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Bohler F, Garden A, Taranikanti V. Analyzing diversity, equity, and inclusion content on dermatology fellowship program websites. Med Educ Online 2024; 29:2347762. [PMID: 38691015 PMCID: PMC11064734 DOI: 10.1080/10872981.2024.2347762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education's online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution's DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution's DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties' webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.
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Affiliation(s)
- Forrest Bohler
- Medical Student, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Allison Garden
- Medical Student, Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, SC, USA
| | - Varna Taranikanti
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Bhattacharjee R, Reynolds A, Zhan L, Knittig L, Nagaraj R, Zhao Y. Developing a framework for promoting interest and engagement of scholarship of teaching and learning for medical students. Med Educ Online 2024; 29:2336332. [PMID: 38560892 PMCID: PMC10986435 DOI: 10.1080/10872981.2024.2336332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The scholarship of teaching and learning (SoTL) is a field of academic research that focuses on improving learning through reflective and informed teaching. Currently, most SoTL-related work is faculty-driven; however, student involvement in SoTL has been shown to benefit both learners and educators. Our study aims to develop a framework for increasing medical students' interest, confidence, and engagement in SoTL. METHODS A student-led SoTL interest group was developed and a year-round program of SoTL was designed and delivered by student leaders of the group under the guidance of a faculty advisor. Individual post-session surveys were administered to evaluate participants' perceptions of each session. Pre- and post-program surveys were administered to evaluate the program impact. RESULTS The year-round SoTL program consistently attracted the participation of medical students and faculty. Survey responses indicated strong medical student interest in the program and positive impact of the program. Increased interest and confidence in medical education research were reported by the student participants. The program design provided opportunities for student participants to network and receive ongoing feedback about medical education research they were interested or involved in. CONCLUSION Our study provides insights for developing a framework that other institutions can reference and build upon to educate and engage students in SoTL.
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Affiliation(s)
| | - Austin Reynolds
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Lilian Zhan
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Laura Knittig
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Ranjini Nagaraj
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Yuan Zhao
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
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Kresse ME, Morris RW, Weaver JS, Chang CY. Current state of musculoskeletal fellowship program directors and future directions. Skeletal Radiol 2024; 53:1165-1172. [PMID: 38133671 DOI: 10.1007/s00256-023-04553-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To better understand the current state of musculoskeletal fellowship program directors and identify opportunities for formal training that could increase job satisfaction, provide a broader knowledge base for mentoring/advising trainees and increase diversity in musculoskeletal radiology. MATERIALS AND METHODS Eighty-one fellowship program directors who signed the Fellowship Match Memorandum of Understanding with the Society of Skeletal Radiology were sent a survey with questions about demographics, career, background, and training both for musculoskeletal radiology and for the fellowship director role. RESULTS A 57/81 (70%) of program directors responded, representing 27 different states with a range of 1-9 fellowship positions. Nearly half are in their forties (48%) with most identifying as White (67%) followed by Asian (30%). The majority are male (72%) with over half (60%) remaining at the institution where they completed prior training. Over half plan to change roles within 5 years and do not feel adequately compensated. Top qualities/skills identified as important for the role include effective communication, being approachable, and clinical excellence. Other than clinical excellence, most do not report formal training in skills identified as important for the role. CONCLUSIONS Given the high amount of interaction with trainees, program directors play a key role in the future of our subspecialty. The low diversity among this group, the lack of formal training, and the fact that most do not feel adequately compensated could limit mentorship and recruitment. Program directors identified effective communication, organizational/planning skills, and conflict resolution as the top skills they would benefit from formal training.
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Affiliation(s)
- Maxine E Kresse
- Department of Radiology and Medical Imaging, University of Virginia, PO Box 800170, Charlottesville, VA, 22908, USA.
| | - Robert W Morris
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Jennifer S Weaver
- University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Connie Y Chang
- Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA
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O'Brien EM, Guris RD, Quarshie W, Lin EE. The state of point-of-care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment. Paediatr Anaesth 2024; 34:544-550. [PMID: 38358309 DOI: 10.1111/pan.14851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/20/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Point-of-care ultrasound is an invaluable bedside tool for anesthesiologists and has been integrated into anesthesiology residency training and board certification in the United States. Little is known about point-of-care ultrasound training practices in pediatric anesthesia fellowship programs. AIMS To describe the current state of point-of-care ultrasound education in pediatric anesthesia fellowship programs in the United States. METHODS We conducted a cross-sectional survey study distributed to 60 American Accreditation Council for Graduate Medical Education-accredited pediatric anesthesia fellowship programs. Two programs were in their initial accreditation period and were excluded due to lack of historical data. Program directors or associate program directors were invited to complete this 23-item survey. RESULTS Thirty-three of fifty-eight programs (57%) completed the survey. Of those, 15 programs (45%) reported having a point-of-care ultrasound curriculum. Programs with ≤3 fellows per year were less likely to have an ultrasound curriculum compared to programs with ≥4 fellows per year (30% programs 0-3 fellows/year vs. 69% programs ≥4 fellows/year, odds ratio 0.19 [95% confidence intervals 0.04-0.87]; p = .03). Program directors and associate program directors rated point-of-care ultrasound training as highly valuable to fellows' education. Barriers to use most commonly included lack of experience (64%), lack of oversight/interpretive guidance (58%), and lack of time (45%). Programs without point-of-care ultrasound training had significantly higher odds of listing lack of ultrasound access as a primary barrier (50% programs without vs. 13% programs with, odds ratio 6.5, [95% confidence intervals 1.3-50]; p = .04). CONCLUSIONS This observational survey-based study suggests that fewer than half of pediatric anesthesia training programs in the United States offer point-of-care ultrasound education. Additional research is needed to optimize this education and training in pediatric anesthesia fellowship programs.
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Affiliation(s)
- Elizabeth M O'Brien
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Associate Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rodrigo Daly Guris
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - William Quarshie
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elaina E Lin
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Butt A, Christian J, Kress A, Lu BY, Hurwitz ME, Goldberg SB, Podoltsev NA, Gilkes L, Lee AI. Providing 0.1 Full-Time Equivalent (FTE) Support to Fellowship Core Faculty Improves Faculty Involvement in Fellowship Education and Recruitment. J Cancer Educ 2024; 39:325-334. [PMID: 38430454 DOI: 10.1007/s13187-024-02414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
In 2022, the American Council for Graduate Medical Education (ACGME) recommended that core faculty (CF) in medical subspecialty fellowships receive at least 0.1 full-time equivalent (FTE) salary support, with plans to enforce compliance in July 2023. After early feedback raised concerns about potential unintended consequences, ACGME deferred enforcement to July 2024. Hence, there is an urgent need to understand the ramifications of providing FTE support for CF. In 2020, the Yale hematology and medical oncology (HO) fellowship program began providing 0.1 FTE support to all CF. Perceptions regarding this were assessed via surveys distributed to all CF in 2021 and 2022 and to all HO fellows in 2021. The vast majority (83.3%) of CF survey respondents reported improved job satisfaction and an increased sense of involvement in the fellowship program as a result of the new 0.1 FTE-supported CF program. Most CF increased attendance at fellowship conferences, devoted more time to mentorship, and increased participation in recruitment. In free text comments, CF respondents described that providing 0.1 FTE support made them "feel rewarded," gave them "a sense of commitment" to the fellowship, and helped "offset clinical requirements." HO fellows reported "a positive impact" of the new program with faculty being "more present at lectures." The median number of times faculty were available to interview fellowship applicants rose markedly after introduction of the program. The FTE-supported CF program was viewed enthusiastically by fellows and faculty, resulting in increased CF involvement in fellowship education and recruitment.
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Affiliation(s)
- Ayesha Butt
- Section of Hematology, Yale School of Medicine, 333 Cedar St., P.O. Box 208028, New Haven, CT, 06520-8028, USA
| | | | - Anna Kress
- Section of Hematology, Yale School of Medicine, 333 Cedar St., P.O. Box 208028, New Haven, CT, 06520-8028, USA
| | | | - Michael E Hurwitz
- Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Sarah B Goldberg
- Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Nikolai A Podoltsev
- Section of Hematology, Yale School of Medicine, 333 Cedar St., P.O. Box 208028, New Haven, CT, 06520-8028, USA
| | | | - Alfred Ian Lee
- Section of Hematology, Yale School of Medicine, 333 Cedar St., P.O. Box 208028, New Haven, CT, 06520-8028, USA.
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Katz J, Hunt J, Cammuso K, Moreno-De-Luca D. Development and Implementation of an Autism Spectrum and Intellectual Developmental Disorders Specialty Track Within Child and Adolescent Psychiatry Fellowship. Acad Psychiatry 2024; 48:296-297. [PMID: 37231223 DOI: 10.1007/s40596-023-01797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Julia Katz
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jeffrey Hunt
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Karen Cammuso
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel Moreno-De-Luca
- Warren Alpert Medical School of Brown University, Providence, RI, USA.
- University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada.
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Sherry DR, Patell R, Han HJ, Dodge LE, Braun IM, Buss MK. Palliative Medicine Fellows' Discussions, Perceptions, and Training Regarding Medical Cannabis. J Pain Symptom Manage 2024; 67:471-477.e6. [PMID: 38417464 DOI: 10.1016/j.jpainsymman.2024.02.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/01/2024]
Abstract
CONTEXT Medical cannabis is increasingly considered for palliation of pain, nausea/vomiting, anorexia, and other symptoms. OBJECTIVES We aimed to determine whether training in hospice and palliative medicine (HPM) adequately prepares fellows to counsel patients about medical cannabis. METHODS A previously validated questionnaire was adapted for HPM fellows. Domains included fellows' practices recommending cannabis and their knowledge of its effectiveness and risks compared with standard treatments. U.S. HPM fellowships were sent surveys in 2022 and 2023. RESULTS Forty six programs participated, 123 fellows responded (response rate of 42%) including 69% female; 55% White, and 28% Asian. Of respondents, 65% reported receiving formal training regarding medical cannabis; 57% reported discussing medical cannabis with over five patients; 23% recommended medical cannabis to more than five patients in the preceding year. Only 19%, however, felt sufficiently informed to issue cannabis-related recommendations. HPM fellows with prior training were not more likely to feel sufficiently informed to discuss cannabis (RR: 1.17; 95% CI: 0.82-1.66) or to recommend cannabis to patients (RR: 2.05, 95% CI: 0.89-4.71). Fellows rate cannabis as equally or more effective than conventional treatments for the following symptoms: anorexia/cachexia (63%), nausea/vomiting (43%), pain (25%), and neuropathic pain (21%). CONCLUSION Most HPM fellows report formal training in the use of medical cannabis. Over half of trainees reported discussing medical cannabis with patients, but few considered themselves sufficiently informed to make cannabis-related clinical recommendations. These results suggest both a need for expanded high-quality evidence for medical cannabis in palliative care and for improved formal education for HPM fellows.
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Affiliation(s)
- Dylan R Sherry
- Fox Chase Cancer Center (D.R.S.), Temple University Health System, Philadelphia, Pennsylvania, USA.
| | - Rushad Patell
- Beth Israel Deaconess Medical Center (R.P., H.J.H., L.E.D.), Harvard Medical School, Boston, Massachusetts, USA
| | - Harry J Han
- Beth Israel Deaconess Medical Center (R.P., H.J.H., L.E.D.), Harvard Medical School, Boston, Massachusetts, USA
| | - Laura E Dodge
- Beth Israel Deaconess Medical Center (R.P., H.J.H., L.E.D.), Harvard Medical School, Boston, Massachusetts, USA
| | - Ilana M Braun
- Dana Farber Cancer Institute, Harvard Medical School (I.M.B.), Boston, Massachusetts, USA
| | - Mary K Buss
- Tufts Medical Center, Tufts University School of Medicine (M.K.B.), Boston, Massachusetts, USA
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Guerreiro MDM, Ogata JFM, Sanudo A, Prestes ACY, Conzi MF, Kawakami MD, Miyoshi MH, Almeida MFBD, Guinsburg R. Acquisition of Behavioral Skills after Manikin-Based Simulation of Neonatal Resuscitation by Fellows in Neonatology. Am J Perinatol 2024; 41:1094-1102. [PMID: 35272385 DOI: 10.1055/a-1793-8024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Behavioral performance of health professionals is essential for adequate patient care. This study aimed to assess the behavioral skills of fellows in neonatology before and after a simulation training program on neonatal resuscitation. STUDY DESIGN From March 2019 to February 2020, a prospective cohort with 12 second-year fellows in neonatology were evaluated during three training cycles (16 hours each) in manikin-based simulation of neonatal resuscitation with standardized scenarios. Each cycle lasted 1 month, followed by a 3-month interval. One video-recorded scenario of approximately 10 minutes was performed for each fellow at the beginning and at the end of each training cycle. Therefore, each fellow was recorded six times, before and after each one of three training cycles. Anxiety of the fellows was assessed by the Beck Anxiety Inventory applied before the first training cycle. The videos were independently analyzed in a random order by three trained facilitators using the Behavioral Assessment Tool. The behavioral performance was evaluated by repeated measures of analysis of variance adjusted for anxiety and for previous experience in neonatal resuscitation. RESULTS Fellows' overall behavioral performance improved comparing the moment before the first training and after the second training. The specific skills, such as communication with the team, delegation of tasks, allocation of attention, use of information, use of resources, and professional posture, showed a significant improvement after the second month of training. No further gains were noted with the third training cycle. Anxiety was observed in 42% of the fellows and its presence worsened their behavioral performance. CONCLUSION An improvement in behavioral performance was observed, comparing the moment before the first training and after the second training, without further gains after the third training. It is worth noting the important role of anxiety as a modulator of acquisition and retention of behavioral skills in health professionals in training. KEY POINTS · Simulation training should improve technical and behavioral skills of providers. · Behavioral skills improve after a first cycle of training, but not after a repeat cycle. · Anxiety modulates trainees' behavioral performance.
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Affiliation(s)
- Maiana D M Guerreiro
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Joice F M Ogata
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Adriana Sanudo
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Ana Claudia Y Prestes
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Maria F Conzi
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Mandira D Kawakami
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Milton H Miyoshi
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Maria Fernanda B de Almeida
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
| | - Ruth Guinsburg
- Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo
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Grant AR, Zvi YS, Michalowski AK, Mattingly DA, Smith EL. The Relative Importance of Factors That Applicants Weigh When Ranking Adult Reconstruction Fellowships as Well as Their Perspectives on Robotic-Assisted Arthroplasty. J Arthroplasty 2024; 39:1609-1615.e2. [PMID: 38103804 DOI: 10.1016/j.arth.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Orthopedic Surgery Fellowship programs offer highly specialized training that varies based on the training environment and surgical experience. Additionally, for Adult Reconstruction programs, robotic-assisted surgery exposure has been a widely discussed topic. The purpose of this study was to determine the relative value of various factors to Adult Hip and Knee Fellowship applicants, and their perceptions of robotic-assisted arthroplasty. METHODS We surveyed 780 applicants who applied to our fellowship to matriculate in 2020 to 2024. We received 158 responses (20.3% response rate). We assessed factors concerning people and perceptions, logistics, salary and benefits, program reputation and curriculum, and surgical experience. Additionally, we surveyed fellows' attitudes toward using robotic surgery and its impact on patient outcomes. RESULTS The highest-rated factors were Level of Hands-On Operative Experience (4.83), Revision Hip Volume (4.72), Revision Knee Volume (4.71), Multiple Surgical Exposures to the Hip (4.59), and Clinical Case Variety (4.59). Respondents who were postfellowship matriculation placed significantly more value on Exposure to Multiple Attendings with Surgical Diversity (P = .01), and Anterior Hip Volume (P = .04), and less value on Geographic Location (P = .04) and Patient-Specific Instrumentation (P = .02) than prematriculates. Overall, 65% of applicants plan to or currently use robotics, 7.6% do not, and 27.2% said "Maybe". Those who plan to or currently use robotics most cited procedure fidelity, patient-preference, and marketability as reasons to use robotics. CONCLUSIONS Hands-on surgical experience and revision volume were the most important factors for fellowship applicants. Applicants placed lower importance on robotics exposure and their perspectives on robotics in their future practice were highly variable. Our results will inform fellowship programs and future applicants what previous applicants have valued in their training to help guide fellowship program structure, resource management, as well as recruitment.
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Affiliation(s)
- Andrew R Grant
- Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts; School of Medicine, New York Medical College, Valhalla, New York
| | - Yoav S Zvi
- Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts
| | - Anna K Michalowski
- Department of Orthopedic Surgery, Tufts Medical Center, Boston, Massachusetts
| | - David A Mattingly
- Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts
| | - Eric L Smith
- Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts
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Dragojlovic N, Romanoski NL, Bolger A, Friedlander T, Helkowski W, Huss SA, Jenkins JG, Knowlton T, Nguyen DH, Rand SE, Raum G, Sullivan W, Tonkin BK, Escalon MX. Association of Academic Physiatrists Residency and Fellowship Program Directors' Resident Recruitment Subcouncil Position Paper on Residency Recruitment. Am J Phys Med Rehabil 2024; 103:561-565. [PMID: 38363773 DOI: 10.1097/phm.0000000000002447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
ABSTRACT Residency recruitment practices have undergone significant changes in the last several years. Interviews are now conducted fully virtually leading to both positive and negative downstream effects, including decreased cost to applicants and programs, decreased time away from clinical activities, flexibility in scheduling, and increased applications for applicants and program directors. In response to these changes, the Association of Academic Physiatrists Residency and Fellowship Program Directors Council convened a workgroup consisting of program directors, program coordinators, residents, and medical students who reviewed the available literature to provide an evidence-based set of best practices for program leaders and applicants. Available data from the Association of American Medical Colleges and its relevance to future recruitment cycles are also discussed.
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Affiliation(s)
- Nikola Dragojlovic
- From the Department of Physical Medicine and Rehabilitation, McGovern Medical School at UTHealth Houston, Houston, Texas (ND); Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania (NLR); Division of Pediatric Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (AB); Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio (AB); Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland (TF); Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (WH, GR); Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, New York (SAH); Department of Physical Medicine and Rehabilitation, University of Virginia Health, Charlottesville, Virginia (JGJ); Association of Academic Physiatrists, Owings Mills, Maryland (TK); Texas College of Osteopathic Medicine, UNT Health Science Center, Fort Worth, Texas (DHN); Department of Physical Medicine and Rehabilitation, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York (SER); Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (WS); Department of Physical Medicine and Rehabilitation, University of Minnesota School of Medicine, Minneapolis, Minnesota (BKT); and Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York (MXE)
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Alotaibi FF, Alshahrani A, Mohamed G, AlShamrani MA, Bin Amir H, Alsaeed A, Heji A, Alghanmi S, Alqurishi M, Alanazi A, Aldraye H, Asiri M, Alqahtani M, Alreshaid AA, AlKawi A, AlHazzani A, AlZawahmah M, Alokaili RN, Shuaib A, Al-Ajlan FS. Diagnostic accuracy of large and medium vessel occlusions in acute stroke imaging by neurology residents and stroke fellows: A comparison of CT angiography alone and CT angiography with CT perfusion. Eur Stroke J 2024; 9:356-365. [PMID: 37990504 DOI: 10.1177/23969873231214218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Neurology senior residents and stroke fellows are first to clinically assess and interpret imaging studies of patients presenting to the emergency department with acute stroke. The aim of this study was to compare the diagnostic accuracy of brain CT angiography (CTA) with and without CT perfusion (CTP) between neurology senior residents and stroke fellows. METHODS In this neuroimaging study, nine practitioners (four senior neurology residents (SNRs) and five stroke fellows (SFs)) clinically assessed and interpreted the imaging data of 50 cases (15 normal images, 21 large vessel occlusions (LVOs) and 14 medium vessel occlusions (MeVOs) in two sessions, 1 week apart in comparison to final diagnosis of experienced neuroradiologist and experienced stroke neurologist consensus. Interrater agreement of CTA alone and CTA with CTP was quantified using kappa statistics, sensitivity, specificity and overall accuracy. RESULTS Overall, arterial occlusions were correctly identified in 221/315 (70.1%) with CTA alone and in 266/315 (84.4%) with CTA and CTP (p < 0.001). The sensitivity of overall arterial occlusions detection with CTA alone was 94.2% (95% CI: 90.8%-96.6%) while with addition of CTP was 98% (95% CI: 95.6%-99.3%), The specificity of CTA alone was 74.7% (95% CI: 67.2%-81.3%) which increased with CTP to 84.4% (95% CI: 77.7%-89.8%). The likelihood of correct identification with CTA alone was 156/189 (82.54%) for LVOs and 65/126 (51.59%) for MeVOs. This increased to 169/189 (89.42%; p = 0.054) for LVOs and 97/126 (76.98%; p < 0.001) for MeVOs when the CTA images with CTP were viewed. There was good overall interrater agreement between readers when using CTA alone (k 0.71, 95% CI, 0.62-0.80) and almost perfect (k 0.85, 95% CI, 0.76-0.94) when CTP was added to the image for interpretation. CTA and CTP had a significantly lower median interquartile range (IQR) interpretation time than CTA alone (114 [IQR, 103-120] s vs 156 [IQR, 133-160] s, p < 0.001). DISCUSSION In cerebral arterial occlusions, the rate of LVO and MeVOs detections increases when adding CTP to CTA. The accuracy and time for diagnosing arterial occlusion can be significantly improved if CTP is added to CTA. As MeVOs are commonly missed by front-line neurology senior residents or stroke fellows, cases with significant deficits and no apparent arterial occlusions need to be reviewed with neuroradiological expertise.
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Affiliation(s)
- Fawaz F Alotaibi
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Asma Alshahrani
- Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Gamal Mohamed
- Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed A AlShamrani
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hussain Bin Amir
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Alsaeed
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Alaa Heji
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Suwaidi Alghanmi
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Alqurishi
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Azhar Alanazi
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hamad Aldraye
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Muhannad Asiri
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Alqahtani
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdulrahman A Alreshaid
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Alfaisal University, Riyadh, Saudi Arabia
| | - Ammar AlKawi
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Alfaisal University, Riyadh, Saudi Arabia
| | - Adel AlHazzani
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Alfaisal University, Riyadh, Saudi Arabia
| | - Mohamed AlZawahmah
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Riyadh N Alokaili
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ashfaq Shuaib
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Fahad S Al-Ajlan
- Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Alfaisal University, Riyadh, Saudi Arabia
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12
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Dotters-Katz SK, Kirsch E, Cantrell S, Shanks A, Temming L, Gray B. Best Practices for Writing Letters of Recommendation for Maternal-Fetal Medicine Fellowship: An Empty Scoping Review. Am J Perinatol 2024; 41:1103-1105. [PMID: 36796401 DOI: 10.1055/s-0043-1763484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVES Though letters of recommendation (LOR) for Maternal-Fetal Medicine (MFM) fellowship are a critical part of application process, little is known regarding best practices for writing them. This scoping review sought to identify published data outlining best practices in writing MFM fellowship LOR. STUDY DESIGN Scoping review conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and JBI guidelines. MEDLINE, Embase, Web of Science, and ERIC were searched, by professional medical librarian using database-specific controlled vocabulary and keywords representing MFM, fellowship, as well as personnel selection, academic performance, examinations, or clinical competence in 4/22. Prior to execution, the search was peer reviewed by another professional medical librarian using the Peer Review Electronic Search Strategies (PRESS) checklist. Citations imported to Covidence, dual screened by authors with disagreements resolved by discussion, and extraction performed by one author and checked by the second. RESULTS A total of 1,154 studies were identified, with 162 removed as duplicates. Of the 992 screened, 10 imported for full-text review. None of these met inclusion criteria; four were not about fellows and six did not report on best practices for writing LOR for MFM. CONCLUSION No articles were identified that outlined best practices for writing LOR for MFM fellowship. The lack of guidance and published data guiding those writing LOR for MFM fellowship applicants is concerning given the importance of these as a tool used by fellowship directors in selecting applicants for interviews and ranking. KEY POINTS · No published articles were identified addressing best practices for writing LOR for MFM fellowship.. · Fellowship directors rely on LOR for offering interviews and rank list.. · Future research is urgently needed to identify best practices..
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Affiliation(s)
- Sarah K Dotters-Katz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
| | - Elayna Kirsch
- Duke School of Medicine, Duke University, Durham, North Carolina
| | - Sarah Cantrell
- Duke University Medical Center Library and Archives, Duke University School of Medicine, Durham, North Carolina
| | - Anthony Shanks
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
| | - Lorene Temming
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest School of Medicine Atrium Health, Charlotte, North Carolina
| | - Beverly Gray
- Division of Population and Community Health, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
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Genser L. Comment on: Trends in bariatric surgery training: bariatric operations performed by fellowship council trainees from 2012 to 2019. Surg Obes Relat Dis 2024; 20:552-553. [PMID: 38413320 DOI: 10.1016/j.soard.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Laurent Genser
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière University Hospital, INSERM UMRS 1269, Paris, France
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14
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Francois D, Charles-Belzie MD, Belzie LR, Clerisme JR, Jean-Noel P, Francois PL, Galanter CA. From Stigma to Empowerment: Teaching Advocacy to Child and Adolescent Psychiatry Fellows. Acad Psychiatry 2024; 48:298-299. [PMID: 37369958 DOI: 10.1007/s40596-023-01817-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Dimitry Francois
- Weill Cornell Medicine, NewYork-Presbyterian Westchester Behavioral Health Center, White Plains, NY, USA.
| | | | - Louis R Belzie
- One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | | | - Pierre Jean-Noel
- One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | | | - Cathryn A Galanter
- SUNY Downstate/New York City Health and Hospitals/Kings, Brooklyn, NY, USA
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15
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Durette L, Oden C, Rudig N, Parikh N. Clinicians' Experience with a Graduate Medical Education Implemented Child Psychiatry Access Program. Acad Psychiatry 2024; 48:233-237. [PMID: 37749445 DOI: 10.1007/s40596-023-01860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The authors aim to measure differences in primary care clinicians' (PCC's) perceptions of managing pediatric mental health before and after launch of a child psychiatry access program (the access program) and identify the impact of engaging trainees from child psychiatry, pediatrics, and family medicine in administration and use of this program. METHODS Child psychiatry fellows provide coverage of a grant-funded state-wide access program and engage trainee-peers in learning how to use the program. A survey measuring PCC's experience managing children's mental health conditions was administered before and after the child psychiatry access program launched. Rotation evaluations collect trainee's feedback. RESULTS Statistically significant differences are identified before and after the program's launch in PCC's perception of access to child psychiatry (U = 294.5, p < 0.001) and between PCC's perceptions of the impact of behavioral health problems in their patients in those with less than 4 years post-residency training compared with those with 4 or more years post-residency (U = 524.5, p < .01). Trainee evaluation of the rotation is consistently positive (average 5:6 rating). CONCLUSION The authors conclude that (1) the presence of a state-wide access program positively impacts PCC's reported access to child psychiatry; (2) child psychiatry fellows rate the clinical rotation experience favorably; and (3) there appears to be an association between less time out of primary care residency training and perception of improved access to child psychiatry and less clinical burden from behavioral health issues. Further research is required to understand the impact of a training in this model.
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Affiliation(s)
- Lisa Durette
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA.
| | - Crystal Oden
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
| | - Nathan Rudig
- Center for Community Solutions, Las Vegas, NV, USA
| | - Nina Parikh
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
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16
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Balziano S, Heyman E, Prat D. Patellar Fracture Surgery Performed Autonomously by Residents, Yields Similar Short-Term Outcomes to Surgery Performed by Fellowship-Trained Surgeons. J Surg Educ 2024; 81:872-879. [PMID: 38677897 DOI: 10.1016/j.jsurg.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/12/2023] [Accepted: 03/02/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Open reduction and internal fixation are the gold-standard treatment for displaced patellar fractures. The current literature remains inconclusive on the relationship between resident participation in the operating room and optimal patient outcomes. We hypothesize that surgeries performed solely by residents, without attending supervision, can provide similar outcomes to those performed by fellowship-trained orthopedic surgeons, providing new insights into the relationship between resident autonomy and surgical outcomes in the field of orthopedic trauma. METHODS A tertiary trauma center cohort was retrospectively reviewed for all surgically treated patellar fractures between 2015 and 2020. The cohort was divided into 2 groups: patients operated by residents and patients operated by orthopedic trauma specialists. Demographics, surgical parameters, and radiographs were compared between the groups to evaluate complications and reoperation rates, radiographic outcomes (such as hardware failure, or loss of reduction), and clinical outcomes (including residual pain, painful hardware, decreased range of motion, and infections). RESULTS A total of 129 patellar fractures were included in the study. Demographics and ASA were similar between the groups. There were no significant differences in complications (p = 0.900) or reoperation rates (p = 0.817), with an average follow-up time of 8 months (SD ± 5.3). Residents had significantly longer surgery duration (p =0.002). However, the overall length of stay was shorter in the resident group (p < 0.001). CONCLUSION The study shows patellar fracture surgery performed by adequately trained residents can provide similar outcomes to those performed by fellowship-trained orthopaedic trauma surgeons. These findings highlight the significance of surgical autonomy in residency and its role in contemporary surgical education.
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Affiliation(s)
- Snir Balziano
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel.
| | - Eilon Heyman
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel.
| | - Dan Prat
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
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17
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Mendes G, Poppe AY, Lima FO, Morais A, Pontes-Neto O, Silva GS, Martins SO, Carvalho F. Comprehensive portrait of stroke fellowship training in Brazil: A national survey study. J Stroke Cerebrovasc Dis 2024; 33:107697. [PMID: 38561168 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/15/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The field of vascular neurology has undergone significant advances over the last decade, and care has become more complex. However, vascular neurology training programs remain underdeveloped in many countries, despite stroke impact on health care. There are efforts towards building a nationally regulated curricula in some countries. Still, comprehensive planning and implementation of these programs may be needed on a global scale, especially in countries where stroke treatment is not fully implemented. We aim to comprehensively analyze vascular neurology trainees' profiles in Brazil to describe training program contents from trainees and program directors' perspectives. METHODS We performed an observational, cross-sectional, web-based survey study to describe trainee and program-specific characteristics at vascular neurology fellowship training programs in Brazil. The study was conducted from June to September 2023 using a secure web-based survey sent to active fellows and program directors from all known vascular neurology fellowship programs in the country. All respondents were required to provide informed consent. RESULTS We obtained a 100 % response rate of a total of 12 programs distributed in 7 federal states. Notably, 57 % of the 28 surveyed fellows were women, 60 % were aged 25-30, and 70 % self-identified as White. All fellows had prior neurology training, and 60 % engaged in the program just following residency. Exposure to various training experiences was favorable, except for simulation-based learning and telestroke training. Program directors perceived exposure to be sufficient for most components but similarly found deficiencies in telestroke and simulation-based learning. Scientific productivity was low, with about two-thirds of fellows having no publications or abstracts. Most fellows (92.6 %) reported performing non-fellowship medical activities to supplement their incomes. DISCUSSION In conclusion, the number of vascular neurology training programs and trainees in Brazil is currently insufficient and exhibits an uneven geographic distribution. Despite this, the clinical training provided is extensive, and there is generally some funding available for fellows. These insights highlight the need for strategic improvements in Brazil's stroke education and could inform similar developments in other nations.
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Affiliation(s)
- Gnn Mendes
- Hospital Geral de Fortaleza - HGF - Cerebrovascular Diseases Clinical Research Center; Division of Neurology, Department of Medicine, Centre Hospitalier de l'Université de Montreal - CHUM.
| | - A Y Poppe
- Division of Neurology, Department of Medicine, Centre Hospitalier de l'Université de Montreal - CHUM
| | - F O Lima
- Hospital Geral de Fortaleza - HGF - Cerebrovascular Diseases Clinical Research Center
| | - Abcg Morais
- Hospital Geral de Fortaleza - HGF - Cerebrovascular Diseases Clinical Research Center; Universidade Federal de São Paulo - UNIFESP
| | - O Pontes-Neto
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo - FMRP-USP
| | - G S Silva
- Universidade Federal de São Paulo - UNIFESP; Hospital Israelita Albert Einstein - HIAE
| | - S O Martins
- Universidade Federal do Rio Grande do Sul - UFRGS
| | - Fmm Carvalho
- Hospital Geral de Fortaleza - HGF - Cerebrovascular Diseases Clinical Research Center; Graduate Program in Medical Sciences, Universidade de Fortaleza - UNIFOR
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18
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Wilechansky RM. Fellows' Corner. Hepatology 2024; 79:1241-1242. [PMID: 38758103 DOI: 10.1097/hep.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Robert M Wilechansky
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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19
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Olsen EC, Kamath P, Bergman D, Huang C. Insights into the MSDO Fellowship Match: an analysis of 2020-2022 San Francisco Match Data. Arch Dermatol Res 2024; 316:222. [PMID: 38787440 DOI: 10.1007/s00403-024-02910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/08/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Eric C Olsen
- Wellstar Health System, Kennestone Hospital Graduate Medical Education, 677 Church Street NE, Marietta, GA, 30060, USA.
| | - Preetha Kamath
- Department of Dermatology, University of Alabama Birmingham, Birmingham, AL, USA
| | - Daniel Bergman
- Department of Dermatology, University of Alabama Birmingham, Birmingham, AL, USA
| | - Conway Huang
- Department of Dermatology, University of Alabama Birmingham, Birmingham, AL, USA
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20
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Stryker SD, Hargraves D, Velasquez V, Gottschlich M, Cafferty P, Vale D, Schlaudecker J, Pallerla H, Rich M. The Community Primary Care Champions Fellowship: a mixed methods evaluation of an interprofessional fellowship for physician assistants and physicians. BMC Med Educ 2024; 24:556. [PMID: 38773571 PMCID: PMC11110310 DOI: 10.1186/s12909-024-05559-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/15/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND Primary care in the US faces challenges with clinician recruitment, retention, and burnout, with further workforce shortages predicted in the next decade. Team-based care can be protective against clinician burnout, and opportunities for interprofessional education (IPE) on professional development and leadership could encourage primary care transformation. Despite an increasingly important role in the primary care workforce, IPE initiatives training physician assistants (PAs) alongside physicians are rare. We describe the design, curriculum, and outcomes from an interprofessional primary care transformation fellowship for community-based primary care physicians and PAs. METHODS The Community Primary Care Champions (CPCC) Fellowship was a one-year, part-time fellowship which trained nine PAs, fourteen physicians, and a behavioralist with at least two years of post-graduate clinical experience in six content pillars: quality improvement (QI), wellness and burnout, mental health, social determinants of health, medical education, and substance use disorders. The fellowship included a recurring schedule of monthly activities in self-study, lectures, mentoring, and community expert evening discussions. Evaluation of the fellowship included pre, post, and one-year follow-up self-assessments of knowledge, attitudes, and confidence in the six content areas, pre- and post- wellness surveys, lecture and discussion evaluations, and midpoint and exit focus groups. RESULTS Fellows showed significant improvement in 24 of 28 self-assessment items across all content areas post-fellowship, and in 16 of 18 items one-year post-fellowship. They demonstrated reductions in emotional exhaustion and depersonalization post-fellowship and increased confidence in working in interprofessional teams post-fellowship which persisted on one-year follow-up assessments. All fellows completed QI projects and four presented their work at national conferences. Focus group data showed that fellows experienced collaborative, meaningful professional development that was relevant to their clinical work. They appreciated the flexible format and inclusion of interprofessional community experts in evening discussions. CONCLUSIONS The CPCC fellowship fostered an interprofessional community of practice that provided an effective IPE experience for physicians and PAs. The learning activities, and particularly the community expert discussions, allowed for a flexible, relevant experience, resulting in personal and professional growth along with increased confidence working within interprofessional teams.
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Affiliation(s)
- Shanna D Stryker
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA.
| | - Daniel Hargraves
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA
| | - Veronica Velasquez
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA
| | - Melissa Gottschlich
- Department of Physician Assistant Studies, Mount St. Joseph University, Cincinnati, OH, USA
| | - Patrick Cafferty
- Department of Physician Assistant Studies, Mount St. Joseph University, Cincinnati, OH, USA
| | - Darla Vale
- Department of Physician Assistant Studies, Mount St. Joseph University, Cincinnati, OH, USA
| | - Jeff Schlaudecker
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA
| | - Harini Pallerla
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA
| | - Megan Rich
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0582, Medical Sciences Building 4453C, Cincinnati, OH, 45267, USA
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Murtha TD, Hafler J, Taylor EP, Tala J, Asnes A, Massaro S, Kandil S. Resilience Curriculum Improves Skills of Pediatric Fellows in Delivery of Difficult News. R I Med J (2013) 2024; 107:49-53. [PMID: 38687270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND Delivering difficult news to families is an essential but challenging skill. Pediatric trainees report limited confidence in this skill and perform poorly in simulation. We implemented the American Academy of Pediatrics (AAP) Resilience Curriculum and evaluated performance and self-efficacy in delivering difficult news. METHODS The AAP Resilience Curriculum, using the SPIKES (Set-up, Perception, Invitation, Knowledge, Empathy, and Summary) framework, was taught to pediatric fellows. Fellows' performance during simulations with standardized patients before and after curriculum implementation was scored with a SPIKES checklist. Pre- and post-test surveys assessed self-efficacy in delivering difficult news. RESULTS Fellows (n=19) significantly improved their performance in delivering difficult news, increasing the median SPIKES checklist scores from 78% to 90% completion (P<0.001). Pediatric fellows (n=35) reported improved confidence from 3.4/5 to 3.9 (P=0.01). CONCLUSIONS Pediatric fellows demonstrated significant improvement in their ability to deliver difficult news during a simulated patient encounter and reported increased self-efficacy in delivering difficult news.
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Affiliation(s)
- Tanya D Murtha
- Warren Alpert Medical School of Brown University, Pediatrics, Providence, RI
| | - Janet Hafler
- Yale School of Medicine, Pediatrics, New Haven, CT
| | - Emily Pinto Taylor
- Yale New Haven Children's Hospital, Pediatrics and Medicine, New Haven, CT
| | - Joana Tala
- Yale New Haven Children's Hospital, Pediatrics, New Haven, CT
| | - Andrea Asnes
- Yale School of Medicine, Pediatrics, New Haven, CT
| | | | - Sarah Kandil
- Yale School of Medicine, Pediatrics, New Haven, CT
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22
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Friedmann I, McNamara PJ, Bhattacharya S, Cheng A. Educational Impact of Targeted Neonatal Echocardiography and Hemodynamics Programs on Neonatal-Perinatal Medicine Fellows. Am J Perinatol 2024; 41:e148-e155. [PMID: 35554888 DOI: 10.1055/a-1850-3358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Targeted neonatal echocardiography (TNE) is a real-time cardiac imaging modality used by a hemodynamics program to aid in diagnosis, treatment, and monitoring of neonatal cardiovascular illness. This study aimed to describe trainees' perspectives on existing hemodynamics education and perceived impacts of TNE and hemodynamics services on their education. STUDY DESIGN This was a mixed quantitative and qualitative study that surveyed neonatal-perinatal medicine (NPM) fellow trainees in Canada and the United States, at programs both with and without a hemodynamics service. RESULTS Ninety-two fellows responded to the survey, of whom 24 (26%) were enrolled in a program with an active hemodynamics service, 64 (70%) were training at a program without a hemodynamics service, and 4 (4%) were unsure. Trainees at centers with a hemodynamics service were more satisfied with their cardiovascular physiology education (91 vs. 69%, p = 0.040). Twenty-five percent of all trainees felt they do not have sufficient hemodynamics training to prepare them for independent practice. Areas of knowledge gaps were identified. Bedside teaching combined with didactic teaching was identified as useful means of teaching. CONCLUSION Most trainees believed that TNE and a hemodynamics service are valuable educational assets. Thoughtful curriculum design for real-time and consolidation learning, with specific emphasis on content gaps, should be considered. KEY POINTS · NPM Fellows perceive TNE & Neonatal Hemodynamics service as a valuable educational opportunity.. · Incorporation of TNE/Hemodynamics teaching into NPM curriculum can enrich trainee experience.. · Combining bedside and classroom teaching is key to successful cardiovascular training..
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Affiliation(s)
- Isabel Friedmann
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Patrick J McNamara
- Division of Neonatology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Soume Bhattacharya
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Division of Neonatal-Perinatal Medicine, Department of Paediatrics, London Health Sciences Program, London, Ontario, Canada
| | - Anita Cheng
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Division of Neonatal-Perinatal Medicine, Department of Paediatrics, London Health Sciences Program, London, Ontario, Canada
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Scarpato KR, Miller NL. Editorial Commentary. Urol Pract 2024; 11:596. [PMID: 38447281 DOI: 10.1097/upj.0000000000000548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Kristen R Scarpato
- Vanderbilt University Medical Center, Nashville, Tennessee
- Editorial Committee, Urology Practice®
| | - Nicole L Miller
- Endourology and Laparoscopic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Gray MM, Bruno C, French H, Myers P, Carbajal MM, Reber KM, Christou H, Karpen H, Johnston LC. Changes, Challenges, and Variations in Neonatal-Perinatal Medicine Fellowship: A View from the Program Directors. Am J Perinatol 2024; 41:e163-e173. [PMID: 35554889 DOI: 10.1055/a-1850-3929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Neonatal-perinatal medicine (NPM) fellowship programs in the United States support >800 learners annually. Understanding variations in the programmatic structure, challenges, and needs is essential to optimize the educational environment and ensure the specialty's future. STUDY DESIGN NPM fellowship program directors (PDs) and associate program directors (APDs) were invited to complete an electronic survey on their program administration, recruitment, clinical training, assessment methods, scholarly program, and career pathways. Each participant identified individual programmatic strengths, challenges, opportunities, and threats to the field. RESULTS Representatives from 59 NPM fellowships provided data (response rate 59/96 = 61%). In total, 30% of PDs received less than the Accreditation Council for Graduate Medical Education -recommended protected time for administrative duties, and 44% of APDs received no protected time. Fellow clinical service assignments varied widely from 13 to 18 months and 90 to 175 call nights over 3 years. Recruitment practices varied across programs; 59% of respondents raised concerns over the pipeline of applicants. Conflicts between fellows and advanced practice providers were identified by 61% of responders. Programs varied in their scholarly offerings, with 44% of NPM fellowships interested in adding broader research opportunities. CONCLUSION NPM fellowship leaders identified a need for improved programmatic support, enhanced measures to assess competency, opportunities to strengthen scholarly programs, shared curricular resources, and strategies to balance education with clinical demands. PDs and APDs identified threats to the future of NPM training programs including the diminishing pipeline of applicants into neonatology, challenges with clinical exposure and competence, inadequate support for the educational mission, issues supporting high-quality scholarship, and fewer graduates pursuing physician-investigator pathways. National organizations and academic institutions should take action to address these challenges so that fellowships can optimally prepare graduates to meet their patients' needs. KEY POINTS · Numerous challenges exist for current program directors in NPM including balancing clinical work with scholarly activities, accurately assessing competency, optimizing the culture of the learning environment, and ensuring that fellows are adequately prepared for a range of postgraduate positions.. · Significant variation exists across NPM fellowship programs in clinical service/calls assigned over 3 years of fellowship training, as well as opportunities to pursue scholarly activities across a variety of areas.. · Challenges exist related to ensuring an adequate number of future applicants into the specialty, including those from backgrounds traditionally underrepresented in medicine, as well as those seeking to pursue careers as physician-investigators..
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Affiliation(s)
- Megan M Gray
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Christie Bruno
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Heather French
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patrick Myers
- Department of Pediatrics, Northwestern School of Medicine, Chicago, Illinois
| | - Melissa M Carbajal
- Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Kristina M Reber
- Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Helen Christou
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Heidi Karpen
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
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Johnston LC, Falck AJ, Vasquez MM, Dadiz R, French H, Izatt S, Bonachea E, Karpen HE, Carbajal MM, Payne A, Gillam-Krakauer M, Gray MM. Flipping the Teachers: Impact of a Standardized Physiology Curriculum on Neonatology Medical Educators. Am J Perinatol 2024; 41:e755-e764. [PMID: 36041469 DOI: 10.1055/a-1933-4893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Academic physicians must teach elements in an Accreditation Council for Graduate Medical Education (ACGME)-mandated curriculum while balancing career development and clinical workload. Exploring educator perceptions on the learning environment and comparing two instructional methods (traditional didactics [TD] vs. flipped classroom [FC]) in one pediatric subspecialty may elucidate current challenges, barriers, and strategies to optimize learning and educator satisfaction. STUDY DESIGN A randomized trial comparing effectiveness and learner preference for FC versus TD physiology teaching was conducted in ACGME-accredited neonatal-perinatal medicine (NPM) fellowship programs in 2018 to 2019. Educator preferences were elicited through online surveys pre- and postintervention. Free-text comments were provided for questions exploring strengths, challenges, and opportunities in fellowship education. Statistical analysis included comparisons of demographics and pre-post-intervention educator responses between groups. Thematic analysis of text responses was conducted to identify common subthemes. RESULTS From 61 participating programs, 114 FC educators and 130 TD educators completed surveys. At baseline, all educators experienced professional satisfaction from teaching fellows, but noted challenges with time available to create and/or deliver educational content, limited content expertise amongst faculty, colleagues' limited enthusiasm toward educating fellows, and lack of perceived value of education by institutions given limited protected time or credit toward promotion. Postintervention, educators in both groups noted a preference to teach physiology using FC due to interactivity, learner enthusiasm, and learner-centeredness. FC educators had a 17% increase in preference to teach using FC (p = 0.001). Challenges with FC included ensuring adequate trainee preparation, protecting educational time, and providing educators with opportunities to develop facilitation skills. CONCLUSION Overall, NPM educators in a trial evaluating a standardized, peer-reviewed curriculum report professional satisfaction from teaching, but described logistical challenges with developing/delivering content. Educators preferred instruction using FC, but identified challenges with learner preparedness and ensuring adequate educator time and skill. Future efforts should be dedicated to addressing these barriers. KEY POINTS · Many challenges exist for educators teaching neonatal-perinatal medicine fellows, including time, support, and recognition.. · Many educators preferred using flipped classroom methodology with a standardized curriculum due to interactivity and learner-centeredness.. · Benefits of a standardized, peer-reviewed curriculum include reduced preparation time, adaptability of content, and learning environment enhancement..
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Affiliation(s)
- Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Alison J Falck
- Department of Pediatrics, University of California-San Francisco School of Medicine, San Francisco, California
| | - Margarita M Vasquez
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, Texas
| | - Rita Dadiz
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Heather French
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan Izatt
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Elizabeth Bonachea
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, NY
| | - Heidi E Karpen
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | | | - Allison Payne
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Maria Gillam-Krakauer
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Megan M Gray
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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Erdoes G, Schindler E, Koster A, von Dossow V, Belciu IM, Meier S, El-Tahan MR, Nasr VG. European Pediatric Cardiac Anesthesia Fellowship Program: A First Proof of Concept. J Cardiothorac Vasc Anesth 2024; 38:1088-1091. [PMID: 38423885 DOI: 10.1053/j.jvca.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/22/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
The Pediatric Cardiac Anesthesia (PCA) fellowship is a demanding training program in Europe and the United States. Successful completion of the program requires years of training in anesthesiology, a thorough understanding of cardiovascular anatomy and physiology, and extensive experience in the perioperative management of neonates and children with heart disease. In the context of the first candidate to successfully complete the PCA program in Europe, this article presents excerpts from the design and structure of the European PCA program. The PCA program is evaluated critically by both external and internal reviewers, and points are highlighted that could be included in the next version of the program.
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Affiliation(s)
- Gabor Erdoes
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Ehrenfried Schindler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Andreas Koster
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Vera von Dossow
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Ioana Maria Belciu
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Sascha Meier
- Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Mohammed R El-Tahan
- Cardiothoracic Anesthesia, Anesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansoura, Egypt; King Fahd Hospital of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Viviane G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
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27
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Nowicki KD, Balboni IM, Cidon MJ, Dhanrajani AD, Driest KD, Fair DC, Imundo LF, Mehta JJ, Tarvin SE, Walters HM, Woolnough LC, Edgar LC, Curran ML. Assessing Pediatric Rheumatology Fellow Competence in the Milestone Era: Past, Present, and Future. Arthritis Care Res (Hoboken) 2024; 76:600-607. [PMID: 38108087 DOI: 10.1002/acr.25276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/15/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Starting in 2015, pediatric rheumatology fellowship training programs were required by the Accreditation Council for Graduate Medical Education to assess fellows' academic performance within 21 subcompetencies falling under six competency domains. Each subcompetency had four or five milestone levels describing developmental progression of knowledge and skill acquisition. Milestones were standardized across all pediatric subspecialties. As part of the Milestones 2.0 revision project, the Accreditation Council for Graduate Medical Education convened a workgroup in 2022 to write pediatric rheumatology-specific milestones. Using adult rheumatology's Milestones 2.0 as a starting point, the workgroup revised the patient care and medical knowledge subcompetencies and milestones to reflect requirements and nuances of pediatric rheumatology care. Milestones within four remaining competency domains (professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice) were standardized across all pediatric subspecialties, and therefore not revised. The workgroup created a supplemental guide with explanations of the intent of each subcompetency, 25 in total, and examples for each milestone level. The new milestones are an important step forward for competency-based medical education in pediatric rheumatology. However, challenges remain. Milestone level assignment is meant to be informed by results of multiple assessment methods. The lack of pediatric rheumatology-specific assessment tools typically result in clinical competency committees determining trainee milestone levels without such collated results as the foundation of their assessments. Although further advances in pediatric rheumatology fellowship competency-based medical education are needed, Milestones 2.0 importantly establishes the first pediatric-specific rheumatology Milestones to assess fellow performance during training and help measure readiness for independent practice.
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Affiliation(s)
- Katherine D Nowicki
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
| | | | - Michal J Cidon
- Children's Hospital Los Angeles, Los Angeles, California
| | - Anita D Dhanrajani
- The University of Mississippi Medical Center, Jackson, Mississippi, Tulane University School of Medicine, New Orleans, and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Kyla D Driest
- Nationwide Children's Hospital and The Ohio State University, Columbus
| | | | - Lisa F Imundo
- Columbia University Medical Center, New York City, New York
| | - Jay J Mehta
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stacey E Tarvin
- Riley Hospital for Children at Indiana University, Indianapolis
| | - Heather M Walters
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hamptstead, New York, and Cohen Children's Medical Center of New York, New Hyde Park
| | | | - Laura C Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Megan L Curran
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
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Cameron KA, Rodrigues TJ, Keswani RN. Developing a Mentoring Network to Navigate Fellowship and Beyond: Moving From "Mentor" to "Mentors". Gastroenterology 2024; 166:723-727.e1. [PMID: 38373640 DOI: 10.1053/j.gastro.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Kenzie A Cameron
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Center for Education and Career Development, Northwestern University Clinical and Translational Sciences Institute (NUCATS), Chicago, Illinois.
| | - Terrance J Rodrigues
- Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rajesh N Keswani
- Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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29
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Mehta PM, Prajapati P, Kumar S, Jain N, Vilanilam GK, Purushothaman R, Jensen HK, Kaukis N, Ram R. Review of the demographic and educational profiles of abdominal imaging fellowship program directors in the United States. Curr Probl Diagn Radiol 2024; 53:384-388. [PMID: 38281843 DOI: 10.1067/j.cpradiol.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To evaluate demographics, academic backgrounds, and scholarly activities of Program Directors (PDs) in Abdominal Imaging Fellowships in the United States (US), emphasizing gender representation, international origins, and academic milestones. METHODS A list of Fellowships in Abdominal Imaging programs in the US was obtained from the Society of Abdominal Radiology. The search was expanded using the Fellowship and Residency Electronic Interactive Database. Data for PDs were sourced from program websites, Healthgrades, Doximity, and Elsevier's Scopus. Metrics such as age, gender, education, academic rank, additional qualifications, prior leadership roles, publications, and h-indices were analyzed using R software. A two-tailed unpaired t-test was used to calculate the difference in means of scholarly activity between male and female PDs. RESULTS 113 programs were identified: South (36.28%), Northeast (25.66%), Mid-West (20.35%), West (17.69%). Of 107 PDs, 54% male, 41% female, and average age 48 ± 9.4 years. 66.6% were US graduates, 29.2% were international graduates. Most were Assistant Professors (36.28%). 19.46% had degrees like M.P.H. or M.B.A. 45% had prior leadership roles. Average year of residency graduation was 2007. Mean publication count was 54.16, and mean h-index was 14.663. Male PDs had higher publication counts and h-indices than female PDs (p= 0.009 and p= 0.0019 respectively). CONCLUSION In Abdominal Imaging Fellowship programs in the US, there is an increasing representation of females in Program Director roles. However, research led by female PDs remains less prevalent. The field of Abdominal Imaging values contributions from international graduates and insights from Assistant Professors.
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Affiliation(s)
- Parv M Mehta
- Department of Radiology, Mayo Clinic, 611 3rd Avenue SW, Rochester, Minnesota 55902, United States
| | - Priyanka Prajapati
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Shruti Kumar
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States.
| | - Navita Jain
- Department of Medicine, Lady Hardinge Medical College, Delhi 110001, India
| | - George K Vilanilam
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Rangarajan Purushothaman
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Hanna K Jensen
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
| | - Nicholas Kaukis
- Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, United States
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR 72205, United States
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30
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Ariyaratne S, Jenko N, Mark Davies A, Iyengar KP, Botchu R. Could ChatGPT Pass the UK Radiology Fellowship Examinations? Acad Radiol 2024; 31:2178-2182. [PMID: 38160089 DOI: 10.1016/j.acra.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/12/2023] [Accepted: 11/18/2023] [Indexed: 01/03/2024]
Abstract
RATIONALE AND OBJECTIVES Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI) tool which utilises machine learning to generate original text resembling human language. AI models have recently demonstrated remarkable ability at analysing and solving problems, including passing professional examinations. We investigate the performance of ChatGPT on some of the UK radiology fellowship equivalent examination questions. METHODS ChatGPT was asked to answer questions from question banks resembling the Fellowship of the Royal College of Radiologists (FRCR) examination. The entire physics part 1 question bank (203 5-part true/false questions) was answered by the GPT-4 model and answers recorded. 240 single best answer questions (SBAs) (representing the true length of the FRCR 2A examination) were answered by both GPT-3.5 and GPT-4 models. RESULTS ChatGPT 4 answered 74.8% of part 1 true/false statements correctly. The spring 2023 passing mark of the part 1 examination was 75.5% and ChatGPT thus narrowly failed. In the 2A examination, ChatGPT 3.5 answered 50.8% SBAs correctly, while GPT-4 answered 74.2% correctly. The winter 2022 2A pass mark was 63.3% and thus GPT-4 clearly passed. CONCLUSION AI models such as ChatGPT are able to answer the majority of questions in an FRCR style examination. It is reasonable to assume that further developments in AI will be more likely to succeed in comprehending and solving questions related to medicine, specifically clinical radiology. ADVANCES IN KNOWLEDGE Our findings outline the unprecedented capabilities of AI, adding to the current relatively small body of literature on the subject, which in turn can play a role medical training, evaluation and practice. This can undoubtedly have implications for radiology.
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Affiliation(s)
- Sisith Ariyaratne
- Department of Musculoskeletal Radiology, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK (S.A., N.J., A.M.D., R.B.).
| | - Nathan Jenko
- Department of Musculoskeletal Radiology, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK (S.A., N.J., A.M.D., R.B.)
| | - A Mark Davies
- Department of Musculoskeletal Radiology, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK (S.A., N.J., A.M.D., R.B.)
| | - Karthikeyan P Iyengar
- Department of Trauma & Orthopaedics, Southport & Ormskirk Hospitals, Mersey and West Lancashire Teaching NHS Trust, Southport, UK (K.P.I.)
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK (S.A., N.J., A.M.D., R.B.)
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Stevens PE, Rassbach CE, Qin F, Kuo KW. Spiritual Care in PICUs: A U.S. Survey of 245 Training Fellows 2020-2021. Pediatr Crit Care Med 2024; 25:396-406. [PMID: 38088772 DOI: 10.1097/pcc.0000000000003429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVES To understand the perspectives of pediatric fellows training in critical care subspecialties about providing spiritual care. DESIGN Cross-sectional survey of United States National Residency Matching Program pediatric fellows training in critical care specialties. SETTING Online survey open from April to May 2021. SUBJECTS A total of 720 fellows (165 cardiology, 259 critical care, and 296 neonatology) were contacted, with a response rate of 245 of 720 (34%). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We assessed fellows' survey responses about spiritual care in neonatal and pediatric critical care units. Categorical data were compared using chi-square test or Fisher exact tests. The Wilcoxon rank-sum test was used to compare the percentage correct on ten multiple-choice questions about world religions. Free-text responses were independently coded by two research investigators. A total of 203 of 245 (83%) responding fellows had never received training about spiritual care and 176 of 245 (72%) indicated that they would be likely to incorporate spiritual care into their practice if they received training. Prior training was associated with increased familiarity with a framework for taking a spiritual history ( p < 0.001) and increased knowledge of spiritual practices that could influence medical care ( p = 0.03). Prior training was also associated with increased self-reported frequency of taking a spiritual history ( p < 0.001) and comfort in referring families to spiritual care resources ( p = 0.02). Lack of time and training were the most reported barriers to providing spiritual care. CONCLUSIONS Providing spiritual care for families is important in critical care settings. In 2020-2021, in the United States, 245 pediatric critical care fellows responded to a survey about spiritual care in their practice and reported that they lacked training in this subject. An opportunity exists to implement spiritual care curricula into pediatric fellowship training.
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Affiliation(s)
- Paige E Stevens
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Loma Linda University Children's Hospital, Loma Linda, CA
| | - Caroline E Rassbach
- Department of Pediatrics, Division of Hospital Medicine, Stanford University School of Medicine, Stanford, CA
| | - FeiFei Qin
- Quantitative Sciences Unit, Department of Medicine, Stanford University, Stanford, CA
| | - Kevin W Kuo
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stanford University School of Medicine, Stanford, CA
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Winkler ML, Paras ML, Wright SB, Shenoy ES. National survey of infectious disease fellowship program directors: A call for subspecialized training in infection prevention and control and healthcare epidemiology. Infect Control Hosp Epidemiol 2024; 45:562-566. [PMID: 38173357 DOI: 10.1017/ice.2023.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The importance of infection prevention and control and healthcare epidemiology (IPC/HE) in healthcare facilities was highlighted during the COVID-19 pandemic. Infectious disease (ID) clinicians often hold leadership positions in IPC/HE teams; however, there is no standard for training or certification of ID physicians specializing in IPC/HE. We evaluated the current state of IPC/HE training in ID fellowship programs. DESIGN A national survey of ID fellowship program directors was conducted to assess current IPC/HE training components in programs and plans for expanded offerings. SETTING AND PARTICIPANTS All ID fellowship program directors in the United States and Puerto Rico. METHODS Surveys were distributed using Research Electronic Data Capture (REDCap) to program directors in March 2023, with 2 reminder emails; the survey closed after 4 weeks. RESULTS Of 166 program directors, 54 (32.5%) responded to the survey. Among respondent programs, 49 (90.7%) of 54 programs reported didactic training in IPC/HE averaging 4.4 hours over the course of the fellowship. Also, 18 (33.3%) of 54 reported a dedicated IPC/HE training track. Furthermore, 23 programs (42.6%) reported barriers to expanding training. There was support (n = 47, 87.0%) for formal IPC/HE certification from a professional society within the standard fellowship. CONCLUSIONS Despite the COVID-19 pandemic highlighting the need for ID medical doctors with IPC/HE expertise, formal training in ID fellowship remains limited. Most program directors support formalization of IPC/HE training by a professional organization. Creation of standardized advanced curriculums for ID fellowship training in IPC/HE could be considered by the Society of Healthcare Epidemiology of America (SHEA) to grow, retain, and enhance the IPC/HE physician workforce.
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Affiliation(s)
- Marisa L Winkler
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia
| | - Molly L Paras
- Harvard Medical School, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
| | - Sharon B Wright
- Harvard Medical School, Boston, Massachusetts
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Infection Prevention, Beth Israel Lahey Health, Cambridge, Massachusetts
| | - Erica S Shenoy
- Harvard Medical School, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control Unit and Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control, Mass General Brigham, Boston, Massachusetts
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33
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Kane SK, Palmer MM, Slaven JE, Niehaus JZ. Understanding the Factors that Determine a Fellow's Choice in Neonatal-Perinatal Medicine and How They Establish Their Rank List. Am J Perinatol 2024; 41:e949-e957. [PMID: 36351444 DOI: 10.1055/a-1974-9605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Little is known about why neonatology fellows pick the fellowship program they do. Understanding why fellows choose neonatology and rank their programs would be of benefit to program leadership and to other applicants. STUDY DESIGN This was a survey study sent to current neonatology fellows in the United States between September 2020 and October 2020, and were asked to rank their choices on a Likert scale. Respondents were also able to give free text responses to open-ended questions. RESULTS The most important factor fellows state for choosing their program was location, with multiple reasons given. There were significant differences in how certain subgroups ranked programs. CONCLUSION Location of the fellowship program is the most important factor for fellows. There are differences within subgroups of fellows on how they rank their fellowship program. Fellowship directors can use this information to better inform selections on who to interview and how to rank fellows. KEY POINTS · Patient population appears to be the most important reason why fellows choose neonatology.. · Program location is the most important reason why fellows choose their specific training program.. · Fellowships can continue to highlight fellow camaraderie, scholarship, and clinical opportunities..
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Affiliation(s)
- Sara K Kane
- Division of Neonatology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Megan M Palmer
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - James E Slaven
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Jason Z Niehaus
- Division of Neonatology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Hale JF, Thorndyke L, Milner RJ, Vitello-Cicciu J. Interprofessional reconstruction of a policy for academic advancement: The evolution and evaluation of scholarship for today, tomorrow, and beyond. J Prof Nurs 2024; 52:1-6. [PMID: 38777520 DOI: 10.1016/j.profnurs.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 01/26/2024] [Accepted: 02/15/2024] [Indexed: 05/25/2024]
Abstract
Within higher education, scholarship is narrowly and inconsistently defined, limiting recognition of evolving faculty expectations, particularly for nursing faculty. At this academic medical center, a campus-wide, multi-school, academic advancement policy was achieved with a broader definition of scholarship that included: peer-reviewed publication of federally funded research, as well as innovation in curriculum development, teaching methodology, community engagement, safety and quality improvement, clinical practice, and health policy that would be applicable to tenure and non-tenure track faculty. The background, process, and outcomes of developing an expanded definition of scholarship that encompasses new and evolving areas of scholarship for a reconstructed academic personnel policy is presented. Beginning with a literature review and surveys of other schools' policies, we describe how a campus-wide working group ensured consensus and acceptance of the new policy. Upon approval of the reconstructed document, guidelines for implementation were widely disseminated through training workshops and discussions, integration into new faculty orientation, and faculty development programs. We share our process, outcomes, and lessons learned believing this information to be useful to other institutions engaged in review and revision of their promotion and tenure processes to align with the increasing expectations of nursing faculty of today and tomorrow.
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Affiliation(s)
- Janet Fraser Hale
- UMass Chan Medical School, Worcester, MA 01655, United States of America.
| | - Luanne Thorndyke
- UMass Chan Medical School, Worcester, MA 01655, United States of America.
| | - Robert J Milner
- UMass Chan Medical School, Worcester, MA 01655, United States of America.
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Mendelson LS, Syed MP, Im AP. Call for Hematology/Oncology Fellowship Leadership to Improve Oncology Workforce Diversity Through Recruitment of International Medical Graduates. JCO Oncol Pract 2024; 20:607-609. [PMID: 38447090 DOI: 10.1200/op.24.00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Lauren S Mendelson
- Division of Hematology/Oncology, University of Cincinnati, Cincinnati, OH
| | - Masood Pasha Syed
- Division of Hematology/Oncology, University of Pittsburgh School of Medicine/UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Annie P Im
- Division of Hematology/Oncology, University of Pittsburgh School of Medicine/UPMC Hillman Cancer Center, Pittsburgh, PA
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Ozdag Y, Hayes DS, Garcia VC, El Koussaify J, Manzar S, Vaughan AK, Davis DE, Grandizio LC. Surgeon Factors and Trends Associated With the Use of Subacromial Decompression at the Time of Rotator Cuff Repair. J Hand Surg Am 2024; 49:465-471. [PMID: 38556963 DOI: 10.1016/j.jhsa.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Subacromial decompression (SAD) has historically been described as an essential part of the surgical treatment of rotator cuff disorders. However, investigations throughout the 21st century have increasingly questioned the need for routine SAD during rotator cuff repair (RCR). Our purpose was to assess for changes in the incidence of SAD performed during RCR over a 12-year period. In addition, we aimed to characterize surgeon and practice factors associated with SAD use. METHODS Records from two large tertiary referral systems in the United States from 2010 to 2021 were reviewed. All cases of RCR with and without SAD were identified. The outcome of interest was the proportion of SAD performed during RCR across years and by surgeon. Surgeon-specific characteristics included institution, fellowship training, surgical volume, academic practice, and years in practice. Yearly trends were assessed using binomial logistic regression modeling, with a random effect accounting for surgeon-specific variability. RESULTS During the study period, 37,165 RCR surgeries were performed by 104 surgeons. Of these cases, 71% underwent SAD during RCR. SAD use decreased by 11%. The multivariable model found that surgeons in academic practice, those with lower surgical volume, and those with increasing years in practice were significantly associated with increased odds of performing SAD. Surgeons with fellowship training were significantly more likely to use SAD over time, with the greatest odds of SAD noted for sports medicine surgeons (odds ratio = 3.04). CONCLUSIONS Although SAD use during RCR appears to be decreasing, multiple surgeon and practice factors (years in practice, fellowship training, volume, and academic practice) are associated with a change in SAD use. CLINICAL RELEVANCE These data suggest that early-career surgeons entering practice are likely driving the trend of declining SAD. Despite evidence suggesting limited clinical benefits, SAD remains commonly performed; future studies should endeavor to determine factors associated with practice changes among surgeons.
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Affiliation(s)
- Yagiz Ozdag
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Daniel S Hayes
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Victoria C Garcia
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Jad El Koussaify
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Shahid Manzar
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | | | | | - Louis C Grandizio
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA.
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Petrie S, Cheng I, McMahon M, Lavis JN. Future leaders in a learning health system: Exploring the Health System Impact Fellowship. Healthc Manage Forum 2024; 37:151-155. [PMID: 38016119 PMCID: PMC11044521 DOI: 10.1177/08404704231216951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The Canadian health system is reeling following the COVID-19 pandemic. Strains have become growing cracks, with long emergency department wait times, shortage of human health resources, and growing dissatisfaction from both clinicians and patients. To address long-needed health system reform in Canada, a modernization of training is required for the next generation health leaders. The Canadian Institutes of Health Research Health System Impact Fellowship (HSIF) is an example of a well-funded and connected training program which prioritizes embedded research and embedding technically trained scholars with health system partners. The program has been successful in the scope and impact of its training outcomes as well as providing health system partners with a pool of connected and capable scholars. Looking forward, integrating aspects of evidence synthesis from both domestic and international sources and adapting a general contractor approach to implementation within the HSIF could help catalyze learning health system reform in Canada.
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Affiliation(s)
- Samuel Petrie
- University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Ivy Cheng
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Meghan McMahon
- University of Toronto, Toronto, Ontario, Canada
- CIHR Institute of Health Services and Policy Research, Ottawa, Ontario, Canada
| | - John N. Lavis
- McMaster University, Hamilton, Ontario, Canada
- McMaster Health Forum, Hamilton, Ontario, Canada
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Wang CW, Lees CR, Ko MS, Sewell JL, Kathpalia P. Implementation and Analysis of a 5-Year Online Esophageal Motility Curriculum for Gastroenterology Fellows. Dig Dis Sci 2024; 69:1661-1668. [PMID: 38507124 DOI: 10.1007/s10620-024-08370-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Motility disorders are frequently encountered in gastroenterology (GI) practice, yet a national structured training curriculum for GI fellows in motility disorders is lacking. Since GI fellowships vary considerably in opportunities for specialized esophageal motility (EM) training, novel educational technology may be leveraged to provide standardized EM curriculum to train GI fellows in esophageal manometry. METHODS GI fellows participated in an online EM learning program at a single academic center from 2017 to 2022. Fellows answered case-based questions and were provided with evidence-based, corrective feedback related to core EM learning objectives. The primary outcome was change in knowledge and comfort in interpretation and clinical application of EM studies. RESULTS Sixty-nine fellows actively participated in the online EM curriculum. 65 fellows completed a pre-curriculum test, and 54 fellows completed a post-curriculum test. There was a cumulative improvement between pre-curriculum test and post-curriculum test scores from 70 to 87%, respectively (p < 0.001). Fellows had a mean improvement of 19% in questions as they progressed through the curriculum. Prior to enrolling in the EM course, 26% of fellows felt comfortable in interpreting EM studies compared to 54% of fellows after completion of the program (p < 0.001). CONCLUSION An online, technology-based curriculum was effective in educating GI fellows on core competencies of EM. Fellows demonstrated improvement in proficiency of clinically important EM studies and increased comfort in interpreting EM studies. Further studies are needed to evaluate the use of technology-based learning to widely disseminate a structured training curriculum in EM, particularly in training programs without a motility presence.
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Affiliation(s)
- Connie W Wang
- Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA
| | - Christopher R Lees
- Department of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA, USA
| | - Myung S Ko
- Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA
| | - Justin L Sewell
- Division of Gastroenterology, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
| | - Priya Kathpalia
- Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA.
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Naclerio E, Sekar M, Ghattas YS, Steinmann S, Cannada LK, Dehghan N. Women in Orthopaedics: 10-Year Trends of Fellowship Match Rate and Subspecialty. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202405000-00015. [PMID: 38775597 PMCID: PMC11111387 DOI: 10.5435/jaaosglobal-d-23-00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Orthopaedic surgery has consistently remained one of the least diverse specialties in medicine. There are limited data on the match rate by sex into orthopaedic fellowships. PURPOSE The goals of this study were to determine (1) how the percentage of women applying to orthopaedic fellowships has changed from 2011 to 2021, (2) whether there was a correlation between sex and the likelihood of a successful fellowship match, and (3) which subspecialties tend to have a greater proportion of female applicants and fellows. METHODS The San Francisco (SF) Match service was used to obtain US orthopaedic fellowship applicant data from 2010 to 2021. San Francisco Match has run the match for the orthopaedic fellowship match since 2010. International medical graduates' applications, incomplete applications, or withdrawn applications were excluded. The following variables were collected and assessed: sex, subspecialty choice (except for hand because they do not use SF Match services), and match outcome. The number of female applicants and matches was recorded by year and compared with the number of male applicants and matches. Chi-square analysis was used to analyze categorical variables. RESULTS A total of 6969 applicants to all orthopaedic specialties within SF Match were included during the study period. Overall, 859 were female (12.3%), and 6110 were male (87.7%). The number of female applicants had an increasing trend over the 10-year period from 65 applicants in 2011 to 111 in 2021. The overall proportion of female applicants was between 10.1% and 14.4%. The annual match rate for female applicants was 90.7% to 100% during the study period while the match rate for male applicants was 93.7% to 97.3%. Regarding successful matches, pediatrics had the highest proportion of women (range: 30.2% to 46.2%), followed by foot and ankle (range: 9.8% to 26.4%). Spine (range: 3.2 to 10.9%) and adult reconstruction (range: 3.9% to 9%) had the least number of women among matched applicants. DISCUSSION This study found that the number of female applicants to orthopaedic fellowships has increased over the past 10 years. The difference in fellowship match rates among male versus female applicants did not statistically differ during this 10-year period; however, the proportion of female fellows is not equally distributed among subspecialties, with a higher proportion of women matching into pediatrics and foot and ankle and lower proportion in reconstruction and spine. These data can provide a benchmark for department chairs and society leadership to ensure they are recruiting, interviewing, and selecting candidates who are representative of the current sex demographics of orthopaedic fellowship graduates.
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Affiliation(s)
- Emily Naclerio
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
| | - Molly Sekar
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
| | - Yasmine S. Ghattas
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
| | - Scott Steinmann
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
| | - Lisa K. Cannada
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
| | - Niloofar Dehghan
- From the Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Naclerio, Dr. Sekar, Dr. Dehghan); the College of Medicine-Orlando, University of Central Florida, Orlando, FL (Ms. Ghattas); the Mayo Clinic-Rochester, MN (Dr. Steinmann), Department of Orthopedics Novant Health, University of North Carolina Charlotte, Charlotte, NC (Dr. Cannada); the The CORE Institute, Phoenix, AZ (Dr. Dehghan)
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Sohail AH, Ye IB, Martinez KA, Campos MA, Sohail S, Williams CE, Khan MS, Bhatti U, Hakmi H, Akhtar A, Quazi MA, Sheikh AB, Goyal A, Khan A. Colon and Rectal Surgery Fellowship Applicant and Matching Trends in the United States: An Analysis of National Resident Matching Program Data. Am Surg 2024; 90:985-990. [PMID: 38054447 DOI: 10.1177/00031348231220574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Colon and Rectal Surgery fellowships are training programs that aim to train surgeons in the management of small bowel, colon, rectal, and anal pathologies. OBJECTIVE We investigated trends in Colon and Rectal Surgery fellowship match to help applicants anticipate future fellowship application cycles. DESIGN This was a retrospective cohort study of applicants in the Colon and Rectal Surgery match from 2009 to 2023. Proportion of positions filled, match rates, and rank-order lists were collected. The impact of US-MD, non-US-MD, and DO status on match rate was assessed. We used the Mann Kendall trend test to obtain tau statistic and P-value for temporal trends over time, while associations between categorical variables were investigated by a chi-square test. RESULTS Fellowship programs increased from 43 to 67, positions increased from 78 to 110, and number of applicants rose from 113 to 135. Nearly all positions were filled from 2009 to 2023 (range: 96.3%-100%). The overall match rate fluctuated between 67.3% and 80.7%. The match rate over the past 5 years was 72.0%. The match rate for US-MDs was 80.0%, while non-US-MDs had a 56.2% match rate. The percentage matching at each rank were first choice 28.0%, second choice 10.4%, third choice 6.9%, and fourth choice or lower 23.5%. CONCLUSION Despite an increase in Colon and Rectal Surgery fellowship positions, the overall match rate has not changed significantly over the years, mainly as a result of increased applicants.
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Affiliation(s)
- Amir H Sohail
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Ivan B Ye
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Kevin A Martinez
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Marco A Campos
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | | | | | - Muhammad Salman Khan
- Department of Diagnostic and Interventioanl Imaging, The University of Texas Health Sciences Center, Houston, TX, USA
| | - Umar Bhatti
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Hazim Hakmi
- Department of Surgery, NYU Langone Health, New York, NY, USA
| | - Aisha Akhtar
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mohammed A Quazi
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Arizona Advanced Surgery, Scottsdale, AZ, USA
| | | | - Aman Goyal
- Vanderbilt University Medical Center, Nashville,TN, USA
| | - Aimal Khan
- Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India
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Emil S, Langer JC, Blair G, Aspirot A, Brisseau G, Hancock BJ. The Canadian Pediatric Surgery Workforce: A 10-year Prospective Assessment. J Pediatr Surg 2024; 59:757-762. [PMID: 38395684 DOI: 10.1016/j.jpedsurg.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The Canadian Association of Paediatric Surgeons launched a 10-year prospective assessment of the Canadian pediatric surgery workforce and training environment, beginning in 2013. The results of the first 5 years (2013-2017) were previously published. Here, we present the results of the last 5 years (2018-2022), and the cumulative results of the past decade. METHODS With IRB approval, a web-based survey was sent to all pediatric surgery division chiefs in Canada each year (2013-2022). The survey gathered workforce data on pediatric surgery practices, as well as data regarding fellowship graduates from Canadian training programs. RESULTS Complete responses were received from all 18 divisions (100% response rate). Over the decade studied, the number of pediatric surgeons and full-time equivalent positions increased from 73 to 81, and 65 to 82, respectively. Thirty positions were vacated (15 retirement, 6 new Canadian practice, 8 leaving Canada, 1 other), and 38 were filled (20 new Canadian fellowship graduates, 8 Canadian surgeons moving from other sites in Canada, 10 surgeons coming from outside Canada). Seventy-five fellows completed training eligible for North American certification, including 34 Canadians, 31 Americans, and 10 non-North American foreign nationals (9 of whom left North America after training). The proportion of Canadian graduates who desired, but could not find, a Canadian position improved from 44% in the first 5 years to 20% in the second 5 years. CONCLUSIONS The Canadian pediatric surgery workforce has experienced a modest increase over a decade. A mismatch still exists between Canadian pediatric surgery graduates and attending staff positions, but the situation has improved during the last 5 years. TYPE OF STUDY Survey. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- Sherif Emil
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
| | - Jacob C Langer
- Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Geoffrey Blair
- Division of Pediatric Surgery, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Ann Aspirot
- Division of Pediatric Surgery, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Guy Brisseau
- Division of Pediatric Surgery, Sidra Medicine, Doha, Qatar
| | - B J Hancock
- Division of Pediatric Surgery, Children's Hospital of Winnipeg, Winnipeg, Manitoba, Canada
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VanderVeer-Harris N, Mallory C, Boaretto D, Kolesova M, Bird V. Demographics and Career Trends of Urology Fellowship Directors in the United States. Urol Pract 2024; 11:587-595. [PMID: 38447211 DOI: 10.1097/upj.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/24/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Fellowship directors (FDs) hold significant leadership roles within the academic urology community. We sought to characterize common trends in training and academic productivity among urology FDs. Moreover, we aimed to characterize gender differences across subspecialties to better inform gender-based inclusion efforts and contemporary leadership pathways. METHODS FDs were studied across 6 urologic subspecialties. Society and institutional websites were queried for demographics, education/training institutions, timelines of career milestones, and academic productivity. χ2, Mann-Whitney U, and Kruskal-Wallis tests and Kendall tau rank correlation were employed with an alpha cutoff of .05. RESULTS There were 219 FDs included, representing 208 fellowship programs at 93 institutions. FDs were 176 (80%) males and 43 (20%) females. There was a significant association between gender and subspecialty. The median age for all FDs was 52 years old. Significant differences in age were demonstrated across subspecialties. For all FDs, females were younger than males, at 49 and 53 years, respectively (P = .001). The median H-index for all FDs was 23.5. H-index was significantly different between genders and subspecialities. There was a strong, positive correlation between age vs H-index for all FDs. Half of FDs had completed fellowship training at one of 14 institutions. CONCLUSIONS We describe the landscape of leadership in urology subspecialty training. There are an increasing number of female FDs. Composition of leadership varies by subspecialty; however, the careers of all current urology FDs are marked by lifelong achievements in academic productivity. Moreover, a small group of institutions produce a substantial number of FDs.
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Affiliation(s)
| | - Chase Mallory
- Department of Urology, University of Florida, Gainesville, Florida
| | - Daniel Boaretto
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Maria Kolesova
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Vincent Bird
- Department of Urology, University of Florida, Gainesville, Florida
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Mahoney D, Pavitt S, Blankenburg R. We've Got a New One-Exploring the Resident-Fellow New Admission Interaction and Opportunities for Enhancing Motivation. Acad Pediatr 2024; 24:692-699. [PMID: 38215903 DOI: 10.1016/j.acap.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To characterize the phases of a new admission interaction between collaborating pediatric residents and fellows; to explore trainee perspectives on motivating and demotivating qualities of that interaction; and to identify behaviors that lead to an optimal new admission interaction. METHODS The authors used modified grounded theory with experiential learning theory and self-determination theory as sensitizing concepts to conduct 6 focus groups and journey mapping at Stanford Children's Health from January to March 2021. The sessions were audio-recorded and transcribed verbatim. Two authors independently coded the transcripts and developed categories and themes using constant comparison, while a third author reviewed these findings. The qualitative data were triangulated with surveys and journey mapping data and conceptualized into a model of trainee motivation during the new admission interaction. They outlined an optimal new admission interaction using behaviors consistently described by participants as motivating. RESULTS Developing inter-trainee trust and educational buy-in is essential for both residents and fellows to feel intrinsically motivated and engaged during a new admission. Residents need to feel autonomous, competent, and related to the team in order to develop trust and buy-in. Fellows require assurance of patient safety to develop trust and a sense of self-efficacy in fostering resident growth to develop buy-in. Lack of trust or buy-in from either party leads to a cycle of trainee disengagement. CONCLUSIONS Trainee motivation and engagement with patient care can be impacted by discreet, modifiable behavior by their fellow or resident counterpart, which may help improve the quality of care delivered.
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Affiliation(s)
- David Mahoney
- Department of Pediatrics (D Mahoney), Stanford University School of Medicine, Palo Alto, Calif.
| | - Sara Pavitt
- Department of Neurology and by courtesy Department of Pediatrics (S Pavitt), Dell Medical School, Austin, Tex.
| | - Rebecca Blankenburg
- Department of Pediatrics (R Blankenburg), Stanford University School of Medicine, Palo Alto, Calif.
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Calli JL, Curtin LS. Consolidating NRMP Fellowship Matches to Enhance the Applicant Experience. JAMA Cardiol 2024; 9:487. [PMID: 38506882 DOI: 10.1001/jamacardio.2024.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
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Woodland NM, Amaratunge L, Jahangiri N. I-Excel: A preparation course for specialist international medical graduate candidates for the Australian and New Zealand College of Anaesthetists final fellowship examination. Anaesth Intensive Care 2024; 52:203-206. [PMID: 38318636 DOI: 10.1177/0310057x231214550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
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John MM, Starks H, Allam JS, Moore J, Frank JA, Bosslet GT, Burkart KM, Çoruh B. Variable Practice, Variable Results: Impact of Postinterview Communication Practices Among Critical Care Medicine/Pulmonary and Critical Care Medicine Fellowship Applicants and Program Directors. Chest 2024; 165:1186-1197. [PMID: 37977268 DOI: 10.1016/j.chest.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Although postinterview communication (PIC) guidelines exist, adherence is voluntary. There are no studies of PIC practices in critical care medicine (CCM) and pulmonary and critical care medicine (PCCM) fellowship recruitment. RESEARCH QUESTION What is the frequency, format, goals, and content of PIC between CCM/PCCM applicants and program directors? What is the impact of PIC on applicant and program rank order lists (ROLs)? STUDY DESIGN AND METHODS CCM/PCCM applicants and program directors were separately surveyed after the 2022-2023 National Resident Matching Program Specialty Match. Surveys included multiple-choice, Likert-scale, and two free text questions. Thematic content analysis of free text responses was performed. RESULTS One-third of eligible participants responded (applicants: n = 373 [34%]; program directors: n = 86 [32%]). Applicant respondents applied to CCM (19%), PCCM (69%), or both (12%). Program directors represented CCM (17%), PCCM (57%), or both (26%) programs. Applicant (66%) and program director (49%) respondents reported initiating PIC. PIC did not impact ROL decision for most applicants (73%) or program directors (83%), though 21% of applicants and 17% of program directors moved programs or applicants up on their ROL in response to PIC. One-quarter (23%) of applicants strongly agreed or agreed that PIC was helpful in creating their ROL, 27% strongly disagreed or disagreed, and 29% were neutral. PIC challenges identified by both groups included time; lack of uniformity; peer pressure; misleading language; and uncertainty about motives, rules, and response protocols. INTERPRETATION PIC is common among CCM/PCCM applicants and program directors. About 50% of applicants and 20% of program directors share ranking intentions via PIC. Although PIC did not impact ROL for most applicants and program directors, a minority of applicants and program directors moved programs up on their ROL after receiving PIC from the other party. Applicants have mixed perspectives on PIC value. Applicants and program directors alike desire clear guidance on PIC to minimize ambiguous and misleading communication.
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Affiliation(s)
- Mira M John
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Helene Starks
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA
| | - J Shirine Allam
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University School of Medicine, Atlanta, GA
| | - Jason Moore
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - James A Frank
- Division of Pulmonary and Critical Care, University of California San Francisco School of Medicine, San Francisco, CA
| | - Gabriel T Bosslet
- Division of Pulmonary, Critical Care, Allergy, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Kristin M Burkart
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving School of Medicine, New York, NY
| | - Başak Çoruh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA
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Harden JT, Hill CV, Heyn PC, Oh ES, Perez GA, Whitfield K. Indispensable impact: From NIA Summer Institute to Butler-Williams Scholars Program. J Am Geriatr Soc 2024; 72:1627-1629. [PMID: 38445767 DOI: 10.1111/jgs.18858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/11/2024] [Indexed: 03/07/2024]
Affiliation(s)
- J Taylor Harden
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
| | - Carl V Hill
- Chief Diversity, Equity, and Inclusion Officer, Alzheimer's Association, Chicago, Illinois, USA
| | - Patricia C Heyn
- Center for Optimal Aging, Marymount University, Arlington, Virginia, USA
| | - Esther S Oh
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Departments of Psychiatry and Behavioral Sciences & Neuropathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - G Adriana Perez
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Geyer PK, Hoffmann DS, Barr JY, Widmayer HA, Blaumueller CM. Granting access: Development of a formal course to demystify and promote predoctoral fellowship applications for graduate students. PLoS One 2024; 19:e0301480. [PMID: 38669240 PMCID: PMC11051599 DOI: 10.1371/journal.pone.0301480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/16/2024] [Indexed: 04/28/2024] Open
Abstract
Strong scientific writing skills are the foundation of a successful research career and require training and practice. Although these skills are critical for completing a PhD, most students receive little formal writing instruction prior to joining a graduate program. In 2015, the University of Iowa Medical Scientist Training Program (MSTP) addressed this issue by developing the scientific writing course Grant Writing Basics (GWB). Here we describe the structure of this course and its effectiveness. GWB is an interactive, workshop-based course that uses a National Institutes of Health (NIH) F30 predoctoral fellowship proposal as a platform for building writing expertise. GWB incorporates established pedagogical principles of adult learning, including flipped classrooms, peer teaching, and reiterative evaluation. Time spent in class centers on active student analysis of previously submitted fellowship applications, discussion of writing resources, active writing, facilitated small group discussion of critiques of student writing samples, revision, and a discussion with a panel of experienced study section members and a student who completed a fellowship submission. Outcomes of GWB include a substantial increase in the number of applications submitted and fellowships awarded. Rigorous evaluation provides evidence that learning objectives were met and that students gained confidence in both their scientific writing skills and their ability to give constructive feedback. Our findings show that investment in formal training in written scientific communication provides a foundation for good writing habits, and the knowledge and skills needed to succeed in this vital aspect of a scientific research career. Furthermore, they highlight that evaluation is valuable in guiding course evolution. Strategies embedded in GWB can be adapted for use in any graduate program to advance scientific writing skills among its trainees.
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Affiliation(s)
- Pamela K. Geyer
- Department of Biochemistry and Molecular Biology, University of Iowa, Iowa City, Iowa, United States of America
- Medical Scientist Training Program, University of Iowa, Iowa City, Iowa, United States of America
| | - Darren S. Hoffmann
- Medical Scientist Training Program, University of Iowa, Iowa City, Iowa, United States of America
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, Iowa, United States of America
| | - Jennifer Y. Barr
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Heather A. Widmayer
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Christine M. Blaumueller
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
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Zern EK, Gupta T, Ryoo Ali HJ, Thakker P, Reza N. A Leadership Program to Support Career Development of Cardiovascular Chief Fellows. J Am Coll Cardiol 2024; 83:1623-1625. [PMID: 38631779 PMCID: PMC11064848 DOI: 10.1016/j.jacc.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Emily K Zern
- Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California, USA. https://twitter.com/emilyzernMD
| | - Tripti Gupta
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Prashanth Thakker
- Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Nosheen Reza
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Krishnaswami A. Reflections on the Practice of Geriatric Cardiology After a Mid-Career Geriatrics Fellowship. J Am Coll Cardiol 2024; 83:1619-1622. [PMID: 38631777 DOI: 10.1016/j.jacc.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Ashok Krishnaswami
- Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose California, USA; Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University, Stanford, California, USA; Geriatric Research Education and Clinical Center, U.S. Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, California, USA.
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