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McDaniel LM, Molloy MJ, Blanck J, Beck JB, Shilkofski NA. The Chief Residency in U.S. and Canadian Graduate Medical Education: A Scoping Review. TEACHING AND LEARNING IN MEDICINE 2024:1-10. [PMID: 38247430 DOI: 10.1080/10401334.2023.2298870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024]
Abstract
PHENOMENON Despite the nearly universal presence of chief residents within U.S. and Canadian residency programs and their critical importance in graduate medical education, to our knowledge, a comprehensive synthesis of publications about chief residency does not exist. An understanding of the current state of the literature can be helpful to program leadership to make evidence-based improvements to the chief residency and for medical education researchers to recognize and fill gaps in the literature. APPROACH We performed a scoping review of the literature about chief residency. We searched OVID Medline, PsycINFO, ERIC, and Web of Science databases through January 2023 for publications about chief residency. We included publications addressing chief residency in ACGME specialties in the U.S. and Canada and only those using the term "chief resident" to refer to additional responsibilities beyond the typical residency training. We excluded publications using chief residents as a convenience sample. We performed a topic analysis to identify common topics among studies. FINDINGS We identified 2,064 publications. We performed title and abstract screening on 1,306 and full text review on 208, resulting in 146 included studies. Roughly half of the publications represented the specialties of Internal Medicine (n = 37, 25.3%) and Psychiatry (n = 30, 20.5%). Topic analysis revealed six major topics: (1) selection of chief residents (2) qualities of chief residents (3) training of chief residents (4) roles of chief residents (5) benefits/challenges of chief residency (6) outcomes after chief residency. INSIGHTS After reviewing our topic analysis, we identified three key areas warranting increased attention with opportunity for future study: (1) addressing equity and bias in chief resident selection (2) establishment of structured expectations, mentorship, and training of chief residents and (3) increased attention to chief resident experience and career development, including potential downsides of the role.
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Affiliation(s)
- Lauren M McDaniel
- Department of Pediatrics, Division of Hospital Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Matthew J Molloy
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jaime Blanck
- Informationist Services, Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jimmy B Beck
- Department of Pediatrics, Division of Hospital Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Nicole A Shilkofski
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
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Levy KL, Sheffield V, Sturza J, Heidemann LA. Important Leadership Skills and Benefits of Shared Leadership Training for Chief Residents: A Delphi Analysis. J Healthc Leadersh 2023; 15:221-230. [PMID: 37744472 PMCID: PMC10517684 DOI: 10.2147/jhl.s413799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
Background Chief residents (CRs) have pivotal educational and leadership roles in residency programs. The necessary CR leadership skills that transcend specialties have not been defined and most training on these skills occurs in silo. Objective The primary goal was to define leadership skills important for the general CR role. The secondary aim was to determine which skills should be included in cross-specialty CR training and identify benefits of such training. Methods Sixty-three CRs and 25 program directors (PDs) from 25 residency programs at a single institution were surveyed via a modified Delphi approach in 2022 as part of a needs assessment on CR leadership training. First, respondents answered three open-ended questions about skills needed for the CR role and the potential benefits of cross-specialty CR training. Respondents then rated categorized responses on the importance of the skill, agreement that skills should be included in cross-specialty training, and agreement on benefit of cross-specialty training using a 5-point Likert scale. Positive consensus was defined as 80% agreement. Results Fifty respondents (53%) participated in round one and 28 (32%) in round two. Positive consensus was reached on 38 skills (63%). Nine skills reached consensus on inclusion in cross-specialty training including communication skills and certain management skills. Consensus on benefits of training include learning from and collaborating with other residency programs. Conclusion The authors defined important skills for the CR role that reached consensus across a broad range of specialties and identified the perceived benefits of shared leadership training. Residency programs should consider cross-specialty leadership training for CRs with a focus on communication and management skills.
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Affiliation(s)
- Kathryn L Levy
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Virginia Sheffield
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Lauren A Heidemann
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Morrow MM, Schafer MJ, Kantarci K, Mielke MM, Vachon CM, Winham SJ. Leadership Development in Early Career Scientists: Themes and Feedback from Executive Coaching and Mindful Leadership Training. J Womens Health (Larchmt) 2023; 32:877-882. [PMID: 37585518 PMCID: PMC10457600 DOI: 10.1089/jwh.2023.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Background: Career development is essential for all academic stages, but particularly critical for the growth and retention of early career scientists. In addition to scientific technical training, professional skill development is crucial for the upward transition from postdoctoral trainee to early faculty member and beyond. Building leadership skills, specifically, is an important component of professional development, and the evaluation and reporting of professional development are important to improve and enhance the impact of programs. Methods: The purpose of this article is to share the program evaluation performed on leadership development activities, including executive coaching and mindful leadership training provided to a small group of early career scientists who participated in the National Institutes of Health (NIH)-funded Mayo Clinic Specialized Center of Research Excellence (SCORE) in Sex Differences Career Enhancement Core and Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 programs during 2020-2022. Results: Eighty-seven percent of participants rated their satisfaction with the executive coaching program as "Very Satisfied" or "Satisfied," and 75% of participants were "Very Satisfied" or "Satisfied" with the mindful leadership training program. The findings of this program evaluation highlight the value of communication skills for navigating precarious situations, building self-efficacy and intentionality in making and holding boundaries for an individual's time and energy. Further, the individualized small group format of the activities allowed for deeper introspection and peer to peer connection. Conclusion: The identification of common themes within the Mayo Clinic program provides guidance to other academic environments on areas where they can support their early career scientists.
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Affiliation(s)
- Melissa M.B. Morrow
- Center for Health Promotion, Performance, and Rehabilitation Research, Department of Nutrition, Metabolism, and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
| | - Marissa J. Schafer
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Celine M. Vachon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
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Ratnakaran B, Hanafi S, Wobbe H, Howland M. Evolving Roles and Needs of Psychiatry Chief Residents During the COVID-19 Pandemic and Beyond. J Healthc Leadersh 2023; 15:95-101. [PMID: 37342310 PMCID: PMC10278644 DOI: 10.2147/jhl.s408556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023] Open
Abstract
Psychiatry chief residents have diverse leadership roles within psychiatry residency programs. Chief residents have historically been viewed as "middle managers", and other leadership roles include administrative work, teaching, and advocacy for residents. Chief residents also help in managing the logistics of complex healthcare systems and mediating between many groups with conflicting needs and perspectives. The COVID-19 pandemic has changed the functioning of psychiatry residency programs, and this has also led to the evolution of the roles of the chief residents in psychiatry. During the COVID-19 pandemic, the chief residents had to help with adapting to the changes in teaching and clinical work with residents and faculty. They had to liaison with various healthcare providers in making decisions related to COVID-19 in residency programs. Along with these changes, chief residents also had to advocate for the wellbeing and needs of their fellow residents. This perspective article is written by authors who have served during or after the transition to the COVID-19 pandemic. We discuss our experiences as chief residents as well as evolving roles and wellness needs of chief residents in psychiatry. Based on the administrative, advocacy, academic and middle management roles of chief residents in psychiatry and their wellbeing, we also make recommendations for support and interventions needed for chief residents in the context of the COVID-19 pandemic and beyond.
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Affiliation(s)
- Badr Ratnakaran
- Department of Psychiatry, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Sarah Hanafi
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Heather Wobbe
- Department of Psychiatry, Summa Health, Akron, OH, USA
| | - Molly Howland
- Department of Psychiatry, Cleveland Clinic, Cleveland, OH, USA
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Beaulieu-Jones BR, de Geus SWL, Rasic G, Woods AP, Papageorge MV, Sachs TE. COVID-19 Did Not Stop the Rising Tide: Trends in Case Volume Logged by Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2023; 80:499-510. [PMID: 36528544 PMCID: PMC9682049 DOI: 10.1016/j.jsurg.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The coronavirus pandemic has profoundly impacted all facets of surgical care, including surgical residency training. The objective of this study was to assess the operative experience and overall case volume of surgery residents before and during the pandemic. METHODS Using data from the Accreditation Council for Graduate Medical Education annual operative log reports, operative volume for 2015 to 2021 graduates of Accreditation Council for Graduate Medical Education -accredited general, orthopedic, neuro- and plastic surgery residency programs was analyzed using nonparametric Kendall-tau correlation analysis. The period before the pandemic was defined as AY14-15 to AY18-19, and the pandemic period was defined as AY19-20 to AY20-21. RESULTS Operative data for 8556 general, 5113 orthopedic, 736 plastic, and 1278 neurosurgery residency graduates were included. Between 2015 and 2021, total case volume increased significantly for general surgery graduates (Kendall's tau-b: 0.905, p = 0.007), orthopedic surgery graduates (Kendall's tau-b: 1.000, p = 0.003), neurosurgery graduates (Kendall's tau-b: 0.905, p = 0.007), and plastic surgery graduates (Kendall's tau-b: 0.810, p = 0.016). Across all specialties, the mean total number of cases performed by residents graduating during the pandemic was higher than among residents graduating before the pandemic, though no formal significance testing was performed. Among general surgery residents, the number of cases performed as surgeon chief among residents graduating in AY19-20 decreased for the first time in 5 years, though the overall volume remained higher than the prior year, and returned to prepandemic trends in AY20-21. CONCLUSIONS Over the past 7 years, the case volume of surgical residents steadily increased. Surgical trainees who graduated during the coronavirus pandemic have equal or greater total operative experience compared to trainees who graduated prior to the pandemic.
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Affiliation(s)
- Brendin R Beaulieu-Jones
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Susanna W L de Geus
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Alison P Woods
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marianna V Papageorge
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Teviah E Sachs
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
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Frich JC, Bratholm C, Ravnestad H, Friberg ML, Mjåset C, Kaarbøe OM. Medical leadership development during the COVID-19 pandemic. BMJ LEADER 2022; 6:316-318. [PMID: 36794602 DOI: 10.1136/leader-2021-000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/27/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND A leadership development programme (The Health Leadership School) was launched in 2018 for junior doctors and medical students in Norway. OBJECTIVE To study participants' experiences and self-assessed learning outcomes, and if there were any differences in outcome among participants who met face-to-face versus and those who had to complete half of the programme in a virtual classroom due to the COVID-19 pandemic. METHODS Participants who completed The Health Leadership School in 2018-2020 were invited to respond to a web-based questionnaire. RESULTS A total of 33 (83%) out of 40 participants responded. The majority of respondents (97%) somewhat agreed or strongly agreed that they had gained knowledge and skills they did not learn in medical school. Respondents reported a high learning outcome for most competency domains, and there was no difference in outcome when comparing scores of those who met face-to-face versus and those who had to complete half of the programme in a virtual classroom. Among participants who participated in virtual classroom sessions due to the COVID-19 pandemic, the majority agreed that the programme could be run as a combination of face-to-face and virtual sessions. CONCLUSION This brief report suggests that leadership development programmes for junior doctors and medical students can be run in-part using virtual classroom sessions, but that face-to-face sessions are important to foster relational and teamwork skills.
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Affiliation(s)
- Jan C Frich
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Clara Bratholm
- Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Håvard Ravnestad
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Morten L Friberg
- Department of Internal Medicine, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Oddvar M Kaarbøe
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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Tracy TF. In the Footsteps of Mixter: Leadership and Management at the Point of Surgical Care. J Am Coll Surg 2022; 234:1119-1126. [PMID: 35703809 DOI: 10.1097/xcs.0000000000000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Thomas F Tracy
- From Alpert Medical School, Brown University, Providence, RI
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Stoller JK. Emotional Intelligence: Leadership Essentials for Chest Medicine Professionals. Chest 2020; 159:1942-1948. [PMID: 32956713 DOI: 10.1016/j.chest.2020.09.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 11/29/2022] Open
Abstract
Emotional intelligence (EI) has become widely appreciated as an important leadership attribute, in business, education and, increasingly, in health care. Defined as "the capacity to understand your own and others' emotions and to motivate and develop yourself and others in service of improved work performance and enhanced organizational effectiveness," EI is correlated with a number of success attributes in several sectors; for example, in business, with enhanced business performance and enhanced personal career success, and in health care, with enhanced patient satisfaction, lower burnout, lower litigation risk, and enhanced leadership success. While multiple models of EI have evolved, perhaps the most popular model is framed around four general rubrics with component competencies. The general rubrics are: self-awareness, self-management, social awareness, and relationship management. EI can be measured by using available instruments, and it can be learned and taught. Indeed, teaching EI has become increasingly common in health-care organizations in service of improving health care and health-care leadership. Although more research is needed, ample evidence supports the notion that EI is a critical success element for success as a health-care leader, especially because EI competencies differ markedly from the clinical and scientific skills that are core to being a clinician and/or investigator. This review of EI presents evidence in support of the relevance of EI to health care and health-care leadership, discusses how and when EI can be developed among health-care providers, and considers remaining questions.
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Affiliation(s)
- James K Stoller
- Cleveland Clinic Lerner College of Medicine, Education and Respiratory Institutes, Cleveland, OH.
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