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Dissertations / Theses on the topic 'Residency'
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1
Waddington, Keirrie L. "New Graduate Residency." Thesis, Carlow University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10825506.
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Background: Shortly after the graduate nurses’ orientation period, the expectation is to rapidly function as a competent nurse. With this expectation, the graduate nurse experiences stress when attempting to quickly make the transition from student to practicing professional nurse. New nurses report that the primary reason they are leaving their employment within the first year is related to stress and thus low job satisfaction.
Purpose: The overall turnover rate for a community Catholic Hospital’s Critical Care Department is 60% within the past year. Combating the turnover, increasing satisfaction, and ensuring patient safety is what is needed for this hospital.
Methodology: The design for this project is comparative and correlational utilizing the Casey Fink New Graduate Nurse Survey. Residents involved in the revised residency program were surveyed on their job satisfaction and comfort-confidence after six months of residency. The results from the new residents were compared to nurses who had completed the previous residency program who had at least six months of experience.
Results: The results demonstrated the new residency program had no statistical significance on comfort, however, presented a statistically significant association with how new nurses experience the work environment of the Critical Care department.
Conclusions: The results of the study revealed a need for on-going assessment of the residents past the six month integration period. Another identified need that was noted was for on-going preceptor education and consistency. The study also discovered the need to explore other methods of increasing comfort during and after their residency period.
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Michael, Gary E. "ETSU Residency Training Seminar." Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/6431.
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Sillman, Kathryn V. "Examining the Role of Residency Content Coaching in an Urban Teacher Residency Program." Thesis, Boston College, 2016. http://hdl.handle.net/2345/bc-ir:104987.
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Thesis advisor: Marilyn Cochran-SmithThe clinical experience of future urban teachers is increasingly regarded as one of the most important aspects of teacher preparation (NCATE, 2010; NRC, 2010). However, there is widespread agreement that further knowledge must be acquired on what constitutes rich clinical experience, and on the influence of such learning opportunities especially in urban, high-needs contexts (Anderson & Stillman, 2013; Levine, 2006; Picus, Monk, & Knight, 2012). This dissertation aims to increase our understanding of clinical experience. Based on sociocultural and socio-constructivist perspectives, and drawing on Lave and Wenger’s (1991) theories of learning within communities of practice, this dissertation employed qualitative research methods to examine the phenomenon of content coaching during an urban teacher residency program. This dissertation argues that residency content coaching provided a context within which residents could integrate what they were learning about “ambitious teaching” (Lampert & Graziani, 2009; Newmann & Wehlage, 1993) into their own practice through ongoing negotiations with their coaches. Coaching interactions were by and large responsive to individual resident’s learning needs, and guided residents to begin to place their students’ learning at the center of decision-making when planning, teaching, and assessing. The dissertation further investigates the actual and aspirational characteristics of coaching in this context. Overall findings suggest that content coaching addresses several persistent problems of traditional pre-service fieldwork supervision (Darling-Hammond, 2010; Featherstone, 2007), and offers a more coherent approach. Consequently, this dissertation contributes to our collective understanding of clinical experience in preparing teachers to teach ambitiously in urban classrooms
Thesis (PhD) — Boston College, 2016
Submitted to: Boston College. Lynch School of Education
Discipline: Teacher Education, Special Education, Curriculum and Instruction
4
Redman, Pam. "Effectiveness of a Critical Care Nurse Residency Program." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3201.
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The importance of nurse residency programs is addressed in the literature; however, a review of residency program outcomes and effectiveness is needed. Guided by Roy's adaptation model and Deming's plan-do-check-act model, the purpose of this quality improvement project was to assess the current state of a longstanding critical care nurse residency program in meeting organizational goals and objectives and to recommend modifications to the program related to external factors, internal challenges, and educational deficits of nurses entering the program. A review of the evidence-based literature and feedback from focus groups of leadership stakeholders were used to develop recommendations for residency program improvement. Using qualitative analysis of the focus group data, three common themes emerged related to external factors: financial resources, patient acuity, and generational differences that influence nurse satisfaction with the residency program. Three additional themes emerged related to organizational barriers to satisfaction with the program: preceptor availability and development, limited training hours due to productivity standards, and leader time to support novice nurses. Reality shock when starting to practice in the high acuity critical care area was the most frequently reported educational deficit among new nurses. Recommendations for program improvement included obtaining feedback from residency program participants and preceptors, initiating preceptor development pathways, reinstituting a dedicated cost center for nurse residents' training, and using competency assessment tools to customize training plans for residency program participants. This project has the potential for social change by increasing job satisfaction and retention of new nurses and improving health outcomes in critical care patients.
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Christian, Alan B. "Influences on the retention of residency-trained and non-residency trained Navy Dental Corps officers." Monterey California. Naval Postgraduate School, 2004. http://hdl.handle.net/10945/9924.
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This research project identifies key influences on the retention of Navy Dental Officers beyond their post-obligation period. Two sample groups were selected. The first sample group was selected from Dental Officers who did not receive a Navy sponsored residency program and the second group from Dental Officers who completed a Navy sponsored residency program. Logistic regression models were developed for the Non-Residency and Residency sample data obtained from Bureau of Medicine and Surgery Manpower Information System. The results revealed that accession source, dental specialty and the number of operational tours as a percentage of total tours an officer completes during his or her obligation period were significant factors for retention of Dental Officers in the Non-Residency Model. Significant factors identified for the Residency Model were gender, age when first paid as a Navy Dentist, the number of years Dental Officers waited to begin a Navy-sponsored residency program and dental specialty. Dental Officers who receive their residency training between their sixth and eight year of service are more likely to remain on active duty more than one year beyond their obligated service commitment than officers beginning residency programs earlier or later in their careers.
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Franklin, Tammy Lea. "Educating Nurses About Nurse Residency Program." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6562.
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Educating Nurses About a Nurse Residency Program
by
Tammy Lea Franklin
MSN, Walden University, 2012
BSN, Oklahoma City University, 2010
Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice
Walden University
May 2019
The problem addressed in this project was the challenges related to retention of new graduate nurses. This includes Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Bachelor of Science Nurses (BSNs) on two medical/surgical units in an acute care facility. The purpose was to work with a project team to develop an education module and accompanying resources to present to new medical/surgical BSNs, RNs, and LPNs through a 3-month nurse residency program. The framework guiding the project was Duchscher's transition shock which guides the stages of doing, being, and knowing for new graduate nurses as they move from classroom to the bedside. The project question was: Will an educative process specifically designed to implement a 3-month nurse residency program for new graduate RNs, and LPNs in the two medical/surgical units increase retention rates when compared to data 1 year pre-intervention? The educational modules included 6 2-hour concept based sessions delivered biweekly over a 3-month period by the medical/surgical specialty coordinators. Results showed positive and statistically significant results of a 17% turnover rate of new graduate medical/surgical nurses compared to a 33% turnover rate specific to the medical-surgical new graduate nurses 1 year pre-intervention. The project contributed to positive social change by providing education that increased retention, job satisfaction, and provided professional socialization.
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Harrington, Paul Dillon III Gropper Sareen Annora Stepnick. "College freshmen weight gain residency effects /." Auburn, Ala., 2009. http://hdl.handle.net/10415/1962.
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Nivens, Ryan Andrew. "Teaching Mathematics Methods During Residency 1." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/220.
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Bossaer, John B., and M. Decoske. "What’s Next? Options After Residency Training." Digital Commons @ East Tennessee State University, 2011. https://www.amzn.com/1449604838.
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Securing and Excelling in a Pharmacy Residency is a practical guide and handbook for pharmacy students seeking a residency, residents currently enrolled in a program, and residency program leadership. This user-friendly text encourages high-quality pharmacy residency training, which elevates the individual, the profession, and ultimately patient care.
Answering the need for residency training and improvement raised by the ASHP/ACCP joint 2020 initiative, Securing and Excelling in a Pharmacy Residency uniquely prepares students for the increasingly competitive pharmacy residency market. This one-of-a-kind resource is also helpful to guide individuals currently enrolled in a residency and their mentors. This valuable resource also addresses options after residency training, priceless guidance for both current residents and faculty advisers.
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Bird, Michele Marie. "Evaluation of a nursing residency program." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/808.
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Recruitment and retention of professional nurses are crucial issues for hospital departments of nursing. Recognizing the necessity to bridge the gap that persists between nursing education and nursing services, hospitals have designed programs to assist new nurses make the transition to current nursing practice. By helping individuals make the transition to current nursing practice it is hoped that staff nurses will be retained.
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Wolbeck, Erin Patricia. "Implications of sex offender residency restrictions." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3219.
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This study examines the potential effects of sex offender residency restriction laws on both the offenders and potential victimsin Riverside County, CA. Through the use of census data and mapping software the residentially zoned areas in which sex offenders can or can not live are examined.
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Ajanaku, Abiola Olatokunbo. "Systematic Review of Nurse Residency Programs." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4771.
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The first 2 years of a new graduate nurses career can be stressful and traumatic. Many new graduates leave the profession within their first 2 years of employment. Organizations have sought to implement programs that will promote new graduate job retention. Nurse residency programs (NRPs) are programs geared toward fostering and nurturing new graduates once they begin their nursing careers. Residency programs can last anywhere from 3 months to 1year, depending on the nursing specialty. A key component in retaining new graduates is to facilitate a successful transition into nursing practice. This project served as a systematic review regarding the current state of NRPs and best practices to assure a successful implementation. A total of 44 articles met the inclusion criteria identified for the project. Analysis of each article used Melnyk and Fineout-Overholt's 7 levels of evidence. Benner's novice to expert theory served as the theoretical framework for this project. This systematic review revealed variety in the length and type of NRPs. Best practices include the usage of the University Health System Consortium (UHC)/ American Association of Colleges Nursing (AACN)
or Vizient model. NRPs may differ in curriculum however each program supports the increase in NG retention and job satisfaction as well as new graduate improved competence and confidence. Assuring that new graduates receive a successful orientation and transition into practice will promote positive social change within the organization, improved new graduate competence, and, ultimately, quality patient outcomes.
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O'Donnell, Anne E. "Effective mentoring in physical therapy : approaches for residency training." Thesis, NSUWorks, 2012. https://nsuworks.nova.edu/hpd_pt_stuetd/13.
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PURPOSE: This study aimed to investigate how physical therapy mentors instill clinical judgment and competence during residency training. The researcher investigated effective mentoring behaviors and techniques in physical therapy residency training. SUBJECTS: Participants included physical therapy residency faculty, physical therapy residents currently enrolled in U.S. residency programs credentialed by the American Physical Therapy Association (APTA), and resident graduates (ie, within the past 2 years) from APTA programs. METHOD: A quantitative survey design was used to gain information about effective mentoring behaviors and techniques of physical therapy residency faculty who foster clinical expertise in physical therapy residents. Two online surveys were created: one for residency program faculty and one for current and past residents. RESULTS: Findings revealed that most mentors felt confident to mentor residents based on their past experiences instructing students and mentoring residents in physical therapy. Most mentor respondents had not taken APTA's Credentialed Clinical Instructor Program (CCIP), and fewer had taken Advanced CCIP (ACCIP). Mentor respondents who had taken both courses felt that CCIP was less helpful in mentoring residents than was ACCIP. Findings indicated important resident benefits, mentor behaviors, and characteristics of mentor-mentee relationships in residency programs. Results revealed mentoring and teaching strategies that were most effective for different stages of residency programs. CONCLUSIONS: These findings will help guide residency program faculty in effective mentoring practices and have added to the literature about how mentoring methods impact development of clinical expertise in physical therapy residents. These results (a) revealed a need for advanced training specific to mentoring residents, (b) can be used to determine what mentoring behaviors and techniques work best with residents, and (c) can serve as a basis for further developing residency training curricula. RECOMMENDATIONS: Further investigation is needed to determine which components of mentoring help residency faculty feel prepared to mentor residents. Further development and testing of mentor training programs are warranted. Additional research using qualitative methodology and this study's findings related to important resident benefits, mentor behaviors, and characteristics of mentor-mentee relationships in residency programs is necessary. Further research is also needed to investigate how reflection is used in mentoring in residency programs.
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Nied, Alice M. "New Nurse Residency - An Evidence Based Approach." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/197.
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Nurse educators believe that their graduates are well-prepared for entry level positions in nursing. In the acute healthcare setting, new graduates are placed on virtually every type of nursing unit, including critical care. Employers have developed formal orientations to familiarize new graduate nurses new with the institution and its policies and procedures and to teach the things employers believe new RNs need to know but do not, either because they were never taught the material or they have not retained it.
The purposes of this project were to (a) examine the evidence relative to a disconnect between nursing education and nursing practice, (b) design a formal residency program for new graduates based on the evidence, and (c) implement and evaluate the residency program. Based on the evidence, a 16-week new nurse residency was developed in which Residents were each assigned both a Preceptor and Mentor to assist their progress. Weekly educational offerings were targeted at specific competency deficits identified by Residents, Preceptors and Mentors at the beginning of the residency program.
Seven out of the original 10 Residents completed the Residency. Pre-residency, the Residents were very confident of their clinical skills and abilities and this was unchanged post-residency. The Preceptors and Mentors were much less confident of the clinical skills and abilities of the Residents pre-residency. Post-residency, the confidence level of the Preceptors and Mentors was improved, but significantly so only for the Mentors.
It is imperative that nursing administrators be aware of the discrepancy between the confidence new nurses have in their own skills and the perceptions of the nurses who work side by side with them on a daily basis. Residencies for new graduate nurses are costly. Nursing administrators must make the determination if the benefits outweigh the costs. They may find the results of not having a residency are far more costly.
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Blackwelder, Reid B. "Celebration and Ceremony: Recreating the Residency Experience." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/6959.
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Hanson-Dvoracek, Andrew. "Julius Eastman's 1980 residency at Northwestern University." Thesis, University of Iowa, 2011. https://ir.uiowa.edu/etd/1226.
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Post-minimalist American composer Julius Eastman's residency at Northwestern University in 1980 provides a rare opportunity to mitigate, if not eliminate, the problems involved in defining his compositional style. Eastman occupies a complex and unlikely position in late twentieth-century music as an openly gay, African-American composer of serious art music who both a member of the Creative Associates at SUNY Buffalo as well as participated in the diverse musical culture of Downtown New York. Eastman's surviving scores are notated in a fragmentary and idiosyncratic fashion and the composer's outrageous personality left few people with whom he worked closely or on a regular basis. However, scores of three of Eastman's works survive. Crazy Nigger, Evil Nigger, and Gay Guerilla were performed on January 16, 1980, as the culmination of Eastman's residency at Northwestern. Eastman's use of inflammatory was influenced by the political timeframe of their composition, particularly black cultural narratives and the state of gay rights conflict in the era between Stonewall and the AIDS crisis. Drawing upon newspaper reports, early scholarship on Eastman's biography, and interviews with concert participants, this thesis documents the rehearsal process and the controversy surrounding the titles of the works. For Members Only, the black student organization at Northwestern, protested advertisements of the concert in the midst of their own conflict with the student government.
A viable analytical framework for Eastman's works draws from the techniques of earlier minimalist theorists, including John Roeder's adaptation of set theory. Crazy Nigger, the earliest and longest of the three works, provides to be the least complex example of Eastman's "vertically additive process." Whereas composer Philip Glass extends an original melodic kernel by adding notes horizontally, Eastman adds notes vertically to create increasingly dense textures. Evil Nigger's use of the process is more complicated, introducing additional elements such as ostinati and de-emphasizing the kind of sectional form found in Crazy Nigger. In Gay Guerilla, the last of the three works to be composed, Eastman totally obscured any salient perception of form by eliding several simultaneous occurrences of the vertically additive process and introducing a quotation of the Lutheran chorale "Ein feste Burg." With these three analysis, a more generalized concept of Eastman's compositional style thus consists of his vertically additive process, the introduction of modernist harmony into minimalist technique, the use of hendecachords (11-note sets), a gradual dissolution with the sectional form dominant in concert-length minimalist works, and a move away from post-modernity that Eastman termed "organic music."
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Rys, Gregory Paul. "Nurse Practitioner Residency Programs: An Educational Journey." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2056.
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Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with minimal leadership and clinical experiences directly into practice. One resolution to mitigate this concern would be an NP residency program. Evaluating the knowledge and attitudes of stakeholders prior to the implementation of a NP residency program is an important first step to this implementation plan. The purpose of this project was to assess the knowledge and attitudes about NP residency programs of 2 stake holders: administrators and NPs at a rural upstate New York health care system, Bassett Healthcare, and to compare responses of those fiscally with those clinically oriented. Using literature less than 6 years old about NP residencies, a 28-question survey tool was created to assess knowledge and attitudes of NP residency programs. Content validity was established by 6 hand-selected NPs and administrators who had expert knowledge of residency programs. Once validity was established, the tool was distributed to a convenience sample of NPs and administrators at Bassett Healthcare Network via e-mail. The sample included 20 administrators and 44 NPs. A Mann-Whitney U test revealed no statistical differences between the 2 groups on any item. However, a majority of both groups felt the programs should be mandatory for all NPs. This project may be the first step in formation of a NP residency program that could alleviate transitional stress, decrease turnover, and produce better clinically-prepared NPs, thus benefitting the profession and society.
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Tudiver, Fred, Jeri Ann Basden, and Ivy A. Click. "Bringing Family Medicine Residents into the Future: Integrating Evidence-Based Quality Improvement into a Family Medicine Residency." Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/6404.
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Mizukami, Tetsuo. "New urban ethnicity : Japanese sojourner residency in Melbourne." Monash University, Dept. of Anthropology and Sociology, 1999. http://arrow.monash.edu.au/hdl/1959.1/8556.
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Wehrli, Bryan. "Locus and praxis in the Denver teacher residency." Thesis, The University of New Mexico, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3681913.
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The purpose of this qualitative study was to explore the concepts of praxis and locus as they pertain to teacher education practices and novice learning in the Denver Teacher Residency Program. The term locus was meant to suggest a nuanced and comprehensive way to consider the K-12 school and classroom as the essential location for learning to teach. The term praxis referred to adaptive expertise, or practical reasoning, problem solving, and wisdom informed by theory in practice. An analytical case study investigated two research questions: 1) In what ways is teacher learning deliberately located in the clinical setting of a K-12 classroom? 2) In what ways do clinical practices, learning experiences, and curricula develop the capacity for praxis in residents? An emergent research design for this case study included extended fieldwork and interim data analysis. Data collection included interviews with, and observations of program participants (residents, instructors, field coordinators, mentor teachers, program administrators), as well as document review (e.g., curricular documents, assignment descriptions, assigned texts).
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Kersting, Ann L. "Listeria monocytogenes, zoonotic exposure, rural residency, and prevention." Columbus, Ohio : Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1221751504.
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Allen, Casandra. "Strategies to Develop a New Nurse Residency Program." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6507.
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The ongoing shortage of registered nurses is a nationwide phenomenon. Many factors contribute to the dissatisfaction and stress of new graduate nurses during the initial transition phase of their career. The lack of peer and leadership support is among the many factors that lead to constant turnover. New nurses entering the workforce are caring for patients with more complex health problems. The Commission on Collegiate Nursing Education (CCNE) has developed standards for accreditation of entry-to-practice nurse residency programs (NRP). The purpose of this DNP project was to propose a formal evidenced-based nurse residency program to the stakeholders of an acute care hospital based on the CCNE standards. The Iowa model of evidenced-based practice was used to outline this formal residency program, and Benner's novice to expert theory guided its development. Eight organizational stakeholders participated in the presentation of the proposal for the evidenced-based nurse residency program. A questionnaire based on the standards for accreditation of entry-to-practice nurse residency programs was used for evaluation. The majority of respondents indicated that the standards presented in the presentation were consistent with the requirements of accredited NRPs. For the three primary categories, program faculty, institutional commitment and resources, and management of patient care delivery, 89% of participants indicated an excellent rating on a four-point scale on the questionnaire. The proposed education, once implemented, could result in social change by ultimately improving work satisfaction, improved retention, improved quality of care, and ultimately improved patient health outcomes.
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Zhen, Shuyi. "Learning in a pre-service teacher residency program." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1749.
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Teacher educators worldwide are seeking ways to develop stronger links with schools, to improve the quality of initial teacher preparation. In this study the researcher investigated a residency approach to initial teacher education (ITE) in a one-year Graduate Diploma of Education course designed to prepare primary school teachers at a university in Western Australia. A mixed methods inquiry approach was employed to examine the nature and quality of the professional learning experiences of the pre-service teacher participants.
The Teacher Residency Program (TRP) was based on a medical residency model, with residents given a semester-length placement in two schools. Each placement provided a continuous two-day per week placement and concluded with a five-week fulltime block teaching experience. University course work complemented the in-school practical experience during each of the placement periods. The researcher used concurrent nested research design with quantitative data embedded in the qualitative data to explore the professional learning of the residents; Specifically, the researcher sought evidence of perspective transformation in the residents’ learning process, and a determination of how particular elements of the TRP supported or hindered residents’ professional development.
The findings indicate that the residents perceived their professional learning as one of continuous growth. The data confirm that the TRP provided a professionally oriented study of teaching that provided time and opportunity for cumulative learning from both course work and practical teaching. Through the lens of a transformative learning paradigm, the study found that individual development in the TRP varies considerably. Further the residents experienced perspective transformation relating to a range of aspects about learning to teach. The process of transforming perspectives about teaching and learning was multidimensional, individualistic and contextually dependent. Elements of the TRP that assisted residents’ professional development were the concurrent university course work integrated with extended clinical school placement; the opportunities for continuous two-day per week school placement; the block practicum and the two different school placement learning experiences. Aspects that appeared to hinder residents’ professional development were related to the quantity and quality of the university course work offered; the discrepancies that the residents experienced between what they studied about teaching and what they experienced in schools; differences between mentor teachers, and the length of the course. The findings of this study have implications relevant to other ITE programs for improving the learning outcomes of pre-service teachers.
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Facun-Granadozo, Ruth. "Doing the Dynamic Dance: Three Teacher Candidates’ Residency Experiences." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5962.
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Johnson, Cameron Laurence 1969. "Experimental study of residency and emigration in house mice." Thesis, The University of Arizona, 1996. http://hdl.handle.net/10150/278572.
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I used enclosures with exits for emigration to test whether house mice could regulate their numbers by emigration to two levels of resources. Exits had a water obstacle likley to be crossed only by true emigrants. Enclosures had excess food and water and the number of shelters was held constant. I introduced a pair of mice into enclosures about every other night, until no more would become residents. I ran 7 trials in single enclosures and 8 in double enclosures (2 single enclosures joined with a tunnel). The number of mice that stayed within a given size enclosure was consistant, and was 2.3 times higher in double enclosures than in single enclosures. Weather, predation, starvation, and disease did not act in any trials. My data support the contention that house mice can control their population numbers through spacing and emigration.
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Roberts, Elizabeth W. "Development of a Nurse Residency Program in Perinatal Nursing." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7730.
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Staffing turnover created a challenge for the women’s services department of a hospital in the southern United States, potentially compromising care for women and infants during childbirth. The gap in practice was the lack of a structured nurse orientation/residency program for nurses new to perinatal nursing, which requires specific competencies not learned at the prelicensure level of education. The guiding practice-focused question was whether a multidisciplinary team could develop a formal evidence-based perinatal nurse residency program that would meet the needs of on-boarding and support for the new nursing hires at this facility. A team of experienced nurses, which included two nurses from labor and delivery, high risk antepartum, mother baby, and assistant nurse manager developed a comprehensive program, which included defined competencies, didactic materials, detailed simulations, and evaluation tools. A multidisciplinary team of six nurses, and the assistant nurse manager achieved consensus on the quality and comprehensive nature of the program plan using the Appraisal of Guidelines for Research and Evaluation Instrument II assessment tool. The implications of this project to bring about positive social change include the potential for improved nursing care for patients during childbirth as a result of increased nurse knowledge and mentoring support. Improved retention might also contribute to stable teamwork and peer support. This project has the potential to improve both physical and psychological outcomes for women and infants in the perinatal period.
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Radziukaitė, Skirmantė. "Kauno medicinos universiteto gydytojų rezidentų pasirengimo praktiniam darbui įvertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2007. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20070803.091534-08051.
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Darbo tikslas: įvertinti Kauno medicinos universiteto gydytojų rezidentų pasirengimą praktiniam darbui sveikatos priežiūros įstaigose.
Uždaviniai: 1. Įvertinti KMU rezidentūros studijų programų aprašą; 2. Įvertinti Lietuvos medicinos normų struktūros atitikimą reikalavimams; 3. Įvertinti KMU gydytojų rezidentų nuomonę apie savo pasirengimą praktinei veiklai.
Tyrimo metodika: Tyrimo objektas: KMU rezidentūros studijų programos; medicinos normos; 2006 m. KMU rezidentūros studijas baigę gydytojai rezidentai. Tyrimo metodai: mokslinės literatūros analizė; dokumentų analizė; anketinė apklausa; statistinė duomenų analizė programa SPSS 12.
Rezultatai: 1. Įvertintos 28 rezidentūros studijų programos turi aiškią ir vienodą visoms programoms struktūrą. Daugelyje programų išsamiai aprašyta jų sudėtis ir turinys, nėra bendros vidinio studijų kokybės užtikrinimo politikos. Šešiolikoje studijų programų rasta netikslumų šioje dalyje. 2. Septynios profesinės kvalifikacijos neturi patvirtintų medicinos normų. Visos medicinos normos turi vienodą ir aiškią struktūrą. Rezidentūros studijų programos parengtos remiantis šių normų reikalavimais. 3. Su medicinos norma yra susipažinę 53,8 proc. rezidentų, kurie taip pat geriau žinojo savo specialybės ligų sąrašą (p=0,029). Specialybės ligų simptomus, geriau žinojo konservatyviojo profilio rezidentai (Fišerio tiksliojo testo p=0,027). Pakankamai bendravimo su ligoniais patirties mano turintys 36,5 proc. rezidentų. Diagnozuoti ir gydyti navikus mano... [toliau žr. visą tekstą]Aim of the study: to evaluate Kaunas University of Medicine residents preparation for a practical activity and work in health care institutions. Objectives: 1. the evaluation of description of residential studies programs; 2. the evaluation of structure of medical standards; 3. the evaluation of resident’s opinion of their preparation for practical activity. Methods: The object of analysis: KMU programs of residency studies; medical standards; KMU doctors graduated in 2006. Methods of analysis: the analysis of scientific literature; the analysis of documents; questionnaire; the analysis of statistical data using the program SPSS 12. Results: 1. There was 28 residency studies programs evaluated, that had clear and equal for all programs structure. The constitution and content of programs were clearly described. There was no security of common internal residency programs quality politics and procedures. Some inaccuracy was found in sixteen residency programs. 2. Seven professional qualifications did not have certified medical standards. The standards had equal and clear structure. The residency programs were organized according to these standards. 3. 53, 8 % of residents got to know the medical standards, they also better knew their specialty diseases (p=0,029). Medical residents of traditional profile better knew the symptoms of their specialty diseases (Fisher exact test p=0,027). 36, 5 % of residents assumed that they had enough experience in communication with patients... [to full text]
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Boyer, Susan. "Impact of Nurse Residency Program on Transition to Specialty Practice." Thesis, American Sentinel University, 2016. http://hdl.handle.net/10919/73486.
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While academic nursing programs teach the concepts and theory of providing care, these programs cannot provide sufficient experiential learning to prepare the nurse for all that might be faced in diverse clinical practice settings. As a result, each nurse faces transition to practice hardships with the first nursing role and again each time the clinical setting changes. The Specialty Nurse Residency intervention offers support and instruction during the crucial transition period. Efficacy of the intervention is evaluated based on data analysis from pre and post-intervention survey responses. This quantitative, descriptive study solicits feedback from experienced staff to answer the question: Are the positive outcomes of the Specialty Nurse Residency program reproducible in specialty units other than the Burn ICU as evidenced by preceptor, manager and educator feedback before and after program implementation? The intervention engages new-to-specialty nurses within an evidence-based support system that validates competence and development of clinical reasoning skills. Preceptor development and support are key elements of intervention and program delivery, as these crucial staff members safeguard program and learner success.Doctorate of Nursing Practice
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Rogers, Lauren Elizabeth. "Staff Development Introducing Self-Care Within the Nurse Residency Curriculum." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7070.
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Caregiver burnout is an issue for health care organizations, negatively influencing cost, engagement, and workforce stability. Nurse residency programs are intended to address the gap in practice between academia and clinical practice and provide social support during this transitional time. Self-care education can positively affect novice acute care nurses' transition into their new professional role while building connections with the health care organization during the first year of employment. The purpose of this project was to develop a staff educational module to address the nursing practice problem of evidence-based self-care education within a nurse residency curriculum at the doctoral site. The practice focus question for this project was can evidence-based staff development project be developed identifying self-care strategies for novice acute care nurses within a nurse residency program. Orem's theory of self-care, which highlights the importance of taking time to care for self as integral to human functioning, and Watson's caring theory, which emphasizes the loving care of self as a vital prerequisite for caring for others, were the theoretical frameworks. This module was developed based on existing peer-reviewed journals, national organizations' position statements, white papers, and expert opinion and was synthesized using Melynk's hierarchy of evidence for intervention studies tool. This module was developed and shared with doctoral site stakeholders. The recommendation was to integrate this educational product into the existing nurse residency program. The positive implications this project has for the nursing profession include improved well-being and job satisfaction for the novice acute care nurses and potential long-term effects on organizational cost related to turnover
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Gawad, Nada. "Assessing Decision-Making Skills in Surgery: Collecting Validity Evidence for the Script Concordance Test." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38383.
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Most in-hospital adverse events are attributable to surgical care and of these, clinical decision-making (CDM) errors account for approximately half. The assessment of CDM is integral to establishing competence among surgical trainees. One proposed assessment tool is the script concordance test (SCT), which is based on the dual process theory of CDM, but evidence demonstrating valid results is needed. This thesis collects content and response process validity evidence for the assessment of CDM using the SCT.
To gather content evidence, a Delphi technique was conducted with a panel of local general surgeons (n=15) consisting of the top decision-makers voted by staff and resident surgeons. Items achieving consensus were mapped on a table of specifications to determine the breadth of topics covered as defined by the Royal College medical expert competencies in general surgery. The final SCT was administered to 29 residents and 14 staff surgeons and results were analyzed. To gather response process evidence, cognitive interviews were then conducted with ten residents and five staff surgeons based on results of the final SCT. Data from the cognitive interviews were analyzed using a priori deductive codes based on Tourangeau’s cognitive model of response process.
The first round of the Delphi yielded agreement ranging from 40-100% and consensus for 21 cases. The 21 cases made up the final SCT and encompassed 13 of the 19 competencies in general surgery. The final SCT reflected a test of the intraoperative management of open, adult general surgery. Notable absent competencies were described by experts to be outside the scope of general surgery, too difficult for the resident level of training, or presenting an unrealistic intraoperative finding.
Cognitive interviews demonstrated variability in CDM among test-takers. Consistent with the dual process theory, test-takers relied on scripts formed through past experiences, when available, to make decisions. However, test-takers’ response process was also influenced by issues with respect to their comprehension, recall, and response matching cognitive steps. Due to issues with response matching in particular, when answering an SCT question test-takers indicating different numerical ratings may have the same rationale.
The Delphi technique, table of specifications, and cognitive interviews provide validity evidence supporting the SCT for assessing CDM of general surgery trainees. Substantial issues with respect to the numerical rating scale suggests further revisions to the test format are required before consideration of its use in summative assessment.
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Towe, Aaron, Brent Baker, and Sarah Gach. "Assessing Knowledge, Behavior, and Attitudes of Family Medicine Residents toward Opioid Prescribing in Rural South Central Appalachia Residency Program." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/147.
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Intro: Opioids and their role in medicine, their use and abuse, have become a topic of intense scrutiny and interest over the last several years. Since 1999, the number of opioid overdose deaths has quadrupled, while the amount of prescription opioids sold in the U.S has increased by the same factor. Federal lawmakers, law enforcement, pharmaceutical companies, and investigative journalists have all become involved in what is often called “the opioid epidemic”, a stage where the issues of pain management, drug abuse, regulation, and autonomy are in seeming opposition. Physicians are uniquely positioned on this stage, both as healers and healthcare providers, professionals tasked with managing pain, preventing and treating addiction and overdose, and advocating for the needs of the population they serve. Paradoxically, issues related to pain management, addiction, and abuse are widely underrepresented in the educational curricula of most physicians’ formal training. This study aims to assess the attitudes and knowledge related to opioids in family medicine residents in a rural Appalachian residency program; as well as measure how these attitudes and knowledge change in the cohort after a limited course of education in issues surrounding opioid use, prescription, and abuse. It is our hope that this intervention will edify the residents, and they will feel more prepared to confront issues surrounding opioids as they move forward in their careers.
Methods:
Residents were given a ten-item questionnaire that assessed their knowledge of current Tennessee and Virginia state laws with regards to the prescription of opioids: The questionnaire also included an open-ended question where residents were asked to express how they felt about prescribing opioids: opinions they had formed, things they learned, things that they wished were different. Responses were uniquely identified by a paired code that abstracted the identity of the respondent from subsequent analysis. After anonymous collection of the completed questionnaire and open-ended response, a 30 minute didactic session was administered by the authors outlining common issues with opioid prescriptions, an overview of current TN and VA state law regarding opioid prescription, clinic policy, and discussion with residents of current thinking regarding best practices. The questionnaire was then administered again, responses were anonymously gathered and paired with their pre-didactic identification number. The responses were then analyzed to assess the impact of the didactic on understanding of current opioid prescribing law, and the open ended responses were examined for common themes in residents’ perception of prescribing opioids while in residency.
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Conclusions:
In general, short and focused didactic education regarding current state laws regarding opioid prescription appears to benefit residents understanding of how to prescribe opioids appropriately. Residents generally find the processes surrounding opioid prescription challenging, medically and emotionally, and are interested in more education about the topic.
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McMillan, Naya S. "The role of neighborhood residency in the decision to evacuate." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2010r/mcmillan.pdf.
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Simpson, Christopher. "A satisfaction survey among residency trained osteopathic family medicine physicians /." View abstract, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3248457.
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Kamboj, Amritpal K. "Nurse residency| An answer to improve new graduate nurse competency." Thesis, Western University of Health Sciences, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3560103.
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The Institute of Medicine (IOM) report To err is human: Building a safer health system raised the very important concern of patient safety. The ultimate goal of this report was to provide a call-for-action that promoted patient safety at the point-of-delivery (Kohn, Corrigan, & Donaldson, 2000). Registered Nurses (RNs) represent the largest discipline providing and coordinating patient care redesign. The aim of creating safe and quality care would not be possible without the presence of competent nurses. Conversely, new graduate nurses are prone to errors due to lack of transitional support from academics to practice. With the growing shortage of experienced RNs nationally, there is a need to evaluate and promote programs to assist in the transition, retention, and recruitment of competent new nurses. Structured residency programs offer a means to increase the competency of newly graduated RNs. This study performed secondary data analysis of the Versant 18-Week Residency Program to provide evidence of the success of this approach in assisting new nurses in their transition from academia to practice.
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Wallace, Rick L. "Clinical Medical Librarian Effectiveness in an ETSU Medical Residency Program." Digital Commons @ East Tennessee State University, 2004. https://dc.etsu.edu/etsu-works/8797.
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White, Elizabeth, B. Mizell, Jodi Polaha, Leigh Johnson, David W. Stewart, J. Jessee, and R. Sevinsky. "Evidence Heart Failure Process Implementation at a Residency-Teaching Clinic." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6569.
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Tanyanyiwan, Vimbai. "Establishing the residency of artificial persons in cross border transactions." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/9614.
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Includes bibliographical references.The basis of residence taxation is that residents enjoy protection in the state where they contribute towards the costs of government. In tax treaties residence is used for purposes of allocating income and taxing rights between contracting states. For treaty purposes residence is determined on a day to day basis, hence a person can be resident in two countries at concurrent time periods. It is important to determine the residence of a corporation in a specific jurisdiction for purposes of ascertaining the treaty benefits that the entity can enjoy and the allocation of income between contracting states in a treaty. Usually a company’s tax residence is considered to create a sufficient connection with the country that has jurisdiction over it. The recognition of the residence status of natural and juristic persons is the cornerstone of international taxation. Residence is also used as an antiavoidance tax measure in international tax.
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Pritchard, David. "The Effect of Residency Requirements on Police as Capable Guardians." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/63.
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The debate over police residency requirements dates to the advent of the modern police force in the early 19th Century. Many reasons have been put forth regarding these requirements, from effectiveness to availability to economic impact. On the other hand, opponents have argued that quality of life, employee retention, and applicant pool should be considered in the decision to have residency mandates. This study seeks to determine the effectiveness of resident police officers within the context of the Routine Activities Theory. In particular, it considered whether police officers are more capable guardians when they live in the jurisdictions where they work, specifically when using a marked take home police vehicle as a place keeper. Data was collected regarding police residency, Group A crime, Group B crime, and social disorganization in 25 apartment complexes in Chesterfield County, VA, during a six month period. It was found that police residency had a statistically significant and moderately strong negative effect on the rate of Group A crime and signs of social disorganization, as measured by police calls for service. Police residency showed a weak negative effect on Group B crime, but it was not statistically significant.
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Bates, Adam, and Adam Bates. "Detecting Compute Cloud Co-residency with Network Flow Watermarking Techniques." Thesis, University of Oregon, 2012. http://hdl.handle.net/1794/12507.
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This paper presents co-resident watermarking, a traffic analysis attack for cloud environments that allows a malicious co-resident virtual machine to inject a watermark signature into the network flow of a target instance. This watermark can be used to exfiltrate co-residency data, compromising isolation assurances. While previous work depends on virtual hypervisor resource management, our approach is difficult to defend without costly underutilization of the physical machine. We evaluate co-resident watermarking under many configurations, from a local lab environment to production cloud environments. We demonstrate the ability to initiate a covert channel of 4 bits per second, and we can confirm co-residency with a target VM instance in less than 10 seconds. We also show that passive load measurement of the target and behavior profiling is possible. Our investigation demonstrates the need for the careful design of hardware to be used in the cloud.
This thesis includes unpublished co-authored
material.
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Nivens, Ryan Andrew. "A Residency Model: Shifting from Traditional to On-Site Education." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/225.
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I report how methods course assignments shifted from simulation to actual participation in remediation, assessment, and co-teaching in a K- 6 methods course in a state where policies dictate a residency model in place of traditional courses followed by student teaching
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Tarasidis, Andrew, Karilynn Dowling, Anh Dinh, Pooja Subedi, Daniel Ventricelli, and Nicholas E. Hagemeier. "Residency, Fellowship, and Graduate School Value Beliefs among Student Pharmacists." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1439.
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Objectives: To compare pharmacy students’ value beliefs across residency training, fellowship training, and graduate education with research and non-research emphases using expectancy-value theory as a framework. Method: First through fourth professional year (P1-P4) students (N=263) completed the 26-item Postgraduate Training Value Instrument (PTVI) for four postgraduate training paths. Items were responded to using a 5-point Likert scale. Intrinsic, attainment, utility, financial value and perceived cost scores were calculated for each training path. Using SAS 9.0, ANOVA procedures were employed to test differences between mean value construct scores across training paths. Results: An 84% response rate was obtained. Value construct scores ranged from 2.02 for financial value of fellowship training to 3.36 for intrinsic value of residency training. Positive value scores (i.e., scores that theoretically support task choice) were noted for two (residency intrinsic value and residency utility value) of the 20 evaluated value constructs. Students reported statistically significantly higher intrinsic, attainment, utility, and financial value scores for residency training as compared to other paths (pImplications: To our knowledge, this is the first study to theoretically quantify students’ value beliefs across commonly pursued postgraduate training paths. Our results indicate an overall lack of intrinsic, attainment, utility, and financial value for most paths and high perceived cost across all paths. The PTVI could be used to target interventions across curricula that seek to promote the value of various postgraduate training paths. Research is warranted to explore students’ value beliefs longitudinally.
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Nivens, Ryan Andrew. "Ready2Teach: Shifts in Teacher Preparation Through Residency and Situated Learning." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/298.
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Residency models for education in the medical profession have existed for many years. Nationwide, policies are being implemented to bring this model to the field of teacher preparation. How this plays out within education programs is less researched, and there is a need to document the transition from traditional teacher education, that is, education that is based heavily in the college classroom, to a residency model, where preservice teachers spend a significant amount of time in an elementary school classroom. This paper describes how a year-long residency model is implemented and presents the changes in curriculum, scheduling and challenges encountered.
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Esmail, Dinez Diamond. "Development of a Graduate Nurse Residency Program in Women's Services." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4138.
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Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical support for this project was Duchscher's, theory of transition, which suggests that allowing graduates time to adjust within a context of support allows them to develop their thinking and practice and helps them move through the stages of professional role transition. The project included a review of literature, development of a nurse residency plan, all materials needed to operationalize the program in the institution, and plans for implementing and evaluating the program over time within the context of institutional challenges, goals, and strengths. Collaboration with institutional stakeholders helped to ensure the contextual relevance of the program and ongoing administrative ownership to provide momentum for the program to move forward following delivery of the products of the DNP project to the institution. In sum, the products of this project comprise a turn-key solution to the institutional need for a graduate nurse residency program in women's services. Social change implications include possible improvement in the recruitment and retention of graduate nurses as well as the consistent development of competent and safe practitioners who will improve maternal and newborn outcomes at the facility.
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Arnold, Bryan P. "Democratic Education and An Urban Teacher Residency: A Case Study." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6056.
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Over the course of American schooling scholars note that democratic education and citizenship have not been abandoned, but perhaps marginalized or pushed aside, as test scores and achievement have become the most desired outcomes. Democratic education must move out of the margins and into high priority. The current political climate of increased division and divisiveness could not illustrate this need any more. Another well-documented challenge within the American educational system, particularly in high need areas is the need for highly qualified teachers. Urban Teacher Residency (UTR) programs have offered a possible solution to this growing problem in recruiting, training, and retaining highly qualified teachers in urban settings. UTRs are designed to alleviate one of the longstanding education challenges of both, quality and quantity of educators within some of the most underserved schools. While the rise in teacher residency programs, particularly in urban settings, and the marginalization of democratic education may seem unconnected, an effort to illuminate their potential relationships guides this study. Qualitative case study methodology (including analysis of program documents, interviews with teachers, and interviews with staff) was undertaken to understand the inclusion of democratic habits in one UTR, as well as the resulting enactment of democratic education by the UTR residents and alumni in one UTR, Mid-Atlantic Teacher Residency (MATR).
Findings reveal the use of democratic habits by the residents and in the MATR program was mixed. Democratic habits of associated living, collaboration, student voice, critical inquiry, and student-centered learning were the most prevalent through the MATR program components of coursework, mentorship, and the cohort during the residency year. As teachers, the resident alumni exhibited democratic habits through their professional relationships and attitudes towards student-centered instruction, particularly through the use of activities. A few of the alumni exhibited aspects of democratic education through their discussion of social justice and their commitment to citizenship development. Overall, however, limited evidence of a commitment to democratic education was present in the data, which may be in part due to the program’s relatively low emphasis on democratic education. Other barriers that emerged in the data included: classroom management struggles, administrative support and policies, a lack of promoting democratic education through the program, a disconnect from the residents’ coursework to their classroom practices, and being new teachers. While it does not appear that MATR or other UTRs are currently foregrounding democratic education or democratic principles, I close by discussing why UTRs should emphasize democratic education and offering suggestions for how they might do so.
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Wood, Frank Edwin. "Understanding The Influence Of Donor Residency On Motivations Toward Philanthropic Donations." NSUWorks, 2013. http://nsuworks.nova.edu/hsbe_etd/119.
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Non-profit organizations have provided substantial services and resources to society such as arts, education, and social services. The cultivation and generation of financial donations through fundraising and development efforts are critical to the operation of non-profit organizations. This reality compels these organizations to continually attract and retain donors. To assist non-profit organizations' efficacy in fundraising, prior research has indicated the need for more studies on individual donor actions which could lead to a comprehensive model of donor behavior.
One variable that had not yet been studied in relation to donor behavior is the influence of residency on donor motivations, specifically donors that own homes in different communities. Extant research reports that differences exist for homeowners related to their primary and secondary residences. These differences are evidenced by disparity in place attachment for the homeowners and by a variance in their behaviors at each home.
This study surveyed non-profit organization donors in South Florida who own primary and secondary homes in different communities to determine if donors would exhibit a difference in their motivations for giving based on their different residences. Partial Least Squares regression, augmented with permutation tests, was run to evaluate hypotheses: donors would exhibit a difference in various motivations for making donations to non-profit organizations based on their residences.
Results indicate no significant difference in donor motivation between the two residences; however, the significance levels of the latent variables did exhibit differences. The motivation factor of affinity for a cause/organization indicates an area of significance to both researchers and practitioners. The results of the study point to no differences in the amount donated based on whether the donor is considering their primary or secondary residence.
Based on these findings, fundraisers do not need to target potential donors based on "seasonal" versus "permanent" residency; altruism, egoism, and tangible/financial benefits are similarly applicable regardless of location. One useful finding for managers with future fundraising campaigns is donor-perceived differences in affinity for organizations/causes and affinity for community. Fundraising efforts that center on campaigns and activities that create greater bonds between the donor and the organization/cause/community could foster greater fundraising results than those that appeal to simply "doing good" and "being important".
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Rekman, Janelle. "The Development of a Workplace-Based Surgical Clinic Assessment Tool." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/34234.
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Purpose of Study: Workplace-based assessment is an opportunity for a learner to be assessed in their community of practice by an expert rater. The challenges and biases brought into this assessment relationship are complex. A shift towards Competency Based Medical Education in post-graduate residency education has triggered consideration of how to implement feasible assessment tools for the operating room, the in-patient ward, and the outpatient clinic. Competent performance in outpatient clinic is vital to surgical practice, yet no assessment tool currently exists to assess daily performance of technical and nontechnical skills of surgery residents. This project describes the development of a competency-based assessment tool, the Ottawa Clinic Assessment Tool (OCAT).
Research Question: How does the OCAT demonstrate validity for measurement of surgical resident performance in clinic?
Method: A consensus group of experts was gathered to generate ideas reflective of a competent ‘generalist’ surgeon in clinic. An entrustability anchor scale was developed. A six-month pilot study of the OCAT was conducted in orthopedics, general surgery and obstetrics and gynecology with quantitative and qualitative evidence of validity collected. Two subsequent feedback sessions, and a survey for staff and residents evaluated the OCAT for clarity and utility.
Results: The OCAT was developed as a 13-item tool, with a global assessment item and 2 short answers questions. 44 staff surgeons completed 132 OCAT assessments of 79 residents. Psychometric data was collected as evidence of internal structure validity and relations with other variables. Analysis of feedback indicated the rating scale was practical and useful for surgeons and residents.
Conclusions & Contribution to the Research Field: Surgical programs will require a daily clinic assessment tool to help define resident competency progression. Multiple sources of validity evidence collected in this pilot project demonstrate that the OCAT can measure resident clinic competency in a valid and feasible manner.
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McQuilkin, Michelle. ""Mentorship of a Medical Student Scholarly Project and Matching into a Primary Care Residency "." Thesis, The University of Arizona, 2018. http://hdl.handle.net/10150/626864.
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Min, Alice A., Lisa R. Stoneking, Kriti H. Grall, and Karen Spear-Ellinwood. "Implementation of the Introductory Clinican Development Series: an optional boot camp for Emergency Medicine interns." Dove Press, 2014. http://hdl.handle.net/10150/617202.
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UA Open Access Publishing FundBackground: The transition from medical student to first-year intern can be challenging. The stress of increased responsibilities, the gap between performance expectations and varying levels of clinical skills, and the need to adapt to a new institutional space and culture can make this transition overwhelming. Orientation programs intend to help new residents prepare for their new training environment. Objective: To ease our interns’ transition, we piloted a novel clinical primer course. We believe this course will provide an introduction to basic clinical knowledge and procedures, without affecting time allotted for mandatory orientation activities, and will help the interns feel better prepared for their clinical duties. Methods: First-year Emergency Medicine residents were invited to participate in this primer course, called the Introductory Clinician Development Series (or “intern boot camp”), providing optional lecture and procedural skills instruction prior to their participation in the mandatory orientation curriculum and assumption of clinical responsibilities. Participating residents completed postcourse surveys asking for feedback on the experience. Results: Survey responses indicated that the intern boot camp helped first-year residents feel more prepared for their clinical shifts in the Emergency Department. Conclusion: An optional clinical introductory series can allow for maintenance of mandatory orientation activities and clinical shifts while easing the transition from medical student to clinician.
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Min, Alice A., David A. Sbarra, and Samuel M. Keim. "Sleep disturbances predict prospective declines in resident physicians’ psychological well-being." Co-Action, 2015. http://hdl.handle.net/10150/621337.
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UA Open Access Publishing FundBackground: 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 (N69) resident physicians completed the Brief Resident Wellness Profile (M17.66, standard deviation [SD] 3.45, range: 017) and the Pittsburgh Sleep Quality Index (M6.22, SD 2.86, range: 1225) 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, p0.003, 95% confidence interval [CI]: 0.33, 0.07) and the lagged within-person effect of resident sleep disturbance (B 0.15, SE0.07, p0.037, 95% CI: 0.29, 0.009) were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicatorof 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.
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Jensen, Samantha, and Amanda Stoltz. "Assessing Resident Physician Knowledge about Breastfeeding Medicine in a Rural Family Medicine Clinic." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/asrf/2021/presentations/51.
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Title: Assessing Resident Physician Knowledge about Breastfeeding Medicine in a Rural Family Medicine Clinic
Authors: Samantha Jensen, MD and Amanda Stoltz, MD, Bristol Family Medicine Residency Program, Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
Introduction: Many residents and faculty encourage the long-term goal of breastfeeding, and our residency program provides extensive training in obstetrics and newborn nursery. However, there is little structure and direct guidance for breastfeeding medicine already built in to the family medicine residency training. We aimed to develop a dedicated breastfeeding medicine longitudinal curriculum to improve the effectiveness of family medicine physician residents as teachers and advocates by improving residents’ fund of knowledge, provide structure for encouraging breastfeeding at prenatal visits, and incorporate breastfeeding into our family medicine practice by improving the on-site locations for breastfeeding and pumping.
Method: The method of research was pre-lecture and post-lecture surveys comprised of 15 questions, including knowledge-based questions, assessment of confidence level, and a question on perceived barriers to breastfeeding. Participants attending two educational sessions during the study, and additional educational sessions have continued after study conclusion. The post-lecture survey was completed 12 weeks after first lecture. Lecture topics included an overview of breastfeeding medicine, how to encourage breastfeeding at prenatal appointments, contraindications, maternal nutritional supplements, formula supplementation, galatogogues, and the storage of breastmilk.
Results: Results were compiled from the responses of 20 pretests and 9 posttest surveys. Results showed an increase in correct responses to the knowledge portion 61.15% pretest versus 77.69% posttest (t(28) 3.41, p<0.01). Resident physician confidence also increased by the conclusion of the study (t=28, p<.01).
Conclusions: It can be concluded that educational lectures increase knowledge and confidence in resident physicians with regards to breastfeeding medicine. Areas for future study include specific research focusing on methods to increase access to resources for breastfeeding mothers.