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Ryabova, Elena V. "Digital Migration of Individuals: Legal Issues of International Taxation." Migration law 2 (June 3, 2021): 26–30. http://dx.doi.org/10.18572/2071-1182-2021-2-26-30.
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Purpose: to assess the existing prospects for e-tax residence on the basis of the revealed significant characteristics of existing approaches to e-individual residence in foreign countries and international tax consequences. Methods: an analysis of the legal regime for e-residents in Estonia from the standpoint of taxing digital business in this country by Russian tax residents, an analysis of the legal regime for digital “nomads” introduced by countries with a comfortable climate, as well as an analysis of a draft introducing e-tax residence regime in Ukraine. The paper is based on the comparative study and the extrapolation of the findings got from the analysis of the draft law in Ukraine to the Russian reality. Findings: the analysis of e-residency regimes for individuals in foreign countries showed the existence of two main approaches to their design: (1) e-residency, not based on physical presence and loss of tax residency in one’s own country, with the right to conduct digital business through a company — tax resident (Estonian experience), and (2) tax residency for digital “nomads” for the purpose of physical presence in a country with comfortable climatic environment and remote work in their countries, accompanied by the potential loss of tax residency in the country of labor or business. Conclusion: In connection with the digitalization, the legislator in foreign countries provides interesting ideas regarding the digital or physical attraction of migrants to their countries. Several countries have announced the launch of e-tax residency programs. However, in the context of traditional international taxation related to personal income such programs will show ineffectiveness.
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Faville, Elizabeth, Suzanne Turner, and John A. Armitstead. "Strengths in numbers: Assessing the use of StrengthsFinder 2.0 in a pharmacy residency program." American Journal of Health-System Pharmacy 77, Supplement_3 (July 28, 2020): S66—S70. http://dx.doi.org/10.1093/ajhp/zxaa156.
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Abstract Purpose To quantify the trends of StrengthsFinder 2.0 domains and traits in pharmacy residents within a single residency program. To recognize and discuss the application of resident StrengthsFinder 2.0 traits within a residency program. Methods This is a retrospective review of StrengthsFinder 2.0 domains and traits among first- and second-year postgraduate year (PGY) pharmacy residents over the past 6 years in a community-based health system. Perspectives on the utility of the StrengthsFinder 2.0 assessment within a residency program, from the viewpoints of a residency program director, a system director of pharmacy, and a current resident, were also obtained and recorded. Results A total of 34 residents with 170 StrengthsFinder 2.0 traits were included in this data analysis. The top StrengthsFinder 2.0 domains of all pharmacy residents were Strategic Thinking and Relationship Building, being exhibited by 36% and 28%, respectively. Learner, Achiever, Harmony, Input, and Restorative were found to be the most frequently reported StrengthsFinder 2.0 traits among all pharmacy residents examined. Learner and Harmony were found to be the top traits of first-year pharmacy residents (11% and 9%), while Achiever and Learner were the most common traits found in the second-year pharmacy residents (13% and 10%). The system pharmacy director, residency program director, and current resident agreed that the assessment tool enhances the resident experience. However, each has their own perspective on the benefits of the StrengthsFinder assessment with respect to the residency program. Conclusion Overall, the top 5 StrengthsFinder 2.0 traits seen in pharmacy residents who have completed a PGY1 or PGY2 residency at Lee Health were: Learner (18%), Achiever (9%), Harmony (7%), Input (6%), and Restorative (6%). Achiever, Harmony, Learner, Input, and Restorative were found to be the most common traits across all categories reported. These trends are similar to those reported in previous studies of StrengthsFinder 2.0 assessment of pharmacy students and residents. Evaluating individual StrengthsFinder 2.0 traits at the start of the residency year provides a framework for each resident to complete ongoing self-evaluations. In addition, familiarity with the common traits seen within residents allows residency leadership members to make more thoughtful decisions regarding resident assignments for learning experiences or committee appointments.
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Starosta, Kaitlin, Susan L. Davis, Rachel M. Kenney, Michael Peters, Long To, and James S. Kalus. "Creating objective and measurable postgraduate year 1 residency graduation requirements." American Journal of Health-System Pharmacy 74, no. 6 (March 15, 2017): 389–96. http://dx.doi.org/10.2146/ajhp160138.
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Abstract Purpose The process of developing objective and measurable postgraduate year 1 (PGY1) residency graduation requirements and a progress tracking system is described. Summary The PGY1 residency accreditation standard requires that programs establish criteria that must be met by residents for successful completion of the program (i.e., graduation requirements), which should presumably be aligned with helping residents to achieve the purpose of residency training. In addition, programs must track a resident’s progress toward fulfillment of residency goals and objectives. Defining graduation requirements and establishing the process for tracking residents’ progress are left up to the discretion of the residency program. To help standardize resident performance assessments, leaders of an academic medical center–based PGY1 residency program developed graduation requirement criteria that are objective, measurable, and linked back to residency goals and objectives. A system for tracking resident progress relative to quarterly progress targets was instituted. Leaders also developed a focused, on-the-spot skills assessment termed “the Thunderdome,” which was designed for objective evaluation of direct patient care skills. Quarterly data on residents’ progress are used to update and customize each resident’s training plan. Implementation of this system allowed seamless linkage of the training plan, the progress tracking system, and the specified graduation requirement criteria. Conclusion PGY1 residency requirements that are objective, that are measurable, and that attempt to identify what skills the resident must demonstrate in order to graduate from the program were developed for use in our residency program. A system for tracking the residents’ progress by comparing residents’ performance to predetermined quarterly benchmarks was developed.
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盧奐廷, 盧奐廷, 林名男 Huan-Ting Lu, 吳晉祥 Ming-Nan Lin, 黃信彰 Jin-Shang Wu, 林偉瑄 Shinn-Jang Hwang, and 林季緯 Wei-Hsuan Lin. "工時規範對家庭醫學住院醫師訓練影響—住院醫師觀點." 台灣家庭醫學雜誌 32, no. 1 (March 2022): 045–56. http://dx.doi.org/10.53106/168232812022033201005.
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<p>目的：本研究探討家庭醫學科住院醫師自2019年適用勞動基準法規定後，對工時規範之滿意度、健康影響、學習成效、醫療品質與病人安全層面進行調查，並進一步比較不同訓練職級、不同醫院訓練容額、與不同醫院層級住院醫師在工時規定影響看法上的差異。</p> <p>方法：以2017至2019訓練年度進入家庭醫學專科醫師訓練計畫的住院醫師為對象，以問卷調查工時限制所造成的影響。結果：共有286位家庭醫學住院醫師參與研究，其中有近九成滿意目前工時限制規定，且普遍認為工時限制不會降低訓練品質。其中第一年住院醫師超時的比例較高，較資深住院醫師同意工時規定會減少教學指導與學習體驗的比例較高，但多數還是認為並不影響教學品質。超過半數第一年住院醫師認為醫療錯誤發生率會降低，資深住院醫師則多認為不變。雖然所有醫院層級的住院醫師都認為工作時疲勞情況與嗜睡程度有所改善，但地區與區域級醫院仍有少部分住院醫師認為工作時疲勞及嗜睡程度更明顯。</p> <p>結論：實施工時限制後，大部分家庭醫學科住院醫師滿意目前工時限制規定，認為工時限制不會降低訓練品質，也不需要延長受訓年限。學員普遍認為對於工時限制對住院醫師的身心健康有正向影響，對於病人受到的醫療品質與病人安全則不受影響。</p> <p> </p><p>Objective: The study assessed family medicine residents’ overall satisfaction with the resident duty hour restriction implemented in 2019 and explored their perceptions of the impacts of the restriction on their well-being, education, and patient safety. The study further compared the differences in residents’ perceptions based on the level of residency training, size of residency training program, and level of training hospital.</p> <p>Methods: Residents admitted to the family medicine residency training program by the Taiwan Association of Family Medicine from 2017 to 2019 were selected to participate in this study. A prospective anonymous questionnaire survey was administered to family medicine residents nationwide to gather their opinions and suggestions regarding the newly implemented resident duty hour reform.</p> <p>Results: A total of 286 family medicine residents responded to the questionnaire survey. Nearly 90% of the residents were satisfied with the current duty hour regulations and found the restriction unlikely to compromise the quality of residency training. First-year residents reported a greater frequency of working overtime, compared to residents of other levels. The more senior the residents, the stronger the belief that duty hour restriction reduced time for learning and faculty guidance; however, the majority of the responding residents were of the opinion that the restriction did not affect the overall quality of residence training. Over 50% of the first-year residents felt the restriction helped reduced the likelihood of medical error, while more senior residents found the likelihood unchanged. Regardless of the levels of their training hospitals, a great part of the residents found the problems of fatigue and daytime sleepiness alleviated, yet there was still a minority of residents in regional and district hospitals felt the problems aggravated.</p> <p>Conclusion: After the implementation of duty hour restriction, most family medicine residents are satisfied with the current regulations and feel no significant impact of the restriction on the quality of residency training. In their opinion, there is no need to extend the length of residency training. The duty hour reform does exert positive influences on their physical and mental health and bring about no impact on patients’ safety and quality of care.</p> <p> </p>
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Santalo, Oscar, Joelle Farano, Jacqualine Igwe, and Niaz Deyhim. "Survey of health-system pharmacy administration and leadership residencies." American Journal of Health-System Pharmacy 77, no. 6 (February 6, 2020): 449–56. http://dx.doi.org/10.1093/ajhp/zxz327.
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Abstract Purpose To perform an inquiry with response measurement from health-system pharmacy administration and leadership (HSPAL) residency program directors and residents to distinguish variances between the programs and identify enhancement opportunities for key stakeholders. Methods Members from the Pharmacy Administration Resident Collaboration Research Committee developed separate 20-question survey instruments to assess the strengths and areas of opportunity for HSPAL residency programs from the perspective of residency program directors and residents. The survey instruments were designed to evaluate the level of pharmacy service integration across HSPAL programs nationwide. Results Nearly half of the residency program directors within the listserv (40.74%, 33/81) participated in the survey. The recognized areas of opportunity by residency program directors include community pharmacy leadership, professional organization involvement, sterile compounding, and supply chain management. About a third (32.54%, 41/126) of the residents participated in the survey. Residents reported the least exposure to community pharmacy leadership, human resource management, informatics, professional organizations, and ambulatory care/specialty rotations. The overall recommendations for HSPAL residency programs are to incorporate C-suite–level experiences, improve alumni engagement, develop longitudinal human resource/financial experiences, and encourage resident credential obtainment. Conclusion In order to foster professional and leadership growth for HSPAL residents, residency programs should consider incorporating C-suite–level experiences, longitudinal human resource/finance experiences, alumni engagement opportunities, rotation variety, professional organization involvement, and support in credential obtainment.
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Lozano, Paula, Vincent M. Biggs, Barbara J. Sibley, Terri M. Smith, Edgar K. Marcuse, and Abraham B. Bergman. "Advocacy Training During Pediatric Residency." Pediatrics 94, no. 4 (October 1, 1994): 532–36. http://dx.doi.org/10.1542/peds.94.4.532.
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Despite broad concerns about the welfare of children, most pediatric residents are not able to engage in child advocacy during their busy training years. Yet residency can provide an opportunity for young pediatricians to learn valuable advocacy skills by undertaking an independent project with an experienced mentor. We describe the University of Washington Pediatrics Residency Program's experience in training interested residents in child advocacy. Basic requirements are that advocacy projects must not interfere with clinical training, resident participation must be voluntary, and faculty with advocacy skills must be available to help guide the residents. Four resident projects are outlined and guidelines for instituting such programs are presented.
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Gudgel, Brett M., Andrew T. Melson, Justin Dvorak, Kai Ding, and R. Michael Siatkowski. "Correlation of Ophthalmology Residency Application Characteristics with Subsequent Performance in Residency." Journal of Academic Ophthalmology 13, no. 02 (July 2021): e151-e157. http://dx.doi.org/10.1055/s-0041-1733932.
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Abstract Purpose Only from reviewing applications, it is difficult to identify which applicants will be successful ophthalmology residents. The change of the USMLE Step 1 scoring to “Pass/Fail” removes another quantitative metric. We aimed to identify application attributes correlated with successful residency performance. This study also used artificial intelligence (AI) to evaluate letters of recommendation (LOR), the Dean's letter (MSPE), and personal statement (PS). Design Retrospective analysis of application characteristics versus residency performance was conducted. Participants Residents who graduated from the Dean McGee Eye Institute/University of Oklahoma Ophthalmology residency from 2004 to 2019 were included in this study. Methods Thirty-four attributes were recorded from each application. Residents were subjectively ranked into tertiles and top and bottom deciles based on residency performance by faculty present during their training. The Ophthalmic Knowledge Assessment Program (OKAP) examination scores were used as an objective performance metric. Analysis was performed to identify associations between application attributes and tertile/decile ranking. Additional analysis used AI and natural language processing to evaluate applicant LORs, MSPE, and PS. Main Outcome Measures Characteristics from residency applications that correlate with resident performance were the primary outcome of this study. Results Fifty-five residents and 21 faculty members were included. A grade of “A” or “Honors” in the obstetrics/gynecology (OB/GYN) clerkship and the presence of a home ophthalmology department were associated with ranking in the top tertile but not the top decile. Mean core clerkship grades, medical school ranking in the top 25 U.S. News and World Report (USNWR) primary care rankings, and postgraduate year (PGY)-2 and PGY-3 OKAP scores were predictive of being ranked in both the top tertile and the top decile. USMLE scores, alpha-omega-alpha (AOA) status, and number of publications did not correlate with subjective resident performance. AI analysis of LORs, MSPE, and PS did not identify any text features that correlated with resident performance. Conclusions Many metrics traditionally felt to be predictive of residency success (USMLE scores, AOA status, and research) did not predict resident success in our study. We did confirm the importance of core clerkship grades and medical school ranking. Objective measures of success such as PGY-2 and PGY-3 OKAP scores were associated with high subjective ranking.
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Kwan, Benjamin Y. M., Benedetto Mussari, Pam Moore, Lynne Meilleur, Omar Islam, Alexandre Menard, Don Soboleski, and Nicholas Cofie. "A Pilot Study on Diagnostic Radiology Residency Case Volumes From a Canadian Perspective: A Marker of Resident Knowledge." Canadian Association of Radiologists Journal 71, no. 4 (February 10, 2020): 490–94. http://dx.doi.org/10.1177/0846537119899227.
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Purpose: New guidelines from the Accreditation Council for Graduate Medical Education (ACGME) have proposed minimum case volumes to be obtained during residency. While radiology residency programs in Canada are accredited by the Royal College of Physicians and Surgeons of Canada, there are currently no minimum case volumes standards for radiology residency training in Canada. New changes in residency training throughout Canada are coming in the form of competency-based medical education. Using data from a pilot study, this article examines radiology resident case volumes among recently graduated cohorts of residents and determines whether there is a correlation between case volumes and measures of resident success. Materials and Methods: Resident case volumes for 3 cohorts of graduated residents (2016-2018) were extracted from the institutional database. Achievement of minimum case volumes based on the ACGME guidelines was performed for each resident. Pearson correlation analysis (n = 9) was performed to examine the relationships between resident case volumes and markers of resident success including residents’ relative knowledge ranking and their American College of Radiology (ACR) in-training exam scores. Results: A statistically significant, positive correlation was observed between residents’ case volume and their relative knowledge ranking ( r = 0.682, P < .05). Residents’ relative knowledge ranking was also statistically significant and positively correlated with their ACR in-training percentile score ( r = 0.715, P < .05). Conclusions: This study suggests that residents who interpret more cases are more likely to demonstrate higher knowledge, thereby highlighting the utility of case volumes as a prognostic marker of resident success. As well, the results underscore the potential use of ACGME minimum case volumes as a prognostic marker. These findings can inform future curriculum planning and development in radiology residency training programs.
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Truong, Julie T., Mitchell J. Barnett, Terrill T.-L. Tang, Eric J. Ip, Janet L. Teeters, and Katherine K. Knapp. "Factors Impacting Self-Perceived Readiness for Residency Training." Journal of Pharmacy Practice 28, no. 1 (March 27, 2014): 112–18. http://dx.doi.org/10.1177/0897190014527318.
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Objective: To examine the factors impacting postgraduate year 1 (PGY1) residents’ self-perceived readiness for residency. Methods: A total of 1801 residents who matched in American Society of Health-System Pharmacists (ASHP)-accredited PGY1 programs were e-mailed individualized invitations to take an online survey. The survey collected self-ratings of readiness for residency training competencies including time management and organization, foundational knowledge, clinical practice, project management, and communication. Key Findings: Data from 556 completed surveys were analyzed. Residents agreed they were ready to perform activities requiring time management and organization (median = 4, mean = 4.08), foundational knowledge (median = 4, mean = 3.83), clinical practice (median = 4, mean = 3.67), and communication (median = 4, mean = 4.05). Residents who completed at least 1 academic advance pharmacy practice experience (APPE), 5 clinical APPEs, or held a bachelors degree felt more confident than their counterparts in regard to project management ( P < .001, <.001, and .01, respectively). Conclusion: PGY1 residents generally felt prepared for time management and organization, foundational knowledge, and communication residency training competencies. This was significant for those who completed 1 or more academic APPEs, 5 or more clinical rotations, or a bachelors degree. Study results may assist pharmacy schools in preparing students for residency training, prospective resident applicants in becoming more competitive candidates for residency programs, and residency program directors in resident selection.
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Stohl, Hindi E., Nancy A. Hueppchen, and Jessica L. Bienstock. "Can Medical School Performance Predict Residency Performance? Resident Selection and Predictors of Successful Performance in Obstetrics and Gynecology." Journal of Graduate Medical Education 2, no. 3 (September 1, 2010): 322–26. http://dx.doi.org/10.4300/jgme-d-09-00101.1.
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Abstract Background During the evaluation process, Residency Admissions Committees typically gather data on objective and subjective measures of a medical student's performance through the Electronic Residency Application Service, including medical school grades, standardized test scores, research achievements, nonacademic accomplishments, letters of recommendation, the dean's letter, and personal statements. Using these data to identify which medical students are likely to become successful residents in an academic residency program in obstetrics and gynecology is difficult and to date, not well studied. Objective To determine whether objective information in medical students' applications can help predict resident success. Method We performed a retrospective cohort study of all residents who matched into the Johns Hopkins University residency program in obstetrics and gynecology between 1994 and 2004 and entered the program through the National Resident Matching Program as a postgraduate year-1 resident. Residents were independently evaluated by faculty and ranked in 4 groups according to perceived level of success. Applications from residents in the highest and lowest group were abstracted. Groups were compared using the Fisher exact test and the Student t test. Results Seventy-five residents met inclusion criteria and 29 residents were ranked in the highest and lowest quartiles (15 in highest, 14 in lowest). Univariate analysis identified no variables as consistent predictors of resident success. Conclusion In a program designed to train academic obstetrician-gynecologists, objective data from medical students' applications did not correlate with successful resident performance in our obstetrics-gynecology residency program. We need to continue our search for evaluation criteria that can accurately and reliably select the medical students that are best fit for our specialty.
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Daneshvar, Farshid, Michael Weinreich, Danial Daneshvar, Michael Sperling, Chadi Salmane, Harout Yacoub, James Gabriels, Thomas McGinn, and Marianne C. Smith. "Cardiorespiratory Fitness in Internal Medicine Residents: Are Future Physicians Becoming Deconditioned?" Journal of Graduate Medical Education 9, no. 1 (February 1, 2017): 97–101. http://dx.doi.org/10.4300/jgme-d-15-00720.1.
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ABSTRACT Background Previous studies have shown a falloff in physicians' physical activity from medical school to residency. Poor fitness may result in stress, increase resident burnout, and contribute to mortality from cardiovascular disease and other causes. Physicians with poor exercise habits are also less likely to counsel patients about exercise. Prior studies have reported resident physical activity but not cardiorespiratory fitness age. Objective The study was conducted in 2 residency programs (3 hospitals) to assess internal medicine residents' exercise habits as well as their cardiorespiratory fitness age. Methods Data regarding physical fitness levels and exercise habits were collected in an anonymous cross-sectional survey. Cardiopulmonary fitness age was determined using fitness calculator based on the Nord-Trøndelag Health Study (HUNT). Results Of 199 eligible physicians, 125 (63%) responded to the survey. Of respondents, 11 (9%) reported never having exercised prior to residency and 45 (36%) reported not exercising during residency (P < .001). In addition, 42 (34%) reported exercising every day prior to residency, while only 5 (4%) reported exercising daily during residency (P < .001), with 99 (79%) participants indicating residency obligations as their main barrier to exercise. We found residents' calculated mean fitness age to be 5.6 years higher than their mean chronological age (P < .001). Conclusions Internal medicine residents reported significant decreases in physical activity and fitness. Residents attributed time constraints due to training as a key barrier to physical activity.
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Hays, Annette, Manorama Khare, David Pluta, Rhonda Verzal, and Joseph P. Garry. "First-Year Resident Perceptions of Virtual Interviewing." Family Medicine 54, no. 10 (November 1, 2022): 814–19. http://dx.doi.org/10.22454/fammed.2022.364201.
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Background and Objectives: Virtual interviews (VI) for residency programs present a relatively new paradigm for recruitment. To date, studies have been small, largely descriptive, and focused on surgical and subspecialty areas. The purpose of the study was to assess residents’ perceptions about their VI experience and to compare those in primary care versus non-primary care specialties. Methods: An electronic survey was sent to 35 designated institutional officials in Illinois with a resulting snowball sample to assess first-year residents’ perceptions of their virtual interviewing experience. A total of 82 postgraduate year-1 residents responded to the survey. We used descriptive analysis and χ2 tests to analyze results. Results: Respondents were mostly female (52.4%), White (79%), non-Hispanic (76%), attending a university residency program (76.3%), and in a primary care specialty (61.7%). In general, most respondents (54.8%-75.3%) felt their VI accurately portrayed their residency program experience. Resident morale, resident-faculty camaraderie, and educational opportunities were perceived as being best portrayed in the VI. Compared to non-primary care residents, primary care residents felt that their program’s VI more accurately portrayed the patient population served (P=.0184), resident morale in the program (P=.0038), and the overall residency experience (P=.0102). Still, 25.7% of respondents felt they were not accurately represented in the VI. Conclusions: Respondents reported that the VI portrays the residency experience fairly well, yet there is opportunity to improve the overall experience. The more difficult experiences to convey (morale, camaraderie, and the overall resident experience) may be areas in which primary care programs are outpacing other training programs.
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Al-Busaidi, Ibrahim S., Sultan Z. Al-Shaqsi, Awatif K. Al-Alawi, Siham Al-Sinani, and Ammar Al-Kashmiri. "Characteristics, Trends, and Factors Associated With Publication Among Residents of Oman Medical Specialty Board Programs." Journal of Graduate Medical Education 11, no. 4s (August 1, 2019): 104–9. http://dx.doi.org/10.4300/jgme-d-19-00259.
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ABSTRACT Background Research during residency is associated with better clinical performance, improved critical thinking, and increased interest in an academic career. Objective We examined the rate, characteristics, and factors associated with research publications by residents in Oman Medical Specialty Board (OMSB) programs. Methods We included residents enrolled in 18 OMSB residency programs between 2011 and 2016. Resident characteristics were obtained from the OMSB Training Affairs Department. In April 2018, MEDLINE and Google Scholar databases were searched independently by 2 authors for resident publications in peer-reviewed journals using standardized criteria. Results Over the study period, 552 residents trained in OMSB programs; 64% (351 of 552) were female, and the mean age at matriculation was 29.4 ± 2.2 years. Most residents (71%, 393 of 552) were in the early stages of specialty training (R ≤ 3) and 49% (268 of 552) completed a designated research block as part of their training. Between 2011 and 2016, 43 residents published 42 research articles (range, 1–5 resident authors per article), for an overall publication rate of 8%. Residents were the first authors in 20 (48%) publications. Male residents (odds ratio [OR] = 2.07; P = .025, 95% CI 1.1–3.91) and residents who completed a research block (OR = 2.57; P = .017, 95% CI 1.19–5.57) were significantly more likely to publish. Conclusions Research training during residency can result in tangible research output. Future studies should explore barriers to publication for resident research and identify interventions to promote formal scholarly activity during residency.
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Quattlebaum, Thomas G. "Techniques for Evaluating Residents and Residency Programs." Pediatrics 98, no. 6 (December 1, 1996): 1277–83. http://dx.doi.org/10.1542/peds.98.6.1277.
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A comprehensive, functioning evaluation system is an important component of a residency program. It should focus on the residency program as well as on the residents and should provide feedback to the residents, their teachers, and the program director. Such a system allows residents and their faculty advisors to receive timely, ongoing, formative feedback concerning resident progress. Likewise, it can help the faculty recognize the strengths and weaknesses of the training program by providing data that can lead to the curriculum changes needed to improve resident experiences. Additionally, it can alert the residency program director to residents whose performance is significantly below that of their peers, allowing intensive faculty and advisor help for these individuals. The practical aspects of providing feedback and implementing an evaluation system apply no less to community-based educational experiences than they do to inpatient and outpatient training areas.
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Mutter, Olga, Jordan Hylton, Stacey Jeronis, David Jaspan, and Marisa Rose. "A National Obstetrics and Gynecology Residency Education Curriculum: National Needs Assessment." Reproductive Medicine 1, no. 3 (December 9, 2020): 216–23. http://dx.doi.org/10.3390/reprodmed1030017.
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While standardized national residency education curricula have been successfully implemented in other specialties, there is no such curriculum in Obstetrics & Gynecology (Ob/Gyn). With this study, we sought to evaluate: (1) the current state of and satisfaction with resident didactic education (2) perceptions regarding centralization and standardization of resident didactic education and (3) the need for a standardized national Ob/Gyn residency education curriculum. In 2019, a web-based needs assessment survey was administered to residents and program leadership from all 267 Ob/Gyn residency programs nationwide. Main outcomes were reported with descriptive statistics. A total of 782 (83 program directors, 46 assistant program directors, and 653 residents) participants completed the survey. Respondents represented a diverse range of regions, program types, and program sizes. Almost all (97%) participants agreed or strongly agreed that residents nationwide should have equal access to high quality Ob/Gyn educational resources. Further, 92% agreed or strongly agreed that core resources should be centrally located. A majority (78%) agreed or strongly agreed that there is a need for a national Ob/Gyn residency education curriculum. Our results demonstrate a perceived need for a centrally located, standardized, national residency education curriculum in Ob/Gyn.
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Rogers, Thomas S., Rebecca Wilcox, and Sarah K. Harm. "Design and Implementation of a Pathology-Specific Handoff Tool for Residents." Academic Pathology 6 (January 1, 2019): 237428951983918. http://dx.doi.org/10.1177/2374289519839186.
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Miscommunication is a source of clinical errors. Tools to decrease the risk of miscommunication (ie, patient handoff tools) are routinely used in clinical specialties that see patients but not routinely used in pathology residency programs. Our primary goal was to develop a structured handoff tool for pathology residents useful for both patient-specific communication and information about general laboratory operation with a secondary goal to increase resident confidence in on-call situations. The CATCH tool was developed and implemented in a pathology residency program with a pre- and postimplementation survey given to residents. The structured handoff tool for pathology residents provided consistent and timely communication between residents and attending physicians. Resident confidence with pathology on-call issues was more likely related to progression through the residency training program rather than implementation of a structured handoff tool.
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Worley, Brandon, Luvneet Verma, and Jillian Macdonald. "Aesthetic Dermatologic Surgery Training in Canadian Residency Programs." Journal of Cutaneous Medicine and Surgery 23, no. 2 (November 16, 2018): 164–73. http://dx.doi.org/10.1177/1203475418814228.
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Background: The public and other physicians expect dermatologists to be experts on aesthetic dermatology services. In Canada, current challenges may limit residents from achieving competency in aesthetic dermatology during their training. This may adversely affect patient safety, create medicolegal risks, and deter graduates from offering aesthetic procedures. Objectives: The objective of this article is to characterize the curriculum, hands-on learning opportunities, and perceptions of aesthetic dermatologic training in Canadian dermatology residency training programs. Methods: An online survey of faculty and residents within Canadian dermatology residency programs was performed. The main outcome measures were the hours of formal aesthetic dermatology teaching, the frequency of hands-on dermatology resident training with injectables and devices, and comparing faculty and resident perspectives regarding resident aesthetic dermatology training. Results: Thirty-six faculty members (40%) and 47 residents (34%) responded to the survey. Lasers, fillers, neuromodulators, and mole removal were most commonly taught in the 10 hours or fewer of formal instruction. Residents commonly observed rather than performed procedures. High dissatisfaction among residents was reported with the quality and quantity of aesthetic dermatology training. Faculty and resident respondents supported increasing aesthetic dermatology education, and approximately 70% of residents plan to offer aesthetic services. Discounted pricing or resident-led clinics were felt to be ways to increase resident hands-on experience. Conclusions: The standardization of core competencies in aesthetic dermatologic procedures is essential to ensure patient safety and practitioner competence. At present, formal aesthetic dermatology training in residency may be insufficient for hands-on training. The majority of dermatology faculty and resident respondents support increasing aesthetic dermatology training.
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Weaver, Sally P. "Increasing Residency Research Output While Cultivating Community Research Collaborations." Family Medicine 50, no. 6 (June 8, 2018): 460–64. http://dx.doi.org/10.22454/fammed.2018.734196.
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Background and Objectives: Having a research curriculum in addition to hosting a resident research day stimulates research activity in residency programs. Research collaborations outside an individual residency program may also promote research in residency. This paper describes a community-wide health research forum that engages faculty and residents in research while bringing together potential research collaborators from the community. Methods: A yearly research forum has been held at a large community-based family medicine residency program for the past 10 years. This forum invites both residency faculty and residents to present scholarly works, and also invites researchers from the community to present health-related research. Presenters outside the residency come from hospital systems, the local university, other residency programs, and community private physicians. Results: Peer-reviewed research publications have increased greatly since the advent of the research forum in 2006, with six publications from 1997-2006 and 26 from 2007-2016. Greater increases in numbers of peer reviewed presentations were also seen. Collaborative research has occurred between residency faculty and multiple departments at the local university including the business school, social work, public health, physiology, and statistics. There are now 28 collaborative projects completed or in progress. Conclusions: Development and implementation of a regional health research event has been a success in increasing faculty and resident research productivity. The even greater success however, is the progress made in advancing research collaborations between the local university and the residency program.
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Chen, Jenny X., Elliott Kozin, Jordan Bohnen, Brian George, Daniel G. Deschler, Kevin Emerick, and Stacey T. Gray. "Assessments of Otolaryngology Resident Operative Experiences Using Mobile Technology: A Pilot Study." Otolaryngology–Head and Neck Surgery 161, no. 6 (August 13, 2019): 939–45. http://dx.doi.org/10.1177/0194599819868165.
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Objectives Surgical education has shifted from the Halstedian model of “see one, do one, teach one” to a competency-based model of training. Otolaryngology residency programs can benefit from a fast and simple system to assess residents’ surgical skills. In this quality initiative, we hypothesize that a novel smartphone application called System for Improving and Measuring Procedural Learning (SIMPL) could be applied in an otolaryngology residency to facilitate the assessment of resident operative experiences. Methods The Plan Do Study Act method of quality improvement was used. After researching tools of surgical assessment and trialing SIMPL in a resident-attending pair, we piloted SIMPL across an otolaryngology residency program. Faculty and residents were trained to use SIMPL to rate resident operative performance and autonomy with a previously validated Zwisch Scale. Results Residents (n = 23) and faculty (n = 17) were trained to use SIMPL using a standardized curriculum. A total of 833 assessments were completed from December 1, 2017, to June 30, 2018. Attendings completed a median 20 assessments, and residents completed a median 14 self-assessments. All evaluations were resident initiated, and attendings had a 78% median response rate. Evaluations took residents a median 22 seconds to complete; 126 unique procedures were logged, representing all 14 key indicator cases for otolaryngology. Discussion This is the first residency-wide application of a mobile platform to track the operative experiences of otolaryngology residents. Implications for Practice We adapted and implemented a novel assessment tool in a large otolaryngology program. Future multicenter studies will benchmark resident operative experiences nationwide.
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Lourenço, Elora Sampaio, Dora Pedroso Kowacs, Jay Raman Gavvala, Pedro André Kowacs, and Fábio Augusto NASCIMENTO. "EEG education in Brazil: a national survey of adult neurology residents." Arquivos de Neuro-Psiquiatria 80, no. 1 (January 2022): 43–47. http://dx.doi.org/10.1590/0004-282x-anp-2021-0150.
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ABSTRACT Background: In light of the established challenges of resident EEG education worldwide, we sought to better understand the current state of neurology resident EEG education in Brazil. Objective: To define Brazilian EEG practices including in-residency requirements for EEG training and competency. Methods: We assessed the perspectives of adult residents (PGY1-3) on EEG education and their level of confidence interpreting EEG with a 24-question online survey. Results: We analyzed 102 responses from 52 Brazilian neurology residency programs distributed in 14 states. There were 18 PGY1s, 45 PGY2s, and 39 PGY3s. Ninety-six percent of participants reported that learning how to read EEG during residency was very or extremely important. The most commonly reported barriers to EEG education were insufficient EEG exposure (70%) and ineffective didactics (46%). Residents believed that standard EEG lectures were the most efficient EEG teaching method followed by interpreting EEG with attendings’ supervision. Roughly half of residents (45%) reported not being able to read EEG even with supervision, and approximately 70% of all participants did not feel confident writing an EEG report independently. Conclusion: Despite the well-established residency EEG education requirements recommended by the Brazilian Academy of Neurology (ABN), there seems to be a significant lack of comfort interpreting EEG among Brazilian adult neurology residents. We encourage Brazilian neurology residency leadership to re-evaluate the current EEG education system in order to ensure that residency programs are following EEG education requirements and to assess whether EEG benchmarks require modifications.
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Cohen, Samuel A., and Suzann Pershing. "Geographic Trends in the Ophthalmology Residency Match: Influence of Program and Applicant Characteristics." Journal of Academic Ophthalmology 14, no. 01 (January 2022): e81-e92. http://dx.doi.org/10.1055/s-0042-1743416.
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Abstract Introduction The ophthalmology residency match remains competitive. Several prior studies have examined various factors that contribute to a successful match into an ophthalmology residency program; however, the role of geographic location in the ophthalmology residency match process is unclear. The purpose of our study was to evaluate geographic trends in the ophthalmology residency match and to determine whether geographic trends vary based on program level factors such as program rank or funding source and/or applicant factors such as year of training, gender, and medical degree earned. Specifically, we assessed associations with residents training at the residency program affiliated with their medical school and/or within the same geographic region as their medical school, using data obtained through publicly available sources and residency program surveys. Methods We used the American Medical Association's Fellowship and Residency Electronic Interactive Database database to identify accredited ophthalmology residency programs. Residency program Web sites and email inquiries were used to collect demographic and geographic information for residents in the graduating classes of 2021 to 2023. Statistical analysis included χ2 testing and multivariate logistic regression. Results In total, 1,378 residents were included from 110 ophthalmology residency programs and 218 medical schools. Residents who matched at the residency program affiliated with their medical school (18%) were evenly distributed among the Midwest, Northeast, South, and West regions (p = 0.2236). Residency programs in the West (31.7%) matched fewer regional medical students compared with programs in the South (61.2%), Midwest (57.4%), and Northeast (58.4%) (p < 0.0001). Attending a publicly funded medical school was associated with higher odds of matching into a regional residency program (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.10–1.90; p = 0.0001) and attending a privately funded medical school was associated with higher odds of matching into a top-ranked residency program (OR, 1.53, 95% CI, 1.34–1.82; p = 0.0002). Conclusions The majority of current ophthalmology residents trained at programs in the same geographic region as their medical schools, with nearly 20% of residents training at their medical school-affiliated program. Geographic differences in match results were observed based on resident gender, medical school characteristics, and residency program region.
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Woods, Suzanne K., Leigh Burgess, Catherine Kaminetzky, Diana McNeill, Sandro Pinheiro, and Mitchell T. Heflin. "Defining the Roles of Advisors and Mentors in Postgraduate Medical Education: Faculty Perceptions, Roles, Responsibilities, and Resource Needs." Journal of Graduate Medical Education 2, no. 2 (June 1, 2010): 195–200. http://dx.doi.org/10.4300/jgme-d-09-00089.1.
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Abstract Background Residency program directors rely on an informal network of faculty mentors to provide guidance for residents. Faced with increasingly sophisticated competency-based evaluation systems and scrutiny of patient safety and resident well-being in today's environment, residency programs need more structured mechanisms for mentoring. Objective To clarify the role of resident advisors and mentors so that residents receive the right combination of direction and oversight to ensure their successful transition to the next phase of their careers. Methods The Duke Internal Medicine Residency Program undertook a formal assessment of the roles, responsibilities, and resource needs of its key faculty through a focus group made up of key faculty. A follow-up focus group of residents and chief residents was held to validate the results of the faculty group assessment. Results The distinction between advising and mentoring was our important discovery and is supported by literature that identifies that mentors and advisors differ in multiple ways. A mentor is often selected to match resources and expertise with a resident's needs or professional interests. An advisor is assigned with a role to counsel and guide the resident through the residency processes, procedures, and key learning milestones. Conclusion The difference between the role of advisor and that of mentor is of critical importance and allowed for the evolution of faculty participants' role as resident advisors, including the formulation of expectations for advisors, and the creation of an advisor toolkit. Our modifiable toolkit can enhance the advising process for residents in many disciplines. We saw an improvement in resident satisfaction from 2006 to 2009.
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Morbitzer, Kathryn A., Kamakshi V. Rao, Denise H. Rhoney, Ashley L. Pappas, Emily A. Durr, Said M. Sultan, Stephen F. Eckel, Scott W. Savage, B. Rowell Daniels, and Nicole R. Pinelli. "Implementation of the flipped residency research model to enhance residency research training." American Journal of Health-System Pharmacy 76, no. 9 (April 17, 2019): 608–12. http://dx.doi.org/10.1093/ajhp/zxz064.
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Abstract Purpose The attainment of fundamental research skills to create and disseminate new knowledge is imperative for the advancement of pharmacy practice. Research training is an important component of postgraduate residency training; however, the traditional model of performing residency research has several limitations that have hindered the ability of residents to complete high-quality research projects. Therefore, our institution developed and implemented the flipped residency research model with the 2013–2014 pharmacy practice residency class. Summary The flipped residency research model modifies the research timeline to better align research activities with residents’ abilities at specific time points during the year. In the 4 years following implementation of the flipped residency research model, our institution found improvements in a number of areas pertaining to the research process compared with an evaluation of the 7 years prior to implementation. A decrease in the number of reviews required from institutional review boards was observed, resulting in improved institutional review board efficiency. The flipped residency research model also addressed limitations surrounding manuscript development and submission, as demonstrated by an improved publication rate. Additionally, residents who participated in the flipped residency research model self-reported increased comfort with research-related abilities associated with study design, implementation, manuscript development and submission, and biostatistics. Conclusion The modified research timeline of the flipped residency research model better aligns research activities with resident experiences and abilities. This realignment has translated to demonstrable impact in the success of residency projects and dissemination of results. Research is needed to investigate the impact of the flipped residency research model on longer term scholarly success.
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Prager, Jeremy D., Charles M. Myer, and Charles M. Myer. "Attrition in Otolaryngology Residency." Otolaryngology–Head and Neck Surgery 145, no. 5 (July 11, 2011): 753–54. http://dx.doi.org/10.1177/0194599811414495.
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Attrition is a disruptive problem in residency training programs. Resident attrition has been more thoroughly investigated and reported in other medical fields with limited data specific to otolaryngology. Using a Web-based survey of otolaryngology residency program directors, information regarding a 5-year cohort of residents was collected. The survey response rate was 61% (59 of 97 programs), representing 779 of 1239 training positions (63%). Forty-two percent of responding programs (25 of 59) lost a total of 47 residents (range, 1-7; mode 1). The overall attrition rate was 6% for the 5-year cohort (47 of 779) or 1.2% annually. Involuntary attrition affected 6 residents. Eighteen residents voluntarily left for other medical programs. Four left medicine entirely. The remaining 19 residents’ career paths were not described. Attrition within otolaryngology occurs with less frequency than general surgery and is likely comparable to other surgical subspecialties.
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Cruz, Maria Lourdes Carmela, Joshua B. Utay, and Ashley H. Mullen. "Entrustment trends in orthotic and prosthetic residencies." Prosthetics and Orthotics International 44, no. 2 (March 5, 2020): 73–80. http://dx.doi.org/10.1177/0309364620909236.
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Background: Orthotic and prosthetic residency preceptors have little guidance transitioning residents between observing and performing patient care. Understanding current entrustment trends and factors can help guide resident progression during residency. Objectives: To identify entrustment trends and factors within an orthotics and prosthetics residency affecting a supervisor’s decision to entrust residents with independent patient care. Study design: Cross-sectional study Methods: In this cross-sectional study, 831 National Commission of Orthotic and Prosthetic Education preceptors were invited to complete a 26-question, online questionnaire that examined possible entrustment factors. Results: A total of 77 preceptors completed the questionnaire. The top-reported behavioral qualities impacting entrustment were recognition of limitations and willingness to ask for help ( n = 45) and competence ( n = 37). Preceptors ranked evaluation ( n = 27) as the professional skill which most affected entrustability; technical skill least affected entrustability ( n = 4). Preceptors of 12-month residencies entrust residents to indirect supervision when they have completed approximately 75% (i.e. 9 months) of the program. Preceptors of 18-month residencies reported that they entrust their residents by the time they reach 50% (i.e. 9 months) of their training. A small number of preceptors ( n = 19) never allow a resident to independently perform practice management. Conclusion: Residency supervisors value interpersonal and evaluation skills when making entrustment decisions. Residency mentors can use these findings to inform their entrustment decisions and support a resident’s progression toward independent practice. Clinical relevance This study presents information which can inform clinical preceptors and residents on what factors contribute to the decision to progress a resident from observation to independent patient care. These findings may influence clinical education standards which aim to promote both resident training and patient access to quality care.
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Patel, Mitesh, Jasneet S. Bhullar, Gokulakkrishna Subhas, and Vijay Mittal. "Present Status of Autonomy in Surgical Residency—a Program Director's Perspective." American Surgeon 81, no. 8 (August 2015): 786–90. http://dx.doi.org/10.1177/000313481508100816.
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As surgery residents graduate and begin their careers as junior attending surgeons, the question of whether a surgeon can complete a case alone still lingers. Allowing autonomy during residency answers this question. The purpose of this study was to gather input from general surgery residency program directors on how they achieve autonomy for residents in their programs. An online survey of 18 questions was sent to all general surgery residency program directors in the United States between April and June of 2013 via e-mail. Questions were asked regarding classification of autonomy, percentage of case completed by the resident independently, and in what area a resident worked with minimal supervision. Of the 202 delivered, 85 program directors were responded (42%). Seventy-eight per cent of programs classified a resident as surgeon junior whether the resident completed more than 50 per cent of the case. Most classified autonomy as either the resident completing >75 per cent of a case (41%) or completing the critical steps of a surgery (41%). Eighty-eight per cent stated that chief residents completed the majority of cases under supervision, whereas only 12 per cent stated the chief had autonomy in the operating room and also acted as teaching assistant. While, 60 per cent stated their chief residents did not work in any area of the hospital independently. Despite differences in how autonomy is defined among programs, most program directors feel that their chief residents do not achieve complete autonomy. Programs should allow their residents to work in a progressive responsibility as they progress into their fourth and fifth years of residency to achieve autonomy.
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Hershkovitz, Yehuda, Adi Rasco, and Orna Tal. "Shortening shift’s length—Should we ask the residents if this is what they want?" PLOS ONE 17, no. 8 (August 2, 2022): e0272548. http://dx.doi.org/10.1371/journal.pone.0272548.
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Introduction Work overload in hospitals enforced reducing shifts length of physicians in many countries over the last decade. In Israel, the current shift standard is of 26 hours, however, there is a residents’ struggle alongside a governmental intent to short the shifts to 16 hour. We aim to evaluate residents and interns support and preferences regarding shortening shifts and their ramifications to quality of life and residency programs. Methods A structured questionnaire was distributed to all resident and interns in a single center. We evaluated their current quality of residency and life, their support in the shorter shifts model, offering alternative program components such as reduced pay, longer residency or replacement in order to allow rest. We compared those who support the new model to those who objected to identify common characteristics to draw a resident profile for acceptance of change. Results Overall, 151 physicians answer the questionnaire. 70.2% support the shorter shifts model. Residents above 35 years old and those reaching completion of residency, significantly less support the shortening shifts model. No other demographic nor professional parameters were different between the supporters and non-supporters. Option of reduced pay or longer residency dramatically reduced the support rate to less than 30% and 20%, respectively. Replacement by other physician (resident or senior physician) in order to allow rest was supported by only 40%. Conclusion Residents’ standpoints regarding a desirable change are crucial to plan a successful implementation. A national survey is required before a new model is introduced, to achieve an optimal transparent efficient process.
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Reardon, Claudia L., Greg Ogrinc, and Art Walaszek. "A Didactic and Experiential Quality Improvement Curriculum for Psychiatry Residents." Journal of Graduate Medical Education 3, no. 4 (December 1, 2011): 562–65. http://dx.doi.org/10.4300/jgme-d-11-0008.1.
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Abstract Background Quality improvement (QI) education in residency training is important and necessary for accreditation. Although the literature on this topic has been growing, some specialties, in particular psychiatry, have been underrepresented. Methods We developed a didactic and experiential QI curriculum within a US psychiatry residency program that included a seminar series and development of QI projects. Evaluation included resident knowledge using the Quality Improvement Knowledge Application Tool, implementation of resident QI projects, and qualitative and quantitative satisfaction with the curriculum. Results Our curriculum significantly improved QI knowledge in 2 cohorts of residents (N = 16) as measured by the Quality Improvement Knowledge Application Tool. All resident QI projects (100%) in the first cohort were implemented. Residents and faculty reported satisfaction with the curriculum. Conclusions Our curriculum incorporated QI education through didactic and experiential learning in a moderately sized US psychiatry residency program. Important factors included a longitudinal experience with protected time for residents to develop QI projects and a process for developing faculty competence in QI. Further studies should use a control group of residents and examine interprofessional QI curricula.
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Backeris, Mark E., Patrick J. Forte, Shawn T. Beaman, and David G. Metro. "Financial Implications of Different Interpretations of ACGME Anesthesiology Program Requirements for Rotations in the Operating Room." Journal of Graduate Medical Education 5, no. 2 (June 1, 2013): 315–19. http://dx.doi.org/10.4300/jgme-d-13-00075.1.
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Abstract Background The Accreditation Council for Graduate Medical Education (ACGME) standards for resident education in anesthesiology mandate required rotations including rotations inside the operating room (OR). When residents complete rotations outside the OR, other providers must be used to maintain the OR's clinical productivity. Objective We quantified and compared the costs of replacing residents by using two different working patterns that are compliant with the ACGME anesthesiology program requirements: (1) the minimum amount of time in the OR, and (2) working the maximum amount of time permitted in the OR. Methods We calculated resident replacement costs over a 36-month residency period in both a minimum and maximum OR time model. We used a range of Certified Registered Nurse Anesthetist (CRNA) pay scales determined by a local market analysis for cost comparisons. Results Depending on CRNA pay rates, the cost differentials to replace a resident in the OR between the minimum and maximum OR time models ranged from $236,000 to $581,876, assuming a 50-hour resident work week, and $373,400 to $931,001, assuming an 80-hour resident work week. This cost was per resident over the entire 3 years of their residency. Conclusions Varying the amount of time residents work in the OR (as allowed under ACGME program requirements) has significant financial implications over a 36-month anesthesiology residency. The larger the residency, the more significant will be the impact on the department and sponsoring institution.
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Miller, Jamie L., Teresa V. Lewis, Jennifer Walling, Abriel O'Donnell, Stephen B. Neely, and Peter N. Johnson. "Publication Rates of Pediatric-Focused Resident Research Projects Presented at The Pediatric Pharmacy Association Bruce Parks Memorial Residency Showcase." Journal of Pediatric Pharmacology and Therapeutics 26, no. 2 (February 15, 2021): 163–71. http://dx.doi.org/10.5863/1551-6776-26.2.163.
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OBJECTIVES The primary objective was to identify the number of residency projects presented at the Pediatric Pharmacy Association (PPA) Bruce Parks Memorial Residency Showcase that were subsequently published. Secondary objectives included a comparison of subsequent publications after residency completion between those who did and did not publish their residency project and an analysis of factors associated with subsequent publications. METHODS This was a descriptive study including all pediatric-focused resident projects presented at the PPA Bruce Parks Memorial Residency Showcase from 2006 to 2015. Literature searches for all the pediatric-focused residency projects and any subsequent publications were performed. Data collection included residency type (i.e., postgraduate year 1 [PGY1], postgraduate year 2 [PGY2]), project category, and initial position after residency. A zero-inflated Poisson regression was used to analyze subsequent publication status while controlling for other factors. Statistical analyses were performed using SAS/STAT, with a priori p value < 0.05. RESULTS There were 434 projects presented by 401 residents. Seventy-four (17.1%) were published, with the majority being PGY2s (74.3%). Subsequent publications were identified for 162 residents (40.4%), with a higher percentage in those who published their pediatric-focused residency project versus those who did not, 59.5% versus 32.8%, p < 0.001. Factors associated with subsequent publications were those who published their residency project, initial position in academia, and PGY2s. CONCLUSIONS Of the residency projects presented at the showcase <20% were subsequently published. Those who published their residency research project were more likely to have subsequent publications. Future efforts should be taken to ensure that residents have the tools/confidence to independently publish their research/scholarship.
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Akins, Ralitsa B., and Gilbert A. Handal. "Utilizing Quality Improvement Methods to Improve Patient Care Outcomes in a Pediatric Residency Program." Journal of Graduate Medical Education 1, no. 2 (December 1, 2009): 299–303. http://dx.doi.org/10.4300/jgme-d-09-00043.1.
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Abstract Objective Although there is an expectation for outcomes-oriented training in residency programs, the reality is that few guidelines and examples exist as to how to provide this type of education and training. We aimed to improve patient care outcomes in our pediatric residency program by using quality improvement (QI) methods, tools, and approaches. Methods A series of QI projects were implemented over a 3-year period in a pediatric residency program to improve patient care outcomes and teach the residents how to use QI methods, tools, and approaches. Residents experienced practice-based learning and systems-based assessment through group projects and review of their own patient outcomes. Resident QI experiences were reviewed quarterly by the program director and were a mandatory part of resident training portfolios. Results Using QI methodology, we were able to improve management of children with obesity, to achieve high compliance with the national patient safety goals, improve the pediatric hotline service, and implement better patient flow in resident continuity clinic. Conclusion Based on our experiences, we conclude that to successfully implement QI projects in residency programs, QI techniques must be formally taught, the opportunities for resident participation must be multiple and diverse, and QI outcomes should be incorporated in resident training and assessment so that they experience the benefits of the QI intervention. The lessons learned from our experiences, as well as the projects we describe, can be easily deployed and implemented in other residency programs.
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Ledford, Christy J. W., Dean A. Seehusen, Melinda M. Villagran, Lauren A. Cafferty, and Marc A. Childress. "Resident Scholarship Expectations and Experiences: Sources of Uncertainty as Barriers to Success." Journal of Graduate Medical Education 5, no. 4 (December 1, 2013): 564–69. http://dx.doi.org/10.4300/jgme-d-12-00280.1.
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Abstract Background Scholarly activity during residency is vital to resident learning and ultimately to patient care. Incorporating that activity into training is, however, a challenge for medical educators. Most research on medical student and resident attitudes toward scholarly activity to date has been quantitative and has focused on level of interest, desire to perform scholarship, and perceived importance of scholarship. Objective We explored attitudes, expectations, and barriers regarding participation in scholarly activity among current residents and graduates of a single family medicine residency program. Methods Using a phenomenologic approach, we systematically analyzed data from one-on-one, semistructured interviews with residents and graduates. Interviews included participant expectations and experiences with scholarly activity in residency. Results The 20 participants (residents, 15 [75%]; residency graduates, 5 [25%]) identified uncertainty in their attitudes toward, and expectations regarding, participation in scholarly activity as an overarching theme, which may present a barrier to participation. Themes included uncertainty regarding their personal identity as a clinician, time to complete scholarly activity, how to establish a mentor-mentee relationship, the social norms of scholarship, what counted toward the scholarship requirements, the protocol for completing projects, and the clinical relevance of scholarship. Conclusions Uncertainty about scholarly activity expectations can add to learner anxiety and make performing scholarly activity during residency seem like an insurmountable task. Programs should consider implementing a variety of strategies to foster scholarly activity during residency, including clarifying and codifying expectations and facilitating mentoring relationships with faculty.
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Sharma, Rahul, Jeremy D. Sperling, Peter W. Greenwald, and Wallace A. Carter. "A Novel Comprehensive In-Training Examination Course Can Improve Residency-Wide Scores." Journal of Graduate Medical Education 4, no. 3 (September 1, 2012): 378–80. http://dx.doi.org/10.4300/jgme-d-11-00154.1.
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Abstract Introduction The annual American Board of Emergency Medicine (ABEM) in-training examination is a tool to assess resident progress and knowledge. We implemented a course at the New York-Presbyterian Emergency Medicine Residency Program to improve ABEM scores and evaluate its effect. Previously, the examination was not emphasized and resident performance was lower than expected. Methods As an adjunct to required weekly residency conferences, an intensive 14-week in-training examination preparation program was developed that included lectures, pre-tests, high-yield study sheets, and a remediation program. We compared each residents in-training examination score to the postgraduate year-matched national mean. Scores before and after course implementation were evaluated by repeat measures regression modeling. Residency performance was evaluated by comparing residency average to the national average each year and by tracking ABEM national written examination pass rates. Results Following the course's introduction, odds of a resident scoring higher than the national average increased by 3.9 (95% CI 1.9-7.3) and percentage of residents exceeding the national average increased by 37% (95% CI 23%-52%). In the time since the course was started the overall residency mean score has outperformed the national average and the first-time ABEM written examination board pass rate has been 100%. Conclusion A multifaceted residency-wide examination curriculum focused around an intensive 14-week course was associated with marked improvement on the in-training examination.
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Woodfin, Michael, Karine D. Bojikian, Parisa Taravati, Leona Ding, Michele D. Lee, and Shu Feng. "The Early Impact of COVID-19 on Ophthalmology Resident Training and Wellness." Journal of Academic Ophthalmology 12, no. 02 (July 2020): e292-e297. http://dx.doi.org/10.1055/s-0040-1721071.
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Abstract Objective The aim of this article is to assess the initial impact of the coronavirus disease 2019 (COVID-19) pandemic on ophthalmology resident training and wellness. Design Online national survey of ophthalmology residents distributed by residency program directors and education coordinators of participating programs. Setting US ophthalmology residency programs during the COVID-19 pandemic (May 20th, 2020 to June 10th, 2020). Participants Ophthalmology residents enrolled in the US residency programs currently in postgraduate years two through four of training. Results Two-hundred thirty-six of 785 (30.1%) residents responded to the survey. One-hundred eighteen of 234 (50.4%) residents reported exposure to known COVID-19 positive patients, and of those exposed, 44 of 118 (37.2%) felt that they did not have adequate personal protective equipment. One-hundred ninety-five of 233 (83.7%) residents reported a decrease in primary surgical cases during the pandemic, with 68 (29.2%) reporting a loss of more than 50 primary cases. One-hundred sixty-four of 234 (70.1%) residents were concerned that the pandemic would negatively impact their surgical skills beyond residency, and 15% reported that they were more likely to pursue fellowship due to the pandemic. 31.0% of residents met criteria of burnout, 9.1% were depressed, and 13.4% had generalized anxiety. Concerns about COVID-19 infection were correlated with increased anxiety and burnout during the pandemic. Conclusions The COVID-19 pandemic has decreased resident surgical and clinical volumes and has negatively impacted ophthalmology residency training. Residents with increased concern for contracting COVID-19 and those actively engaged in a job search had significantly higher odds of increased anxiety.
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Shih, Jessica G., Whitney L. Quong, Aaron D. C. Knox, Nick Zhygan, Douglas J. Courtemanche, Mitchell H. Brown, and Joel S. Fish. "Burn Care and Surgical Exposure amongst Canadian Plastic Surgery Residents: Recommendations for Transitioning to a Competency-Based Medical Education Model." Journal of Burn Care & Research 40, no. 6 (July 18, 2019): 796–804. http://dx.doi.org/10.1093/jbcr/irz086.
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Abstract With the ongoing implementation of a competency-based medical education (CMBE) model for residency programs in North America, emphasis on the duration of training has been refocused onto ability and competence. This study aims to determine the exposure of burn-related core procedural competencies (CPCs) in Canadian Plastic Surgery Residents in order to enhance curricular development and help define its goals. A retrospective review of burn-related resident case logs encompassing all 10 English-speaking plastic surgery residency programs from 2004 to 2014 was performed, including analysis of personal competence scores and resident role by Postgraduate Year (PGY)-year. Case logs of a total of 55 graduating plastic surgery residents were included in the study. Overall, 4033 procedures in burn and burn-related care were logged, accounting for 6.8% of all procedures logged. On average, each resident logged 73 burn procedures, 99% of which were CPCs. The most frequently performed procedure was harvest and application of autograft, allograft, or xenograft, while emergent procedures such as escharotomy and compartment release were performed on average less than one time per resident. Personal competence scores as well as role of the resident (surgical responsibility) increased as PGY-year progressed during residency. Canadian plastic surgery residency programs provide adequate exposure to the majority of the scope of burn care and surgery. However, infrequently encountered but critical procedures such as escharotomy and fasciotomy may require supplementation through dedicated educational opportunities. CMBE should identify these gaps in learning through facilitation of resident competency evaluation. With consideration for the amount of exposure to burn-related CPCs as identified, plastic surgery residency programs can work toward achieving competency in all aspects of burn care and surgery prior to the completion of residency.
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Swan, Joshua T., Mary Giouroukakis, Brandon R. Shank, Daniel J. Crona, Karen Berger, and Eric Wombwell. "The Value of Pharmacy Residency Training for Health Systems." Journal of Pharmacy Practice 27, no. 4 (March 20, 2014): 399–411. http://dx.doi.org/10.1177/0897190013515707.
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Purpose: Identify and summarize articles that describe the value that pharmacy residency training offers to sponsoring health systems. Summary: There is a tremendous gap between the number of resident applicants and the number of pharmacy residencies available. Informing health-system administration executives about the proven value of residency training is key to expanding the number of available positions. To address this disparity, a comprehensive and systematic literature search to identify publications highlighting the value that pharmacy residency training provides to the sponsor hospital or health system was conducted. Articles were identified through query of PubMed and SciVerse SCOPUS and through review of bibliographies from relevant articles. Twenty articles were identified and summarized in this annotated bibliography that demonstrate perceived and quantitative value of pharmacy residency training for health systems that sponsor residency training. Conclusion: Pharmacy residency training programs are essential for pharmacists that will primarily engage in direct patient care activities. This annotated bibliography includes key publications that provide evidence of the value that pharmacy residents provide to the sponsoring health system. This manuscript will aid prospective residency directors interested in developing new residency positions at new institutions or for residency program directors interested in expanding the total number of resident positions available at the existing sites.
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Sepulveda, Debra, and Kalli Varaklis. "Implementing a Multifaceted Quality-Improvement Curriculum in an Obstetrics-Gynecology Resident Continuity-Clinic Setting: A 4-Year Experience." Journal of Graduate Medical Education 4, no. 2 (June 1, 2012): 237–41. http://dx.doi.org/10.4300/jgme-d-11-00158.1.
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Abstract Background Although many residency programs are instituting quality improvement (QI) curricula in response to both institutional and external mandates, there are few reports of successful integration of resident initiated projects into these QI curricula with documented impact on health care processes and measures. Intervention We introduced a multifaceted curriculum into an Obstetrics-Gynecology continuity clinic. Following a needs assessment, we developed a didactic session to introduce residents to QI tools and the how to of a mentored resident-initiated project. Resident projects were presented to peers and faculty and were evaluated. A postgraduation survey assessed residents' satisfaction with the curriculum and preparedness for involvement in QI initiatives after residency. We also assessed whether this resulted in sustained improvement in health care measures. Results The curriculum was presented to 7 classes of residents (n = 25) and 17 resident initiated projects have been completed. Twenty-one residents (84%) completed the preintervention survey and 12 of 17 (71%) residents who completed the entire curriculum completed the postintervention survey. Sustained change in surrogate health measures was documented for 4 projects focused on improving clinical measures, and improvement in clinical systems was sustained in 9 of the remaining 13 projects (69%). Most of the respondents (75%, n = 9) agreed or strongly agreed that the projects done in residency provided a helpful foundation to their current QI efforts. Conclusion This project successfully demonstrates that a multifaceted program in QI education can be implemented in a busy Obstetrics-Gynecology residency program, resulting in sustained improvement in surrogate health measures and in clinical systems. A longitudinal model for resident projects results in an opportunity for reflection, project revision, and a maintenance plan for continued clinical impact.
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Agarwal, Nitin, Michael D. White, Susan C. Pannullo, and Lola B. Chambless. "Analysis of national trends in neurosurgical resident attrition." Journal of Neurosurgery 131, no. 5 (November 2019): 1668–73. http://dx.doi.org/10.3171/2018.5.jns18519.
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OBJECTIVEResident attrition creates a profound burden on trainees and residency programs. This study aims to analyze trends in resident attrition in neurological surgery.METHODSThis study followed a cohort of 1275 residents who started neurosurgical residency from 2005 to 2010. Data obtained from the American Association of Neurological Surgeons (AANS) included residents who matched in neurosurgery during this time. Residents who did not finish their residency training at the program in which they started were placed into the attrition group. Residents in the attrition group were characterized by one of five outcomes: transferred neurosurgery programs; transferred to a different specialty; left clinical medicine; deceased; or unknown. A thorough internet search was conducted for residents who did not complete their training at their first neurosurgical program. Variables leading to attrition were also analyzed, including age, sex, presence of advanced degree (Ph.D.), postgraduate year (PGY), and geographical region of program.RESULTSResidents starting neurosurgical residency from 2005 to 2010 had an overall attrition rate of 10.98%. There was no statistically significant difference in attrition rates among the years (p = 0.337). The outcomes for residents in the attrition group were found to be as follows: 33.61% transferred neurosurgical programs, 56.30% transferred to a different medical specialty, 8.40% left clinical medicine, and 1.68% were deceased. It was observed that women had a higher attrition rate (18.50%) than men (10.35%). Most attrition (65.07%) occurred during PGY 1 or 2. The attrition group was also observed to be significantly older at the beginning of residency training, with a mean of 31.69 years of age compared to 29.31 in the nonattrition group (p < 0.001). No significant difference was observed in the attrition rates for residents with a Ph.D. (9.86%) compared to those without a Ph.D. (p = 0.472).CONCLUSIONSA majority of residents in the attrition group pursued training in different medical specialties, most commonly neurology, radiology, and anesthesiology. Factors associated with an increased rate of attrition were older age at the beginning of residency, female sex, and junior resident (PGY-1 to PGY-2). Resident attrition remains a significant problem within neurosurgical training, and future studies should focus on targeted interventions to identify individuals at risk to help them succeed in their medical careers.
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Barnhardt, Elizabeth W., Frances Comer, Elizabeth Zmuda, and Alexander Rakowsky. "Impact of an osteopathic presence in a large categorical pediatric residency training program." Journal of Osteopathic Medicine 121, no. 1 (January 1, 2021): 35–42. http://dx.doi.org/10.1515/jom-2019-0317.
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Abstract Context Nationwide Children’s Hospital (NCH) has a large pediatric residency program with 43 residents in the categorical pediatric program and 10 residents in the Internal Medicine-Pediatrics (IM-Peds) program per class. Of the 43 categorical pediatric residents, four are in the osteopathic recognition track (ORT) and continue their osteopathic education throughout residency. There is currently a lack of data examining the effect of an ORT, and specifically a pediatric ORT, on a residency program. Objective To evaluate the impact of an ORT osteopathic recognition track on an overall residency program’s perceptions of osteopathic manipulative treatment (OMT) and to evaluate allopathic (MD) resident perception of osteopathic educational sessions. Methods An anonymous survey was conducted in June 2017 and distributed to 141 residents (both categorical and IM-Peds) to gather baseline information regarding perceptions and knowledge of OMT. Based on the initial results, a four-part case-based educational series was implemented during the 2018–2019 academic year to teach osteopathic principles to MD residents. A second survey was distributed following each session. Results For the initial survey, 59 (41.8%) residents responded. Survey results demonstrated that resident perceptions of OMT as an efficacious treatment option increased after starting their residency at NCH (p=0.04), and 25 of 43 (58.1%) MD residents stated an interest in learning OMT skills. A total of 140 attendees were present at the four educational sessions. One hundred and thirty-eight residents (98.5%) found the educational sessions beneficial and 132 (94.2%) stated they would refer a patient for OMT. Conclusion ORT residents make a significant impact on their colleagues’ perceptions and knowledge of OMT. This study suggests that further efforts to highlight the clinical applications of OMT in pediatric patients would be welcomed by residents.
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Gossa, Weyinshet, Christine Jones, Sorana Raiculescu, Mesfin Melaku, Elnathan Kebebew, Meseret Zerihun, and Michael D. Fetters. "Family Medicine Residents’ Attitudes About Training in Ethiopia and the United States." Family Medicine 51, no. 5 (May 7, 2019): 424–29. http://dx.doi.org/10.22454/fammed.2019.190022.
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Background and Objectives: In Ethiopia, family medicine began in 2013. The objective of this study was to compare family medicine residents’ attitudes about training in Ethiopia with those at a program in the United States. Methods: Family medicine residents at Addis Ababa University in Addis Ababa, Ethiopia and the University of Maryland in Baltimore, Maryland completed a 43-item Likert scale survey in 2017. The survey assessed residents’ attitudes about residency education, patient care, independence as family physicians, finances, impact of residency on personal life, and women’s issues. We calculated descriptive statistics on the demographics data and analyzed survey responses using a two-sample t-test. Results: A total of 18 (75%) Ethiopian residents and 18 (60%) US residents completed the survey (n=36). The Ethiopian residents had a wider age distribution (25-50 years) than the US residents (25-34 years). More US residents were female (72%) compared to the Ethiopian cohort (50%), while more Ethiopian residents were married (72%) compared to the US cohort (47%). There were statistically significant differences in attitudes toward patient care (P=0.005) and finances (P<0.001), differences approaching significance in attitudes toward residency education, and no significant differences in independence as family physicians, the impact of residency on personal life, and women’s issues in family medicine. Conclusions: Across two very different cultures, resident attitudes about independence as family physicians, the impact of residency on personal life and women’s issues, were largely similar, while cross-national differences in attitudes were found relative to residency education, patient care, and finances.
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Carek, Peter J., Joseph W. Gravel, Stanley Kozakowski, Perry A. Pugno, Gerald Fetter, and Elissa J. Palmer. "Impact of Proposed Institute of Medicine Duty Hours: Family Medicine Residency Directors' Perspective." Journal of Graduate Medical Education 1, no. 2 (December 1, 2009): 195–200. http://dx.doi.org/10.4300/jgme-d-09-00003.1.
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Abstract Purpose To examine the opinions of family medicine residency program directors concerning the potential impact of the Institute of Medicine (IOM) resident duty hour recommendations on patient care and resident education. Methods A survey was mailed to 455 family medicine residency program directors. Data were summarized and analyzed using Epi Info statistical software. Significance was set at the P < .01 level. Results A total of 265 surveys were completed (60.9% response rate). A majority of family medicine residency program directors disagreed or strongly disagreed that the recent IOM duty hour recommendations will, in general, result in improved patient safety and resident education. Further, a majority of respondents disagreed or strongly disagreed that the proposed IOM rules would result in residents becoming more compassionate, more effective family physicians. Conclusion A majority of family medicine residency program directors believe that the proposed IOM duty hour recommendations would have a primarily detrimental effect on both patient care and resident education.
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Raad, Wissam N., Adil Ayub, Chyun-Yin Huang, Landon Guntman, Sadiq S. Rehmani, and Faiz Y. Bhora. "Robotic Thoracic Surgery Training for Residency Programs." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 13, no. 6 (November 2018): 417–22. http://dx.doi.org/10.1097/imi.0000000000000573.
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Objective Robotic-assisted surgery is increasingly being used in thoracic surgery. Currently, the Integrated Thoracic Surgery Residency Program lacks a standardized curriculum or requirement for training residents in robotic-assisted thoracic surgery. In most circumstances, because of the lack of formal residency training in robotic surgery, hospitals are requiring additional training, mentorship, and formal proctoring of cases before granting credentials to perform robotic-assisted surgery. Therefore, there is necessity for residents in Integrated Thoracic Surgery Residency Program to have early exposure and formal training on the robotic platform. We propose a curriculum that can be incorporated into such programs that would satisfy both training needs and hospital credential requirements. Methods We surveyed all 26 Integrated Thoracic Surgery Residency Program Directors in the United States. We also performed a PubMed literature search using the key word “robotic surgery training curriculum.” We reviewed various robotic surgery training curricula and evaluation tools used by urology, obstetrics gynecology, and general surgery training programs. We then designed a proposed curriculum geared toward thoracic Integrated Thoracic Surgery Residency Program adopted from our credentialing experience, literature review, and survey consensus. Results Of the 26 programs surveyed, we received 17 responses. Most Integrated Thoracic Surgery Residency Program directors believe that it is important to introduce robotic surgery training during residency. Our proposed curriculum is integrated during postgraduate years 2 to 6. In the preclinical stage postgraduate years 2 to 3, residents are required to complete introductory online modules, virtual reality simulator training, and in-house workshops. During clinical stage (postgraduate years 4–6), the resident will serve as a supervised bedside assistant and progress to a console surgeon. Each case will have defined steps that the resident must demonstrate competency. Evaluation will be based on standardized guidelines. Conclusions Expansion and utilization of robotic assistance in thoracic surgery have increased. Our proposed curriculum aims to enable Integrated Thoracic Surgery Residency Program residents to achieve competency in robotic-assisted thoracic surgery and to facilitate the acquirement of hospital privileges when they enter practice.
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Nelson, T. Reid, Crystal L. Hightower, Jeff Coogan, Benjamin D. Walther, and Sean P. Powers. "Patterns and consequences of life history diversity in salinity exposure of an estuarine dependent fish." Environmental Biology of Fishes 104, no. 4 (March 20, 2021): 419–36. http://dx.doi.org/10.1007/s10641-021-01080-0.
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AbstractWhile it is common knowledge that Red Drum (Sciaenops ocellatus) inhabit oligohaline waters (salinity <5), lifetime reconstructions of salinity histories have been lacking, and this study provides unique insight into interannual and ontogenetic patterns of oligohaline occupancy by this economically valuable sportfish. Growth consequences of oligohaline exposure and the relationship of oligohaline residency with river discharge were also investigated. Oligohaline exposure varied most during years 2 and 3 of life. During this time, 22% (n = 26/120 individuals) of Red Drum were oligohaline residents (≥ 90% of these years spent in oligohaline salinities), 34% (n = 41) were meso-polyhaline residents (< 10% of years 2 and 3 spent in oligohaline waters), and 44% (n = 53) spent time in both oligohaline and meso-polyhaline salinities. Trends in oligohaline residency match putative Red Drum life history. Oligohaline residents were present during years 1–6 of life; however, oligohaline residency peaked during the second year of life (n = 37, 31%) and by year 7 no oligohaline residents remained. Growth of oligohaline resident Red Drum during years 2–3 of life was lower than non-resident fish. However, long-term growth consequences of oligohaline residency were not apparent. The proportion of oligohaline residents during years 2 or 3 of life was positively related to river discharge. This divergence in salinity residency by juvenile Red Drum demonstrates that life history diversity was present in this population and that oligohaline waters provided important nursery habitat for fish that successfully recruited to the adult population.
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Simasek, Madeline, Stephanie L. Ballard, Phillip Phelps, Rowena Pingul-Ravano, N. Randall Kolb, Alan Finkelstein, Jacqueline Weaver-Agostoni, and Teiichi Takedai. "Meeting Resident Scholarly Activity Requirements Through a Longitudinal Quality Improvement Curriculum." Journal of Graduate Medical Education 7, no. 1 (March 1, 2015): 86–90. http://dx.doi.org/10.4300/jgme-d-14-00360.1.
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Abstract Background Quality improvement (QI) skills are learned during residency, yet there are few reports of the scholarly activity outcomes of a QI curriculum in a primary care program. Intervention We examined whether scholarly activity can result from a longitudinal, experiential QI curriculum that involves residents, clinic staff, and faculty. Methods The University of Pittsburgh Medical Center Shadyside Family Medicine Residency implemented a required longitudinal outpatient practice improvement rotation (LOPIR) curriculum in 2005. The rotation format includes weekly multidisciplinary work group meetings alternating with resident presentations delivered to the entire program. Residents present the results of a literature review and provide 2 interim project updates to the residency. A completed individual project is required for residency graduation, with project results presented at Residency Research Day. Scholarly activity outcomes of the curriculum were analyzed using descriptive statistics. Results As of 2014, 60 residents completed 3 years of the LOPIR curriculum. All residents satisfied the 2014 Accreditation Council for Graduate Medical Education (ACGME) scholarly activity and QI requirements with a literature review presentation in postgraduate year 2, and the presentation of a completed QI project at Residency Research Day. Residents have delivered 83 local presentations, 13 state/regional presentations, and 2 national presentations. Residents received 7 awards for QI posters, as well as 3 grants totaling $21,639. The educational program required no additional curriculum time, few resources, and was acceptable to residents, faculty, and staff. Conclusions LOPIR is an effective way to meet and exceed the 2014 ACGME scholarly activity requirements for family medicine residents.
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Weidner, Amanda, Ryan Gilles, and Dean A. Seehusen. "Residency Scholarship Within Practice-based Research Networks." Family Medicine 52, no. 2 (February 7, 2020): 91–96. http://dx.doi.org/10.22454/fammed.2020.303653.
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Background and Objectives: Finding scholarship opportunities is a common struggle for family medicine residency programs, especially community-based programs. Participation in practice-based research networks (PBRNs) has been suggested as one option, but little is known about resident engagement in PBRNs. This study explores how PBRNs are currently involving family medicine residency programs and whether there are additional opportunities for engagement. Methods: We conducted a cross-sectional survey of 126 primary care PBRN directors regarding residency program involvement in PBRN governance and scholarly activity. We used descriptive statistics to characterize our sample and bivariate analyses to assess association between involvement of residency programs in PBRNs and PBRN characteristics. Results: Most responding PBRNs (N=56, 44.4% response rate) included at least one residency program (80%) and many had residency faculty involved in projects (67.3%), though involvement of residents was less common (52.7%). When involved, residents were part of fewer projects but participated in the full range of research activities. Few PBRNs had deeper engagement with residencies such as written goals specifying their inclusion in projects (23.6%) or residency faculty participation in the PBRN’s governing body (45.5%). Most PBRNs not currently involving residents are interested in doing so (73.9%), and half of these have the resources to do this. Conclusions: Most family medicine and primary care PBRNs have some involvement with residency programs, usually at the faculty level. Building on current PBRN involvement and making connections between local PBRNs and residency programs where none exist represents an excellent opportunity for education and for growing the research capacity of the discipline.
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Morris, Laura E., Erik Lindbloom, Robin L. Kruse, Karla T. Washington, Nikole J. Cronk, and Heather L. Paladine. "Perceptions of Parenting Residents Among Family Medicine Residency Directors." Family Medicine 50, no. 10 (November 2, 2018): 756–62. http://dx.doi.org/10.22454/fammed.2018.978635.
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Background and Objectives: Parenting during residency is increasingly common, and resident parents face unique demands on their time and emotional and cognitive resources. Physicians at all levels of training perceive negative impacts of parenting on career and family life. Surveys of program directors (PDs) in other specialties reveal concern about performance and quality of life of parenting residents. The primary aims of this study were to examine family medicine PDs’ perceptions of parenting residents’ performance and the adequacy of parenting support structures. Methods: Data were collected from the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Family Medicine Residency Program Directors survey. Directors provided the number and status of parenting residents and rated adequacy of parenting resources, resident performance, and impact of parenting on residents using a Likert scale. Results were compared between male/female PDs and male/female residents. Results: Response rate was 57.1%. Less than half of PDs reported adequate parenting support structures in their program (46%). Over 40% of PDs reported that 81%-100% of female residents who take parental leave end up extending their residency training, the most common response category. PDs did not report gender-based differences in performance of parenting residents. PDs most often reported significantly worse well-being for female parenting residents but perceived improved well-being of male parents. Conclusions: Less than half of family medicine PDs feel their program has adequate parenting resources. Female parenting residents commonly extend residency training. PDs perceive parenting negatively impacts well-being of female residents, but not male residents.
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Hayward, Alison Schroth, Sean S. Lee, Katherine Douglass, Gabrielle A. Jacquet, James Hudspeth, Jessica Walrath, Bradley A. Dreifuss, Janette Baird, and Janis P. Tupesis. "The Impact of Global Health Experiences on the Emergency Medicine Residency Milestones." Journal of Medical Education and Curricular Development 9 (January 2022): 238212052210837. http://dx.doi.org/10.1177/23821205221083755.
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OBJECTIVES Identify the impact of experiences in global health (GH) on the Accreditation Council for Graduate Medical Education (ACGME) competencies in emergency medicine (EM) residents and describe the individual characteristics of EM residents with global health experience compared to those without. METHODS From 2015 to 2018, 117 residents from 13 nationally accredited United States EM residency training programs were surveyed. Specifically, the survey gathered demographic data and information regarding timing, type, location and duration of short term experiences in global health (STEGH). The survey collected both qualitative and quantitative data regarding resident experiences, including number of procedures performed and self-assessment of the impact on their residency milestones. ACGME milestone data from survey respondents was collected from each resident's training program coordinators. Chi-squared analysis and t-tests were conducted to assess differences between residents with STEGH and those without. A generalized linear model (GLM) was utilized to assess the effects of time and experience with interaction on achieving milestones in each of the competency domains, to compare milestone achievement over time between residents with STEGH and those without. RESULTS Out of 117 EM residents, 60 were female (44%), the mean age was 30 years (standard deviation = 3.1), and 84 (71.8%) reported STEGH in general, including prior to residency (64.5%). 33 (28.2%) reported having completed STEGH during residency. The results of the GLM analysis showed that residents with STEGH during residency had significantly higher scores compared to those without the experience or STEGH pre-residency across all six competencies CONCLUSIONS STEGH in EM residents was associated with higher milestone achievement in certain ACGME competency domains including medical knowledge, practice-based learning and improvement, and professionalism. Participation in STEGH during residency appeared to show the strongest effect, with higher scores across all six competencies.
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Fliotsos, Michael J., Sidra Zafar, Fasika A. Woreta, Peter M. Ugoh, and Divya Srikumaran. "A Comparative Analysis of Ophthalmology Resident Physician Performance Based on Use of Parental Leave." Journal of Academic Ophthalmology 13, no. 01 (January 2021): e1-e4. http://dx.doi.org/10.1055/s-0040-1721465.
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Abstract Background Taking parental leave during ophthalmology residency may be perceived to negatively affect resident surgical volume and educational outcomes. However, limited data exist on whether taking parental leave is associated with objective measures of resident performance. The objective of the present study was to determine the association between taking parental leave and key measures of resident performance. Methods Educational records of ophthalmology resident physicians who graduated from 2015 to 2019 at the Johns Hopkins University School of Medicine Wilmer Eye Institute were reviewed. Measures of resident performance assessed were Ophthalmic Knowledge Assessment Program scores, number of publications during residency, Accreditation Council for Graduate Medical Education milestones scores, and surgical volumes. These outcomes were compared for residents who took parental leave compared with their peers who did not take parental leave. Results Twenty-five residents were included in the study. Four female residents (16%) took parental leave 8 weeks in duration. There were no significant differences between residents who did and did not take parental leave when considering mean Ophthalmic Knowledge Assessment Program scores (p = 0.27), number of publications during residency (p = 0.19), milestone scores (p-value range 0.09–0.40), and surgical volume by subspecialty category (p-value range 0.11–0.45). Conclusion Parental leave did not negatively influence any of the studied measures of resident performance.
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Bingham, Jennifer M., Armando Silva Almodovar, Ann M. Taylor, David R. Axon, Milap C. Nahata, Sandra Leal, Terri Warholak, and Nicole Scovis. "A Research Partnership to Enhance Postgraduate Pharmacy Residency Training Outcomes." Pharmacy 8, no. 3 (July 31, 2020): 134. http://dx.doi.org/10.3390/pharmacy8030134.
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Pharmacy residents must complete research as part of their program; however, challenges exist in providing experiences that result in successful research dissemination outcomes. A university-based research team, integrated into an ambulatory care pharmacy residency program aimed to improve presentation and publication rates of pharmacy resident research projects. Data on the number of postgraduate year-2 (PGY2) residents and their productivity were collected and summarized to assess progress. A total of 13 residents completed their residency over seven years. Each resident produced one regional presentation, and one national presentation beginning in year four. To date, three peer-reviewed papers have been published, with another one in-press. Responses from residents found lack of guidance, lack of data availability for projects and feedback fatigue were barriers to a positive research experience. To address these problems, a university-based research team was integrated to provide research mentor guided support, ensure study feasibility, and provide structured feedback. This program evaluation highlighted the integration of a PGY2 ambulatory care pharmacy residency with a designated, interprofessional university-based research team. Future work is warranted to reduce research-related barriers and formally evaluate resident post-program knowledge, skills, and subsequent dissemination rates.
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Golden, Blair P., Bruce L. Henschen, David T. Liss, Sara L. Kiely, and Aashish K. Didwania. "Association Between Internal Medicine Residency Applicant Characteristics and Performance on ACGME Milestones During Intern Year." Journal of Graduate Medical Education 13, no. 2 (April 2, 2021): 213–22. http://dx.doi.org/10.4300/jgme-d-20-00603.1.
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ABSTRACT Background Residency programs apply varying criteria to the resident selection process. However, it is unclear which applicant characteristics reflect preparedness for residency. Objective We determined the applicant characteristics associated with first-year performance in internal medicine residency as assessed by performance on Accreditation Council for Graduate Medical Education (ACGME) Milestones. Methods We examined the association between applicant characteristics and performance on ACGME Milestones during intern year for individuals entering Northwestern University's internal medicine residency between 2013 and 2018. We used bivariate analysis and a multivariable linear regression model to determine the association between individual factors and Milestone performance. Results Of 203 eligible residents, 198 (98%) were included in the final sample. One hundred fourteen residents (58%) were female, and 116 residents (59%) were White. Mean Step 1 and Step 2 CK scores were 245.5 (SD 12.0) and 258 (SD 10.8) respectively. Step 1 scores, Alpha Omega Alpha membership, medicine clerkship grades, and interview scores were not associated with Milestone performance in the bivariate analysis and were not included in the multivariable model. In the multivariable model, overall clerkship grades, ranking of the medical school, and year entering residency were significantly associated with Milestone performance (P ≤ .04). Conclusions Most traditional metrics used in residency selection were not associated with early performance on ACGME Milestones during internal medicine residency.