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Chiel L, Gans HA, Bales M, King S, Mason K, Schwartz A, Kesselheim J, Boyer D. A Pilot Survey on the Perceptions of Pediatric Subspecialty Fellows and Program Directors on Virtual Compared with In-Person Interview Experiences. J Pediatr 2024; 270:114019. [PMID: 38514003 DOI: 10.1016/j.jpeds.2024.114019] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/25/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
Pediatric fellowship programs have conducted virtual interviews since the start of the COVID-19 pandemic in 2020. In this national survey of fellowship program directors and fellows interviewed in-person and virtually, fellowship program directors and fellows formed accurate impressions, regardless of format, but our data did not clearly support one interview format over another.
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Affiliation(s)
- Laura Chiel
- Instructor, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Hayley A Gans
- Stanford University Medical Center, Department of Pediatrics, Center for Academic Medicine, Palo Alto, CA
| | - Melissa Bales
- Pediatric Subspecialty Program Coordinator, Department of Pediatric, Riley Hospital for Children at Indiana University School of Medicine, Indianapolis, IN
| | - Sarah King
- Director of Fellowship Programs, Department of Graduate Medical Education, Children's Mercy Kansas City, Kansas City, MO
| | - Katherine Mason
- Assistant Dean Faculty Development, Warren Alpert Medical School at Brown University, Vice Chair of Education, Department of Pediatrics, Providence, RI
| | - Alan Schwartz
- The Michael Reese Endowed Professor of Medical Education, Department of Medical Education, University of Illinois at Chicago, Chicago, IL; Research Professor, Department of Pediatrics, University of Illinois at Chicago, Chicago, IL; Director, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN), McLean, VA
| | - Jennifer Kesselheim
- Associate Professor and Designated Institutional Official, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Debra Boyer
- Designated Institutional Official and Chief Medical Education Officer, Nationwide Children's Hospital, Columbus, OH
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Kane SK, Wetzel EA, Niehaus JZ, Abu-Sultaneh S, Beardsly A, Bales M, Parsons D, Rowan CM. Development and Implementation of a Quick Response (QR) Code System to Streamline the Process for Fellows' Evaluation in the Pediatric Intensive Care Unit (PICU) and the Neonatal Intensive Care Unit (NICU) at a Large Academic Center. Cureus 2023; 15:e47462. [PMID: 38021709 PMCID: PMC10662199 DOI: 10.7759/cureus.47462] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND/OBJECTIVE Useful feedback and evaluation are critical to a medical trainee's development. While most academic physicians understand that giving feedback to learners is essential, many do not consider the components of feedback to be truly useful, and there are barriers to implementation. We sought to use a quick reader (QR) system to solicit feedback for trainees in two pediatric subspecialties (pediatric critical care and neonatal-perinatal medicine) at one institution to increase the quality and quantity of feedback received. METHODS New valuations were modified from the existing evaluations and imported into online systems with QR code capability. Each fellow was given a QR code linking to evaluations and encouraged to solicit feedback and evaluations in a variety of clinical settings and scenarios. Evaluation numbers and quality of evaluations were assessed and compared both pre- and post-intervention. RESULTS There were increases in the number of evaluations completed for both the pediatric critical care fellows and the neonatal-perinatal medicine fellows. There was no overall change in the quality of written evaluations received. Satisfaction with the evaluation system improved for both faculty and fellows of both training programs. CONCLUSION In our critical care units, we were successfully able to implement a QR code-driven evaluation for our fellows that improved access for the faculty and offered the ability of the learner to solicit evaluations, without compromising the number or quality of evaluations. What's new: Quick reader (QR) codes can be used by learners to solicit evaluations and feedback from faculty. They can increase the quantity of written evaluations received without affecting their quality.
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Affiliation(s)
- Sara K Kane
- Pediatrics/Neonatology, Indiana University School of Medicine, Indianapolis, USA
| | - Elizabeth A Wetzel
- Pediatrics/Neonatology, Indiana University School of Medicine, Indianapolis, USA
| | - Jason Z Niehaus
- Pediatrics/Neonatology, Indiana University School of Medicine, Indianapolis, USA
| | - Samer Abu-Sultaneh
- Pediatrics/Critical Care Medicine, Indiana University School of Medicine, Indianapolis, USA
| | - Andrew Beardsly
- Pediatrics/Critical Care Medicine, Indiana University School of Medicine, Indianapolis, USA
| | - Melissa Bales
- Pediatrics, Indiana University School of Medicine, Indianapolis, USA
| | - Deb Parsons
- Pediatrics, Indiana University School of Medicine, Indianapolis, USA
| | - Courtney M Rowan
- Pediatrics/Critical Care Medicine, Indiana University School of Medicine, Indianapolis, USA
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Gans HA, Boyer D, Bales M, Fussell J. National Pediatric Subspecialty Recruitment Sessions Increase Program Visibility and Impact Candidate Application Choices. J Grad Med Educ 2023; 15:399-400. [PMID: 37363682 PMCID: PMC10286917 DOI: 10.4300/jgme-d-22-00749.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Affiliation(s)
- Hayley A. Gans
- Clinical Professor, Pediatric Infectious Diseases, Department of Pediatrics, Stanford University Medical Center
| | - Debra Boyer
- Professor, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine
| | - Melissa Bales
- Program Coordinator, Department of Pediatrics, Indiana University School of Medicine
| | - Jill Fussell
- Professor, Department of Pediatrics, University of Arkansas for Medical Sciences
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Bales M, DeAlmeida K, Oei C, Hampton D, Bohr N. Quantifying Compassion Fatigue in Ancillary and Clinical Staff in an Adult Emergency Department. West J Emerg Med 2022; 23:841-845. [DOI: 10.5811/westjem.2022.8.57733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Emergency department (ED) staff are at a high risk for compassion fatigue (CF) due to a work environment that combines high patient acuity, violence, and other workplace stressors. This multifaceted syndrome has wide-ranging impacts which, if left untreated, can lead to adverse mental health conditions including depression, anxiety, and substance use disorders. However, the majority of studies examining CF look solely at clinicians; as a result, there is little information on the impact of CF across other roles involved in supporting patient care. We conducted this study to establish the prevalence of CF across both clinical and non-clinical roles in the adult ED setting.
Methods: For this single institution, cross-sectional study, all full- and part-time ED staff members who worked at least 50% of their shifts in the ED or within the adult trauma service line were eligible to participate. Using the Professional Quality of Life Scale, which measures CF via compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS), we assessed for group differences between roles using non-parametric one-way ANOVA.
Results: A total of 152 participants (response rate = 38.0%) completed the survey. This included attending physicians (n = 15, 9.7%), resident/fellow physicians (n = 23, 15.1%), staff nurses (n = 54, 35.5%), emergency technicians (n = 21, 13.8%), supportive clinical staff (n = 28, 18.4%), and supportive ancillary staff (n = 11, 7.2%). Across all roles, the majority of respondents had average levels of BO (median = 25.0, interquartile range [IQR] 20.0-29.0) and STS (median = 23.0, IQR 18.0-27.0) coupled with high levels of CS (median = 38.0, IQR 33.0-43.0). There was a difference in CS by role (P = .01), with nurses reporting lower CS than attending physicians. Secondary traumatic stress also differed by role (P = .01), with attending physicians reporting lower STS than both emergency technicians and nurses. Group differences were not seen in BO.
Conclusions: Rates of compassion fatigue subcomponents were similar across all ED team members, including non-clinical staff. Programs to identify and mitigate CF should be implemented and extended to all roles within the ED.
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Affiliation(s)
- Melissa Bales
- University of Chicago Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - Katelyn DeAlmeida
- University of Chicago Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - Courtney Oei
- University of Chicago Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - David Hampton
- University of Chicago Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - Nicole Bohr
- University of Chicago Medicine, Department of Emergency Medicine, Chicago, Illinois
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Van Der Waerden J, Sutter-Dallay A, Dugravier R, Bales M, Barandon S, Charles M, Bois C, Glangeaud N, Verdoux H, Melchior M. Dépression maternelle : facteurs de risque, conséquences sur le développement des enfants et interventions de prévention. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2015.09.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
La dépression maternelle en période périnatale est fréquente et peut avoir des répercussions négatives sur le développement des enfants. La prévention de la dépression chez les femmes qui ont des enfants en bas âge est donc un objectif de santé publique prioritaire. Ceci exige une bonne connaissance des facteurs associés à la dépression maternelle, des conséquences sur le développement des enfants, et des mesures préventives pouvant être efficaces. Cette session thématique abordera chacun de ces trois axes à partir de résultats récents d’études épidémiologiques et d’intervention menées en France (ELFE, EDEN, CAPEDP). Les facteurs associés à la dépression maternelle au cours de la grossesse et en post-partum, ainsi que l’accès à des interventions de prévention qui visent à prévenir les difficultés psychologiques des mères, telles que l’entretien prénatal précoce et les cours de préparation à la parentalité, ont pu être étudiés à partir des données de la cohorte ELFE, une étude représentative au niveau national. Les résultats montrent notamment que les femmes qui ont une situation sociale défavorisée ont des niveaux élevés de difficultés psychologiques, alors que ce sont celles qui bénéficient le moins des interventions de prévention. L’impact en termes de difficultés comportementales ou développementales chez les enfants a pu être étudié à partir des données de la cohorte EDEN montrant l’importance de différentes trajectoires longitudinales de dépression maternelle vis-à-vis du développement émotionnel, comportemental et cognitif des enfants jusqu’à 6 ans. Enfin, la faisabilité et l’efficacité d’interventions de prévention de la dépression maternelle seront discutées à partir des résultats de l’étude CAPEDP, un programme de visites à domicile chez des familles en situation difficile.
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Bales M, Pambrun E, Melchior M, Glangeaud-Freudenthal NC, Charles MA, Verdoux H, Sutter-Dallay AL. Prenatal Psychological Distress and Access to Mental Health Care in the ELFE Cohort. Eur Psychiatry 2020; 30:322-8. [DOI: 10.1016/j.eurpsy.2014.11.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/08/2014] [Accepted: 11/17/2014] [Indexed: 11/28/2022] Open
Abstract
AbstractBackground:Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care.Methods:We used data from the French cohort Étude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses.Results:Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad.Limitations:Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics.Conclusions:Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority.
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Gentile TR, Bales M, Arp U, Dong B, Farrell R. Response of large area avalanche photodiodes to low energy x rays. Rev Sci Instrum 2012; 83:053105. [PMID: 22667600 DOI: 10.1063/1.4714348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
For an experiment to study neutron radiative beta-decay, we operated large area avalanche photodiodes (APDs) near liquid nitrogen temperature to detect x rays with energies between 0.2 keV and 20 keV. Whereas there are numerous reports of x ray spectrometry using APDs at energies above 1 keV, operation near liquid nitrogen temperature allowed us to reach a nominal threshold of 0.1 keV. However, due to the short penetration depth of x rays below 1 keV, the pulse height spectrum of the APD become complex. We studied the response using monochromatic x ray beams and employed phenomenological fits of the pulse height spectrum to model the measurement of a continuum spectrum from a synchrotron. In addition, the measured pulse height spectrum was modelled using a profile for the variation in efficiency of collection of photoelectrons with depth into the APD. The best results are obtained with the collection efficiency model.
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Affiliation(s)
- T R Gentile
- Stop 8461, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, USA
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Affiliation(s)
- M Bales
- Bales Scientific Inc., Walnut Creek, CA, USA
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