisheries information, and a report on the ecological condition of the Spokane River System. These needs were addressed in 1998 by acquiring a central location with a data storage and analysis system, coordinating a pilot project with StreamNet, compiling fisheries distribution data throughout the blocked area, identifying data gaps based on compiled information, and researching the ecological condition of the Spokane River. In order to ensure that any additional information collected throughout the life of this project will be easily stored and manipulated by the central storage facility, it was necessary to develop standardized methodologies between the JSAP fisheries managers. The use of common collection and analytical tools is essential to the process of streamlining joint management decisions. In 1999 and 2000 the project

  17. Examining the Quality of Rectal Cancer Operative Reports in Teaching Institutions: Is There an Opportunity for Resident Education?

    Science.gov (United States)

    Parrish, Aaron B; Sanaiha, Yas; Petrie, Beverley A; Russell, Marcia M; Chen, Formosa

    2016-10-01

    The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed. Overall adherence to checklist items was 55 per cent, and was significantly higher in attending versus resident dictated reports (67% vs 51%, P < 0.01). Senior residents had significantly higher adherence to checklist items than junior residents (55% vs 44%, P < 0.01). However, overall adherence to rectal cancer checklist items was low. This represents an opportunity to improve the quality of operative documentation in rectal cancer surgery, which could also impact the technical quality of the operation itself.

  18. Resident Fish Stock above Chief Joseph and Grand Coulee Dams; 2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connor, Jason M. (Kalispel Department of Natural Resources, Usk, WA); McLellan, Jason G. (Washington Department of Fish and Wildlife, Spokane, WA); Butler, Chris (Spokane Tribe of Indians, Department of Natural Resources, Wellpinit, WA)

    2003-09-01

    In 1980, the United States Congress enacted the Northwest Power Planning and Conservation Act (PL 96-501, 1980), which established the Northwest Power and Conservation Council (NPCC), formerly the Northwest Power Planning Council. The NPCC was directed by Congress to develop a regional Power Plan and also the Columbia River Basin Fish and Wildlife Program (FWP) to restore or replace losses of fish caused by construction and operation of hydroelectric dams in the Columbia River Basin. In developing the FWP, Congress specifically directed NPCC to solicit recommendations for measures to be included in the Program from the region's fish and wildlife agencies and Indian tribes. All measures adopted by the Council were also required to be consistent with the management objectives of the agencies and tribes [Section 4.(h)(6)(A)], the legal rights of Indian tribes in the region [Section 4.(h)(6)(D)] and be based upon and supported by the best available scientific knowledge [Section 4.(h)(6)(B)]. The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, also known as the Joint Stock Assessment Project (JSAP) specifically addresses NPPC Council measure 10.8B.26 of the 1994 program. The Joint Stock Assessment Project is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (Blocked Area). A three-phase approach of this project will enhance the fisheries resources of the Blocked Area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information is housed in a central location, allowing managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP is designed and guided jointly by fisheries managers in the Blocked Area

  19. Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams; 2001 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connor, Jason M. (Kalispell Department of Natural Resources, Usk, WA); McLellan, Jason G. (Washington Department of Fish and Wildlife, Spokane, WA); O' Connor, Dick (Washington Department of Fish and Wildlife, Olympia, WA)

    2003-01-01

    In 1980, the United States Congress enacted the Northwest Power Planning and Conservation Act (PL 96-501, 1980), which established the Northwest Power Planning Council (NPPC). The NPPC was directed by Congress to develop a regional Power Plan and also the Columbia River Basin Fish and Wildlife Program (FWP) to restore or replace losses of fish caused by construction and operation of hydroelectric dams in the Columbia River Basin. In developing the FWP, Congress specifically directed NPPC to solicit recommendations for measures to be included in the Program from the region's fish and wildlife agencies and Indian tribes. All measures adopted by the Council were also required to be consistent with the management objectives of the agencies and tribes [Section 4.(h)(6)(A)], the legal rights of Indian tribes in the region [Section 4.(h)(6)(D)] and be based upon and supported by the best available scientific knowledge [Section 4.(h)(6)(B)]. The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, also known as the Joint Stock Assessment Project (JSAP) specifically addresses NPPC Council measure 10.8B.26 of the 1994 program. The Joint Stock Assessment Project is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (Blocked Area). A three-phase approach of this project will enhance the fisheries resources of the Blocked Area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information is housed in a central location, allowing managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP is designed and guided jointly by fisheries managers in the Blocked Area and the Columbia Basin Blocked Area Management Plan

  20. Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams; 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connor, Jason M. (Kalispel Tribe of Indians, Usk, WA); McLellan, Jason G. (Washington Department of Fish and Wildlife); Butler, Chris (Spokane Tribe of Indians, Wellpinit, WA)

    2006-02-01

    In 1980, the United States Congress enacted the Northwest Power Planning and Conservation Act (PL 96-501, 1980), which established the Northwest Power and Conservation Council (NPCC), formerly the Northwest Power Planning Council. The NPCC was directed by Congress to develop a regional Power Plan and also the Columbia River Basin Fish and Wildlife Program (FWP) to restore or replace losses of fish caused by construction and operation of hydroelectric dams in the Columbia River Basin. In developing the FWP, Congress specifically directed NPCC to solicit recommendations for measures to be included in the Program from the region's fish and wildlife agencies and Indian tribes. All measures adopted by the Council were also required to be consistent with the management objectives of the agencies and tribes [Section 4.(h)(6)(A)], the legal rights of Indian tribes in the region [Section 4.(h)(6)(D)] and be based upon and supported by the best available scientific knowledge [Section 4.(h)(6)(B)]. The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, also known as the Joint Stock Assessment Project (JSAP) specifically addresses NPPC Council measure 10.8B.26 of the 1994 program. The Joint Stock Assessment Project is a management tool using ecosystem principles to manage artificial and native fish assemblages in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (Blocked Area). A three-phase approach of this project will enhance the fisheries resources of the Blocked Area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information is housed in a central location, allowing managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP is designed and guided jointly by fisheries managers in the Blocked Area. The

  1. Resident Fish Stock above Chief Joseph and Grand Coulee Dams; 2003-2004 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connor, Jason M. (Kalispel Tribe of Indians, Usk, WA); McLellan, Jason G. (Washington Department of Fish and Wildlife, Olympia, WA); Butler, Chris (Spokane Tribe of Indians, Wellpinit, WA)

    2005-11-01

    In 1980, the United States Congress enacted the Northwest Power Planning and Conservation Act (PL 96-501, 1980), which established the Northwest Power and Conservation Council (NPCC), formerly the Northwest Power Planning Council. The NPCC was directed by Congress to develop a regional Power Plan and also the Columbia River Basin Fish and Wildlife Program (FWP) to restore or replace losses of fish caused by construction and operation of hydroelectric dams in the Columbia River Basin. In developing the FWP, Congress specifically directed NPCC to solicit recommendations for measures to be included in the Program from the region's fish and wildlife agencies and Indian tribes. All measures adopted by the Council were also required to be consistent with the management objectives of the agencies and tribes [Section 4.(h)(6)(A)], the legal rights of Indian tribes in the region [Section 4.(h)(6)(D)] and be based upon and supported by the best available scientific knowledge [Section 4.(h)(6)(B)]. The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, also known as the Joint Stock Assessment Project (JSAP) specifically addresses NPPC Council measure 10.8B.26 of the 1994 program. The Joint Stock Assessment Project is a management tool using ecosystem principles to manage artificial and native fish assemblages in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (Blocked Area). A three-phase approach of this project will enhance the fisheries resources of the Blocked Area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information is housed in a central location, allowing managers to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP is designed and guided jointly by fisheries managers in the Blocked Area. The

  2. Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

    Science.gov (United States)

    Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

    2017-11-01

    The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p plastic surgery residents.

  3. Case reports in medical education: a platform for training medical students, residents, and fellows in scientific writing and critical thinking.

    Science.gov (United States)

    Florek, Aleksandra G; Dellavalle, Robert P

    2016-04-06

    A case report is a detailed narrative that usually illustrates a diagnostic or therapeutic problem experienced by one or several patients. Case reports commonly serve as the first line of evidence for new interventions or they function as alarms that an issue exists with an already established therapy. Case reports are of minor importance in evidence-based medicine; however, they make meaningful contributions to both the knowledge and education of medical students, residents, and fellows. Case reports are written with the goal of sharing information for medical, scientific, or educational purposes. They often serve as medical or even undergraduate students' first experience with medical writing and they provide a solid foundation for manuscript preparation and publication. In the last few decades, there has been an exponential increase in medical student research, specifically in the number of manuscripts published by medical students. It is important to foster this academic spirit among students by encouraging them to become involved in research. This editorial will focus on the value and educational benefits of writing case reports for medical students, university students, residents, and fellows.

  4. Case report

    African Journals Online (AJOL)

    abp

    2014-04-24

    Apr 24, 2014 ... and most of the bites occurred in an area of substandard housing. [1]. Other idenfiable risk factors are; poverty, unemployment and rat infestations [2]. Patient and observation. We report a case ... navigation of rats within and around the house before the incidence. No similar incidence in the other siblings.

  5. Trauma morning report is the ideal environment to teach and evaluate resident communication and sign-outs in the 80 hour work week.

    Science.gov (United States)

    Ottinger, Mary E; Monaghan, Sean F; Gregg, Shea C; Stephen, Andrew H; Connolly, Michael D; Harrington, David T; Adams, Charles A; Cioffi, William G; Heffernan, Daithi S

    2017-09-01

    The 80h work week has raised concerns that complications may increase due to multiple sign-outs or poor communication. Trauma Surgery manages complex trauma and acute care surgical patients with rapidly changing physiology, clinical demands and a large volume of data that must be communicated to render safe, effective patient care. Trauma Morning Report format may offer the ideal situation to study and teach sign-outs and resident communication. Surgery Residents were assessed on a 1-5 scale for their ability to communicate to their fellow residents. This consisted of 10 critical points of the presentation, treatment and workup from the previous night's trauma admissions. Scores were grouped into three areas. Each area was scored out of 15. Area 1 consisted of Initial patient presentation. Area 2 consisted of events in the trauma bay. Area 3 assessed clarity of language and ability to communicate to their fellow residents. The residents were assessed for inclusion of pertinent positive and negative findings, as well as overall clarity of communication. In phase 1, residents were unaware of the evaluation process. Phase 2 followed a series of resident education session about effective communication, sign-out techniques and delineation of evaluation criteria. Phase 3 was a resident-blinded phase which evaluated the sustainability of the improvements in resident communication. 50 patient presentations in phase 1, 200 in phase 2, and 50 presentations in phase 3 were evaluated. Comparisons were made between the Phase 1 and Phase 2 evaluations. Area 1 (initial events) improved from 6.18 to 12.4 out of 15 (pReport, with diverse attendance including surgical attendings and residents in various training years, is the ideal venue for real-time teaching and evaluation of sign-outs and reinforcing good communication skills in residents. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Peak bone mass density among residents of metro Manila: A preliminary report

    International Nuclear Information System (INIS)

    Lim-Abrahan, M.A.; Guanzon, L.V.; Guzman, A.M. de; Villaruel, C.M.; Santos, F.

    1998-01-01

    Study Objective: To determine the peak bone mass density among residents of Metro Manila using dual X-ray absorptiometry (DEXA). Design: Cross-sectional study. Setting: Philippine General Hospital, a university based tertiary care hospital, and St. Luke's Medical Center, a private tertiary care center. Subjects: Forty five (45) healthy subjects aged 15-50 years old, all current residents of Metro Manila, were randomly chosen from among hospital companions were included in the study. There were 23 females and 22 males, with 3 to 4 subjects for each age range of 5. Methods: Bone mass density measurements on the lumbar spine and the femur using dual X-ray absorptiometry (DPXL Lunar) were taken. The values were also age-matched and matched with that of a young adult based on programmed Caucasian norm provided by Lunar Co. The values were then scattered against age for each sex. Ten (10) cc of blood was also extracted from the patients, with the 5 cc of blood separated for future studies. Parathormone assay and biochemistry examinations were also done. Patents were also interviewed as to their lifestyle, diet, use of contraceptive pill or hormonal replacement treatment, using a Filipino version of the revised questionnaire on the WHO Study on Osteoporosis. Dietary content was estimated using a previous day food recall. Results: The mean weight and height for females were 59.48±16.34 kg and 153.52±5.09 cm respectively, and for males, 58.14±10.06 kg and 162.52±6.75 cm respectively. The mean bone mass density at the L 2 L 4 level for females was 1.12±0.11 g/cm 2 and 0.91±0.11 g/cm 2 at the femur. The highest BMD in both the lumbar spine femoral neck measurements among females was achieved among those aged 30-35 years of age with the lowest BMD occurring between 15-19 and 45-50 years of age in the lumbar spine among female subjects. The highest BMD at the lumbar spine and the femoral neck among males was achieved between the ages 30-35 years of age with the lowest IND

  7. Radon and remedial action in Spokane River Valley residences: an interim report

    International Nuclear Information System (INIS)

    Turk, B.H.; Prill, R.J.; Fisk, W.J.; Grimsrud, D.T.; Moed, B.A.; Sextro, R.G.

    1986-03-01

    Fifty-six percent of 46 residences monitored in the Spokane River Valley in eastern Washington/northern Idaho have indoor radon concentrations above the National Council for Radiation Protection (NCRP) guidelines of 8 pCi/1. Indoor levels were over 20 pCi/1 in eight homes, and ranged up to 132 pCi/1 in one house. Radon concentrations declined by factors of 4 to 38 during summer months. Measurements of soil emanation rates, domestic water supply concentrations, and building material flux rates indicate that diffusion of radon does not significantly contribute to the high concentrations observed. Rather, radon entry is dominated by pressure-driven bulk soil gas transport, aggravated by the local subsurface soil composition and structure. A variety of radon control strategies are being evaluated in 14 of these homes. Sub-surface ventilation by depressurization and overpressurization, basement overpressurization, and crawlspace ventilation are capable of successfully reducing radon levels below 5 pCi/1 in these homes. House ventilation is appropriate in buildings with low-moderate concentrations, while sealing of cracks has been relatively ineffective

  8. Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents

    Science.gov (United States)

    There is a lack of validation of self-reported cognitive problems with objective neuropsychological measures. The validity of four self-reported cognitive items from a health questionnaire (HQ) and the Symptoms Checklist 90-Revised (SCL-90-R) was examined with objective clinical ...

  9. A National Curriculum of Fundamental Skills for Plastic Surgery Residency: Report of the Inaugural ACAPS Boot Camp.

    Science.gov (United States)

    Davidson, Edward H; Barker, Jenny C; Egro, Francesco M; Krajewski, Alexandra; Janis, Jeffrey E; Nguyen, Vu T

    2017-02-01

    The Inaugural American Council of Academic Plastic Surgeons Plastic Surgery Boot Camp program was developed in response to ongoing changes in graduate medical education. The Boot Camp is a hands-on, practicum-based, 3-day course to introduce core concepts in plastic surgery for new plastic surgery residents (in both integrated and independent tracks). The course was held in Pittsburgh in July to August 2015. There were 43 attendees (35 integrated/8 independent) representing 22 residency programs across 15 states. Faculty was composed of 8 local personnel and 5 visiting. Lecture topics and practical sessions covered the full spectrum of plastic surgery. All trainees completed an online survey evaluation both during the course and at 6 months. Participant responses were overwhelmingly positive. A total of 72% of respondents rated the Boot Camp ≥ 8 on a 1 to 10 scale (10 is excellent) for the overall course rating; 79% of respondents agreed or strongly agreed with the statement that the simulation scenarios were realistic; and 75% of participants agreed or strongly agreed with the statement that they found simulation-based training to be a valuable way to teach this material. Respondents reported an increase in comfort and confidence across topics after attending the Boot Camp at both 0- and 6-month time points. Instructors received positive evaluations across all topics. This successful inaugural course serves as a benchmark for development of a logistical blueprint, business plan, and curriculum for a proposed expansion to regional centers, to potentially encompass all incoming residents in plastic surgery.

  10. What's the agreement between self-reported and biochemical verification of drug use? A look at permanent supportive housing residents.

    Science.gov (United States)

    Rendon, Alexis; Livingston, Melvin; Suzuki, Sumihiro; Hill, Whitney; Walters, Scott

    2017-07-01

    Self-reported substance use is commonly used as an outcome measure in treatment research. We evaluated the validity of self-reported drug use in a sample of 334 adults with mental health problems who were residing in supportive housing programs. The primary analysis was the calculation of the positive predictive values (PPVs) of self-report compared to an oral fluid test taken at the same time. A sensitivity analysis compared the positive predictive values of two self-reported drug use histories: biological testing window (ranging between the past 96h to 30days depending on drug type) or the full past 90-day comparison window (maximum length recorded during interview). A multivariable logistic regression was used to predict discordance between self-report and the drug test for users. Self-reported drug use and oral fluid drug tests were compared to determine the positive predictive value for amphetamines/methamphetamines/PCP (47.1% agreement), cocaine (43.8% agreement), and marijuana (69.7% agreement) drug tests. Participants who misreported their drug use were more likely to be older, non-White, have no medical insurance, and not report any alcohol use. In general, amphetamine/methamphetamine/PCP and cocaine use was adequately captured by the biological test, while marijuana use was best captured by a combination of self-report and biological data. Using the full past 90day comparison window resulted in higher concordance with the oral fluid drug test, indicating that self-reported drug use in the past 90days may be a proxy for drug use within the biological testing window. Self-report has some disadvantages when used as the sole measure of drug use in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Dietary Behaviors of Elderly People Residing in Central Iran: A Preliminary Report of Yazd Health Study (YAHS

    Directory of Open Access Journals (Sweden)

    Davood Bahrami

    2016-06-01

    Full Text Available Introduction: Food habits play important roles in maintaining physical and mental health and preventing chronic illnesses in the elderly. The aim of the present study was to investigate dietary behaviors of elderly people residing in Yazd city which is located in central Iran. Methods: The present analysis was conducted on 1684 participants entered to Yazd Health Study (YAHS aged over 60 years during 2014-2015. Demographic characteristics, health status, physical activity, economic status, education and dietary behaviors were collected by using a validated questionnaire. Results: Our analysis revealed that only 1.2% of the elderly consumed more than two servings of dairy per day. Furthermore only 3 and 9.8 percent of elders consumed more than three servings/day of vegetables and fruits, respectively. The study also showed that 22.9% ate more than five servings of sugar per day, 22.5% took more than four units of legumes weekly, 56.1% ate two to three servings of poultry per week, 77% reported eating fast foods for at least once a week, 47.8% consumed canned foods less than once a week of and 86.3% reported taking breakfast for at least five times a week. For cooking 18.9% of elderly still use hydrogenated vegetable oils, 52.8% of the elderly did not separate visible fats from red meat before cooking, 65.8% chose high-fat dairy and  24% of older people reported using frying and grilling as their primary cooking method. Our findings also suggest that dietary behavior is different between elder men and women. Conclusion: Unhealthy dietary habits, including low vegetables, fruits and dairy products intake, are highly prevalent among elderly people residing in Yazd. Community based interventions targeting this age group, in order to improve their dietary intake, are highly recommended.

  12. Perceived Neighborhood Social Disorder and Residents' Attitudes toward Reporting Child Physical Abuse

    Science.gov (United States)

    Gracia, Enrique; Herrero, Juan

    2006-01-01

    Objective: This study aimed to explore the relationship between perceived neighborhood social disorder and attitudes toward reporting child physical abuse. Method: Data from a national probabilistic sample (N = 9,759) were used. Responses about the perception of neighborhood social disorder, perceived frequency of child physical abuse in Spanish…

  13. Special analysis of community annoyance with aircraft noise reported by residents in the vicinity of JFK Airport, 1972

    Science.gov (United States)

    Borsky, P. N.

    1975-01-01

    During the summer of 1972, about 1500 residents were interviewed twice in 11 communities near JFK airport. Detailed aircraft operations reports were also collected for this period, and an effort has been made to analyze recorded human response data in relation to a number of physical exposure parameters. A series of exposure indexes, based on an arithmetic integration of aircraft operations, were correlated with summated aircraft noise annoyance responses. None of these correlations were as good as the CNR index which assumes a logrithmetic integration of numbers of aircraft exposures and includes a day-night differential weighting of 10:1. There were substantial variations in average annoyance responses among communities with similar CNR exposures, substantiating previous findings that attitudinal and other personal variables also play an important role in determining annoyance differences.

  14. Ten years after the IOM report: Engaging residents in quality and patient safety by creating a House Staff Quality Council.

    Science.gov (United States)

    Fleischut, Peter M; Evans, Adam S; Nugent, William C; Faggiani, Susan L; Lazar, Eliot J; Liebowitz, Richard S; Forese, Laura L; Kerr, Gregory E

    2011-01-01

    Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

  15. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

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

  16. Self-reported oral health status of adults resident in Medway, Kent in 2009.

    Science.gov (United States)

    Pau, Allan; Allen, Christopher D

    2011-10-01

    In order to assess the oral health status, oral behaviours and use of oral healthcare services of the adult population of Medway (Kent) in 2009, NHS Medway commissioned an assessment. Its aims were to understand oral health and impacts, behaviours and the use of dental services in order to inform future development of dental services. A self-reported postal questionnaire survey using relevant questions from the 1998 national Adult Dental Health Survey (ADHS) was performed. A stratified sample was drawn from all those aged 16 years and over, living in Medway and registered with a general medical practice. Stratification was into the three areas within Medway (Chatham, Gillingham and Rainham, and Rochester and Strood). Where appropriate, respondents answered the questions using a five-point Likert scale. The resulting data were analysed by area of domicile, age, gender, and deprivation. Eight thousand questionnaires were sent out, of which 3101 (39%) were returned. Because of this low response and the need to weight responses to represent the distribution of the Medway population, this investigation must be considered as a service evaluation rather than a research project. Of respondents, 4% were edentate, 16% had 1-20 teeth, and 80% had 21 or more teeth. Fifty-one per cent of respondents reported at least one oral health impact; most commonly this was physical pain and psychological discomfort; least commonly, social disability and handicap. Sixteen per cent reported that their last dental visit was over 24 months ago and 31% reported that they attended only when in trouble or never (most commonly, because of anxiety and cost). There were marked variations in oral health status and use of dental services between those living in the most and least deprived areas. • Medway adults were more likely than the 2009 national ADHS respondents to be dentate but less likely to have 21 or more teeth. •Oral health impacts have been substantial, especially the experience of

  17. Wind energy report : views of residents of PEI and visitors to PEI

    International Nuclear Information System (INIS)

    2010-08-01

    Tourist brochures describe Prince Edward Island (PEI) as an island with pastoral landscapes and sandy beaches. At the same time, PEI is encouraging and actively supporting the development of a major wind energy industry. PEI is also promoting itself as Canada's green province. This report discussed a wind energy survey that was implemented to capture perceptions of wind energy production and wind farms, and their perceived effects on the landscape. Specifically, the survey questioned whether wind farms fit with the gentle island brand for visitors, and whether they support the attempt to label PEI as a green province. The survey also compared perceptions of renewable and non-renewable energy generation methods and determined if there was support for further expansion of wind farms on PEI. The report discussed the objectives of the study as well as the methodology including data collection; statistical issues; and sample characteristics. General travel data for visitors was also presented, such as composition and size of travel party; type of visitation; and regions visited while on PEI. Topics and results that were addressed in the survey included propensity for taking scenic driving tours; percentage of electricity generated from coal, gas, oil, or diesel; desired method to generate electricity; willingness to pay for electricity from renewable energy sources; impressions of fossil based methods; impressions of wind power; percentage of electricity generated from wind turbines; perception of the phrase promoting PEI as Canada's green province; seeing a wind farm on PEI; and attitudes toward wind farms on PEI. In general, the report demonstrated support from both Islanders and visitors for the development of energy though renewable sources, particularly wind energy. tabs., figs.

  18. Self-reported heart disease among Arab and Chaldean American women residing in southeast Michigan.

    Science.gov (United States)

    Jamil, Hikmet; Fakhouri, Monty; Dallo, Florence; Templin, Thomas; Khoury, Radwan; Fakhouri, Haifa

    2008-01-01

    This study estimates the prevalence of heart disease among Arab and Chaldean American women and examines the association between Arab and Chaldean ethnicity and heart disease among a sample of women. This was a cross-sectional study of a convenience sample of 2084 Arab, Chaldean, and African American women aged > or = 18 years who completed a survey that was distributed at churches, mosques, and small businesses in southeast Michigans. Logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between ethnicity and self-reported heart disease before and after adjusting for demographic, socioeconomic status, health care, chronic conditions, and health behavior variables. A sample of 2084 Arab, Chaldean, and African American women 18 years of age and older. The overall prevalence of heart disease was 5.1%. Estimates were higher for Arabs (7.1%), lower for Chaldeans (6.6%), and lowest among African Americans (1.8%). In the unadjusted model, Chaldeans and Arabs were four times more likely to have heart disease than were African Americans. However, in the fully adjusted model, the association between Chaldean or Arab ethnicity and heart disease was no longer statistically significant. Arab or Chaldean ethnicity was not significantly associated with self-reported heart disease among women, which suggests that other factors account for this relationship. Future studies should collect more detailed socioeconomic status, acculturation, and health behavior information.

  19. A staff intervention targeting resident-to-resident elder mistreatment (R-REM) in long-term care increased staff knowledge, recognition and reporting: Results from a cluster randomized trial

    Science.gov (United States)

    Teresi, Jeanne A.; Ramirez, Mildred; Ellis, Julie; Silver, Stephanie; Boratgis, Gabriel; Kong, Jian; Eimicke, Joseph P.; Pillemer, Karl A.; Lachs, Mark S.

    2013-01-01

    Background Elder abuse in long term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue. Objectives The objective was to evaluate the impact of a newly developed R-REM training intervention for nursing staff on knowledge, recognition and reporting of R-REM. Design The design was a prospective cluster randomized trial with randomization at the unit level. Methods A sample of 1405 residents (685 in the control and 720 in the intervention group) from 47 New York City nursing home units (23 experimental and 24 control) in 5 nursing homes was assessed. Data were collected at three waves: baseline, 6 and 12 months. Staff on the experimental units received the training and implementation protocols, while those on the comparison units did not. Evaluation of outcomes was conducted on an intent-to-treat basis using mixed (random and fixed effects) models for continuous knowledge variables and Poisson regressions for longitudinal count data measuring recognition and reporting. Results There was a significant increase in knowledge post-training, controlling for pre-training levels for the intervention group (p<0.001), significantly increased recognition of R-REM (p<0.001), and longitudinal reporting in the intervention as contrasted with the control group (p=0.0058). Conclusions A longitudinal evaluation demonstrated that the training intervention was effective in enhancing knowledge, recognition and reporting of R-REM. It is recommended that this training program be implemented in long term care facilities. PMID:23159018

  20. Kalispel (i.e. Kalispell) resident fish project; annual report, 1997

    International Nuclear Information System (INIS)

    1997-01-01

    In 1997 the Kalispel Natural Resource Department (KNRD) in conjunction with the Washington Department of Fish and Wildlife (WDFW) continued the implementation of a habitat and population enhancement project for bull trout (Salvelinus confluentus), westslope cutthroat (Oncorhynchus clarki lewisi) and largemouth bass (Micropterus salmoides). Habitat enhancement measures, as outlined in the recommendations from the 1996 annual report, were conducted during field season 1997. Fencing and planting of riparian areas and instream structures were implemented. As a precursor to these enhancement efforts, pre-assessments were conducted to determine the affects of the enhancement. Habitat quality, stream morphology and fish populations were pre-assessed. This season also began the first year of post-assessment monitoring and evaluation of measures implemented during 1996. The largemouth bass hatchery construction was completed in October and the first bass were introduced to the facility that same month. The first round of production is scheduled for 1998

  1. Report on the results of the fourteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Yanagida, Jitsuro; Kambe, Masayuki; Hakoda, Masayuki

    2004-01-01

    The fourteenth medical examination of atomic-bomb (A-bomb) survivors resident in North America was carried out from June 18th through July 2nd and from July 24th through August 6th, 2003, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the fourteenth medical examination was 453, 65 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 71.6 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 45.4%. Previous history of malignant tumors was observed in 15.7% of the survivors examined, with major sites being the mammary gland, uterine, colon, and prostate. As a result of the blood test, 14.9% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 28.4% of the survivors examined. Latent hypothyroidism was found in 21.2% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  2. Report on the results of the thirteenth medical examination of atomic bomb survivors resident in north america

    International Nuclear Information System (INIS)

    Yamamoto, Yasuji; Ohta, Michiya; Urabe, Takeshi

    2002-01-01

    The thirteenth medical examination of A-bomb survivors resident in North America was carried out from June 13th through June 27th and from July 12th through July 26th, 2001, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the thirteenth medical examination was 399, 53 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 69.5 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 39.3%. Previous history of malignant tumors was observed in 13.6% of the survivors examined, with major sites being the mammary gland, uterine, and colon. As a result of the blood test, 9.5% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 32.1% of the survivors examined. Latent hypothyroidism was found in 18.5% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  3. Report on the results of the fifteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Kambe, Masayuki; Matsumura, Makoto; Suyama, Akihiko

    2006-01-01

    The fifteenth medical examination of A-bomb survivors resident in North America was carried out from May 11th through May 25th and from June 15th through June 29th, 2005, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the fifteenth medical examination was 435, 68 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 73.1 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 51.8%. Previous history of malignant tumors was observed in 19.6% of the survivors examined, with major sites being the mammary gland, uterus, colon, and prostate. As a result of the blood test, 12.8% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 26.2% of the survivors examined. Latent hypothyroidism was found in 16.9% of the survivors examined. Among the examinees of A-bomb survivors, statistically significant associations with exposure status were not found in any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  4. Report on the results of the thirteenth medical examination of atomic bomb survivors resident in north america

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji; Ohta, Michiya [Hiroshima Prefectural Medical Association (Japan); Urabe, Takeshi [Hiroshima Prefectural Hospital (Japan)] [and others

    2002-05-01

    The thirteenth medical examination of A-bomb survivors resident in North America was carried out from June 13th through June 27th and from July 12th through July 26th, 2001, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the thirteenth medical examination was 399, 53 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 69.5 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 39.3%. Previous history of malignant tumors was observed in 13.6% of the survivors examined, with major sites being the mammary gland, uterine, and colon. As a result of the blood test, 9.5% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 32.1% of the survivors examined. Latent hypothyroidism was found in 18.5% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  5. Income inequality and self-reported health in a representative sample of 27 017 residents of state capitals of Brazil.

    Science.gov (United States)

    Massa, K H C; Pabayo, R; Chiavegatto Filho, A D P

    2018-02-01

    The association between income inequality and health has been analyzed predominantly in developed countries with modest levels of inequality. The study aimed to analyze the association between income inequality and self-reported health (SRH) in the adult population of the 27 Brazilian capitals. Individuals aged 18 years or older from the National Health survey residing in Brazilian capitals in 2013 were analyzed (n = 27 017). Bayesian multilevel models were applied after controlling for individual factors and area-level socioeconomic characteristics. We found a significant association between income inequality and SRH, even after controlling for individual and contextual factors. The results indicate greater odds of poor SRH among those living in areas with medium (OR = 1.31, 95% CI: 1.17-1.47) and high income inequality level (OR = 1.39, 95% CI: 1.24-1.56). Income inequality remained significantly associated with SRH, even after controlling for other contextual socioeconomic characteristics, such as local illiteracy rate, violence and per capita income. The study highlights the importance of the individual and contextual characteristics associated with SRH. Our findings suggest that city-level income inequality can have a detrimental effect on individual health, over and above other contextual socioeconomic characteristics and individual factors. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Association between Continuous Wearable Activity Monitoring and Self-Reported Functioning in Assisted Living Facility and Nursing Home Residents.

    Science.gov (United States)

    Merilahti, J; Korhonen, I

    2016-01-01

    Physical functioning is a key factor in independent living, and its preclinical state assessment and monitoring during the subject's normal life would be beneficial. The aim of the study is to analyse associations between ambulatory measured physical activity behaviour and sleep patterns (wrist actigraphy) and self-reported difficulties in performing activities of daily living. Participants, setting and design: 36 residents in assisted living facilities and nursing homes (average age=80.4±9.0 years) without dementia in free living conditions participated. Actigraphic monitoring is integrated with the facilities' social alarm system. Indices on activity level, activity rhythm, sleep pattern and external stimuli response of sleep-wake behaviours were extracted from the actigraph data and correlated (Spearman rank-order correlation) with activities of daily living measures. Bonferroni correction for multiple comparisons was applied. Activity level (ρ=-0.49, pliving scores. The similarity of subject-wise activity pattern to facility common activities had a trend with activities of daily living (ρ=-0.44, passisted living facility settings. However, variance between individuals was large in this dataset which decreases the reliability of the results. Furthermore, external stimuli such as weather and facility-related activities can affect subjects' activity and sleep behaviour and should be considered in the related studies as well.

  7. The project to design and develop an energy-related program for public housing residents: Final report

    Energy Technology Data Exchange (ETDEWEB)

    1986-12-01

    This demonstration project studied how to minimize the costs associated with public housing tenants in standard public housing as well as under homeownership transfers. A related problem was how to graduate the tenants to another level of responsibility and self-sufficiency through resident business developments and training in energy-related fields. The goal that emanated was the design and development of an energy-related demonstration program that educates public housing residents, facilities indigenous business development where appropriate, and trains residents to provide needed services.

  8. Report on the results of the eighteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Usui, Shizuteru; Matsumura, Makoto; Yanagida, Jitsuro

    2012-01-01

    The eighteenth medical examination of A-bomb survivors resident in North America was carried out from June 15th through 29th and from July 13th through 27th, 2011, in the cities of Los Angeles, Honolulu, San Francisco, and Seattle. The total number of those who underwent the eighteenth medical examination was 378, 77 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 77.6 years. The examination items included an medical interview, clinical (including surgical and gynecological) examinations, physical measurement, electrocardiography (ECG), and hematology, blood biochemistry, urine, and fecal occult blood reaction tests, and cervical cancer screening. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of about 60%. Previous history of malignant tumors was observed in about 18% of the survivors examined, with major cancer sites being the prostate, mammary gland, colon, and uterus. As a result of the blood biochemistry test, about 38% and 67% of the survivors examined were diagnosed with diabetes mellitus and/or impaired glucose tolerance (IGT) and dyslipidemia, respectively. Analyses of the A-bomb survivors who underwent this examination showed no statistically significant associations between exposure status and any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination, receiving medical treatment, and clinical follow-up, if any, was mailed to each examinee. (author)

  9. Report on the results of the seventeenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Usui, Shizuteru; Matsumura, Makoto; Yanagida, Jitsuro

    2010-01-01

    The seventeenth medical examination of A-bomb survivors resident in North America was carried out from September 16th through 30th and from October 7th through 21st, 2009, in the cities of Los Angeles, Honolulu, San Francisco, and Seattle. The total number of those who underwent the seventeenth medical examination was 394, 71 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 76.3 years. The examination items included an interview, clinical (including surgical and gynecological) examinations and physical measurement, transcutaneous measurement of arterial oxygen saturation, electrocardiography (ECG), and hematology, blood biochemistry, urine, and fecal occult blood reaction test and cervical cancer screening. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 57.6%. Previous history of malignant tumors was observed in 23.2% of the survivors examined, with major cancer sites being the prostate, mammary gland, colon, and uterus. As a result of the blood biochemistry test, 24.8% of the survivors examined were diagnosed with impaired glucose tolerance (IGT). Abnormal total cholesterol levels and thyroid dysfunction were found in 51.9% and 23.0% of the survivors examined, respectively. Analyses of the A-bomb survivors who underwent this examination showed no statistically significant associations between distance from the hypocenter and any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination, receiving medical treatment, and clinical follow-up, if any, was mailed to each examinee. (author)

  10. Disability and physical and communication-related barriers to health care related services among Florida residents: A brief report.

    Science.gov (United States)

    Bauer, Sarah E; Schumacher, Jessica R; Hall, Allyson; Marlow, Nicole M; Friedel, Claudia; Scheer, Danielle; Redmon, Susan

    2016-07-01

    Research has not fully characterized barriers to health care faced by persons with disabilities (PWD) which constitutes a critical gap given the increased risk of chronic illness faced by PWD. To understand the current barriers to seeking health care-related services for PWD in Florida. The study was based on a random-digit-dial telephone interview survey of respondents aged 18 and over (n = 1429). Multivariable logistic regression assessed the relationship between disability and physical and communication barriers. One thousand four hundred and twenty-nine Florida residents participated in the survey. Thirty-three percent of respondents (n = 471) reported having a disability. PWD were significantly older (mean age 68 vs. 61) and had lower levels of income and education than persons without disabilities (PWOD) (p barrier (Odds Ratio [OR] = 16.6 95% CI: 7.9, 34.9), a clinical experience barrier (OR = 13.9 95% CI: 6.9, 27.9) a communication and knowledge barrier (OR = 6.7 95% CI: 4.0, 11.3) and a barrier coordinating care (OR = 5.7 95% CI: 3.4, 9.6) compared to persons without disabilities (PWOD). PWD disproportionately face health care access difficulties that can impede the receipt of high quality care within and between provider visits. Efforts to reduce physical barriers and improve communication between providers and PWD may improve functional status and quality of life for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Substandard antimalarials available in Afghanistan: a case for assessing the quality of drugs in resource poor settings.

    Science.gov (United States)

    Lalani, Mirza; Kaur, Harparkash; Mohammed, Nader; Mailk, Naiela; Wyk, Albert van; Jan, Sakhi; Kakar, Rishtya Meena; Mojadidi, Mohammed Khalid; Leslie, Toby

    2015-06-01

    Good-quality antimalarials are crucial for the effective treatment and control of malaria. A total of 7,740 individual and packaged tablets, ampoules, and syrups were obtained from 60 randomly selected public (N = 35) and private outlets (N = 25) in Afghanistan. Of these, 134 samples were screened using the Global Pharma Health Fund (GPHF) MiniLab® in Kabul with 33/126 (26%) samples failing the MiniLab® disintegration test. The quality of a subsample (N = 37) of cholorquine, quinine, and sulfadoxine/pyrimethamine tablets was assessed by in vitro dissolution testing following U.S. Pharmacopeia (USP) monographs at a bioanalytical laboratory in London, United Kingdom. Overall, 12/32 (32%) samples of sulfadoxine/pyrimethamine and quinine were found not to comply with the USP tolerance limits. Substandard antimalarials were available in Afghanistan demonstrating that continuous monitoring of drug quality is warranted. However, in Afghanistan as in many low-income countries, capacity to determine and monitor drug quality using methods such as dissolution testing needs to be established to empower national authorities to take appropriate action in setting up legislation and regulation. © The American Society of Tropical Medicine and Hygiene.

  12. Accreditation council for graduate medical education (ACGME annual anesthesiology residency and fellowship program review: a "report card" model for continuous improvement

    Directory of Open Access Journals (Sweden)

    Long Timothy R

    2010-02-01

    Full Text Available Abstract Background The Accreditation Council for Graduate Medical Education (ACGME requires an annual evaluation of all ACGME-accredited residency and fellowship programs to assess program quality. The results of this evaluation must be used to improve the program. This manuscript describes a metric to be used in conducting ACGME-mandated annual program review of ACGME-accredited anesthesiology residencies and fellowships. Methods A variety of metrics to assess anesthesiology residency and fellowship programs are identified by the authors through literature review and considered for use in constructing a program "report card." Results Metrics used to assess program quality include success in achieving American Board of Anesthesiology (ABA certification, performance on the annual ABA/American Society of Anesthesiology In-Training Examination, performance on mock oral ABA certification examinations, trainee scholarly activities (publications and presentations, accreditation site visit and internal review results, ACGME and alumni survey results, National Resident Matching Program (NRMP results, exit interview feedback, diversity data and extensive program/rotation/faculty/curriculum evaluations by trainees and faculty. The results are used to construct a "report card" that provides a high-level review of program performance and can be used in a continuous quality improvement process. Conclusions An annual program review is required to assess all ACGME-accredited residency and fellowship programs to monitor and improve program quality. We describe an annual review process based on metrics that can be used to focus attention on areas for improvement and track program performance year-to-year. A "report card" format is described as a high-level tool to track educational outcomes.

  13. Preliminary Report of a Pilot Tele-Health Palliative Care and Bioethics Program for Residents in Skilled Nursing Facilities

    Directory of Open Access Journals (Sweden)

    Sean O’Mahony

    2009-12-01

    Full Text Available Currently about 25% of Americans die in nursing homes, many with poorly controlled pain and other symptoms, with minimal provisions for psychosocial support. New models are necessary to lessen structural and process barriers to give effective end-of-life care in nursing homes. Objectives: 1 To extend hospital-based Bioethics Consultation Services (BCS and Palliative Care Services (PCS at Montefiore Medical Center (MMC in the Bronx to two local Skilled Nursing Facilities (SNFs, Morningside House Aging in America (MSH using direct face-to-face consultations and Beth Abraham Health Systems (BAHS via video consultations (VC; 2 Achieve improvements in quality of life and comfort for elderly residents and their families; 2a Improve the level of practice and increase staff satisfaction with palliative care content-related knowledge and bioethical analysis. Methods: We report preliminary findings of this two group quasi experimental project with results of pre- and post- tests rating content-related knowledge in aspects of end-of-life care for staff. Select pre-test and post-test questions were given to physicians and other staff, but were re-configured for, registered and licensed practice nurses, social workers, and certified nursing assistants from the End-of-Life Physician Education Resource Center (EPERC. Patient, family, and staff ratings of the quality of palliative care were measured with a Palliative Outcomes Scale (POS one week prior to and post consultation. Results: 72 staff attended in-services; 53 completed pre-tests and 49 post-tests. Overall knowledge scores increased for 9 of the 16 items that were analyzed. There were improvements in knowledge scores in 12 of 16 items tested for staff content related knowledge which were statistically significant in regard to management of cancer pain from 63.8% to 81.5% (p = 0.03 and a trend to significance for assessment and management of delirium from 31.6% to 61.9% (p = 0.073. Seventy five POS

  14. Project to design and develop an energy-related program: For public housing residents and renters: Volume 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This demonstration project was undertaken as a result of an unsolicited proposal submitted by THE ASSIGNMENT GROUP (TAG) to the Office of Minority Economic Impact, Department of Energy (DOE). The problem to which the proposal responded was how to minimize the costs associated with public housing tenants in standard public housing as well as under homeownership transfers. A related problem was how to graduate the tenants to another level of responsibility and self-sufficiency through resident business developments and training in energy-related fields. The size and gravity of the problem necessitated a purpose or aim that had nationwide application, yet lent itself to a microscopic look. Consequently, the goal that emanated was the design and development of an energy-related demonstration program that educates public housing residents, facilitates indigenous business development where appropriate, and trains residents to provide needed services.

  15. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

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

  16. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

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

  17. Report on the results of the eleventh medical examination of atomic bomb survivors resident in North America

    Energy Technology Data Exchange (ETDEWEB)

    Yamakido, Michio [Hiroshima Univ. (Japan). School of Medicine; Dohy, Hiroo; Neriishi, Kazuo [and others

    1998-01-01

    The 11th medical examination of A-bomb survivors was conducted in 1997. Two medical teams conducted health examinations in Los Angeles and Seattle, and in San Francisco and Hawaii, respectively. The total number of A-bomb survivors resident in North America as of the end of July 1997 was 1,060, an increase of 17 over that confirmed in 1995. The number of survivors exposed <2,000-m from the hypocenter was 234, accounting for 22.1% of the total. The confirmed number of in-utero exposed survivors was 26. As to the past medical history information, breast cancer, thyroid cancer, and heart disease were frequently observed in the <2,000-m group. Frequent subjective symptoms include complete exhaustion or fatigue, loss of vigor, blurring of vision, itching of the skin, which were reported in more than 40% of the survivors. The frequencies of nocturia, nervousness, severe headache, and excessive sweating in cold weather were higher in the <2,000-m group. Chest pain was seen frequently in the <2,000-m group for males, but no difference was observed in females. Nocturia was observed in more than half of the males in the <2,000-m group. There were 99 cases (22.8%) with fasting plasma glucose level of 110 mg/dl or above, consisting of 39 males (32.0%) and 60 females (19.2%). Abnormal HbA1c levels were observed in 33 cases (7.6%), including 12 males (9.8%) and 11 females (6.7%). The proportion of cases with abnormal HbA1c levels was higher in males. No difference by exposure status was observed either for fasting plasma glucose or HbA1c. The disease of the highest prevalence was hyperlipidemia (57.4%), followed by hypertension (35.0%), obesity (27.2%), liver disease (21.9%), thyroid disease (20.0%), gastrointestinal disease (20.7%), heart disease (13.4%) and urological disease (12.9%). Malignant tumors were observed in two cases in L.A., two in Seattle, and one in S.F. Cancer will be important issue in the future examinations. (K.H.)

  18. [Report from Minamisoma City: diversity and complexity of psychological distress in local residents after a nuclear power plant accident].

    Science.gov (United States)

    Hori, Arinobu; Tsumuraya, Kunihiro; Kanamori, Ryo; Maeda, Masaharu; Yabe, Hirooki; Niwa, Shinichi

    2014-01-01

    Natural disasters can severely impact local communities. When a disaster is limited in type or scope, the loss and distress felt by individual residents can be sympathetically visualized and shared, and this can help bring the community together. In 2011, however, Japan experienced the Great East Japan Earthquake and accompanying tsunami, and the scale of this disaster was compounded by the Fukushima nuclear power plant accident. As a result of this complex disaster, residents experienced very different problems, particularly in Fukushima Prefecture. In this paper, we describe the situation in Minamisoma City, which is located to the north of the Fukushima Daiichi nuclear power plant. After the accident, the city was divided into three zones. The southern part of the city, which is within 20 km of the plant, was designated as a restricted area; the middle section, located between 20 and 30 km of the plant, was initially designated as an evacuation readiness area; and the northern part of the city received no evacuation-related designation. In April 2012, ordinary residents were finally allowed to visit the restricted area, but utilities and municipal services in the area had not yet been restored, and residents were still prohibited from staying overnight even in August 2013. The overall situation was further complicated by the existence of conflicting opinions regarding exposure to low dose ionizing radiation and compensation for subsequent distress. Things became so complex that residents of the same city sometimes struggled to imagine their neighbors' feelings and state of mind. After the disaster, aging of the city accelerated dramatically. The proportion of elders (those aged 65 or older) in the population stood at 25.9% in March 2011, but this had increased to 32.9% by March 2013. Elders tend to have strong emotional ties to their hometowns, while younger generations are more likely to move away and start over. As some young people have left the area or

  19. Report on the results of the tenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Shibata, Jun; Ohta, Nobuhiro; Sasaki, Hideo

    1996-01-01

    The 10th medical examination of A-bomb survivors resident in North America was conducted from 6 June to 6 July 1995 in L.A., S.F., Seattle, Wailuku, and Honolulu. Since this is the 10th medical examination, results of the previous examination are summarized. With the exclusion of 55 whose death has been confirmed, the total registered number of A-bomb survivors resident in North America is 1,043. The examinees in the present examination amounted to 463 (48 of them are the children of A-bomb survivors), 26 of whom are newly registered survivors. The mean age of the examinees in 64 years. The proportion of those having US nationality gradually increased and reached 62% at the time of the 10th examination, while that of those who have Japanese nationality and permanent US residency rights decreased to 30%. When the examination program was initiated, A-bomb survivors resident in 15 states of the US, but now, in Canada and 31 states of the US. About 90% of these survivors reside along the west coast of the US including Hawaii. The number of holders of A-bomb survivor's health handbook has increased year after year, reaching 612. When the holders in North-America visit Japan for medical treatment, they are treated similarly with their counterparts in Japan. The major subjective symptoms are complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness or tingling. The prevalence of obesity, hypertension, and diabetes mellitus and the proportion of abnormal ECG findings has been increasing with the age. The prevalence of hypercholesterolemia was high and that of low HDL cholesterolemia was low. A significant difference was observed between the A-bomb survivors in Hiroshima and North America. Hypertension, hyperlipidemia, obesity, ischemic heart disease, and diabetes mellitus were observed mainly. Diseased of specific places were not observed. (H.O.)

  20. Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success.

    Science.gov (United States)

    Rogers, Laura Q; Gutin, Bernard; Humphries, Matthew C; Lemmon, Christian R; Waller, Jennifer L; Baranowski, Tom; Saunders, Ruth

    2006-01-01

    Patients perceive physicians who practice healthy personal behaviors as more credible and better able to motivate patients to make healthy lifestyle choices. To evaluate internal medicine resident physicians as role models for promoting exercise by an assessment of physician physical activity behavior, cardiovascular fitness, physical activity knowledge, personal use of behavior modification techniques, attitudes toward personal physical activity practice, and confidence (i.e., self-efficacy) in the knowledge and personal utilization of behavior modification techniques and to explore the associations with self-reported patient counseling behavior, confidence, and perceived success. Cross-sectional study of internal medicine resident physicians with a self-administered survey, treadmill fitness testing, and a 7-day physical activity recall. Fifty-one resident physicians agreed to participate (response rate = 81%). Fitness levels were below average for 60%, average for 25%, and above average or excellent for 15%. The mean energy expenditure was 234 kcal/kg/week, with 41% of physicians meeting recommended physical activity guidelines. Few reported high self-efficacy (33%) or perceived success (25%) in the ability to be regularly active. Few demonstrated adequate knowledge useful for patient counseling (e.g., listing 3 ways to integrate physical activity into daily life [27%], calculating target heart rate [29%], and identifying personal exercise stages of change [25%]). Personal use of behavior modification techniques was reported infrequently. Although 88% reported confidence in the knowledge of exercise benefits, less than half reported confidence in the knowledge of local facilities, American College of Sports Medicine (ACSM) guidelines, and behavior modification techniques. Multiple linear regression demonstrated that a higher level of training (p = .02) and a greater confidence in the knowledge of ACSM guidelines (p = .048, total R2 = .21) independently predicted

  1. Genetic and phenotypic catalog of native resident trout of the Interior Columbia River Basin, fiscal year 1998 report: Populations of the Upper Yakima Basin, 1999 Annual Report

    International Nuclear Information System (INIS)

    Trotter, Patrick C.; McMillan, Bill; Gayeski, Nick; Spruell, Paul; Berkley, Regan

    1999-01-01

    The objective of this project is to photo-document upper Columbia Basin native resident trout populations in Washington, and to ascertain their species or subspecies identity and relative genetic purity using a nonlethal DNA technique

  2. Clinical use of Nintendo Wii bowling simulation to decrease fall risk in an elderly resident of a nursing home: a case report.

    Science.gov (United States)

    Clark, Robert; Kraemer, Theresa

    2009-01-01

    Of the estimated 1.7 million residents of nursing homes in the United States, approximately half fall annually; and 11% of these sustain injury. This is twice the rate for persons dwelling in the community. By addressing fall risk, physical therapists have an opportunity to reduce falls which are the leading cause of injury deaths, as well as the most common cause of nonfatal injuries for older adults in the United States. This case report examines the effect of a novel interactive video game intervention to address balance dysfunction in an elderly resident of a nursing home who was at risk for falls. The patient is an 89-year-old resident diagnosed with an unspecified balance disorder and a history of multiple falls. Self reports of gait abnormalities, scores on several clinical measures, and her fall history classified her as having substantial risk for future falls. A nontraditional approach to balance training, employing the Nintendo Wii bowling simulation, was used as intervention for this patient's balance disorder. After 6 one-hour treatment sessions, the patient's Berg Balance Score improved from 48 to 53. On the Dynamic Gait Index, the patient improved her score from 19 to 21. The patient's Timed Up and Go Test improved from 14.9 to 10.5 seconds, all suggesting a reduced risk of falling. The patient's ABC Score improved from 88 to 90%. Physical therapy intervention, using the Nintendo Wii bowling simulation, may have decreased fall risk for this individual.

  3. Report on the results of the seventh medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Ito, Chikako; Kodama, Kazunori; Sasaki, Hideo; Ishibashi, Shinzo; Dote, Keigo; Watanabe, Tadaaki; Hirata, Katsumi; Sugimoto, Sumio.

    1990-01-01

    During a one-month period from June 13 through July 13, 1989, the seventh medical examination was conducted at five cities, including San Francisco, Los Angeles, Seattle, Wailuku and Honolulu, for A-bomb survivors residents in North America. Nine hundred and eighteen A-bomb survivors, including 21 living in Canada, were confirmed, consisting of 234 men and 684 women as of the end of July 1989. The number was increased by 167, compared with that as of the end of July 1987. During the past three years, there were 40 deaths; and 878 A-bomb survivors (223 men and 655 women) are still alive. Ninety percent of the survivors came from Hiroshima. U.S. nationality was seen in 61% and Japanese nationality with permanent U.S. residency rights was seen in 32%. The majority (39%) of the A-bomb survivors were in their fifties, with an average age of 59.4 years. The survivors were residing in 26 states in the USA and in 3 provinces in Canada. The acquisition rate of the A-bomb survivors' health handbook was 52%. Four hundred and six A-bomb survivors participated in the medical examination, including one male and 8 female children born to A-bomb survivors. Questionnaire survey revealed a history of surgical resection for cancer in 21 survivors. Subjective symptoms included complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness of the body. Overall evaluation revealed the necessity of medical treatment or observation in 71%. This was independent of exposure status. Hypertension was the most common (27%), followed by obesity, hyperlipidemia, heart disease, and diabetes mellitus. Malignant tumors were seen in 9 survivors, consisting of 3 with breast cancer, 2 with colorectal cancer, and single survivors with lung cancer, Hodgkin's disease, cervical cancer, or hepatoma. Only 29% of them have had finantial guarantee for their health management according to the Japanese law. (N.K.)

  4. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey.

    Science.gov (United States)

    Cooper, Claudia; Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill

    2018-01-01

    There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening "at least sometimes" in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052-1.349). Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.

  5. Radiation oncology training in the United States: report from the Radiation Oncology Resident Training Working Group organized by the Society of Chairman of Academic Radiation Oncology Programs (SCAROP)

    International Nuclear Information System (INIS)

    1999-01-01

    Purpose: In response to the major changes occurring in healthcare, medical education, and cancer research, SCAROP addressed issues related to post-graduate education that could enhance existing programs and complement the present system. Methods and Materials: SCAROP brought together a Working Group with a broad range of representatives organized in subcommittees to address: training, curriculum, and model building. Results: The Working Group emphasized the importance of training physicians with the necessary clinical, scientific, and analytical skills, and the need to provide expert radiation oncology services to patients throughout the United States. Opportunities currently exist for graduates in academic medicine, although there may be limited time and financial resources available to support academic pursuits. Conclusions: In the face of diminishing resources for training and education and the increased scope of knowledge required, a number of models for resident training are considered that can provide flexibility to complement the present system. This report is intended to initiate dialogue among the organizations responsible for radiation oncology resident education so that resident training can continually evolve to meet the needs of cancer patients and take advantage of opportunities for progress through innovative cancer care and research

  6. Idaho Water Rental Pilot Project probability/coordination study resident fish and wildlife impacts. Phase 3. Annual report 1996

    International Nuclear Information System (INIS)

    Leitzinger, E.

    1997-12-01

    Phase 3 began in 1995 with the overall goal of quantifying changes in resident fish habitat in the Snake River Basin upstream of Brownlee Reservoir resulting from the release of salmon flow augmentation water. Existing data, in the form of weighted usable area versus flow relationships, were used to estimate habitat changes for white sturgeon (Acipenser transinontanus) and rainbow trout (Oncorhynchus mykiss) in the Snake River between C.J. Strike Dam and Brownlee pool. The increased flows resulted in increased habitat for adult and juvenile white sturgeon and adult rainbow trout. But, the flows have failed to meet mean monthly flow recommendations for the past three years despite the addition of the flow augmentation releases. It is unlikely that the flow augmentation releases have had any significant long-term benefit for sturgeon and rainbow trout in the Snake River. Flow augmentation releases from the Boise and Payette rivers have in some years helped to meet or exceed minimum flow recommendations in these tributaries. The minimum flows would not have been reached without the flow augmentation releases. But, in some instances, the timing of the releases need to be adjusted in order to maximize benefits to resident fishes in the Boise and Payette rivers

  7. Education Research: Neurology resident education

    Science.gov (United States)

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

    2016-01-01

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

  8. Comparison of Self-Reported Data on Student Doctor Network to Objective Data of the National Resident Matching Program.

    Science.gov (United States)

    Sura, Karna; Wilson, Lynn D; Grills, Inga S

    2017-12-01

    To compare matching outcomes between self-reporting on Student Doctor Network (SDN) and objective data from the National Resident Matching Program (NRMP). Data were collected from SDN starting in the 2010 to 2011 academic year and extending to the 2015 to 2016 academic year. A total of 193 radiation oncology applicants had reported data during the period. A total of four applicants (2.1%) did not match and were excluded from the analysis. Applicants were compared with the NRMP charting outcomes of 2011, 2014, and 2016. US allopathic seniors comprised a majority of those reporting on SDN (95.2%). The majority of applicants (58.2%) self-reported in the later years between 2014 and 2016. Those reporting on SDN were more likely to be members of Alpha Omega Alpha (39.7% on SDN versus 27.5% in 2016 NRMP, 23.6% in 2014 NRMP, and 31.2% in 2011 NRMP) and had higher mean United States Medical Licensing Examination (USMLE) step 1 and step 2 scores. Of the applicants, 81% matched within their top three ranked residencies on their match list. Common themes associated with reasons for their successful match included research experience, letters of recommendation, and away rotations. Common themes associated with advice given to future applicants were the importance of research, personality, and away rotations. Self-reporting on SDN does have a bias toward more successful radiation oncology applicants compared with the objective NRMP data. However, if self-reporting increases, SDN may serve as a reasonably accurate source of information for future applicants. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. [Report on health status of residents in areas with industrial, mining or military sites in Sardinia, Italy].

    Science.gov (United States)

    Biggeri, Annibale; Lagazio, Corrado; Catelan, Dolores; Pirastu, Roberta; Casson, Felice; Terracini, Benedetto

    2006-01-01

    The work described in the present report has been requested by the Secretary of Hygiene, Health and Social Welfare of the Sardinia Region (Italy). It has been carried out by the Regional Epidemiological Observatory within the domain of ESA (Epidemiology Development and Environment) and with the support of the European Union. Eighteen areas (for a total of 73 municipalities) were identified a priori as "potentially polluted", accounting for a population of 917,977 in 2001 census (56% of the total population of Sardinia). The areas have been named after the most important town, as listed below (in brackets rounded 2001 population), major activities in industrial areas are briefly described. Portoscuso (59,000). Processing of aluminium and other metals. Foundry. Power plants. Dismissed mines (mainly coal mining, lead, zinc). Plants for storing and treating special wastes. Italian Law 349/1986 classified this area as "at high risk of environmental crisis" and classified some plants as being "at high technological risk" (Norma Seveso Decree 334/1999). The area is part of the Sulcis National Restoration site. San Gavino (24,000). Industrial and commercial activities. Lead and zinc foundry. Dairy factories. Food industry. Sarroch (52,000). Petrochemical and refinery industry. Power plants. Mining. Incinerator. Plants for storing and treating special wastes. Gas and mineral oil deposits. Ottana (15,000). Chemical industry. Production of plastics and synthetic fibres. Denim production. Porto Torres (168,000). Chemical industry: production of basic chemicals (benzene, toluene, ethylene, propylene and others), polyethylene, elastomers and vinyl chloride. Textile industry. First and second category landfills. Some plants have been classified "at high technological risk" (Norma Seveso Decree 334/1999). The area is a National Restoration site. The town of Sassari is included. Tortolì (23,000). Construction of steel structures for offshore facilities of the oil and gas industry

  11. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey

    Science.gov (United States)

    Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill

    2018-01-01

    Background There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. Methods 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Outcomes Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident’s interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening “at least sometimes” in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052–1.349). Interpretation Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies. PMID:29561867

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Evaluation of FRP Confinement Models for Substandard Rectangular RC Columns Based on Full-Scale Reversed Cyclic Lateral Loading Tests in Strong and Weak Directions

    Directory of Open Access Journals (Sweden)

    Hamid Farrokh Ghatte

    2016-09-01

    Full Text Available Although many theoretical and experimental studies are available on external confinement of columns using fiber-reinforced polymer (FRP jackets, as well as numerous models proposed for the axial stress-axial strain relation of concrete confined with FRP jackets, they have not been validated with a sufficient amount and variety of experimental data obtained through full-scale tests of reinforced concrete (RC columns with different geometrical and mechanical characteristics. Particularly, no systematical experimental data have been presented on full-scale rectangular substandard RC columns subjected to reversed cyclic lateral loads along either their strong or weak axes. In this study, firstly, test results of five full-scale rectangular substandard RC columns with a cross-sectional aspect ratio of two (300 mm × 600 mm are briefly summarized. The columns were tested under constant axial load and reversed cyclic lateral loads along their strong or weak axes before and after retrofitting with external FRP jackets. In the second stage, inelastic lateral force-displacement relationships of the columns are obtained analytically, making use of the plastic hinge assumption and different FRP confinement models available in the literature. Finally, the analytical findings are compared with the test results for both strong and weak directions of the columns. Comparisons showed that use of different models for the stress-strain relationship of FRP-confined concrete can yield significantly non-conservative or too conservative retrofit designs, particularly in terms of deformation capacity.

  15. Report on the results of the twelfth medical examination of atomic bomb survivors residing in North America

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji [Hiroshima Prefectural Medical Association (Japan); Ohama, Koso; Fujiwara, Saeko (and others)

    2000-06-01

    The twelfth medical examination of atomic bomb survivors residing in North America, was conducted in San Francisco and Seattle from May 20 through June 2 1999, and in Los Angeles and Hawaii from June 9 through 23 1999, The examination included an interview, measurement of height, weight, and blood pressure, an ECG, urine and stool tests, blood tests, a physical examination, examination of the breast, thyroid, and rectum by a surgeon, and screening for uterine cancer and a gynecological interview and examination by an obstetrician and gynecologist. The total confirmed number of A-bomb survivors residing in North America as of the end of June 1999 was 1076. Of the 1062 survivors that remained after excluding the 14 subjects whose survey was incomplete, 279 males and 654 females had been exposed in Hiroshima, and 10 males and 119 females in Nagasaki. The peak age at the time of exposure in both sexes was 15-19 years, followed by 10-14 years. The number of survivors exposed <2000 m from the hypocenter was 236, accounting for 21.9% of the total. The confirmed number of survivors exposed in utero was 26. The survivors' age (mean {+-}S.D.) was: 69.0{+-}8.69 years; males, 68.4{+-}80.5 years; females, 69.2{+-}8.91 years. A total of 414 survivors were examined (male 129; female 285; mean age 68.0 years). Approximately 80% of the examinees had experienced at least one general symptom. Many still complain of symptoms that suggest possible posttraumatic stress disorder as a result of exposure to the A-bomb. It will be necessary to consider providing mental health care by psychiatrists beginning with the next examination. The prevalence of life-style diseases has been gradually increased with age. A previous history of cancer was found in 9.2% of the examinees. The most prevalent was of breast cancer, followed by malignant tumors of the colon, rectum, uterus, brain, stomach, and thyroid. The need for cancer screening and promotion of life-style education was keenly felt. (K.H.)

  16. Report on the results of the twelfth medical examination of atomic bomb survivors residing in North America

    International Nuclear Information System (INIS)

    Yamamoto, Yasuji; Ohama, Koso; Fujiwara, Saeko

    2000-01-01

    The twelfth medical examination of atomic bomb survivors residing in North America, was conducted in San Francisco and Seattle from May 20 through June 2 1999, and in Los Angeles and Hawaii from June 9 through 23 1999, The examination included an interview, measurement of height, weight, and blood pressure, an ECG, urine and stool tests, blood tests, a physical examination, examination of the breast, thyroid, and rectum by a surgeon, and screening for uterine cancer and a gynecological interview and examination by an obstetrician and gynecologist. The total confirmed number of A-bomb survivors residing in North America as of the end of June 1999 was 1076. Of the 1062 survivors that remained after excluding the 14 subjects whose survey was incomplete, 279 males and 654 females had been exposed in Hiroshima, and 10 males and 119 females in Nagasaki. The peak age at the time of exposure in both sexes was 15-19 years, followed by 10-14 years. The number of survivors exposed <2000 m from the hypocenter was 236, accounting for 21.9% of the total. The confirmed number of survivors exposed in utero was 26. The survivors' age (mean ±S.D.) was: 69.0±8.69 years; males, 68.4±80.5 years; females, 69.2±8.91 years. A total of 414 survivors were examined (male 129; female 285; mean age 68.0 years). Approximately 80% of the examinees had experienced at least one general symptom. Many still complain of symptoms that suggest possible posttraumatic stress disorder as a result of exposure to the A-bomb. It will be necessary to consider providing mental health care by psychiatrists beginning with the next examination. The prevalence of life-style diseases has been gradually increased with age. A previous history of cancer was found in 9.2% of the examinees. The most prevalent was of breast cancer, followed by malignant tumors of the colon, rectum, uterus, brain, stomach, and thyroid. The need for cancer screening and promotion of life-style education was keenly felt. (K.H.)

  17. Comparison of knowledge, attitude and practices of resident doctors and nurses on adverse drug reaction monitoring and reporting in a tertiary care hospital.

    Science.gov (United States)

    Rehan, H S; Sah, Ravinder Kumar; Chopra, Deepti

    2012-01-01

    Lack of knowledge of pharmacovigilance (PhV) and adverse event (AE) reporting culture among the healthcare providers have been identified as major factors for under reporting of AE in developing countries. Hence, this study was planned to assess and compare the knowledge, attitude, and practices (KAP) of resident doctors and nurses about PhV and AE reporting. This cross-sectional, questionnaire-based study was conducted to compare KAP of 100 doctors and 100 nurses on PhV and AE reporting. All the respondents felt that AE reporting is necessary and two-thirds were aware of the existing PhV Program of India. Significantly, higher proportion of doctors had correct understanding regarding PhV (Pdoctors (98%) felt that the patients are benefited by reporting AE. Nurses (96%) felt the need for information on drugs causing AE and their management strategy (PDoctors (67%) (Pdoctors and nurses had good knowledge and awareness on AE reporting and PhV but their practices need to be improved.

  18. Report on results of fourth medical examination of atomic bomb survivors residing in the U.S

    International Nuclear Information System (INIS)

    Monzen, Tetsuo; Ito, Chikako; Tanaka, Yoshikiyo; Kodama, Kazunori; Inamizu, Tsutomu.

    1984-01-01

    Review was made of the fourth medical examination and the actual state of health of the U.S. atomic-bomb (A-bomb) survivors. The number of survivors registered with the Committee of A-bomb Survivors residing in the U.S. as of the end of June 1983 in 592 (males 154, females 438), of whom 58.8% possess U.S. citizenship. Survivor's health handbooks issued to survivors under the Japanese A-bomb Survivors Medical Treatment Law are possessed by 29.2%, with female holders being about twice as numerous as males. Responses to the health survey questionnaire were received from 306. Complaints of subjective symptoms tended to be higher in the early entrants, and by place of examination, those of Honolulu had the higher rate. Those who underwent health examination numbered 305 (73 males and 232 females). RBC and hemoglobin value were higher in the U.S. survivors than in Hiroshima survivors. No abnormality was observed in 47.5%. The main abnormalities noted were obesity, hypertension, hyperlipidemia, ischemic heart disease, diabetes mellitus, hypothyroidism, and liver disease. Comparison of those who had received examination on two consecutive occasions in 1981 and 1983 and those who were examined for the first time in 1983 showed a decrease in the frequency of obesity and hypertension. (J.P.N.)

  19. Knowledge, attitudes, and practices of pharmacovigilance and ADRs spontaneous reporting among pediatricians and pediatric residents in Jordan.

    Science.gov (United States)

    Mukattash, Tareq Lewis; Alwadi, Maysa Wadah; Abu-Farha, Rana K; Jarab, Anan; Alzubiedi, Sameh A; Alwedyan, Tareq

    2018-03-08

    Parmacovigilance (PV) is the science that responsible for ADRs reporting and accordingly medication safety. Pediatrics age group is a special concern as they have a higher risk for developing ADRs; this put more burdens on pediatricians for early detection and reporting of ADRs. The present study aims to explore pediatricians' knowledge, attitude, and practices of pharmacovigilance. A structured validated questionnaire was designed to achieve the study goals. A convenient sample of 142 pediatricians took part in the study Results: The majority of pediatricians had a poor knowledge score about pharmacovigilince and ADRs reporting. On the other hand, 71% of respondents had a good attitude score towards reporting ADRs. When exploring their own practice, pediatricians has a low reporting rate. The results of the present study reveals that pediatricians lack knowledge of PV and ADRs reporting. However, they have a good attitude towards ADRs reporting and enhancing their PV practice. This is still not reflected in their own practice. Further training and education about ADRs reporting is very important to move toward safer medications in children. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Residents' Self-Reported Health Effects and Annoyance in Relation to Air Pollution Exposure in an Industrial Area in Eastern-Estonia.

    Science.gov (United States)

    Orru, Hans; Idavain, Jane; Pindus, Mihkel; Orru, Kati; Kesanurm, Kaisa; Lang, Aavo; Tomasova, Jelena

    2018-02-02

    Eastern Estonia has large oil shale mines and industrial facilities mainly focused on electricity generation from oil shale and shale oil extraction, which produce high air pollution emissions. The "Study of the health impact of the oil shale sector-SOHOS" was aimed at identifying the impacts on residents' health and annoyance due to the industrial processing. First, a population-wide survey about health effects and annoyance was carried out. Second, the total and oil shale sectors' emitted concentrations of benzene, phenol, and PM 2.5 were modelled. Third, the differences between groups were tested and relationships between health effects and environmental pollution studied using multiple regression analysis. Compared to the control groups from non-industrial areas in Tartu or Lääne-Viru, residents of Ida-Viru more frequently ( p health effects except asthma were reported more frequently among non-Estonians. People living in regions with higher levels of PM 2.5 , had significantly higher odds ( p health effects was also higher among those who had been working in the oil shale sector. Next to direct health effects, up to a quarter of the residents of Ida-Viru County were highly annoyed about air pollution. Perceived health risk from air pollution increased the odds of being annoyed. Annoyed people in Ida-Viru had significantly higher odds of experiencing respiratory symptoms during the last 12 months, e.g., wheezing (2.30, 1.31-4.04), chest tightness (2.88, 1.91-4.33 or attack of coughing (1.99, 1.34-2.95).

  1. Assessment of a Self-Reported Drinks Diary for the Estimation of Drinks Intake by Care Home Residents: Fluid Intake Study in the Elderly (FISE).

    Science.gov (United States)

    Jimoh, F O; Bunn, D; Hooper, L

    2015-05-01

    We evaluated the accuracy of a newly developed self-completed Drinks Diary in care home residents and compared it with direct observation and fluid intake charts. Observational study. Residential care homes in Norfolk, UK. 22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores drinks intake over 24 hours using the Drinks Diary while care staff used the homes' usual fluid intake chart to record drinks intake. These records were compared with drinks intake assessed by researcher direct observation (reference method), during waking hours (6am to 10pm), while drinks taken from 10pm to 6am were self-reported and checked with staff. Drinks intake assessed by the Drinks Diary was highly correlated with researcher direct observation (Pearson correlation coefficient r=0.93, pDrinks Diary classified 19 of 22 participants correctly as drinking enough or not using both the European Food Safety Authority and US recommendations. The Drinks Diary estimate of drinks intake was comparable with direct observation and more accurate (and reliably completed) than staff records. The Drinks Diary can provide a reliable estimate of drinks intake in elderly care home residents physically and cognitively able to complete it. It may be useful for researchers, care staff and practitioners needing to monitor drinks intake of elderly people, to help them avoid dehydration.

  2. [Epidemiological characteristics of newly reported HIV infections in Chinese and Burmese residents, during 2012-2016 in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan province].

    Science.gov (United States)

    Wang, J B; Chen, X C; Duan, X; Yang, J; Wang, Y K; Yang, T; Ye, R H; Yang, Y C; Yao, S T; Jiang, Y; Duan, S; He, N

    2017-10-10

    Objective: To understand the epidemiological characteristics of newly reported HIV infections in Chinese and Burmese residents during 2012-2016 in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan province (Dehong) and to provide evidence for the development of related programs on prevention and control. Methods: All the HIV infections who were newly reported during 2012-2016 in Dehong, were recruited as the study subjects, with epidemiological characteristics of the cases analyzed by using the software SPSS 22.0. Results: A total of 5 692 HIV infections were newly reported between 2012 and 2016 (including 5 592 in this study), in which the Chinese patients accounted for 43.3 % (2 419) and the rest 56.7 % (3 173) were Burmese. Differences in age, gender and other social characteristics of these newly reported HIV infections were statistically significant between the Chinese and the Burmese (all p -values characteristics of the patients would include: having had primary school education, married, being farmers, and with CD(4)(+)T cells counts ≥350 cells/μl. HIV infection was mainly transmitted through sexual contact among the Chinese patients but through injecting drug use among the Burmese patients. Conclusions: Epidemiological characteristics of the newly reported HIV infections were different between the Chinese and the Burmese, between 2012 and 2016 in Dehong. Targeted prevention and control programs should be taken.

  3. Exploring the relationship between cognition and self-reported pain in residents of homes for the elderly

    NARCIS (Netherlands)

    Oosterman, J.M.; Vries, K. de; Dijkerman, H.C.; Haan, E.H.F. de; Scherder, E.J.A.

    2009-01-01

    Background: Pain poses a major problem in older adults, specifically for those living in homes for the elderly. Previous research indicates that the presence of pain may be associated with changes in cognitive functions. It is unclear, however, how the reported experience of pain relates to

  4. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

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

  6. Examining the Self-Reported Health Behaviors and the Importance of Role Modeling among Resident Directors Affiliated with the Association of College and University Housing Officers-International (ACUHO-I) Institutions

    Science.gov (United States)

    Aldana, Maylen Lizeth

    2009-01-01

    The purpose of this study was to examine self-reported health behaviors (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations and stress management) of Resident Directors who self-reported being affiliated with ACUHO-I. The second purpose of the study was to examine which areas of health behaviors, do…

  7. Residency Allocation Database

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2018-02-27

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

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

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-07-01

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

  10. Multi-institutional study of self-reported attitudes and behaviors of general surgery residents about ethical academic practices in test taking.

    Science.gov (United States)

    Grignol, Valerie P; Grannan, Kevin; Sabra, John; Cromer, Robert M; Jarman, Benjamin; Dent, Daniel; Sticca, Robert P; Nelson, Timothy M; Kukora, John S; Daley, Brian J; Treat, Robert W; Termuhlen, Paula M

    2013-01-01

    Correlation exists between people who engage in academic dishonesty as students and unethical behavior once in practice. Previously, we assessed the attitudes of general surgery residents and ethical practices in test taking at a single institution. Most residents had not participated in activities they felt were unethical, yet what constituted unethical behavior was unclear. We sought to verify these results in a multi-institutional study. A scenario-based survey describing potentially unethical activities related to the American Board of Surgery In-training Examination (ABSITE) was administered. Participants were asked about their knowledge of or participation in the activities and whether the activity was unethical. Program directors were surveyed about the use of ABSITE results for resident evaluation and promotion. Ten programs participated in the study. The resident response rate was 67% (186/277). Of the respondents, 43% felt that memorizing questions to study for future examinations was unethical and 50% felt that using questions another resident memorized was unethical. Most felt that buying (86%) or selling (79%) questions was unethical. Significantly more senior than junior residents have memorized (30% vs 16%; p = 0.04) or used questions others memorized (33% vs 12%; p = 0.002) to study for future ABSITE examinations and know of other residents who have done so (42% vs 20%; p = 0.004). Most programs used results of the ABSITE in promotion (80%) and set minimum score expectations and consequences (70%). Similar to our single-institution study, residents had not participated in activities they felt to be unethical; however the definition of what constitutes cheating remains unclear. Differences were identified between senior and junior residents with regard to memorizing questions for study. Cheating and unethical behavior is not always clear to the learner and represents an area for further education. © 2013 Association of Program Directors in Surgery

  11. Business Use of Residence for Day Care Services. Report Together with Additional Views Submitted by Mr. Ullman, from the Committee on Ways and Means, House of Representatives, Ninety-Fifth Congress, First Session to Accompany H.R. 3340.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Ways and Means.

    This booklet contains the report from the House of Representatives Committee on Ways and Means on the amendment to the Internal Revenue Code which would allow taxpayers an income tax deduction for the business use of any part of their residence for day care services, whether or not that part is exclusively used for day care. Included in the report…

  12. Residents with mild cognitive decline and family members report health students 'enhance capacity of care' and bring 'a new breath of life' in two aged care facilities in Tasmania.

    Science.gov (United States)

    Elliott, Kate-Ellen J; Annear, Michael J; Bell, Erica J; Palmer, Andrew J; Robinson, Andrew L

    2015-12-01

    Care provided by student doctors and nurses is well received by patients in hospital and primary care settings. Whether the same is true for aged care residents of nursing homes with mild cognitive decline and their family members is unknown. To investigate the perspectives of aged care residents with mild cognitive decline and their family members on interdisciplinary student placements in two residential aged care facilities (RACF) in Tasmania. A mixed methods design was employed with both qualitative and quantitative data collected. All participants were interviewed and completed a questionnaire on residents' quality of life, during or after a period of student placements in each facility (October-November, 2012). Qualitative data were coded for themes following a grounded theory approach, and quantitative data were analysed using SPSS. Twenty-one participants (13 residents and 8 family members) were recruited. Four themes were identified from the qualitative data and included (i) increased social interaction and facility vibrancy; (ii) community service and personal development, (iii) vulnerability and sensitivity (learning to care) and (iv) increased capacity and the confidence of enhanced care. Residents' quality of life was reported to be mostly good in the presence of the students, despite their high care needs. Residents with mild cognitive decline and their family members perceive a wide array of benefits of student provided care in RACFs including increased social interaction. Future quantitative research should focus on whether changes in care occur for residents as a result of student involvement. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  13. Genetic and Phenotypic Catalog of Native Resident Trout of the Interior Columbia River Basin; Populations of the Upper Yakima Basin, 1997-1998 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Trotter, Patrick C. (Fishery Science Consultant, Seattle, WA); McMillan, Bill; Gayeski, Nick (Washington Trout, Duvall, WA)

    1999-10-01

    The objective of this project is to photo-document upper Columbia Basin native resident trout populations in Washington, and to ascertain their species or subspecies identity and relative genetic purity using a nonlethal DNA technique.

  14. 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).

  15. Resident-Led Palliative Care Education Project.

    Science.gov (United States)

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

    2016-04-01

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

  16. A Repeat Random Survey of the Prevalence of Falsified and Substandard Antimalarials in the Lao PDR: A Change for the Better.

    Science.gov (United States)

    Tabernero, Patricia; Mayxay, Mayfong; Culzoni, María Julia; Dwivedi, Prabha; Swamidoss, Isabel; Allan, Elizabeth Louise; Khanthavong, Maniphone; Phonlavong, Chindaphone; Vilayhong, Chantala; Yeuchaixiong, Sengchanh; Sichanh, Chanvilay; Sengaloundeth, Sivong; Kaur, Harparkash; Fernández, Facundo M; Green, Michael D; Newton, Paul N

    2015-06-01

    In 2003, a stratified random sample survey was conducted in the Lao People's Democratic Republic (Laos) to study the availability and quality of antimalarials in the private sector. In 2012, this survey was repeated to allow a statistically valid analysis of change through time. The counterfeit detection device 3 (CD-3) was used to assess packaging quality in the field and HPLC and mass spectroscopy analysis chemical analysis performed. The availability of oral artesunate monotherapies had significantly decreased from 22.9% (22) of 96 outlets in southern Laos in 2003 to 4.8% (7) of 144 outlets in 2012 (P pharmaceutical ingredients (APIs) in contrast to the 21 (84%) falsified artesunate samples found in the 2003 survey. Although none of the medicines found in 2012 survey had evidence for falsification, 25.4% (37) of the samples were outside the 90-110% pharmacopeial limits of the label claim, suggesting that they were substandard or degraded. Results obtained from this survey show that patients are still exposed to poorly manufactured drugs or to ineffective medicines such as chloroquine. The quality of artemisinin-based combination therapies (ACTs) used in Laos needs to be monitored, since falsified ACTs would have devastating consequences in public health. © The American Society of Tropical Medicine and Hygiene.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

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

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

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

  20. Student Expenses in Residency Interviewing.

    Science.gov (United States)

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

    2017-08-01

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

  1. Cryo-scanning electron microscopy (Cryo-SEM) of semen frozen in medium-straws from good and sub-standard freezer AI-boars.

    Science.gov (United States)

    Hernández, Marta; Ekwall, Hans; Roca, Jordi; Vazquez, Juan Maria; Martinez, Emilio; Rodríguez-Martínez, Heriberto

    2007-02-01

    A major limiting factor for commercial cryopreservation of boar semen for artificial insemination (AI) is the large individual variation to cooling, where the degree of cell dehydration during ice (re)shaping seems to play a major role. This study investigated, in the frozen state, the degree of dehydration and ice crystal distribution in boar semen doses whose spermatozoa displayed different viability after thawing. Cross-sectioned medium-straws (0.5 mL, n=10) from a total of 10 stud boars classified as "good"(n=5) or sub-standard (e.g., "bad" freezers, n=5) by conventional analyses (computer assisted motility and sperm viability) were examined by Cryo-scanning electron microscopy (Cryo-SEM) to determine whether differences between groups could be already distinguishable prior to thawing. The degree of hydration was monitored in relation to the areas of ice crystal formed extracellularly (lakes), the areas of frozen, concentrated extender (veins) where spermatozoa were located and the degree of compartmentalization (number of lakes) present. Irrespectively of the region studied, the gradient of main dehydration (as lakes) observed along the cross-section area of the straws was very irregular. Most spermatozoa were enclosed in the freezing extender matrix and no obvious signs of external membrane damage were observed. None of the Cryo-SEM variables significantly correlated with post-thaw sperm parameters (p>0.05). However, we identified significant differences (p<0.0001) among boars for all ultrastructure variables studied, including the size of the veins, where differences in solute concentration is expected. We concluded that despite the large variability in ice crystal formation during the conventional freezing process among boars, this is unrelated to inter-boar post-thaw sperm differences.

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

    Science.gov (United States)

    Donovan, Andrea

    2011-04-01

    Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by

  3. Increased levels of harvest and habitat law enforcement and public awareness for anadromous salmonids and resident fish in the Columbia River Basin - Demonstration period, 1992-1994. Final report

    International Nuclear Information System (INIS)

    1995-06-01

    This report was funded by the Bonneville Power Administration (BPA), US Department of Energy, as part of BPA's program to protect, mitigate, and enhance fish and wildlife affected by the development and operation of hydroelectric facilities on the Columbia River and its tributaries. Illegal harvest and violation of habitat protection regulations are factors affecting the survival of many native species of anadromous and resident fish in the Columbia Basin

  4. Increased Levels of Harvest and Habitat Law Enforcement and Public Awareness for Anadromous Salmonids and Resident Fish in the Columbia River Basin -- Demonstration Period, 1992--1994, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    NeSmith, Frank (Idaho Department of Fish and Game, Boise, ID); Long, Mack (Montana Department of Fish, Wildlife and Paks, Kalispell, MT); Matthews, Dayne (Washington Department of Fish and Wildlife, Olympia, WA)

    1995-06-01

    This report was funded by the Bonneville Power Administration (BPA), US Department of Energy, as part of BPA`s program to protect, mitigate, and enhance fish and wildlife affected by the development and operation of hydroelectric facilities on the Columbia River and its tributaries. Illegal harvest and violation of habitat protection regulations are factors affecting the survival of many native species of anadromous and resident fish in the Columbia Basin.

  5. Evaluating Dermatology Residency Program Websites.

    Science.gov (United States)

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

    2016-03-16

    Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms

  6. Asthma morbidity in adult Chicago public housing residents.

    Science.gov (United States)

    Lambertino, Anissa; Turyk, Mary E; Curtis, Luke; Persky, Victoria W

    2009-03-01

    Residents of public housing can experience socioeconomic disadvantages, inadequate access to health care, and particularly substandard indoor air quality due to inadequate building maintenance. This study investigates demographic, medical management, severity, and household factors associated with asthma-related emergency department visits and hospitalizations. A total of 103 adult participants with asthma from four Chicago housing developments completed surveys and underwent household inspections. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related emergency department visits: asthma controller medication use, not keeping an asthma-related doctor's appointment, and frequent nocturnal wheeze episodes. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related hospitalizations: peeling paint, plaster, or wallpaper, environmental tobacco smoke, written action plan for an asthma-related doctor or emergency department visit, and frequent nocturnal wheeze episodes. In multivariate models, factors related to clinical severity and asthma management were related to both emergency department visits and hospitalizations while household conditions were related only to hospitalizations. Interventions to address both asthma management and household environmental triggers may be needed to reduce asthma morbidity in low-income populations.

  7. A Multiple Watershed Approach to Assessing the Effects of Habitat Restoration Actions on Anadromous and Resident Fish Populations, Technical Report 2003-2004.

    Energy Technology Data Exchange (ETDEWEB)

    Marmorek, David

    2004-03-01

    Habitat protection and restoration is a cornerstone of current strategies to restore ecosystems, recover endangered fish species, and rebuild fish stocks within the Columbia River Basin. Strategies featuring habitat restoration include the 2000 Biological Opinion on operation of the Federal Columbia River Power System (FCRPS BiOp) developed by the National Marine Fisheries Service (NMFS), the 2000 Biological Opinion on Bull Trout developed by the US Fish and Wildlife Service (USFWS), and Sub-Basin Plans developed under the Fish and Wildlife Program of the Northwest Power and Conservation Council (NWPCC). There is however little quantitative information about the effectiveness of different habitat restoration techniques. Such information is crucial for helping scientists and program managers allocate limited funds towards the greatest benefits for fish populations. Therefore, it is critical to systematically test the hypotheses underlying habitat restoration actions for both anadromous and resident fish populations. This pilot project was developed through a proposal to the Innovative Projects fund of the NWPCC (ESSA 2002). It was funded by the Bonneville Power Administration (BPA) following reviews by the Independent Scientific Review Panel (ISRP 2002), the Columbia Basin Fish and Wildlife Authority (CBFWA 2002), the NWPCC and BPA. The study was designed to respond directly to the above described needs for information on the effectiveness of habitat restoration actions, including legal measures specified in the 2000 FCRPS BiOp (RPA 183, pg. 9-133, NMFS 2000). Due to the urgency of addressing these measures, the timeline of the project was accelerated from a duration of 18 months to 14 months. The purpose of this pilot project was to explore methods for evaluating past habitat restoration actions and their effects on fish populations. By doing so, the project will provide a foundation of retrospective analyses, on which to build prospective, multi-watershed designs

  8. [Burnout in nursing residents].

    Science.gov (United States)

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

    2011-03-01

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

  9. Plagiarism in residency application essays.

    Science.gov (United States)

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

    2010-07-20

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

  10. Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

    Science.gov (United States)

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

    2011-12-01

    An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

  11. Genetic and Phenotypic Catalog of Native Resident Trout of the interior Columbia River Basin : FY-2001 Report : Populations in the Wenatchee, Entiat, Lake Chelan and Methow River Drainages.

    Energy Technology Data Exchange (ETDEWEB)

    Trotter, Patrick C.

    2001-10-01

    The 1994 Fish and Wildlife Program of the Northwest Power Planning Council specifies the recovery and preservation of population health of native resident fishes of the Columbia River Basin. Among the native resident species of concern are interior rainbow trout of the Columbia River redband subspecies Oncorhynchus mykiss gairdneri 1 and westslope cutthroat trout O. clarki lewisi. The westslope cutthroat trout has been petitioned for listing under the U. S. Endangered Species Act (American Wildlands et al. 1997). Before at-risk populations can be protected, their presence and status must be established. Where introgression from introduced species is a concern, as in the case of both westslope cutthroat trout and redband rainbow trout, genetic issues must be addressed as well. As is true with native trout elsewhere in the western United States (Behnke 1992), most of the remaining pure populations of these species in the Columbia River Basin are in relatively remote headwater reaches. The objective of this project was to photo-document upper Columbia Basin native resident trout populations in Washington, and to ascertain their species or subspecies identity and relative genetic purity using a nonlethal DNA technique. FY-2001 was year three (and final year) of a project in which we conducted field visits to remote locations to seek out and catalog these populations. In FY-2001 we worked in collaboration with the Wenatchee National Forest to catalog populations in the Wenatchee, Entiat, Lake Chelan, and Methow River drainages of Washington State.

  12. 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.

    2011-01-01

    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

  13. Motherhood during residency training: challenges and strategies.

    Science.gov (United States)

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

    2005-07-01

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

  14. The Resident Academic Project Program: A Structured Approach to Inspiring Academic Development During Residency Training.

    Science.gov (United States)

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

    2016-02-15

    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.

  15. Facility Focus: Residence Halls.

    Science.gov (United States)

    College Planning & Management, 2003

    2003-01-01

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

  16. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

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

  17. Psychologic effects of residency.

    Science.gov (United States)

    Reuben, D B

    1983-03-01

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

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

    Science.gov (United States)

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

    2018-04-17

    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

  19. Global health education in emergency medicine residency programs.

    Science.gov (United States)

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid

    2014-06-01

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

  20. Factors influencing residents' evaluations of clinical faculty member teaching qualities and role model status.

    Science.gov (United States)

    Arah, Onyebuchi A; Heineman, Maas J; Lombarts, Kiki M J M H

    2012-04-01

      Evaluations of faculty members are widely used to identify excellent or substandard teaching performance. In order to enable such evaluations to be properly interpreted and used in faculty development, it is essential to understand the factors that influence resident doctors' (residents) evaluations of the teaching qualities of faculty members and their perceptions of faculty members as role-model specialists.   We carried out a cross-sectional survey within a longitudinal study of the System for Evaluation of Teaching Qualities (SETQ) of clinical teachers. The study sample included 889 residents and 1014 faculty members in 61 teaching programmes spanning 22 specialties in 20 hospitals in the Netherlands. Main outcome measures included residents' (i) global and (ii) specific ratings of faculty member teaching qualities, and (iii) global ratings of faculty members as role-model specialists. Statistical analysis was conducted using adjusted multivariable logistic generalised estimating equations.   In total, 690 residents (77.6%) completed 6485 evaluations of 962 faculty members, 848 (83.6%) of whom also self-evaluated. More recently certified faculty members, those who had attended a teacher training programme, and those who spent more time teaching than seeing patients or conducting research were more likely to score highly on most teaching qualities. However, faculty members who had undergone teacher training were less likely to be seen as role models (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.59-0.88). In addition, faculty members were evaluated slightly higher by male than female residents on core teaching domains and overall teaching quality, but were less likely to be seen as role models by male residents (OR 0.80, 95% CI 0.67-0.97). Lastly, faculty members had higher odds of receiving top scores in specific teaching domains from residents in the first 4 years of residency and were less likely to be considered as role models by more

  1. Effect of reminders of personal sacrifice and suggested rationalizations on residents' self-reported willingness to accept gifts: a randomized trial.

    Science.gov (United States)

    Sah, Sunita; Loewenstein, George

    2010-09-15

    Despite expanding research on the prevalence and consequences of conflicts of interest in medicine, little attention has been given to the psychological processes that enable physicians to rationalize the acceptance of gifts. To determine whether reminding resident physicians of the sacrifices made to obtain training, as well as suggesting this as a potential rationalization, increases self-stated willingness to accept gifts from industry. Three hundred one US resident physicians from 2 sample populations (pediatrics and family medicine) who were recruited during March-July 2009 participated in a survey presented as evaluating quality of life and values. Physicians were randomly assigned to receive 1 of 3 different online surveys. The sacrifice reminders survey (n = 120) asked questions about sacrifices made in medical training, followed by questions regarding the acceptability of receiving gifts from industry. The suggested rationalization survey (n = 121) presented the same sacrifice questions, followed by a suggested possible rationalization (based on sacrifices made in medical training) for acceptance of gifts, before the questions regarding the acceptability of gifts. The control survey (n = 60) asked about the acceptability of gifts before asking questions about sacrifices or suggesting a rationalization. Physician self-stated acceptability of receiving gifts from industry. Reminding physicians of sacrifices made in obtaining their education resulted in gifts being evaluated as more acceptable: 21.7% (13/60) in the control group vs 47.5% (57/120) in the sacrifice reminders group (odds ratio, 1.81; 95% confidence interval, 1.27-2.58; P = .001). Although most residents disagreed with the suggested rationalization, exposure to it further increased the perceived acceptability of gifts to 60.3% (73/121) in that group (odds ratio relative to sacrifice reminders group, 1.45; 95% confidence interval, 1.22-1.72; P sacrifices increased the perceived acceptability of

  2. Eating disorder training and attitudes among primary care residents.

    Science.gov (United States)

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

    2013-04-01

    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.

  3. Canadian Plastic Surgery Resident Work Hour Restrictions: Practices and Perceptions of Residents and Program Directors.

    Science.gov (United States)

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

    2018-02-01

    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.

  4. Simulation and resident education in spinal neurosurgery.

    Science.gov (United States)

    Bohm, Parker E; Arnold, Paul M

    2015-01-01

    A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education.

  5. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  6. Residents in difficulty

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Javad Sarabadani

    2015-09-01

    Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.

  8. Research Experience in Psychiatry Residency Programs Across Canada: Current Status

    Science.gov (United States)

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

    2014-01-01

    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

  9. Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

    Science.gov (United States)

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

    2015-04-01

    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.

  10. 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

    2005-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Rebecca L. Collins

    2005-01-01

    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.

  12. Technology in Residence.

    Science.gov (United States)

    Fox, Jordan

    1999-01-01

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

  13. Neurosurgery resident leadership development: an innovative approach.

    Science.gov (United States)

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

    2011-02-01

    A great deal of time and resources go into the development and training of neurosurgeons. One area that has minimal literature and assessment is leadership development. Under the core competency of interpersonal and communication skills, the Accreditation Council for Graduate Medical Education has indicated that residents are expected to work effectively as a member or leader of a healthcare team. This article reveals how a structured leadership program was developed so that residents are better prepared for the role of chief resident and future leadership roles. Beginning in October 2006, residents attended a series of 1-hour workshops conducted monthly. Topics included leadership style, conflict management, effective feedback, team building, team leadership, motivation, and moving from peer to leader. A retrospective pretest was conducted at the end of the program. Residents reported a significant knowledge gain for the majority of topics. Resident comments indicated a greater awareness of the impact of leading and ways to improve their personal leadership. Quantitatively and qualitatively, residents and faculty reported that the leadership program made a significant impact on the development of future neurosurgical leaders.

  14. Burnout among Canadian Psychiatry Residents: A National Survey.

    Science.gov (United States)

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

    2016-11-01

    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.

  15. Problems associated with substandard and counterfeit drugs in developing countries: a review article on global implications of counterfeit drugs in the era of antiretroviral (ARVs) drugs in a free market economy.

    Science.gov (United States)

    Nsimba, Stephen E D

    2008-12-01

    To review the global implications associated with the use of substandard and or counterfeit drugs in developing and may be developed countries. The focus of this review is particularly on antiretroviral (ARVs), antimalarials and other drugs. Review of various literatures through Pub-Med, Medline, Google and Internet search to retrieve and download published materials was done by the author of this review paper. When patients receive a counterfeit medicines, they are subjected to multiple risks. They often suffer more than just an inconvenience; as they become victims of fraud medicines and are all put at risk of adverse effects from unprescribed medicines or substandard ingredients. Additionally, patients may lose confidence in health care professionals including their physician and pharmacist, and potentially modern medicine or the pharmaceutical industry in general. Counterfeit or substandard (poor quality) drugs pose threats to society; not only to the individual in terms of the health side effects experienced, but also to the public in terms of trade relations, economic implications, and the effects on global pandemics. It is vital for suppliers, providers, and patients to be aware of current trends in counterfeiting in order to best prepare for encounters with suspicious products. Furthermore, this is an issue that needs to be continually dealt with on national and international policy levels. Developing countries should try their level best to establish good laboratories for monitoring and checking quality of all pharmaceuticals manufactured locally and those imported or donated to these countries. The Ministries of Health and all stakeholders involved in this issue must ensure that all drugs meet the set or established international standards and national standards. Failure to do so will be to misuse the hard earned forex that is normally borrowed from banks for the procurement and distribution of drugs to its people. Indeed sub-standard medications do more

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

    Science.gov (United States)

    VanDenBerg, C; Murphy, J E

    1997-07-01

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

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

    Science.gov (United States)

    Trompetter, Hester; Scholte, Ron; Westerhof, Gerben

    2011-01-01

    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.

  18. Evaluation of stress experienced by pharmacy residents.

    Science.gov (United States)

    Le, Hung M; Young, Shardae D

    2017-04-15

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

  19. Mainframe computer use and residency cohort data.

    Science.gov (United States)

    Hotch, D; Helford, M; Rivers, D

    1987-01-01

    This paper describes a computer based method that was developed to prepare a profile of the patient care experiences of a cohort in a three-year, university based family practice residency. Sample pages from the report produced by this method and a description of the computer program are presented. This method of presenting patient encounter information may be particularly useful for program-level evaluation and for monitoring resident training.

  20. Burnout Syndrome During Residency.

    Science.gov (United States)

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

    2016-10-01

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

  1. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds

    2002-10-01

    Full Text Available Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each. Self-rated ability or comfort was compared by gender, status (year of residency, faculty, and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted.

  2. Implementation of a "Flipped Classroom" for Neurosurgery Resident Education.

    Science.gov (United States)

    Girgis, Fady; Miller, Jonathan P

    2018-01-01

    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. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2013-09-01

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

  5. Burnout among Canadian Psychiatry Residents: A National Survey

    Science.gov (United States)

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

    2016-01-01

    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

  6. RECONSTRUCTION OF DOSE TO THE RESIDENTS OF OZERSK FROM THE OPERATION OF THE MAYAK PRODUCTION ASSOCIATION: 1948-2002: Progress Report on Project 1.4

    Energy Technology Data Exchange (ETDEWEB)

    Mokrov, Y.; Rovny, Sergey I.; Anspaugh, L. R.; Napier, Bruce A.

    2009-10-23

    This Progress Report for Project 1.4 of the U.S.–Russia Joint Coordinating Committee on Radiation Effects Research continues in the abbreviated format of providing details only on the work accomplished during this six-month reporting period.

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

    Science.gov (United States)

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

    2016-02-01

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

  8. Animal Investigation Program 1976 annual report: Nevada test site and vicinity. [Radioanalysis of tissues from animals residing on or near NTS in 1976

    Energy Technology Data Exchange (ETDEWEB)

    Smith, D.D.; Giles, K.R.; Bernhardt, D.E.; Brown, K.W.

    1978-11-01

    Data are presented from the radioanalysis of tissues collected from cattle and mule deer, desert bighorn sheep, feral horses, and other wildlife that resided on or near the Nevada Test Site during 1976. Other than the naturally occurring potassium-40, gamma-emitting radionuclides were detected infrequently with the exception of /sup 131/I in animal thyroid samples collected after September 25 (the date of a Chinese nuclear test). Strontium-90 concentrations in bones from deer, cattle, and desert bighorn sheep continued the downward trend of recent years. Tritium concentrations were generally within ambient limits with the exception of animals exposed to sources of contamination; e.g., Sedan Crater, drainage ponds from Area 12 tunnels, etc. Analysis of actinide in tissues was emphasized during 1976. Graphs illustrate the /sup 239/P levels in lungs, livers, and femurs from Nevada Test Site beef cattle for the years 1971 through 1976. Femur and lung residue data are nearly identical for each year with liver concentrations being a factor of 2 or 3 lower. Hypothetical dose estimates to man were calculated on the basis of the daily consumption of 0.5 kilogram of liver or muscle from animals that contained peak actinide levels. The highest postulated dose was 11 millirem from tritium from tissues for a mule deer. This dose is about 2% of the 500 millirems/year guide for radiation doses to an individual in the general public. All other postulated doses for consumption of the tissue containing other radionuclides are less than 0.1% of this guide. The food habits of desert bighorn sheep were discussed according to the geographic locations of the animals at time of collection. Grasses made up approximately 60% of the diet at all locations, with shrubs content approaching 30%, and the remainder consisting of various forbs. The movement of 13 mule deer fitted with collars containing a radiotransmitter unit was monitored on a weekly basis.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Evaluating a novel resident role-modelling programme.

    Science.gov (United States)

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

    2017-05-09

    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

  12. Genetic and phenotype catalog of native resident trout of the interior Columbia River Basin: FY-99 report: populations of the Pend Oreille, Kettle, and Sanpoil River Basins of Colville National Forest/ fiscal year 1999 report; ANNUAL

    International Nuclear Information System (INIS)

    Trotter, Patrick C.

    2001-01-01

    The 1994 Fish and Wildlife Program of the Northwest Power Planning Council specifies the recovery and preservation of population health of native resident fishes of the Columbia River Basin. Among the native resident species of concern are interior rainbow trout of the Columbia River redband subspecies Oncorhynchus mykiss gairdneri 1 and westslope cutthroat trout O. clarki lewisi. The westslope cutthroat trout has been petitioned for listing under the U. S. Endangered Species Act (American Wildlands et al. 1997). Before at-risk populations can be protected, their presence and status must be established. Where introgression from introduced species is a concern, as in the case of both westslope cutthroat trout and redband rainbow trout, genetic issues must be addressed as well. As is true with native trout elsewhere in the western United States (Behnke 1992), most of the remaining pure populations of these species in the Columbia River Basin are in relatively remote headwater reaches. The objective of this project is to photo-document upper Columbia Basin native resident trout populations in Washington, and to ascertain their species or subspecies identity and relative genetic purity using a nonlethal DNA technique. FY-99 was year two of a five-year project in which we conducted field visits to remote locations to seek out and catalog these populations. In FY-99 we worked in collaboration with the Colville National Forest and Kalispel Indian Tribe to catalog populations in the northeastern corner of Washington State

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

    Science.gov (United States)

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

    2015-11-01

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

  14. Resident-as-teacher in family medicine: a CERA survey.

    Science.gov (United States)

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

    2015-06-01

    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.

  15. Life satisfaction of people with intellectual disability living in community residences: perceptions of the residents, their parents and staff members.

    Science.gov (United States)

    Schwartz, C; Rabinovitz, S

    2003-02-01

    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.

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

    Science.gov (United States)

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

    2003-01-01

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

  17. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

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

  18. Sleep pattern in medical students and residents.

    Science.gov (United States)

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

    2009-11-01

    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. Developing a curriculum for emergency medicine residency orientation programs.

    Science.gov (United States)

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

    2014-05-01

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

  20. 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.

    2013-01-01

    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

  1. TREATMENT OF HAMSTRING STRAIN IN A COLLEGIATE POLE‐VAULTER INTEGRATING DRY NEEDLING WITH AN ECCENTRIC TRAINING PROGRAM: A RESIDENT'S CASE REPORT

    Science.gov (United States)

    Westrick, Richard B.; Zylstra, Edo; Johnson, Michael R.

    2013-01-01

    Background: Hamstring strain injuries are among the most common injuries seen in sports. Management is made difficult by the high recurrence rates. Typical time to return to sport varies but can be prolonged with recurrence. Eccentric strength deficits remain post‐injury, contributing to reinjury. Eccentric training has shown to be an effective method at prevention of hamstring injury in multiple systematic reviews and prospective RCTs but limited prospective rehabilitation literature. Functional dry needling is a technique that has been reported to be beneficial in the management of pain and dysfunction after muscle strains, but there is limited published literature on its effects on rehabilitation or recurrence of injury. Purpose: The purpose of this case report is to present the management and outcomes of a patient with hamstring strain, treated with functional dry needling and eccentric exercise. Case Description: The subject was an 18‐year‐old collegiate pole‐vaulter who presented to physical therapy with an acute hamstring strain and history of multiple strains on uninvolved extremity. He was treated in Physical Therapy three times per week for 3 weeks with progressive eccentric training and 3 sessions of functional dry needling. Outcomes: By day 12, his eccentric strength on the involved extremity was greater than the uninvolved extremity and he reported clinically meaningful improvement in outcome scores. By Day 20, he was able to return to full sports participation without pain or lingering strength deficits. Discussion: The patient in this case report was able to return to sport within 20 days and without recurrence. He demonstrated significant decreases in pain and dysfunction with dry needling. He had greater strength on the injured extremity compared to contra‐lateral previously injured extremity. Conclusions: This case illustrates the use of functional dry needling and eccentric exercise leading to a favorable outcome in a patient with

  2. Treatment of hamstring strain in a collegiate pole-vaulter integrating dry needling with an eccentric training program: a resident's case report.

    Science.gov (United States)

    Dembowski, Scott C; Westrick, Richard B; Zylstra, Edo; Johnson, Michael R

    2013-06-01

    Hamstring strain injuries are among the most common injuries seen in sports. Management is made difficult by the high recurrence rates. Typical time to return to sport varies but can be prolonged with recurrence. Eccentric strength deficits remain post-injury, contributing to reinjury. Eccentric training has shown to be an effective method at prevention of hamstring injury in multiple systematic reviews and prospective RCTs but limited prospective rehabilitation literature. Functional dry needling is a technique that has been reported to be beneficial in the management of pain and dysfunction after muscle strains, but there is limited published literature on its effects on rehabilitation or recurrence of injury. The purpose of this case report is to present the management and outcomes of a patient with hamstring strain, treated with functional dry needling and eccentric exercise. The subject was an 18-year-old collegiate pole-vaulter who presented to physical therapy with an acute hamstring strain and history of multiple strains on uninvolved extremity. He was treated in Physical Therapy three times per week for 3 weeks with progressive eccentric training and 3 sessions of functional dry needling. By day 12, his eccentric strength on the involved extremity was greater than the uninvolved extremity and he reported clinically meaningful improvement in outcome scores. By Day 20, he was able to return to full sports participation without pain or lingering strength deficits. The patient in this case report was able to return to sport within 20 days and without recurrence. He demonstrated significant decreases in pain and dysfunction with dry needling. He had greater strength on the injured extremity compared to contra-lateral previously injured extremity. This case illustrates the use of functional dry needling and eccentric exercise leading to a favorable outcome in a patient with hamstring strain. Level 4.

  3. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

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

    2017-06-01

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

  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

    2005-01-01

    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. Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching.

    Science.gov (United States)

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

    2017-10-01

    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.

  6. Equipping Residents to Address Alcohol and Drug Abuse: The National SBIRT Residency Training Project

    Science.gov (United States)

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

    2012-01-01

    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

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

    Science.gov (United States)

    Martinez, William; Lehmann, Lisa Soleymani

    2013-12-01

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

  8. Analysis of a Resident Aesthetic Clinic: Process for Rhinoplasty, Resident Experience, and Patient Satisfaction.

    Science.gov (United States)

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

    2017-05-01

    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

  9. Learning styles in two otolaryngology residency programs.

    Science.gov (United States)

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

    2009-12-01

    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.

  10. Evaluation of otolaryngology residency program websites.

    Science.gov (United States)

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

    2014-10-01

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

  11. Pediatric dermatology training survey of United States dermatology residency programs.

    Science.gov (United States)

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

    2014-01-01

    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.

  12. Facilitation of resident scholarly activity: strategy and outcome analyses using historical resident cohorts and a rank-to-match population.

    Science.gov (United States)

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

    2014-01-01

    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.

  13. Extremes in Otolaryngology Resident Surgical Case Numbers: An Update.

    Science.gov (United States)

    Baugh, Tiffany P; Franzese, Christine B

    2017-06-01

    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.

  14. Interventional Pain Procedures in Physical Medicine and Rehabilitation Residencies.

    Science.gov (United States)

    Agarwal, Sanjeev; Cicone, Caitlin; Chang, Philip

    2018-04-01

    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.

  15. Results of the American Academy of Neurology resident survey.

    Science.gov (United States)

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

    2011-03-29

    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.

  16. Research in Psychiatry: Residents' Attitudes and Use.

    Science.gov (United States)

    Hershberg, Richard I.; And Others

    1980-01-01

    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)

  17. Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

    Science.gov (United States)

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

    2013-09-01

    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

  18. Workplace Violence and Harassment Against Emergency Medicine Residents.

    Science.gov (United States)

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

    2016-09-01

    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. Resident Preferences for Program Director Role in Wellness Management.

    Science.gov (United States)

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

    2018-05-01

    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.

  20. Simulation Training in Obstetrics and Gynaecology Residency Programs in Canada.

    Science.gov (United States)

    Sanders, Ari; Wilson, R Douglas

    2015-11-01

    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.

  1. Obstetrics and Gynecology Resident Interest and Participation in Global Health.

    Science.gov (United States)

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

    2017-05-01

    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

  2. Influences on the Retention of Residency-Trained and Non-Residency Trained Navy Dental Corps Officers

    Science.gov (United States)

    2004-06-01

    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

  3. Neuroscience and humanistic psychiatry: a residency curriculum.

    Science.gov (United States)

    Griffith, James L

    2014-04-01

    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

  4. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

    Science.gov (United States)

    Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

    2012-10-23

    To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

  5. Opinions of Otorhinolaryngology Residents about Their Education Process.

    Science.gov (United States)

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

    2015-09-01

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

  6. Measuring the intensity of resident supervision in the department of veterans affairs: the resident supervision index.

    Science.gov (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

    2010-07-01

    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.

  7. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

    Science.gov (United States)

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

    2015-11-01

    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.

  8. A theory-informed, process-oriented Resident Scholarship Program.

    Science.gov (United States)

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

    2016-01-01

    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.

  9. Involving Students in Residence Halls in Hong Kong

    Science.gov (United States)

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

    2016-01-01

    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,…

  10. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents

    Science.gov (United States)

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

    2011-01-01

    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…

  11. Documenting resident procedure and diagnostic experience: simplifying the process.

    Science.gov (United States)

    Baldor, R A; Broadhurst, J

    1997-10-01

    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.

  12. Knowledge and attitudes of residents regarding electroconvulsive therapy

    Directory of Open Access Journals (Sweden)

    Gokay Alpak

    2015-02-01

    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

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

    Science.gov (United States)

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

    2016-11-01

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

  14. Pregnancy during otolaryngology residency: experience and recommendations.

    Science.gov (United States)

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

    2009-05-01

    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

  15. Practice gaps in patient safety among dermatology residents and their teachers: a survey study of dermatology residents.

    Science.gov (United States)

    Swary, Jillian Havey; Stratman, Erik J

    2014-07-01

    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.

  16. Kalispel Resident Fish Project : Annual Report, 1995.

    Energy Technology Data Exchange (ETDEWEB)

    Maroney, Joseph; Donley, Christopher; Scott, Jason; Lockwood, Jr., Neil

    1997-06-01

    In 1995 the Kalispel Natural Resource Department (KNRD) in conjunction with the Washington Department of Fish and Wildlife (WDFW) initiated the implementation of a habitat and population enhancement project for bull trout (Salvelinus confluentus), westslope cutthroat trout (Oncorhynchus clarki lewisi) and largemouth bass (Micropterus salmoides). Habitat and population assessments were conducted in seven tributaries of the Box Canyon reach of the Pend Oreille River. Assessments were used to determine the types and quality of habitat that were limiting to native bull trout and cutthroat trout populations. Assessments were also used to determine the effects of interspecific competition within these streams. A bull trout and brook trout (Salvelinus fontinalis) hybridization assessment was conducted to determine the degree of hybridization between these two species. Analysis of the habitat data indicated high rates of sediment and lack of wintering habitat. The factors that contribute to these conditions have the greatest impact on habitat quality for the tributaries of concern. Population data suggested that brook trout have less stringent habitat requirements; therefore, they have the potential to outcompete the native salmonids in areas of lower quality habitat. No hybrids were found among the samples, which is most likely attributable to the limited number of bull trout. Data collected from these assessments were compiled to develop recommendations for enhancement measures. Recommendations for restoration include riparian planting and fencing, instream structures, as well as, removal of non-native brook trout to reduce interspecific competition with native salmonids in an isolated reach of Cee Cee Ah Creek.

  17. Kalispel Resident Fish Project : Annual Report, 2008.

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Todd [Kalispel Natural Resource Department

    2009-07-08

    In 2008, the Kalispel Natural Resource Department (KNRD) continued to implement its habitat enhancement projects for bull trout (Salvelinus confluentus) and westslope cutthroat trout (Oncorhynchus clarki lewisi). Baseline fish population and habitat assessments were conducted in Upper West Branch Priest River. Additional fish and habitat data were collected for the Granite Creek Watershed Assessment, a cooperative project between KNRD and the U.S. Forest Service Panhandle National Forest (FS) . The watershed assessment, funded primarily by the Salmon Recovery Funding Board of the State of Washington, will be completed in 2009.

  18. FY 1998 Report on development project of structural residence of the next generation. Attachment 4. Frame analysis system manual; 1998 nendo jisedai kozo jutaku kaihatsu jigyo shiryohen. 4. Kako kaiseki system manual

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    Attachment 4 of the FY 1998 report on development project of structural residence of the next generation describes the frame analysis system manual. NAPISOS is a program for analyzing static and dynamic responses of three-dimensional structures. The dynamic response is calculated by numerical integration in the time region. Dynamic load can handle dynamic exciting force, uniform seismic input and forced displacement at a node, and analyze linear elasticity and non-linear properties. The static load can handle nodal force, static seismic coefficient and forced displacement at a node, and analyze linear elasticity and non-linear properties. The static analysis also can perform analysis based on the time history response displacement method as the special case. The program implementation procedures fall into 4 general steps; first: inputting/processing of structural data, second: eigen value analysis or equivalent nodal force calculation, third: response calculation by direct integration, preparation of equivalent damping matrix or pre-stress analysis, and fourth: outputting the results. The input data related to control, structure and load are also described. (NEDO)

  19. News Competition: Physics Olympiad hits Thailand Report: Institute carries out survey into maths in physics at university Event: A day for everyone teaching physics Conference: Welsh conference celebrates birthday Schools: Researchers in Residence scheme set to close Teachers: A day for new physics teachers Social: Network combines fun and physics Forthcoming events

    Science.gov (United States)

    2011-09-01

    Competition: Physics Olympiad hits Thailand Report: Institute carries out survey into maths in physics at university Event: A day for everyone teaching physics Conference: Welsh conference celebrates birthday Schools: Researchers in Residence scheme set to close Teachers: A day for new physics teachers Social: Network combines fun and physics Forthcoming events

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Factors Influencing Resident Choice of Prosthodontic Residency Program.

    Science.gov (United States)

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

    2017-06-01

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

  2. Estimates of the Legal Permanent Resident Population: 2011

    Data.gov (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...

  3. Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition.

    Science.gov (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

    2017-12-01

    program, and 18 (21.2%) exited graduate medical education altogether. Each program had an annual attrition rate ranging from 0.73% to 6.0% (median [IQR], 2.5% [1.5%-3.4%]). Low-attrition programs were more likely than high-attrition programs to use resident remediation (21.0% vs 6.8%; P < .001). Median (IQR) Qualifying Examination pass rates (93% [90%-98%] vs 92% [86%-100%]; P = .92) and Certifying Examination pass rates (83% [68%-84%] vs 81% [71%-86%]; P = .47) were similar. Program directors at high-attrition programs were more likely than their counterparts at low-attrition programs to agree with this statement: "I feel that it is my responsibility as a program director to redirect residents who should not be surgeons." The overall 5-year attrition rate of 8.8% was significantly lower than previously reported. Program directors at low-attrition programs were more likely to use resident remediation. Variations in attrition may be explained by program director attitudes, although larger studies are needed to further define program factors affecting attrition.

  4. Pathology Informatics Essentials for Residents

    Science.gov (United States)

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

    2016-01-01

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

  5. Pathology Informatics Essentials for Residents

    Directory of Open Access Journals (Sweden)

    Walter H. Henricks MD

    2016-07-01

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

  6. Incorporating resident research into the dermatology residency program

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

  8. Coleadership Among Chief Residents: Exploration of Experiences Across Specialties.

    Science.gov (United States)

    Pettit, Jeffrey E

    2015-06-01

    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.

  9. Coleadership Among Chief Residents: Exploration of Experiences Across Specialties

    Science.gov (United States)

    Pettit, Jeffrey E.

    2015-01-01

    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

  10. Burnout among Dutch medical residents

    NARCIS (Netherlands)

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

    2007-01-01

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

  11. 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 ...

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

    Science.gov (United States)

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

    2015-02-01

    For many years, the numerus clausus limiting the number of medical students has increased in France. The government wants to reform the residency process to homogenize medical studies. However, the suggested residency program changes would imply changes in the length of residency, in the mobility of residents after residency, their access to unconventional sectors, and more generally, the responsibility of the resident and his/her status in the hospital. In this context, we have investigated the future plans of all psychiatry residents in France. To study the desires of psychiatry residents in France, regarding their training, their short and long-term career plans, and to analyze the evolution of those desires over the last 40 years. A survey was carried out among residents in psychiatry from November 2011 to January 2012. An anonymous questionnaire including four parts (resident's description, residency training and trainees choice, orientation immediately after residency, professional orientation in 5-10 years) was sent by the French Federative Association of Psychiatrists Trainees (AFFEP) to all French psychiatrist trainees, through their local trainee associations (n=26) and through an on line questionnaire. The questionnaire was answered by 853 of the 1615 psychiatry residents (53%), of which 71% were women. At the end of the residency, 76% of residents reported that they would like to pursue a post-residency position (chief resident, senior physician assistant university hospitals); 22% reported wanting to work in another city. Between 5 to 10 years after completion of the residency, 71% reported wanting to work in a hospital, and 40% preferred to have their own private practice. Almost a third of the trainees wished to work in the child and adolescent psychiatry field, for some of them in an exclusive way, for others, combined with a practice in adult psychiatry. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  13. Struggling to be self-directed: residents' paradoxical beliefs about learning.

    Science.gov (United States)

    Nothnagle, Melissa; Anandarajah, Gowri; Goldman, Roberta E; Reis, Shmuel

    2011-12-01

    Self-directed learning (SDL) skills serve as the basis for physician lifelong learning; however, residency training does not typically emphasize SDL skills. To understand residents' needs regarding SDL curricula, the authors used qualitative methods to examine the residency learning culture and residents' views of SDL. The authors conducted individual, in-depth, semistructured interviews with all 13 final-year residents at the Brown University Family Medicine Residency Program. Interviews were audio taped and transcribed verbatim. Using an iterative individual and group process, four researchers conducted a qualitative analysis of the transcripts, identifying major themes and higher-order interpretations. Major themes included resident beliefs about learning, the learning culture in residency, and developmental progress in learning. Four paradoxes emerged in the analysis: (1) Residents understand and value the concept of SDL, but they engage in limited goal setting and reflection and report lack of skills to manage their own learning, particularly in the clinical setting. (2) Despite being immersed in what aims to be a learner-centered culture, many residents still value traditional, teacher-centered approaches. (3) Residents recognize patient care as the most powerful stimulus for SDL, but they often perceive patient care and learning as competing priorities. (4) Residents desire external guidance for SDL. Graduating residents lacked confidence in their SDL skills and their ability to manage their learning, especially in clinical settings. Fostering SDL skills during residency will likely require training and guidance for SDL as well as changes in the structure and culture of residency.

  14. Menopause education: needs assessment of American obstetrics and gynecology residents.

    Science.gov (United States)

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen

    2013-11-01

    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.

  15. 2009 Canadian Radiation Oncology Resident Survey

    International Nuclear Information System (INIS)

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

    2012-01-01

    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.

  16. Survey of emergency medicine resident debt status and financial planning preparedness.

    Science.gov (United States)

    Glaspy, Jeffrey N; Ma, O John; Steele, Mark T; Hall, Jacqueline

    2005-01-01

    Most resident physicians accrue significant financial debt throughout their medical and graduate medical education. The objective of this study was to analyze emergency medicine resident debt status, financial planning actions, and educational experiences for financial planning and debt management. A 22-item questionnaire was sent to all 123 Accreditation Council on Graduate Medical Education-accredited emergency medicine residency programs in July 2001. Two follow-up mailings were made to increase the response rate. The survey addressed four areas of resident debt and financial planning: 1) accrued debt, 2) moonlighting activity, 3) financial planning/debt management education, and 4) financial planning actions. Descriptive statistics were used to analyze the data. Survey responses were obtained from 67.4% (1,707/2,532) of emergency medicine residents in 89 of 123 (72.4%) residency programs. Nearly one half (768/1,707) of respondents have accrued more than 100,000 dollars of debt. Fifty-eight percent (990/1,707) of all residents reported that moonlighting would be necessary to meet their financial needs, and more than 33% (640/1,707) presently moonlight to supplement their income. Nearly one half (832/1,707) of residents actively invested money, of which online trading was the most common method (23.3%). Most residents reported that they received no debt management education during residency (82.1%) or medical school (63.7%). Furthermore, 79.1% (1,351/1,707) of residents reported that they received no financial planning lectures during residency, although 84.2% (1,438/1,707) reported that debt management and financial planning education should be available during residency. Most emergency medicine residency programs do not provide their residents with financial planning education. Most residents have accrued significant debt and believe that more financial planning and debt management education is needed during residency.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Allen Ghareeb

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stephen C. Morris, MD, MPH

    2016-01-01

    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.

  20. The role of simulation training in anesthesiology resident education.

    Science.gov (United States)

    Yunoki, Kazuma; Sakai, Tetsuro

    2018-03-09

    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.

  1. Assessing work-related musculoskeletal symptoms among otolaryngology residents.

    Science.gov (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.

  2. Factors affecting orthopedic residency selection: a cross-sectional survey.

    Science.gov (United States)

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

    2017-06-01

    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.

  3. 26 CFR 1.6049-8 - Interest and original issue discount paid to residents of Canada.

    Science.gov (United States)

    2010-04-01

    ... residents of Canada. 1.6049-8 Section 1.6049-8 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... original issue discount paid to residents of Canada. (a) Interest subject to reporting requirement. For... nonresident alien individual is an individual who resides in Canada and is not a United States citizen. The...

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Science.gov (United States)

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

    2015-01-01

    To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Fitore Morina

    2016-08-01

    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.

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

    Science.gov (United States)

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

    2014-05-01

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

  8. Nursing home resident quality of life: testing for measurement equivalence across resident, family, and staff perspectives.

    Science.gov (United States)

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

    2015-10-01

    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.

  9. Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents.

    Science.gov (United States)

    Peterson, Eleanor B; Boland, Kimberly A; Bryant, Kristina A; McKinley, Tara F; Porter, Melissa B; Potter, Katherine E; Calhoun, Aaron W

    2016-12-01

    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.

  10. The happy docs study: a Canadian Association of Internes and Residents well-being survey examining resident physician health and satisfaction within and outside of residency training in Canada

    Directory of Open Access Journals (Sweden)

    Ramchandar Kevin

    2008-10-01

    Full Text Available Abstract Background Few Canadian studies have examined stress in residency and none have included a large sample of resident physicians. Previous studies have also not examined well-being resources nor found significant concerns with perceived stress levels in residency. The goal of "The Happy Docs Study" was to increase knowledge of current stressors affecting the health of residents and to gather information regarding the well-being resources available to them. Findings A questionnaire was distributed to all residents attending all medical schools in Canada outside of Quebec through the Canadian Association of Internes and Residents (CAIR during the 2004–2005 academic years. In total 1999 resident physicians responded to the survey (35%, N = 5784 residents. One third of residents reported their life as "quite a bit" to "extremely" stressful (33%, N = 656. Time pressure was the most significant factor associated with stress (49%, N = 978. Intimidation and harassment was experienced by more than half of all residents (52%, N = 1050 with training status (30%, N = 599 and gender (18%, N = 364 being the main perceived sources. Eighteen percent of residents (N = 356 reported their mental health as either "fair" or "poor". The top two resources that residents wished to have available were career counseling (39%, N = 777 and financial counseling (37%, N = 741. Conclusion Although many Canadian resident physicians have a positive outlook on their well-being, residents experience significant stressors during their training and a significant portion are at risk for emotional and mental health problems. This study can serve as a basis for future research, advocacy and resource application for overall improvements to well-being during residency.

  11. An intervention targeting fundamental values among caregivers at residential facilities: effects of a cluster-randomized controlled trial on residents' self-reported empowerment, person-centered climate and life satisfaction.

    Science.gov (United States)

    Roos, Charlotte; Silén, Marit; Skytt, Bernice; Engström, Maria

    2016-07-07

    In Sweden the national fundamental values for care of older people state that care should ensure that they can live in dignity and with a sense of well-being. Our hypothesis was that a caregiver intervention targeting the national fundamental values would improve perceived empowerment, person-centered climate and life satisfaction among older people living in residential facilities. The study was a cluster-randomized controlled trial with a pre- and one post-test design, conducted in 27 units (17 study units) at 12 residential facilities for older people in five municipalities in central Sweden. The units in each municipality were randomly assigned to intervention or control group. The caregiver intervention was carried out using an interpretative approach with eight guided face-to-face seminars, where self-reflection and dialogue were used. Data were collected using questionnaires. The number of residents was 43 (78 %) in the intervention group and 37 (71 %) in the control group. The Chi-square test and Mann-Whitney U-tests were performed to detect differences between groups and Wilcoxon signed rank tests to explore differences in change over time within groups. Furthermore, generalized estimating equation (GEE) models were used to study effects of the intervention controlling for clustering effects. Primary outcome measures were empowerment, person-centered climate and life satisfaction. In the intervention group, improvements at follow-up were found in residents' self-reported empowerment (n = 42; p = 0.001, Median difference 4.0, 95 % CI 1.5;6.0), person-centered climate (n = 42; p ≤0.001, Median difference 8.0, 95 % CI 4.5;11.4) and life satisfaction regarding the factor quality of everyday activities (n = 40; p = 0.033, Median difference 9.7, 95 % CI 1.0;21.9) while disempowerment decreased (n = 43; p = 0.018, Median difference -1.3, 95 % CI -2.0;0.0). In the control group person-centered climate decreased (n = 37; p

  12. Pediatric resident perceptions of shift work in ward rotations.

    Science.gov (United States)

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

    2017-10-01

    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.

  13. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline.

    Science.gov (United States)

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

    2017-03-01

    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

  14. A Curriculum on Care for Complex Patients: Resident Perspectives.

    Science.gov (United States)

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

    2016-01-01

    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.

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

    Science.gov (United States)

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

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Arnon Lavi

    2017-10-01

    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

  17. Resident dashboards: helping your clinical competency committee visualize trainees? key performance indicators

    OpenAIRE

    Friedman, Karen A.; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

    2016-01-01

    Introduction: Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC) through the creation of a resident dashboard.Methods: Program leadership at a large univers...

  18. Injection safety practices among resident doctors in a tertiary health ...

    African Journals Online (AJOL)

    Conclusion: The prevalence of needle stick injury was high, awareness of reporting was high but the level of reporting was low. Behavior change communication models are required to bring about a positive change in the practice of reporting. Key words: Injection safety, resident doctors, University of Benin Teaching ...

  19. Use of dialectical behavior therapy in borderline personality disorder: a view from residency.

    Science.gov (United States)

    Sharma, Binali; Dunlop, Boadie W; Ninan, Philip T; Bradley, Rebekah

    2007-01-01

    The authors describe the use of dialectical behavior therapy (DBT) in treating borderline personality disorder during psychiatry residency, and assess the status of DBT education within psychiatry residencies in the United States. The authors present a patient with borderline personality disorder treated by a resident using DBT, along with perspectives from the resident's supervisors. Additionally, self-report surveys inquiring about the attitudes and experiences of residency directors and PGY-4 residents regarding DBT were sent to program directors with available e-mail addresses on FREIDA online. The DBT method employed by the resident had to be modified to fit the constraints of a residency program. The patient in therapy had a tumultuous course, ultimately resulting in the discontinuation of treatment. Survey results suggested an underemphasis on the education and use of DBT during residency, though the strength of this conclusion is limited by the small proportion of surveys returned. Achieving the efficacy of DBT-based treatment of borderline personality disorder reported in the literature in the setting of a residency program is challenging. Greater exposure to DBT during residency may increase residents' skills in using the technique and the likelihood that they will use it after residency.

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

    Science.gov (United States)

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

    2017-11-01

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

  1. The Effects of Abortion Training on Family Medicine Residents' Clinical Experience.

    Science.gov (United States)

    Summit, Aleza K; Gold, Marji

    2017-01-01

    RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience. Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience. Surveys addressed experience in contraception and abortion, attitudes around abortion provision, and post-residency intentions. Descriptive statistics were generated, and statistical tests were performed to assess changes after training. Surveys had a 90% response rate. After the RHEDI enhanced reproductive health rotation, residents reported increased experience in contraception provision, early pregnancy ultrasound, aspiration and medication abortion, and miscarriage management. After training, residents with experience in IUD insertion increased from 85% to 99%, and contraceptive implant insertion experience rose from 60% to 85%. Residents who had performed any abortions increased from 15% to 79%, and self-rated competency in abortion increased. Finally, almost all residents agreed that early abortion was within the scope of family medicine, and training confirmed residents' intentions to provide reproductive health services after residency. Integrated training in reproductive health, with an emphasis on abortion, increases residents' experience and underscores their understanding of the role of these services in family medicine. Increasing the number of family medicine residency programs that offer this training could help prepare family physicians to meet their patients' needs for reproductive health services.

  2. Report of community dialog forum for residents of Fukushima Prefecture with ICRP on returning life to normal in areas affected with long term radiation from the Fukushima nuclear accident

    International Nuclear Information System (INIS)

    Kawai, Masayoshi

    2013-01-01

    Community dialog forum for residents of Fukushima prefecture with ICRP on returning life to normal in area affected with long-term radiation from the Fukushima nuclear accident was held in November 2012 in Fukushima city. At the dialog residents living in refuge, the press related, medical man of regional hospital, people handling food with inspection, personnel promoting decontamination and others stated present state and relevant issues. Anxiety for radiation and loss of public trust on administration were pointed out with their possible solution. In order to remove rumor damage, positive disclosure of information from Fukushima was quite important and indispensable. (T. Tanaka)

  3. Tickborne Powassan virus infections among Wisconsin residents.

    Science.gov (United States)

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

    2010-04-01

    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.

  4. Workplace Violence and Harassment Against Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Benjamin H. Schnapp

    2016-09-01

    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.

  5. Helping Residents Protect Water Sources

    Science.gov (United States)

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

  6. Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

    Science.gov (United States)

    Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

    2015-06-01

    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.

  7. A patient safety education program in a medical physics residency.

    Science.gov (United States)

    Ford, Eric C; Nyflot, Matthew; Spraker, Matthew B; Kane, Gabrielle; Hendrickson, Kristi R G

    2017-11-01

    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. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows.

    Science.gov (United States)

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M

    2011-02-01

    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.

  9. the contribution of resident physicians

    OpenAIRE

    Trusch, Klaus

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

  11. Sleep Quality Among Psychiatry Residents.

    Science.gov (United States)

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

    2016-01-01

    Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. © The Author(s) 2016.

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

    Science.gov (United States)

    Marwan, Yousef; Ayed, Adel

    2013-01-19

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

  13. Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

    Science.gov (United States)

    Potts, Stacy; Shields, Sara; Upshur, Carole

    2016-06-01

    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.

  14. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    OpenAIRE

    Arvind Rishi MD; Syed T. Hoda MD; James M. Crawford MD, PhD

    2016-01-01

    Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and ins...

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

    Science.gov (United States)

    Ziodeen, Kamilah A; Misra, Sanghamitra M

    2018-04-01

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

  16. Poor Intentions or Poor Attention: Misrepresentation by Applicants to Psychiatry Residency

    Science.gov (United States)

    Caplan, Jason P.; Borus, Jonathan F.; Chang, Grace; Greenberg, William E.

    2008-01-01

    Objective: This study examines the veracity of self-reported data by applicants to psychiatry residency. Methods: The authors reviewed the reported publications of all applicants to a psychiatry residency training program over a 2-year span. Results: Nine percent of applicants reporting publications were found to have misrepresented them.…

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

    Science.gov (United States)

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

    2014-12-01

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

  18. Screening for psychopathology symptoms in Mexican psychiatry residents.

    Science.gov (United States)

    Mesa Ríos, Francisco Javier; Muñoz, Maria Del Carmen Lara

    2011-11-01

    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 formally studied. The authors studied the presence, frequency, and severity of psychological symptoms among psychiatry residents from a public psychiatric hospital in Mexico City, Mexico. The SLC-90 was answered by 92 residents; data were analyzed by SAS software, and gender differences were established. Results were compared with data from a previous study realized in the general Mexican population. Interpersonal sensitivity, depression, obsessive-compulsive, and somatic worries were seen more frequently or more severely than other categories. Female residents reported symptoms more frequently. A significant portion of psychiatry residents reported psychological symptoms, although they described them as less frequent and less severe than found in the general Mexican population. In spite of this, interpersonal sensitivity was shown as the most severe symptomatic dimension in our sample, unlike findings in the general population.

  19. Baylor Pediatric SBIRT Medical Residency Training Program: model description and evaluation.

    Science.gov (United States)

    Bray, James H; Kowalchuk, Alicia; Waters, Vicki; Allen, Erin; Laufman, Larry; Shilling, Elizabeth H

    2014-01-01

    The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment methods for alcohol and substance use problems. This paper describes the training program created for pediatric residents and provides an evaluation of the program. Ninety-five first-year pediatric residents participated in the training program. They were assessed on satisfaction with the program, self-rated skills, observed competency, and implementation into clinical practice. The program was successfully incorporated into the residency curricula in two pediatric residencies. Evaluations indicate a high degree of satisfaction with the program, self-reported improvement in SBIRT skills, observed proficiency in SBIRT skills, and utilization of SBIRT skills in clinical practice. SBIRT skills training can be incorporated into pediatric residency training, and residents are able to learn and implement the skills in clinical practice.

  20. A psychopharmacology course for psychiatry residents utilizing active-learning and residents-as-teachers to develop life-long learning skills.

    Science.gov (United States)

    Muzyk, Andrew J; White, Crystal D; Kinghorn, Warren A; Thrall, Grace C

    2013-09-01

    The authors describe the implementation and evaluation of a 1-year psychopharmacology course using residents-as-teachers and active-learning exercises intended to improve understanding of current psychopharmacology and its evidence base, and skills for life-long learning. Weekly classes were devoted to psychotropic medications, treating specific disorders, and use of psychotropics in special patient populations. Each class was divided into three sections: a pharmacology review, a literature review and a faculty-led discussion of clinical questions. Each class included residents as teachers, an audience response system and questions for self-assessment. Resident and faculty presenters evaluated the course weekly and all residents were given a year-end evaluation Resident and faculty evaluations indicated an overall positive response. The residents reported improved perception of knowledge and engagement with this interactive format. The course was well received, demonstrating the viability and value of residents taking a more active role in their own learning.

  1. Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching.

    Science.gov (United States)

    Balwan, Sandy; Fornari, Alice; DiMarzio, Paola; Verbsky, Jennifer; Pekmezaris, Renee; Stein, Joanna; Chaudhry, Saima

    2015-12-01

    Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions. We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum.

  2. [Experiences of bullying in medical residents].

    Science.gov (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

    2014-01-01

    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.

  3. Teaching Dialectical Behavior Therapy to Psychiatry Residents: The Columbia Psychiatry Residency DBT Curriculum.

    Science.gov (United States)

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

    2017-02-01

    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

  4. Factors associated with primary care residents' satisfaction with their training.

    Science.gov (United States)

    Randall, C S; Bergus, G R; Schlechte, J A; McGuinness, G; Mueller, C W

    1997-01-01

    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.

  5. Residents' leadership styles and effectiveness as perceived by nurses.

    Science.gov (United States)

    McCue, J D; Magrinat, G; Hansen, C J; Bailey, R S

    1986-01-01

    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.

  6. Emergency medicine resident well-being: stress and satisfaction.

    Science.gov (United States)

    Hoonpongsimanont, W; Murphy, M; Kim, C H; Nasir, D; Compton, S

    2014-01-01

    Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress. To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms. An online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level. There were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods. Residents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities.

  7. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    Science.gov (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  8. Experiential Leadership Training for Pediatric Chief Residents: Impact on Individuals and Organizations

    Science.gov (United States)

    Doughty, Robert A.; Williams, Patricia D.; Brigham, Timothy P.; Seashore, Charles

    2010-01-01

    Background The past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum. Objective To determine the perceived value and impact of an experiential leadership training program for pediatric chief residents on the chief residents and on their programs and institutions. Methods The authors conducted a retrospective study. Surveys were sent to chief residents who completed the Chief Resident Training Program (CRTP) between 1988 and 2003 and to their program directors and department chairs asking about the value of the program, its impact on leadership capabilities, as well as the effect of chief resident training on programs and institutions. Results Ninety-four percent of the chief residents and 94% of program directors and department chairs reported that the CRTP was “very” or “somewhat” relevant, and 92% of the chief residents indicated CRTP had a positive impact on their year as chief resident; and 75% responded it had a positive impact beyond residency. Areas of greatest positive impact included awareness of personality characteristics, ability to manage conflict, giving and receiving feedback, and relationships with others. Fifty-six percent of chief residents reported having held a formal leadership position since chief residency, yet only 28% reported having received additional leadership training. Conclusion The study demonstrates a perceived positive impact on CRTP participants and their programs and institutions in the short and long term. PMID:21975638

  9. Using 3D acoustic telemetry to assess the response of resident salmonids to strobe lights in Lake Roosevelt, Washington: Chief Joseph Kokanee Enhancement Feasibility Study, 2001-2002 annual report

    Science.gov (United States)

    Perry, R.W.; Farley, M.J.; Hansen, G.S.; Shurtleff, D.J.; Rondorf, D.W.; LeCaire, R.

    2003-01-01

    In 1995, the Chief Joseph Kokanee Enhancement Project was established to mitigate the loss of anadromous fish due to the construction of Chief Joseph and Grand Coulee dams. The objectives of the Chief Joseph Enhancement Project are to determine the status of resident kokanee (Oncorhynchus nerka) populations above Chief Joseph and Grand Coulee dams and to enhance kokanee and rainbow trout (Oncorhynchus mykiss) populations. Studies conducted at Grand Coulee Dam documented substantial entrainment of kokanee through turbines at the third powerhouse.

  10. avoidable factors, missed opportunities and substandard care

    African Journals Online (AJOL)

    views of Save the Children USA or the Bill and Melinda Gates. Foundation. We are thankful for other funding from the Medical. Research Council, the World Health Organisation and the National. Department of Health. References. 1. De Brouwere V, Tonglet R, Van Lerberghe W. Strategies for reducing maternal mortality in.

  11. Substandard Journal Management: Wastage of Authors’ Motivation

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian

    2018-03-01

    Full Text Available Authors who offer papers for publication to professional journals are under the impression that their work is publication-worthy. The editors as well as reviewers adjudge whether the manuscripts should be taken up for publication. This paper presents certain cases of unreliable journals’ management processes with an aim to show how a journal reviewer or editor could squander authors’ time and negatively impact the motivation of scholars to publish.

  12. Broken windows, mediocre methods, and substandard statistics

    NARCIS (Netherlands)

    Wicherts, J.M.; Bakker, M.

    2014-01-01

    Broken windows theory states that cues of inappropriate behavior like litter or graffiti amplify norm-violating behavior. In a series of quasi-experiments, Keizer, Lindenberg, and Steg altered cues of inappropriate behavior in public places and observed how many passersby subsequently violated

  13. Substandard and Counterfeit Antimicrobials: Recent Trends and ...

    African Journals Online (AJOL)

    Methods: Review of various literatures collected through the internet and other sources. Literature search using PubMed and Medline databases and Google search engine was conducted to identify related publications on the subject. Relevant published and unpublished literature was also consulted as additional source of ...

  14. Genetic and Phenotype [Phenotypic] Catalog of Native Resident Trout of the interior Columbia River Basin : FY-99 Report : Populations of the Pend Oreille, Kettle, and Sanpoil River Basins of Colville National Forest.

    Energy Technology Data Exchange (ETDEWEB)

    Trotter, Patrick C.

    2001-05-01

    The 1994 Fish and Wildlife Program of the Northwest Power Planning Council specifies the recovery and preservation of population health of native resident fishes of the Columbia River Basin. Among the native resident species of concern are interior rainbow trout of the Columbia River redband subspecies Oncorhynchus mykiss gairdneri 1 and westslope cutthroat trout O. clarki lewisi. The westslope cutthroat trout has been petitioned for listing under the U. S. Endangered Species Act (American Wildlands et al. 1997). Before at-risk populations can be protected, their presence and status must be established. Where introgression from introduced species is a concern, as in the case of both westslope cutthroat trout and redband rainbow trout, genetic issues must be addressed as well. As is true with native trout elsewhere in the western United States (Behnke 1992), most of the remaining pure populations of these species in the Columbia River Basin are in relatively remote headwater reaches. The objective of this project is to photo-document upper Columbia Basin native resident trout populations in Washington, and to ascertain their species or subspecies identity and relative genetic purity using a nonlethal DNA technique. FY-99 was year two of a five-year project in which we conducted field visits to remote locations to seek out and catalog these populations. In FY-99 we worked in collaboration with the Colville National Forest and Kalispel Indian Tribe to catalog populations in the northeastern corner of Washington State.

  15. 38 CFR 51.70 - Resident rights.

    Science.gov (United States)

    2010-07-01

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

  16. 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, ...

  17. Surgery resident learning styles and academic achievement.

    Science.gov (United States)

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

    2005-01-01

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

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

    Science.gov (United States)

    Fish, D G

    1966-04-09

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

  19. Residency Programs in Veterinary Internal Medicine. Where Are We Going?

    Science.gov (United States)

    Oliver, J. E., Jr.

    1979-01-01

    Data from the 6th Symposium on Veterinary Medical Education, the Arthur D. Little, Inc. report, and the survey of the American College of Veterinary Internal Medicine are reported as they pertain to the need for more residency programs, program quality and accreditation. Program funding is also discussed. (JMD)

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

    Science.gov (United States)

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

    2016-11-01

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

  1. Conversations with Holocaust survivor residents.

    Science.gov (United States)

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

    2011-03-01

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

  2. Mohs Surgical Reconstruction Educational Activity: a resident education tool

    Directory of Open Access Journals (Sweden)

    Croley JA

    2017-02-01

    Full Text Available Julie A Croley,1 C Helen Malone,1 Brandon P Goodwin,1 Linda G Phillips,2 Eric L Cole,2 Richard F Wagner1 1Department of Dermatology, 2Division of Plastic Surgery, Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA Background: Surgical reconstructive planning following Mohs surgery can be a difficult subject for dermatology residents to master. Prior research demonstrates that active learning is preferred and more effective compared to passive learning models and that dermatology residents desire greater complexity and volume in surgical training. We present a novel, active, problem-based learning tool for the education of Mohs reconstruction with the goal of improving residents’ ability to plan surgical reconstructions.Materials and methods: The Mohs Surgical Reconstruction Educational Activity is an active, problem-based learning activity in which residents designed repairs for planned Mohs defects prior to surgery on an iPad application or on a printed photograph. The attending Mohs surgeon reviewed the reconstructive designs, provided feedback, guided discussion, and facilitated insight into additional issues requiring further review. Residents performed or observed the Mohs and reconstructive surgical procedures for respective repairs. Surveys were administered to participants before and after participating in the Mohs Surgical Reconstruction Educational Activity to assess the educational value of the activity. Survey responses were recorded on a 5-point Likert scale.Results: Mean participant-reported confidence in flap and graft knowledge, flap and graft planning, and flap and graft performance increased 1.50–2.50 Likert scale points upon completion of the Mohs surgery rotation by residents participating in the educational activity. The observed trend was larger in the dermatology resident subset, with increases of 2.00–3.50 Likert scale points reported for these questions. Mean participant-reported

  3. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Science.gov (United States)

    Hoda, Syed T.; Crawford, James M.

    2016-01-01

    Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates. PMID:28725766

  4. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Directory of Open Access Journals (Sweden)

    Arvind Rishi MD

    2016-05-01

    Full Text Available Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9 felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

  5. Trends in violence education in family medicine residency curricula.

    Science.gov (United States)

    Cronholm, Peter F; Singh, Vijay; Fogarty, Colleen T; Ambuel, Bruce

    2014-09-01

    Violence is a significant public health issue with far-reaching implications for the health of individuals and their communities. Our objective was to describe trends in violence-related training in family medicine residency programs since the last national survey was conducted in 1997. Surveys were sent to 337 US family medicine residency programs with the program director having active Society of Teachers of Family Medicine (STFM) membership. Measures included residency setting and characteristics, violence-related curricular content, teaching techniques and personnel, timing of content, and impact of changes in Residency Review Committee (RRC) and Accreditation Council for Graduate Medical Education (ACGME) requirements. Descriptive statistics and bivariate analyses comparing measures across time were used. A total of 201 (60%) surveys were completed. The most common violence curricula was child (83%) and elder abuse (76%), and the most common teachers of violence-related content were family physicians, psychologists, and social workers. The most common teaching methods were clinical precepting (94%), lectures (90%), case vignettes (71%), and intimate partner violence (IPV) shelter experiences (67%). ACGME and RRC changes were not reflected in self-reported measures of curricular emphasis or time. Violence curricular content and number of hours has been constant in family medicine residencies over time. An increase in the reported use of active learning strategies was identified as a trend across surveys. Next steps for violence curricula involve assessment of residents' competency to identify and intervene in violence.

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

    Science.gov (United States)

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

    2004-01-01

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

  7. Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

    Science.gov (United States)

    Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E

    2017-11-10

    The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.

  8. A review of teaching methods and outcomes of resident phacoemulsification.

    Science.gov (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.

  9. Outcomes of the first Family Practice Chief Resident Leadership Conference.

    Science.gov (United States)

    Mygdal, W K; Monteiro, M; Hitchcock, M; Featherston, W; Conard, S

    1991-01-01

    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.

  10. Hospitalist involvement in family medicine residency training: A CERA study.

    Science.gov (United States)

    Baldor, Robert; Savageau, Judith A; Shokar, Navkiran; Potts, Stacy; Gravel, Joseph; Eisenstock, Kimberly; Ledwith, James

    2014-02-01

    Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medicine (39.1%), pediatrics (35.4%), OB/laborists (18.0%), and combined services (8.7%). The majority of programs with a hospitalist training track (or plans to develop one) indicated that this was for a family medicine service. Sixty percent of programs that have a hospitalist service involve hospitalists in teaching. Twenty percent of directors reported that hospitalists serve as family medicine faculty, and 63% viewed them as "good educators." However, 85% reported no reduction in inpatient teaching by family medicine faculty despite using hospitalist teaching services. Hospitalists have a significant educational role in family medicine resident training. Further research is needed to explore how hospitalists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers.

  11. Resident wellness behaviors: relationship to stress, depression, and burnout.

    Science.gov (United States)

    Lebensohn, Patricia; Dodds, Sally; Benn, Rita; Brooks, Audrey J; Birch, Michele; Cook, Paula; Schneider, Craig; Sroka, Selma; Waxman, Dael; Maizes, Victoria

    2013-09-01

    Stress in medical education has been well documented, often with the primary focus on negative factors such as depression and burnout. Few studies have attempted to assess well-being mediating behaviors. This study describes the relationship between wellness behaviors and measures of well-being at the start of family medicine residency. Using an online questionnaire, first-year family medicine residents (n=168) completed standardized measures exploring perceived stress, depression, satisfaction with life, and burnout. A lifestyle wellness behavior measure was developed for the study. Average reported perceived stress levels were consistent with ranges found for medical students and residents. Twenty-three percent of residents scored in a range consistent with depression risk. In terms of burnout risk, 13.7% scored in the high emotional exhaustion range and 23.8% in the high depersonalization range. Two thirds reported high life satisfaction. Higher depersonalization and less time in nurturing relationships were associated with greater likelihood of medication use for sleep, mood, and anxiety in females. Higher alcohol use was associated with increased levels of perceived stress, burnout, and depression. The two wellness behaviors most associated with higher well-being were restful sleep and exercise. At the start of residency, well-being measures are consistent with findings in medical school. Restful sleep and exercise were associated with more positive well-being. Future longitudinal data analysis will help clarify the effect of residency training in well-being and lifestyle behaviors. Identification of protective factors and coping mechanisms could guide residencies in incorporating support services for residents.

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Model Legislation on Student Residency.

    Science.gov (United States)

    Higher Education in the States, 1971

    1971-01-01

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

  14. From Residency to Lifelong Learning.

    Science.gov (United States)

    Brandt, Keith

    2015-11-01

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

  15. Deaths from Resident-to-Resident Aggression in Australian Nursing Homes.

    Science.gov (United States)

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

    2017-12-01

    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.

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

    Science.gov (United States)

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

    Board certified radiation oncologists and medical physicists are required to earn self-assessment module (SAM) continuing medical education (CME) credit, which may require travel costs or usage fees. Data indicate that faculty participation in resident teaching activities is beneficial to resident education. Our hypothesis was that providing the opportunity to earn SAM credit in resident didactics would increase faculty participation in and improve resident education. SAM applications, comprising CME certified category 1 resident didactic lectures and faculty-generated questions with respective answers, rationales, and references, were submitted to the American Board of Radiology for formal review. Surveys were distributed to assess main academic campus physician, affiliate campus physician, physicist, and radiation oncology resident impressions regarding the quality of the lectures. Survey responses were designed in Likert-scale format. Sign-test was performed with P < .05 considered statistically different from neutral. First submission SAM approval was obtained for 9 of 9 lectures to date. A total of 52 SAM credits have been awarded to 4 physicists and 7 attending physicians. Main academic campus physician and affiliate campus physician attendance increased from 20% and 0%, respectively, over the 12 months preceding CME/SAM lectures, to 55.6% and 20%, respectively. Survey results indicated that the change to SAM lectures increased the quality of resident lectures (P = .001), attending physician participation in resident education (P < .0001), physicist involvement in medical resident education (P = .0006), and faculty motivation to attend resident didactics (P = .004). Residents reported an increased amount of time required to prepare lectures (P = .008). We are the first department, to our knowledge, to offer SAM credit to clinical faculty for participation in resident-generated didactics. Offering SAM credit at resident lectures is a cost-effective alternative

  17. Obstetric and Gynecologic Resident Ultrasound Education Project: Is the Current Level of Gynecologic Ultrasound Training in Canada Meeting the Needs of Residents and Faculty?

    Science.gov (United States)

    Green, Jessica; Kahan, Meldon; Wong, Suzanne

    2015-09-01

    Ultrasound is a critical diagnostic imaging tool in obstetrics and gynecology (Ob/Gyn). Obstetric ultrasound is taught during residency, but we suspected a gap in Gyn ultrasound education. Proficiency in Gyn ultrasound allows real-time interpretation and management of pelvic disease and facilitates technical skill development for trainees learning blinded procedures. This study sought to evaluate ultrasound education in Canada's Ob/Gyn residency programs and assess whether residents and physicians perceived a need for a formalized Gyn ultrasound curriculum. We distributed a needs assessment survey to residents enrolled in Canadian Ob/Gyn residency programs and to all obstetrician/gynecologists registered as members of the Society of Obstetricians and Gynaecologists of Canada. Residents were asked to specify their current training in ultrasound and to rate the adequacy of their curriculum. All respondents rated the importance of proficiency in pelvic ultrasound for practicing obstetrician/gynecologists as well as the perceived need for formalized ultrasound training in Ob/Gyn residency programs. Eighty-two residents and 233 physicians completed the survey. Extents and types of ultrasound training varied across residency programs. Most residents reported inadequate exposure to Gyn ultrasound, and most residents and physicians agreed that it is important for obstetrician/gynecologists to be proficient in Gyn ultrasound and that the development of a standardized Gyn ultrasound curriculum for residency programs is important. Current ultrasound education in Ob/Gyn varies across Canadian residency programs. Training in Gyn ultrasound is lacking, and both trainees and physicians confirmed the need for a standardized Gyn ultrasound curriculum for residency programs in Canada. © 2015 by the American Institute of Ultrasound in Medicine.

  18. The use of sleep aids among Emergency Medicine residents: a web based survey

    Directory of Open Access Journals (Sweden)

    Raja Ali

    2006-10-01

    Full Text Available Abstract Background Sleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. We hypothesized residents routinely use pharmacologic sleep aids to manage their sleep deprivation and reduce sleepiness. Methods A web-based survey of US allopathic Emergency Medicine (EM residents was conducted during September 2004. All EM residency program directors were asked to invite their residents to participate. E-mail with reminders was used to solicit participation. Direct questions about use of alcohol and medications to facilitate sleep, and questions requesting details of sleep aids were included. Results Of 3,971 EM residents, 602 (16% replied to the survey. Respondents were 71% male, 78% white, and mean (SD age was 30 (4 years, which is similar to the entire EM resident population reported by the ACGME. There were 32% 1st year, 32% 2nd year, 28% 3rd year, and 8% 4th year residents. The Epworth Sleepiness Scale (ESS showed 38% of residents were excessively sleepy (ESS 11–16 and 7% were severely sleepy (ESS>16. 46% (95 CI 42%–50% regularly used alcohol, antihistamines, sleep adjuncts, benzodiazepines, or muscle relaxants to help them fall or stay asleep. Study limitations include low response and self-report. Conclusion Even with a low response rate, sleep aid use among EM residents may be common. How this affects performance, well-being, and health remains unknown.

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

    Directory of Open Access Journals (Sweden)

    McGrath, Jillian

    2017-01-01

    time dedicated to clinical work during orientation. Only a few programs reported engaging in baseline or milestone assessments, an activity that could offer significant benefits to the residency program.

  20. Teaching residents to write a research paper.

    Science.gov (United States)

    Coleridge, S T

    1993-09-01

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

  1. National undergraduate medical core curriculum in Turkey: evaluation of residents.

    Science.gov (United States)

    Budakoğlu, Işıl İrem; Coşkun, Ozlem; Ergün, Mehmet Ali

    2014-03-01

    There is very little information available on self-perceived competence levels of junior medical doctors with regard to definitions by the National Core Curriculum (NCC) for Undergraduate Medical Education. This study aims to determine the perceived level of competence of residents during undergraduate medical education within the context of the NCC. Descriptive study. The survey was conducted between February 2010 and December 2011; the study population comprised 450 residents. Of this group, 318 (71%) participated in the study. Self-assessment questionnaires on competencies were distributed and residents were asked to assess their own competence in different domains by scoring them on a scale of 1 to 10. Nearly half of the residents reported insufficient experience of putting clinical skills into practice when they graduated. In the theoretical part of NCC, the lowest competency score was reported for health-care administration, while the determination of level of chlorine in water, delivering babies, and conducting forensic examinations had the lowest perceived levels of competency in the clinical skills domain. Residents reported low levels of perceived competency in skills they rarely performed outside the university hospital. They were much more confident in skills they performed during their medical education.

  2. Survival prediction among nursing home residents: A longitudinal study.

    Science.gov (United States)

    Lai, Claudia Kam Yuk; Ho, Lily Yuen Wah; Chin, Kenny Chi Wing; Kwong, Enid Wai Yung

    2018-03-01

    To determine the survival time and predictors of survival of residents in a nursing home. Nursing home residents admitted from June 2008 (when the nursing home started operating) to December 2012 (n = 230) to a new nursing home in Hong Kong were prospectively followed. The predictors of survival in the residents were assessed annually, with the exception of those who did not want to continue with the study, or were hospitalized, discharged from the nursing home or died, to compare changes occurring from 2008 to 2012. Cox's regression analysis was used to examine the predictors of survival. A total of 66 of the nursing home residents (28.7%) died during the study period. The median length of survival was 20.46 months. Sex, the number of diseases, depressive symptoms, cognitive status and nutritional status were found to be significant predictors of survival. It is crucial for healthcare providers to offer quality care to residents in long-term care to enhance their well-being in the final sojourn of their lives. Although there are no consistent reports of predictors in the international literature, it is important to address the modifiable predictors, as this might lead to improvements in the quality of life of the residents. Geriatr Gerontol Int 2018; 18: 428-433. © 2017 Japan Geriatrics Society.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  4. Do You See What I See? How We Use Video as an Adjunct to General Surgery Resident Education.

    Science.gov (United States)

    Abdelsattar, Jad M; Pandian, T K; Finnesgard, Eric J; El Khatib, Moustafa M; Rowse, Phillip G; Buckarma, EeeL N H; Gas, Becca L; Heller, Stephanie F; Farley, David R

    2015-01-01

    Preparation of learners for surgical operations varies by institution, surgeon staff, and the trainees themselves. Often the operative environment is overwhelming for surgical trainees and the educational experience is substandard due to inadequate preparation. We sought to develop a simple, quick, and interactive tool that might assess each individual trainee's knowledge baseline before participating in minimally invasive surgery (MIS). A 4-minute video with 5 separate muted clips from laparoscopic procedures (splenectomy, gastric band removal, cholecystectomy, adrenalectomy, and inguinal hernia repair) was created and shown to medical students (MS), general surgery residents, and staff surgeons. Participants were asked to watch the video and commentate (provide facts) on the operation, body region, instruments, anatomy, pathology, and surgical technique. Comments were scored using a 100-point grading scale (100 facts agreed upon by 8 surgical staff and trainees) with points deducted for incorrect answers. All participants were video recorded. Performance was scored by 2 separate raters. An academic medical center. MS = 10, interns (n = 8), postgraduate year 2 residents (PGY)2s (n = 11), PGY3s (n = 10), PGY4s (n = 9), PGY5s (n = 7), and general surgery staff surgeons (n = 5). Scores ranged from -5 to 76 total facts offered during the 4-minute video examination. MS scored the lowest (mean, range; 5, -5 to 8); interns were better (17, 4-29), followed by PGY2s (31, 21-34), PGY3s (33, 10-44), PGY4s (44, 19-47), PGY5s (48, 28-49), and staff (48, 17-76), p Surgery. Published by Elsevier Inc. All rights reserved.

  5. Posttraumatic growth and benefit-finding in lung cancer survivors: The benefit of rural residence?

    Science.gov (United States)

    Andrykowski, Michael A; Steffens, Rachel F; Bush, Heather M; Tucker, Thomas C

    2017-06-01

    Rural cancer survivors report more distress than non-rural survivors. Little research has examined whether rural residence might also be linked to positive psychological outcomes. Rural ( n = 117) and non-rural ( n = 76) lung cancer survivors completed measures of posttraumatic growth, benefit-finding, and distress. Rural survivors reported more posttraumatic growth than urban survivors. There were no differences in benefit-finding. Mediation analyses indicated distress mediated the relationship between rural residence and posttraumatic growth. Findings suggest rural residence might be beneficial with regard to potential for posttraumatic growth among cancer survivors. Consistent with trauma theory, distress mediated the relationship between rural residence and posttraumatic growth.

  6. Internal Medicine Residents' Perceptions of Cross-Cultural Training

    Science.gov (United States)

    Park, Elyse R; Betancourt, Joseph R; Miller, Elizabeth; Nathan, Michael; MacDonald, Ellie; Ananeh-Firempong, Owusu; Stone, Valerie E

    2006-01-01

    BACKGROUND Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations. OBJECTIVES To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations. DESIGN, SETTING, AND PATIENTS Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate = 87%). Interviews were recorded, transcribed, and analyzed. RESULTS Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms. CONCLUSIONS If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base. PMID:16704391

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

    Science.gov (United States)

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

    2010-01-01

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

  8. Long-Term Care Resident Outcomes Following a Natural Disaster

    Science.gov (United States)

    Cacchione, Pamela Z.; Willoughby, Lisa M.; Langan, Joanne C.; Culp, Kennith

    2015-01-01

    This report describes the outcomes of 17 long-term care residents who were participating in a nursing intervention study. The residents were evacuated for 5 days due to a severe summer storm that caused widespread power outages. These residents were seen the day of the storm and three times per week for 2 weeks following their return to the nursing home. More than half of the participants had significant changes in their NEECHAM Confusion Scale scores (n = 11) and modified Confusion Assessment Method scores (n = 9) scores, suggesting the onset of delirium. Two participants were hospitalized within the 2 weeks of the evacuation. One participant died unexpectedly. This report provides a rare look into the negative effects of a short-term evacuation due to a natural disaster. PMID:21634311

  9. Nursing Home Resident Symptomatology Triggering Transfer: Avoiding Unnecessary Hospitalizations

    Directory of Open Access Journals (Sweden)

    Alyce S. Ashcraft

    2012-01-01

    Full Text Available The purpose of this study was to describe nursing home resident symptomatology and medical diagnoses associated with nursing home to hospital transfers. A retrospective chart review of documented transfers was conducted at a 120-bed, nonprofit urban Continuing Care Retirement Center nursing home facility located in the southwestern United States. The transferred residents (n=101 had seventy different medical diagnoses prior to hospital transfer with hypertension, coronary artery disease, and congestive heart failure most frequently reported. Most frequently reported symptomatology included fatigue, lethargy or weakness, shortness of breath, and change in level of consciousness. Multiple symptomatology was indicative of a wide variety of medical diagnoses. The diagnoses and symptomatology recorded in this paper identify the importance of strategic planning concerning assessment and communication of common nursing home resident symptomatology and the importance of basic nursing and diagnostic procedures for prevention of potentially avoidable hospitalizations.

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

    Science.gov (United States)

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

    2014-12-15

    The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2009-05-01

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

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

    Science.gov (United States)

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

    2011-05-01

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

  13. Continuity of care in dermatology residency programs in the United States.

    Science.gov (United States)

    Loh, Tiffany; Vazirnia, Aria; Afshar, Maryam; Dorschner, Robert; Paravar, Taraneh

    2017-05-15

    As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States must participate in continuity clinic. This requirement may be achieved through multiple means, allowing for program variation. To better assess continuity clinic's role in resident learning, more data on this component of graduate medical education is needed. An anonymous online survey was distributed via the American Board of Dermatology list serv to all U.S. dermatology residents. Continuity clinic organization, setting, frequency, and patient and preceptor characteristics were assessed; resident satisfaction and learning were compared. Of 231 responses, 7.8% reported continuity clinic daily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were "resident-run with attending" and 11.3%were attending-run. The rest were "resident-run with no attending" (0.9%), both resident and attending run(3.0%), or "other" (4.8%). Trainees in resident-run clinics (with attendings) reported greater continuity of care than those in attending-run clinics (p<0.001).Residents reported better teaching with attending presence during patient encounters than when attendings were present only if concerns were raised(p<0.01).

  14. An assessment of emotional intelligence in emergency medicine resident physicians.

    Science.gov (United States)

    Papanagnou, Dimitrios; Linder, Kathryn; Shah, Anuj; London, Kory Scott; Chandra, Shruti; Naples, Robin

    2017-12-27

    To define the emotional intelligence (EI) profile of emergency medicine (EM) residents, and identify resident EI strengths and weaknesses. First-, second-, and third-year residents (post-graduate years [PGY] 1, 2, and 3, respectively) of Thomas Jefferson University Hospital's EM Program completed the Emotional Quotient Inventory (EQ-i 2.0), a validated instrument offered by Multi-Health Systems. Reported scores included total mean EI, 5 composite scores, and 15 subscales of EI. Scores are reported as means with 95% CIs. The unpaired, two-sample t-test was used to evaluate differences in means. Thirty-five residents completed the assessment (response rate 97.2%). Scores were normed to the general population (mean 100, SD 15). Total mean EI for the cohort was 103 (95%CI,100-108). EI was higher in female (107) than male (101) residents. PGY-2s demonstrated the lowest mean EI (95) versus PGY-1s (104) and PGY-3s (110). The difference in PGY-3 EI (110; 95%CI,103-116) and PGY-1 EI (95, 95%CI,87-104) was statistically significant (unpaired t-test, pself-actualization (107); empathy (107); interpersonal relationships (106); impulse control (106); and stress tolerance (106). Lowest subscale score was in assertiveness (98). Self-regard (89), assertiveness (88), and independence (90) were areas in which PGY-2s attained relatively lower scores (unpaired t-test, ptraining that may assist in developing EM residents, specifically in self-regard, assertiveness, and self-expression. Further study is required to ascertain if patterns in level of training are idiosyncratic or relate to the natural maturation of residents.

  15. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

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

  16. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

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

  17. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

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

  18. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

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

  19. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

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

  20. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

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

  1. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

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

  2. Breastfeeding Education and Support Services Provided to Family Medicine and Obstetrics-Gynecology Residents.

    Science.gov (United States)

    Rodriguez Lien, Elizabeth; Shattuck, Karen

    2017-11-01

    Breastfeeding education is known to be insufficient in pediatric (PEDS) training and is, in part, responsible for suboptimal rates of breastfeeding. No recent studies about the level of education provided to family medicine (FM) and obstetrics-gynecology (OB) residency trainees are available. This study was conducted to investigate breastfeeding education and support services provided to FM and OB residents in the United States. The results were compared with a 2011 study of PEDS residents. A cross-sectional study was conducted using a web-based survey emailed to program directors (PDs) of FM and OB residency programs in the United States. Eighteen percent of PDs (95 of 515) completed the survey. Of these, 88% answered questions regarding education and support services provided. A median of 23 hours of breastfeeding education is provided to OB residents (4-year program) and 8 hours provided to FM residents (3-year program). In comparison, PEDS programs reported a median of 9 hours. The most commonly used settings included lectures with faculty and lactation consultants, similar to the PEDS study. Approximately 75% of respondents cited barriers to educating residents, with limited resident time being the most common. Eighty-one percent of respondents identified breastfeeding rooms as the service most frequently provided to residents who breastfeed. FM and PEDS residents are provided similar amounts of breastfeeding education, while OB programs provide more education, but in different settings. Reported barriers to this education are similar in all specialties. Support services are more commonly provided in PEDS programs.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-01

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

  4. Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute

    Directory of Open Access Journals (Sweden)

    Vasantmeghna Srinivasa Murthy

    2014-01-01

    Full Text Available Objectives: To evaluate subjective sleep quality, day-time sleepiness, prevalence of substance use, satisfaction with life among residents at our institute. To evaluate association of sleep qualitywith satisfaction with life and day-time sleepiness. To compare the findings between residents in clinical and para-clinical departments. Materials and Methods: Eighty-four residents filled questionnaires to obtain socio-demographic information and use of substance (s. Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, and Satisfaction With Life scale (SWLS were also used. Association between sleep quality and sleepiness and satisfaction with life was evaluated. From the data collected, comparisons were made between the clinical and para-clinical department residents. Results: A significant number of residents belonging to the clinical faculty were poorsleepers; reported high levels of abnormal day-time sleepiness and less satisfaction with life compared to residents in para-clinical faculties. The differences in correlation between sleepiness and satisfaction with life with sleep quality among the two groups were not found to be significant. A larger percentage of clinical residents reported use of at least one substance during the residency period compared to the para-clinical residents. Conclusions: Poor sleep quality is perceived greatly by the resident doctors in our public hospital, especially among clinical faculties. Interventions are thus necessary in order to ensure adequate sleep among them.

  5. Education on the Business of Plastic Surgery During Training: A Survey of Plastic Surgery Residents.

    Science.gov (United States)

    Ovadia, Steven A; Gishen, Kriya; Desai, Urmen; Garcia, Alejandro M; Thaller, Seth R

    2018-02-14

    Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training. Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training. A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents. Responses from residents at the PGY2 level and above were included for analysis. Tables were prepared to present survey results. Hundred and sixty-six residents including 147 PGY2 and above residents responded to our survey. Only 43.5% reported inclusion of business training in their plastic surgery residency. A majority of residents reported they do not expect on graduation to be prepared for the business aspects of plastic surgery. Additionally, a majority of residents feel establishment of a formal lecture series on the business of plastic surgery would be beneficial. Results from our survey indicate limited training at plastic surgery programs in necessary business skills. Plastic surgery residency programs should consider incorporating or enhancing elements of business training in their curriculum. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  6. 45 CFR 233.40 - Residence.

    Science.gov (United States)

    2010-10-01

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

  7. Breaking Bad News - Perceptions of Pediatric Residents.

    Science.gov (United States)

    Geeta, M G; Krishnakumar, P

    2017-08-15

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

  8. 8 CFR 325.3 - Residence.

    Science.gov (United States)

    2010-01-01

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

  9. Pioneering partnerships: Resident involvement from multiple perspectives

    NARCIS (Netherlands)

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

    2013-01-01

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

  10. 24 CFR 206.39 - Principal residence.

    Science.gov (United States)

    2010-04-01

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

  11. 25 CFR 700.97 - Residence.

    Science.gov (United States)

    2010-04-01

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

  12. Does Targeted Training Improve Residents' Teaching Skills?

    Science.gov (United States)

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

    2015-01-01

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

  13. Negotiations of Acknowledgement among Middle Class Residents

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2013-01-01

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

  14. Screening Mammography Utilization in Tennessee Women: The Association with Residence

    Science.gov (United States)

    Brown, Kathleen C.; Fitzhugh, Eugene C.; Neutens, James J.; Klein, Diane A.

    2009-01-01

    Context: Approximately 70% of US women over age 40 report mammography screening within 2 years. However, rates are likely to vary by age, income, educational level, and residence. Purpose: To describe the prevalence of screening mammography and associated factors in women living in rural and urban areas of Tennessee. Methods: Using pooled data…

  15. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    Science.gov (United States)

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  16. Investigating Black Gay Male Undergraduates' Experiences in Campus Residence Halls

    Science.gov (United States)

    Strayhorn, Terrell L.; Mullins, Taris G.

    2012-01-01

    This qualitative study sought to understand the challenges that Black gay male undergraduates confront in campus residence halls and the supports that enabled their success in facing them. Drawing on in-depth interviews with 29 participants, we found that Black gay men report varied encounters with subtle and overt forms of racism among White…

  17. Psychiatry Residency Education in Canada: Past, Present and Future

    Science.gov (United States)

    Saperson, Karen

    2013-01-01

    Objective: This article provides a brief overview of the history of psychiatry residency training in Canada,and outlines the rationale for the current training requirements, changes to the final certification examination,and factors influencing future trends in psychiatry education and training. Method: The author compiled findings and reports on…

  18. Promoting Scholarship during Child and Adolescent Psychiatry Residency

    Science.gov (United States)

    Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.

    2012-01-01

    Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…

  19. Pediatric residents' perceptions of communication competencies: Implications for teaching.

    Science.gov (United States)

    Rider, Elizabeth A; Volkan, Kevin; Hafler, Janet P

    2008-01-01

    Medical regulatory organizations worldwide require competency in communication skills. Pediatric communication competencies are unique, and little is known about pediatric residents' perceptions regarding these skills. The purpose of this study was to examine pediatric residents' attitudes about communication skills, their perceptions of the importance of learning 15 specific communication skills relevant to pediatrics, confidence in these skills, and relevant program supports. We developed a 47-item cross-sectional questionnaire to study pediatric residents' attitudes and perceptions regarding communication competencies. 104 pediatric housestaff in a university-affiliated program in the US were asked to complete the questionnaire. Scale variables were created and evaluated for reliability. Data were analysed using descriptive and univariate statistics. Response rate was 86% (89/104). Cronbach's alpha reliabilities of the Importance Scale (r = 0.92) and Confidence Scale (r = 0.90) were excellent. Ninety nine percent of the participants agreed that learning to communicate effectively with patients was a priority. All agreed it is important to demonstrate empathy and caring, and to teach medical students to communicate effectively with patients. Pediatric residents agreed that the 15 communication competencies studied were important to learn. Most reported confidence in core communication competencies (interviewing, listening, building rapport, demonstrating caring and empathy), but only half or fewer were confident in 7 more advanced communication skills (ability to discuss end-of-life issues, speaking with children about serious illness, giving bad news, dealing with the 'difficult' patient/parent, cultural awareness/sensitivity, understanding psychosocial aspects, and understanding patients' perspectives). Few reported the availability of relevant program supports for learning these skills. Pediatric residents perceive communication competencies as important and a

  20. Sleep disturbances predict prospective declines in resident physicians’ psychological well-being

    Directory of Open Access Journals (Sweden)

    Alice A. Min

    2015-07-01

    Full Text Available Background: Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year. Methods: Sixty-nine (N=69 resident physicians completed the Brief Resident Wellness Profile (M=17.66, standard deviation [SD]=3.45, range: 0–17 and the Pittsburgh Sleep Quality Index (M=6.22, SD=2.86, range: 12–25 at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents’ self-reported wellness. Results: Accounting for residents’ overall level of sleep disturbance across the entire study period, both the concurrent (within-person within-occasion effect of sleep disturbance (B=−0.20, standard error [SE]=0.06, p=0.003, 95% confidence interval [CI]: −0.33, −0.07 and the lagged within-person effect of resident sleep disturbance (B=−0.15, SE=0.07, p=0.037, 95% CI: −0.29, −0.009 were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicator of resident wellness, predicting decreased well-being 1 month later. Conclusions: Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.

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

    Science.gov (United States)

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

    2016-03-15

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

  2. Using 3D Acoustic Telemetry to Assess the Response of Resident Salmonids to Strobe Lights in Lake Roosevelt, Washington; Chief Joseph Kokanee Enhancement Feasibility Study, Annual Report 2001-2002.

    Energy Technology Data Exchange (ETDEWEB)

    Perry, Russlee; Farley, M.; Hansen, Gabriel

    2003-01-01

    In 1995, the Chief Joseph Kokanee Enhancement Project was established to mitigate the loss of anadromous fish due to the construction of Chief Joseph and Grand Coulee dams. The objectives of the Chief Joseph Enhancement Project are to determine the status of resident kokanee (Oncorhynchus nerka) populations above Chief Joseph and Grand Coulee dams and to enhance kokanee and rainbow trout (Oncorhynchus mykiss) populations. Studies conducted at Grand Coulee Dam documented substantial entrainment of kokanee through turbines at the third powerhouse. In response to finding high entrainment at Grand Coulee Dam, the Independent Scientific Review Panel (ISRP) recommended investigating the use of strobe lights to repel fish from the forebay of the third powerhouse. Therefore, our study focused on the third powerhouse and how strobe lights affected fish behavior in this area. The primary objective of our study was to assess the behavioral response of kokanee and rainbow trout to strobe lights using 3D acoustic telemetry, which yields explicit spatial locations of fish in three dimensions. Our secondary objectives were to (1) use a 3D acoustic system to mobile track tagged fish in the forebay and upriver of Grand Coulee Dam and (2) determine the feasibility of detecting fish using a hydrophone mounted in the tailrace of the third powerhouse. Within the fixed hydrophone array located in the third powerhouse cul-de-sac, we detected 50 kokanee and 30 rainbow trout, accounting for 47% and 45% respectively, of the fish released. Kokanee had a median residence time of 0.20 h and rainbow trout had a median residence time of 1.07 h. We detected more kokanee in the array at night compared to the day, and we detected more rainbow trout during the day compared to the night. In general, kokanee and rainbow trout approached along the eastern shore and the relative frequency of kokanee and rainbow trout detections was highest along the eastern shoreline of the 3D array. However, because we

  3. Identifying Gaps and Inconsistencies in Urogynecologic Surgical Training of Obstetrics and Gynecology Residents.

    Science.gov (United States)

    Weber LeBrun, Emily E; Asumu, Hazel; Richardson, Anne M; Cooper, LouAnn A; Davis, John D

    This study aims to determine the expectations of Obstetrics and Gynecology (ObGyn) residency and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellowship program directors (FPDs) for the independent performance of urogynecologic procedures during residency and to compare these expectations with the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational objectives. Two parallel, anonymous surveys were distributed simultaneously to all directors of accredited ObGyn residency and FPMRS fellowship programs in the United States. Respondents provided their own professional and program demographic information and indicated whether they expected their residents to independently perform 27 selected urogynecologic procedures. Among residency program directors (RPDs) and FPDs, the online survey response rate was 24.8% (n = 59) and 51.9% (n = 27), respectively. More RPDs expected residents to perform prolapse procedures with mesh, including laparoscopic sacrocolpopexy, all apical suspensions, mesh excisions, and cystotomy repairs, than FPDs. In addition, RPDs expected mastery of most urogynecologic procedures by the Post Graduate Year 3 level, whereas most FPDs did not expect independent performance of these procedures during residency at all. There were notable differences between RPDs' expectations and CREOG objectives regarding several surgical procedures. Whereas CREOG recommends independent performance of anterior and posterior repair, vaginal suspension, vaginal hysterectomy, and transobturator slings, a significant number of RPDs did not report expecting mastery of these procedures during residency. Approximately 30% of RPDs expected residents to perform open sacrocolpopexy and vesicovaginal fistula repair, whereas CREOG recommends only the understanding of these, without procedural mastery. Although community needs vary by region and setting, CREOG objectives serve as the standard for resident surgical education. This study highlights

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  6. Resident physician opinions on autopsy importance and procurement.

    Science.gov (United States)

    Hull, Mindy J; Nazarian, Rosalynn M; Wheeler, Amy E; Black-Schaffer, W Stephen; Mark, Eugene J

    2007-02-01

    The national decline in hospital autopsy cases negatively impacts physician education and medical quality control to an unknown degree. The current non-medicolegal autopsy rate is less than 5% of hospital deaths. This study compares internal medicine and pathology resident physician perceptions of the autopsy, including the importance, procurement, technique, and the pathologist-internist interaction. An 84-item survey based on autopsy literature was designed, piloted, and distributed to 214 residents at a single 800+ bed tertiary care academic teaching hospital (Massachusetts General Hospital, Boston) to accomplish this goal. Completed surveys were obtained from 72% of medicine (n = 118) and 84% of pathology (n = 42) residents. Residents strongly agree on the importance of autopsies for education, answering clinical questions, public health, and research. Autopsy rates are deemed inadequate. Internists are comfortable requesting autopsies, but report insufficient guidance and difficulty with answering technical questions. Although not requested on all hospital deaths, internists are more likely to initiate an autopsy request than a decedent's family, and worry significantly less about institutional costs and malpractice litigation than pathologists believe. Internists expressed interest in having an instructional brochure to give families, observing an autopsy, and having increased communication and support with autopsies from pathology residents. The main reasons why autopsy consent is not requested (it is unpleasant, cause of death is known, family is upset or seems unwilling) and why families refuse (patient has suffered enough, body may be handled disrespectfully, religious/moral objections, lack information) were similar for both resident groups. Despite their decline, autopsies still remain important to medicine as indicated by internal medicine and pathology residents at a large academic center. Improving autopsy education, enhancing availability of

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

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  9. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  10. Operative Landscape at Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

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

    2017-07-01

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

  11. On Integrated Residency in Health with emphasis on Health Surveillance.

    Science.gov (United States)

    Rocha, Andrei Fernandes da; Breier, Anelise; Souza, Bianca de; Almeida, Camila Neves de; Santos, Caroline Mello Dos; Rohloff, Claudia Cristina; Scariot, Estela Lopes; Azambuja, João Vinicius Ribeiro; Cartana, Joaquim Basso; Canal, Natalia; Santos, Niura Massário Dos; Reinher, Simone Gonçalves Menegotto

    2017-10-01

    Taking into account the four underpinning areas of Health Surveillance (environmental, epidemiological, health and worker's health), the performance of professionals in this area requires a broad and complex set of information from many fields of knowledge, including that which is not classified as health. Considering the need to prepare professionals to work in Health Surveillance in the Unified Health System (SUS), integrating the four fields of knowledge, the Public Health School of Rio Grande do Sul (ESP/RS) and the surveillance areas of the municipality of Porto Alegre and Rio Grande do Sul State have established a new emphasis in the traditional residency of ESP/RS. This work uses the experience report descriptive method. It shows the activities of residents in the formation course of the first year, fourth class of this in-service education experience and takes stock of results of residency freshmen.

  12. Resident participation in neighbourhood audit tools — a scoping review

    Science.gov (United States)

    Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

    2018-01-01

    Abstract 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 facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. Methods A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. Results In total, 13 participatory instruments were identified. The role of residents in most instruments was as ‘data collectors’; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. Conclusions The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. PMID:29346663

  13. Characteristics of residents and providers in the assisted living pilot program.

    Science.gov (United States)

    Hedrick, Susan; Guihan, Marylou; Chapko, Michael; Manheim, Larry; Sullivan, Jean; Thomas, Mark; Barry, Sarah; Zhou, Andrew

    2007-06-01

    The number of residents in assisted living has rapidly increased, although these facilities still primarily serve people who can pay out of pocket. The U.S. Department of Veterans Affairs was authorized to provide this level of care for the first time in the Assisted Living Pilot Program (ALPP). We describe the residents and providers, comparing them across three facility types and other populations, to assess the characteristics and feasibility of this new approach. We assessed ALPP residents and providers across seven Veterans Affairs Medical Centers. We obtained information from medical records, assessment tools, and a provider survey. We report here on 743 residents placed from 2002 to 2004. The Department of Veterans Affairs contracted with 58 adult family homes, 56 assisted living facilities, and 46 residential care facilities. The average ALPP resident was a 70-year-old unmarried White man referred from an inpatient hospital and living in a private residence prior to placement. Adult family homes enrolled residents requiring greater levels of assistance with activities of daily living than other facility types. Assisted living facilities were less likely than adult family homes to admit residents with functional disabilities and less likely than either adult family homes or adult residential care facilities to admit residents with certain care needs. ALPP placed residents with a wide range of characteristics in community facilities that varied widely in size and services. This information can help determine the role of this type of care in and outside of the Department of Veterans Affairs.

  14. Resident-Perceived Benefit of a Diagnostic and Interventional Musculoskeletal Ultrasound Curriculum

    Science.gov (United States)

    Luz, Jennifer; Siddiqui, Imran; Jain, Nitin B.; Kohler, Minna J.; Donovan, Jayne; Gerrard, Paul; Borg-Stein, Joanne

    2016-01-01

    Musculoskeletal ultrasound (MSUS) training is now a required component of physiatry residency, but formal curriculum guidelines are not yet required or established. The authors’ objective was to assess the educational value of a collaborative residency MSUS training program. The authors designed a structured MSUS training curriculum for residents based on the authors’ experience and previous literature. Twenty-five residents participated in this MSUS curriculum designed by faculty and chief residents. Resident volunteers were trained by the faculty as “table trainers” who taught their peers in small groups. Handson MSUS training sessions were led by a Physical Medicine and Rehabilitation faculty MSUS expert. A Likert scale–formatted questionnaire assessed resident-perceived value of the curriculum. Response rate was 96% (22 of 23). Self-reported MSUS knowledge comparing precurriculum and postcurriculum implementation resulted in significant improvement (P = 0.001). Peer teaching was highly valued, with 86% of residents rating it “very” or “extremely” beneficial (mean [SD] score, 3.9 [1.1]). Self-guided learning, by supplemental scanning and reading, was rated “beneficial” or “very beneficial” by 73% of residents (3.0 [0.7]). The authors’ successful pilot program may serve as a teaching model for other residency programs. PMID:26098924

  15. Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

    Directory of Open Access Journals (Sweden)

    K. A. Almansoori

    2015-01-01

    Full Text Available Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49 was obtained with the majority of residents undertaking one (27% or two (60% fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%, n=46 felt adequately prepared by their residency training for independent general practice, and 84% (n=41 of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

  16. A Qualitative Analysis of Attending Physicians' Use of Shared Decision-Making: Implications for Resident Education.

    Science.gov (United States)

    Schoenfeld, Elizabeth M; Goff, Sarah L; Elia, Tala R; Khordipour, Errel R; Poronsky, Kye E; Nault, Kelly A; Lindenauer, Peter K; Mazor, Kathleen M

    2018-02-01

    Physicians need to rapidly and effectively facilitate patient-centered, shared decision-making (SDM) conversations, but little is known about how residents or attending physicians acquire this skill. We explored emergency medicine (EM) attending physicians' use of SDM in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. We used semistructured interviews with a purposeful sample of EM physicians. Interviews were transcribed verbatim, and 3 research team members performed iterative, open coding of transcripts, building a provisional codebook as work progressed. We analyzed the data with a focus on participants' acquisition and use of skills required for SDM and their use of SDM in the context of resident education. Fifteen EM physicians from academic and community practices were interviewed. All reported using SDM techniques to some degree. Multiple themes noted had negative implications for resident acquisition of this skill: (1) the complex relationships among patients, residents, and attending physicians; (2) residents' skill levels; (3) the setting of busy emergency departments; and (4) individual attending factors. One theme was noted to facilitate resident education: the changing culture-with a cultural shift toward patient-centered care. A constellation of factors may diminish opportunities for residents to acquire and practice SDM skills. Further research should explore residents' perspectives, address the modifiable obstacles identified, and examine whether these issues generalize to other specialties.

  17. Association of reproductive health training on intention to provide services after residency: the family physician resident survey.

    Science.gov (United States)

    Romero, Diana; Maldonado, Lisa; Fuentes, Liza; Prine, Linda

    2015-01-01

    High rates of unintended pregnancy and need for reproductive health services (RHS), including abortion, require continued efforts to train medical professionals and increase availability of these services. With US approval 12 years ago of Mifepristone, a medication abortion pill, abortion services are additionally amenable to primary care. Family physicians are a logical group to focus on given that they provide the bulk of primary care. We analyzed data from an annual survey (2007--2010) of third-year family medicine residents (n=284, response rate=48%--64%) in programs offering abortion training to examine the association between such training and self-reported competence and intentions to provide RHS (with a particular focus on abortion) upon graduation from residency. The majority of residents (75% in most cases) were trained in each of the RHS we asked about; relatively fewer trained in implant insertion (39%), electric vacuum aspiration (EVA) (58%), and manual vacuum aspiration (MVA) (69%). Perceived competence on the part of the graduating residents ranged from high levels in pregnancy options counseling (89%) and IUD insertion (85%) to lows in ultrasound and EVA (both 34%). Bivariate analysis revealed significant associations between number of procedures performed and future intentions to provide them. The association between competence and intentions persisted for all procedures in multivariate analysis, adjusting for number of procedures. Further, the total number of abortions performed during residency increased the odds of intending to provide MVA and medication abortion by 3% and 2%, respectively. Findings support augmenting training in RHS for family medicine residents, given that almost half (45%) of those trained intended to provide abortions. The volume of training should be increased so more residents feel competent, particularly in light of the fact that combined exposure to different abortion procedures has a cumulative impact on intention to

  18. The Role of Social Influence on How Residence Hall Inhabitants Respond to Fire Alarms

    Science.gov (United States)

    Leytem, Michael; Stark, Emily

    2016-01-01

    College resident halls pose a threat for a catastrophic event in the case of fire, but little research has examined potential influences on students' responses to fire alarms, particularly the role of social influence in affecting their behaviors. In the current study, residence hall inhabitants reported their knowledge about fire safety, their…

  19. Burnout and engagement among resident doctors in the Netherlands : a national study

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.H.M.; Gazendam-Donofrio, S.M.; Dillingh, G.S.; Bakker, A.B.; Huisman, Mark; Jacobs, B.; van der Heijden, F.M.M.A.

    Objectives This study was performed in order to gather insight into the well-being of Dutch medical residents. Methods In 2005, all Dutch residents registered through the Medical Registration Committee (n = 5245) were sent a self-report questionnaire to assess socio-demographic and work-related

  20. Prevalence of harassment and discrimination among residents in three training hospitals in Saudi Arabia.

    Science.gov (United States)

    Fnais, Naif; al-Nasser, Muhammad; Zamakhshary, Mohammad; Abuznadah, Wesam; Dhukair, Shahla Al; Saadeh, Mayssa; Al-Qarni, Ali; Bokhari, Bayan; Alshaeri, Taqreed; Aboalsamh, Nouf; Binahmed, AbdulAziz

    2013-01-01

    Multiple surveys of medical residents have shown a high incidence of harassment and discrimination in academic health centers. Harassment has a negative effects on residents' health and on their ability to function. No previous study has documented the prevalence of harassment and discrimination among residents in Saudi Arabia. We aimed in this study to assess the prevalence of harassment and discrimination among residents at a tertiary care academic hospitals in Saudi Arabia. Cross-sectional survey conducted at National Guard Hospitals in Riyadh, Jeddah and Al-Ahsa'a from 27 July to 20 August 2010. The survey included questions on the prevalence of harassment of different types, inlcuding verbal, academic, physical and sexual harassment, as well as discrimination on the basis of gender, region of origin or physical appearance. Of 380 residents, 213 (56%) returned a completed questionnaire (123 male, 57.8%). At least one of type of harassment and discrimination was reported by 83.6% of respondents. The most frequently reported forms were verbal harassment and gender discrimination (61.5% and 58.3%, respectively). Sexual harassment was commonly reported (19.3%) and was experienced significantly more often by female residents than by male residents (P=.0061). Harassment and discrimination of Saudi residents is common with more than three-quarters reporting having had such an experience. Identification of the risk factors is a necessary first step in clarifying this issue and could be used when planning strategies for prevention.

  1. Resident Assistants' Perceptions of Their Behavior in Situations Involving Alcohol

    Science.gov (United States)

    Gold, Aaron S.

    2012-01-01

    The purpose of this exploratory, sequential mixed-methods study was to describe resident assistants' (RAs) perceptions of their behaviors when dealing with situations involving alcohol and underage, undergraduate resident-students. Specifically, Ajzen's (1985) Theory of Planned Behavior (TPB) was used to analyze RAs' reports of…

  2. Predictors of Psychological Well-Being among Assisted-Living Residents.

    Science.gov (United States)

    Cummings, Sherry M.

    2002-01-01

    Examines the psychological well-being of elderly assisted-living residents and factors associated with well-being. Depression, life satisfaction, and demographic, health, and social support variables were measured through interviews. A sizeable minority of the residents reported high levels of depressive symptoms and low life satisfaction.…

  3. Hope, Laughter, and Humor in Residents and Staff at an Assisted Living Facility.

    Science.gov (United States)

    Westburg, Nancy G.

    2003-01-01

    Assesses and compares hope levels and laughter and humor experiences of 24 elderly residents and 21 staff at an assisted living facility. Residents and staff reported numerous benefits from humor and laughing, but differences arose between the two groups about the source and frequency of humor and laughter. Implications for mental health…

  4. Patterns in Functioning among Residents of an Affordable Assisted Living Housing Facility

    Science.gov (United States)

    Fonda, Stephanie J.; Clipp, Elizabeth C.; Maddox, George L.

    2002-01-01

    Purpose: This is the second article reporting a project that (a) characterized the longitudinal functional patterns of residents in an affordable, assisted living housing (ALH) milieu for low-income people and (b) compared the ALH residents' functional patterns with those for similarly low-income, community-dwelling people. Design and Methods:…

  5. Development of a Tool to Assess Resident Physicians' Perceived Competence for Patient-Centered Obesity Counseling

    Science.gov (United States)

    Burton, Amy M.; Brezausek, Carl M.; Hendricks, Peter S.; Agne, April A.; Hankins, Shirley L.; Cherrington, Andrea L.

    2015-01-01

    Physicians report a number of barriers to obesity counseling, among them low perceived competence in the ability to counsel. While there is increasing recognition of the need for resident training on counseling, implementation requires residency programs to have the necessary curricula and tools to evaluate training effectiveness. This study's…

  6. Project WINDFARMperception Visual and acoustic impact of wind turbine farms on residents

    NARCIS (Netherlands)

    Berg, F.; Pedersen, E.; Bouma, J.; Bakker, R.

    2008-01-01

    This report gives the results of the EU financed study WINDFARMpertception on how residents perceive a wind farm in their living environment as far as sound and sight are concerned. The study includes a postal survey among Dutch residents (n = 725, response rate: 37%) and an assessment of their

  7. Burnout and engagement among resident doctors in the Netherlands: a national study.

    NARCIS (Netherlands)

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

    2010-01-01

    OBJECTIVES: This study was performed in order to gather insight into the well-being of Dutch medical residents. METHODS: In 2005, all Dutch residents registered through the Medical Registration Committee (n = 5245) were sent a self-report questionnaire to assess socio-demographic and work-related

  8. Burnout, anxiety, depression, and social skills in medical residents.

    Science.gov (United States)

    Pereira-Lima, K; Loureiro, S R

    2015-01-01

    The medical residency is recognized as a risk period for the development of burnout and mental health problems, such as anxiety and depression, which have impact on the physician and clientele alike. There is a need for studies that address conditions of risk and protection for the development of such problems. This study aimed to verify the rates of burnout, anxiety, and depression presented by resident physicians, as well as the associations of these problems with social skills, as potential protective factors. The hypothesis was defined that the problems (burnout, anxiety, and depression) would be negatively associated with social skills. A total of 305 medical residents, of both genders, of different specialties, from clinical and surgical areas of a Brazilian university hospital were evaluated using the following standardized self-report instruments: Burnout Syndrome Inventory, Social Skills Inventory, and the Patient Health Questionnaire-4. High rates of burnout and mental health problems were verified and social skills were negatively associated with burnout dimensions such as emotional exhaustion, emotional detachment, and dehumanization, but positively associated with personal accomplishment. Furthermore, residents with indicators of problems presented significantly lower social skills means than those of residents without indicators of burnout, anxiety, or depression. More studies are needed, which include other types of instruments in addition to self-report ones and evaluate not only social skills but also social competence in the professional practice. These should adopt intervention and longitudinal designs that allow the continuity or overcoming of the problems to be verified. Since social skills can be learned, the results of the study highlight the importance of developing the interpersonal skills of the professionals during the training of resident physicians in order to improve their practice.

  9. National Survey of Burnout among US General Surgery Residents

    Science.gov (United States)

    Elmore, Leisha C; Jeffe, Donna B; Jin, Linda; Awad, Michael M; Turnbull, Isaiah R

    2017-01-01

    Background Burnout is a complex syndrome of emotional distress that can disproportionately affect individuals who work in healthcare professions. Study Design For a national survey of burnout in US general surgery residents, we asked all Accreditation Council for Graduate Medical Education-accredited general surgery program directors to email their general surgery residents an invitation to complete an anonymous, online survey. Burnout was assessed with the Maslach Burnout Inventory; total scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales were calculated. Burnout was defined as having a score in the highest tertile for EE or DP or lowest tertile for PA. Chi-square tests and one-way analyses of variance were used to test associations between burnout tertiles for each subscale and various resident and training-program characteristics as appropriate. Results From April–December, 2014, 665 residents actively engaged in clinical training had data for analysis; 69% met the criterion for burnout on at least one subscale. Higher burnout on each subscale was reported by residents planning private practice compared with academic careers. A greater proportion of women than men reported burnout on EE and PA. Higher burnout on EE and DP was associated with greater work hours per week. Having a structured mentoring program was associated with lower burnout on each subscale. Conclusions The high rates of burnout among general surgery residents are concerning given the potential impact of burnout on the quality of patient care. Efforts to identify at-risk populations and to design targeted interventions to mitigate burnout in surgical trainees are warranted. PMID:27238875

  10. Global Health Education in US Pediatric Residency Programs.

    Science.gov (United States)

    Butteris, Sabrina M; Schubert, Charles J; Batra, Maneesh; Coller, Ryan J; Garfunkel, Lynn C; Monticalvo, David; Moore, Molly; Arora, Gitanjli; Moore, Melissa A; Condurache, Tania; Sweet, Leigh R; Hoyos, Catalina; Suchdev, Parminder S

    2015-09-01

    Despite the growing importance of global health (GH) training for pediatric residents, few mechanisms have cataloged GH educational opportunities offered by US pediatric residency programs. We sought to characterize GH education opportunities across pediatric residency programs and identify program characteristics associated with key GH education elements. Data on program and GH training characteristics were sought from program directors or their delegates of all US pediatric residency programs during 2013 to 2014. These data were used to compare programs with and without a GH track as well as across small, medium, and large programs. Program characteristics associated with the presence of key educational elements were identified by using bivariate logistic regression. Data were collected from 198 of 199 active US pediatric residency programs (99.5%). Seven percent of pediatric trainees went abroad during 2013 to 2014. Forty-nine programs (24.7%) reported having a GH track, 66.1% had a faculty lead, 58.1% offered international field experiences, and 48.5% offered domestic field experiences. Forty-two percent of programs reported international partnerships across 153 countries. Larger programs, those with lead faculty, GH tracks, or partnerships had significantly increased odds of having each GH educational element, including pretravel preparation. The number of pediatric residency programs offering GH training opportunities continues to rise. However, smaller programs and those without tracks, lead faculty, or formal partnerships lag behind with organized GH curricula. As GH becomes an integral component of pediatric training, a heightened commitment is needed to ensure consistency of training experiences that encompass best practices in all programs. Copyright © 2015 by the American Academy of Pediatrics.

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

    Science.gov (United States)

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

    2016-09-30

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

  12. The Needless Detention of Immigrants in the United States: Why Are We Locking up Asylum Seekers, Children, Stateless Persons, Long-Term Permanent Residents, and Petty Offenders? Report 4.

    Science.gov (United States)

    United States Catholic Conference, Washington, DC. Catholic Legal Immigration Network, Inc.

    This report focuses on "at risk" immigrants in the United States. This fourth report in a series contributes to the now extensive literature on the suffering caused by the INS detention system, with a particular focus on persons who should not be detained, and the INS's failure to pursue alternatives for groups that it should not and need not…

  13. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

    Directory of Open Access Journals (Sweden)

    Dimitrov Vihren

    2006-10-01

    Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

  14. The Burden of the Fellowship Interview Process on General Surgery Residents and Programs.

    Science.gov (United States)

    Watson, Shawna L; Hollis, Robert H; Oladeji, Lasun; Xu, Shin; Porterfield, John R; Ponce, Brent A

    This study evaluated the effect of the fellowship interview process in a cohort of general surgery residents. We hypothesized that the interview process would be associated with significant clinical time lost, monetary expenses, and increased need for shift coverage. An online anonymous survey link was sent via e-mail to general surgery program directors in June 2014. Program directors distributed an additional survey link to current residents in their program who had completed the fellowship interview process. United States allopathic general surgery programs. Overall, 50 general surgery program directors; 72 general surgery residents. Program directors reported a fellowship application rate of 74.4%. Residents most frequently attended 8 to 12 interviews (35.2%). Most (57.7%) of residents reported missing 7 or more days of clinical training to attend interviews; these shifts were largely covered by other residents. Most residents (62.3%) spent over $4000 on the interview process. Program directors rated fellowship burden as an average of 6.7 on a 1 to 10 scale of disruption, with 10 being a significant disruption. Most of the residents (57.3%) were in favor of change in the interview process. We identified potential areas for improvement including options for coordinated interviews and improved content on program websites. The surgical fellowship match is relatively burdensome to residents and programs alike, and merits critical assessment for potential improvement. Published by Elsevier Inc.

  15. Measuring impact of JAMA Dermatology Practice Gaps section on training in US dermatology residency programs.

    Science.gov (United States)

    Britton, Kristina M; Stratman, Erik J

    2013-07-01

    JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.

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

    Science.gov (United States)

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

    2017-04-01

    Dermatology residents routinely teach junior co-residents and medical students. Despite the importance of teaching skills for a successful academic career, no formal teaching instruction programs for dermatology residents have been described to our knowledge, and the extent of teaching opportunities for dermatology residents is unknown. We sought to describe the range of teaching opportunities and instruction available to dermatology residents and to assess the need for additional teaching training from the perspective of dermatology residency program directors nationwide. A questionnaire was administered to 113 US dermatology residency program directors or their designees. Descriptive statistics were used to analyze questionnaire item responses. The response rate was 55% (62/113). All program directors reported that their residents teach; 59% (33/56) reported offering trainees teaching instruction; 11% (7/62) of programs offered a short-term series of formal sessions on teaching; and 7% (4/62) offered ongoing, longitudinal training. Most program directors (74%, 40/54) believed that their residents would benefit from more teaching instruction. Response rate and responder bias are potential limitations. Dermatology residents teach in a broad range