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OBJECTIVE: Trainees and Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) work in complex interpersonal and organisational environments. Engagement in supervision can be a helpful way for trainees and Fellows to achieve interpersonal, professional, and organisational success. Supervision comes in many forms depending on the stage and state of one's career. An awareness of different supervision models is relevant to trainees' understanding of what is expected of them and their supervisors in their work and educational contexts. This paper explores the taxonomy of supervision models available to RANZCP trainees and Fellows in Australia and New Zealand. CONCLUSION: Supervision is a heterogeneous concept with multiple aims, outcomes, and processes that change with ones' stage of career.
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Bolsas de Estudo , Psiquiatria , Humanos , Nova Zelândia , Psiquiatria/educação , Austrália , Bolsas de Estudo/organização & administração , Sociedades Médicas/organização & administraçãoAssuntos
Emprego , Bolsas de Estudo , Direitos Humanos , Internato e Residência , Sindicatos , Médicos , Emprego/organização & administração , Emprego/normas , Bolsas de Estudo/organização & administração , Bolsas de Estudo/normas , Direitos Humanos/normas , Humanos , Internato e Residência/organização & administração , Internato e Residência/normas , Sindicatos/organização & administração , Médicos/organização & administração , Médicos/normas , Estados UnidosRESUMO
BACKGROUND: An endoscopist's adenoma detection rate (ADR) is inversely related to interval colorectal cancer risk and cancer mortality. Previous studies evaluating the impact of gastroenterology fellow participation in colonoscopy on ADR have generated conflicting results. AIMS: We aimed to determine the impact of fellow participation, duration of fellowship training, and physician sex on ADR and advanced ADR (AADR). METHODS: We retrospectively analyzed average-risk patients undergoing screening colonoscopy at Veterans Affairs New York Harbor Healthcare System Brooklyn Campus and Kings County Hospital Center. Review of colonoscopy and pathology reports were performed to obtain adenoma-specific details, including the presence of advanced adenoma and adenoma location (right vs. left colon). RESULTS: There were 893 colonoscopies performed by attending only and 502 performed with fellow participation. Fellow participation improved overall ADR (44.6% vs. 35.4%, p < 0.001), right-sided ADR (34.1% vs. 25.2%, p < 0.001), and AADR (15.3% vs. 8.3%, p < 0.001); however, these findings were institution-specific. Year of fellowship training did not impact overall ADR or overall AADR, but did significantly improve right-sided AADR (p-value for trend 0.03). Female attending physicians were associated with increased ADR (47.1% vs. 37.0%, p = 0.0037). Fellow sex did not impact ADR. CONCLUSIONS: Fellow participation in colonoscopy improved overall ADR and AADR, and female attending physicians were associated with improved ADR. Year of fellowship training did not impact overall ADR or AADR.
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Adenoma , Pólipos do Colo , Colonoscopia/métodos , Neoplasias Colorretais , Bolsas de Estudo , Gastroenterologia , Ensino , Adenoma/diagnóstico , Adenoma/epidemiologia , Adenoma/cirurgia , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Pólipos do Colo/cirurgia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/métodos , Educação/métodos , Educação/estatística & dados numéricos , Bolsas de Estudo/métodos , Bolsas de Estudo/organização & administração , Bolsas de Estudo/estatística & dados numéricos , Feminino , Gastroenterologia/educação , Gastroenterologia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Ensino/organização & administração , Ensino/estatística & dados numéricos , Estados UnidosRESUMO
Editor's note: Sigma Theta Tau International Honor Society of Nursing is a global organization focused on leadership and scholarship, with more than 135,000 members from over 100 countries. This first article in a series highlights why global nursing should matter to U.S. nurses and offers an overview of organizations within the global nursing community.
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Bolsas de Estudo/organização & administração , Internacionalidade , Liderança , Papel do Profissional de Enfermagem , Sociedades de Enfermagem/organização & administração , Saúde Global , Humanos , Relações InterprofissionaisAssuntos
Pesquisa Biomédica/organização & administração , Bolsas de Estudo/organização & administração , Equidade de Gênero/estatística & dados numéricos , Internato e Residência/organização & administração , Cirurgia Plástica/educação , Pesquisa Biomédica/economia , Pesquisa Biomédica/estatística & dados numéricos , Bases de Dados Factuais , Bolsas de Estudo/economia , Bolsas de Estudo/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/economia , Internato e Residência/estatística & dados numéricos , Masculino , Cirurgia Plástica/economia , Inquéritos e Questionários/estatística & dados numéricosRESUMO
BACKGROUND: Non-technical skills (NTS) curricula have demonstrated success in surgical residencies. The purpose of this study is to examine the need for a structured leadership curriculum at our institution. METHODS: A needs-assessment survey analyzing the importance of leadership domains, previously validated by Kazley et al. was delivered to 240 general surgery staff. Respondent groups were broken down into: Attendings, Residents, and Multi-Disciplinary. Statistical analyses were conducted using Cronbach's Alpha (α = 0.9259) and Fisher's exact test (pre-set p-value = 0.05). The importance of each competency was compared among groups and importance was defined as >75% important and very important responses. RESULTS: Nineteen of 33 competencies were important for all groups, including 3 with 100% importance: interpersonal communication, team-work, and problem-solving. Several competencies showed statistically significant differences among groups. CONCLUSION: A diverse range of surgery staff agreed that 19 leadership domains are important to teach residents, with some variance among respondent groups.
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Currículo , Bolsas de Estudo , Cirurgia Geral/educação , Internato e Residência , Liderança , Avaliação das Necessidades , Competência Clínica/normas , Bolsas de Estudo/métodos , Bolsas de Estudo/organização & administração , Humanos , Internato e Residência/métodos , Internato e Residência/organização & administraçãoRESUMO
The AONL Nurse Executive Fellowship supports nurses who are new to an executive role in developing critical executive competencies. Participants engage in an in-depth specialized assessment process to help them understand themselves and the impact on their leadership. Learnings from the 1st 2 cohorts of fellowship participants provide insight into challenges faced by new executives and how self-awareness can improve performance to address those challenges.
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Educação Continuada em Enfermagem/métodos , Bolsas de Estudo/organização & administração , Liderança , Enfermeiros Administradores/educação , Humanos , Descrição de Cargo , Mentores , Enfermeiros Administradores/organização & administração , Papel do Profissional de Enfermagem , Pesquisa Metodológica em Enfermagem , Cultura Organizacional , Estados UnidosRESUMO
BACKGROUND: Pediatric orthopaedic fellowship directors (FDs) have a valuable impact on the education of trainees and future leaders in the field. There is currently no research on the characteristics of pediatric orthopaedic FDs. METHODS: Programs were identified using the Pediatric Orthopaedic Society of North America fellowship directory. Operative, nonoperative, and specialty programs were included. Data was collected through Qualtrics survey, e-mail, telephone, and online searches. Variables included demographics (age, sex, race/ethnicity), Hirsch index (h-index) as a measure of research productivity, graduate education, residency and fellowship training, years of hire at current institution and as FD, and leadership roles. RESULTS: Fifty-five FDs were identified. The majority (49/55, 89%) were male and 77% (27/35) were Caucasian. The mean age at survey was 51.1±8.2 years. The mean h-index was 17.2. Older age correlated with higher h-index (r=0.48, P=0.0002). The average duration from fellowship graduation to FD appointment was 9.6±6.7 and 6.9±6.1 years from institutional hire. Sixteen FDs (29%) had additional graduate level degrees. Almost all (52/55, 95%) FDs completed orthopaedic surgery residencies and all graduated fellowship training. Twenty-nine percent (16/55) completed more than 1 fellowship. Most FDs (51/55, 93%) completed a fellowship in pediatric orthopaedic surgery. Ten FDs (18%) completed pediatric orthopaedic surgery fellowships that included spine-specific training. One-third of all current FDs were fellowship-trained at either Boston Children's Hospital (9/55, 16%) or Texas Scottish Rite Hospital for Children (9/55, 16%). CONCLUSIONS: Pediatric orthopaedic FDs are typically early-career to mid-career when appointed, with a strong research background. Nearly a third completed additional graduate degrees or multiple fellowships. Although male dominated, there are more female FDs leading pediatric orthopaedic programs compared with adult reconstruction, trauma, and spine fellowships. As fellowships continue to grow and diversify, this research will provide a baseline to determine changes in FD leadership.
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Bolsas de Estudo/organização & administração , Liderança , Ortopedia/educação , Pediatria/educação , Diretores Médicos/estatística & dados numéricos , Adulto , Educação de Pós-Graduação em Medicina , Escolaridade , Feminino , Humanos , Internato e Residência , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , População Branca/estatística & dados numéricosRESUMO
BACKGROUND AND OBJECTIVES: Scholarship is recognized as a challenge in many family medicine residency programs. Among evaluations of scholarship curricula, few describe resident experiences of such interventions. To bridge this gap in knowledge, we measured resident confidence, satisfaction, and participation before and after implementing a new scholarship curriculum. METHODS: The redesigned curriculum included a structured project timeline, resident research in progress meetings, faculty mentorship, scholarly skills workshops, and mentored journal clubs. We conducted a curriculum evaluation via surveys of residents prior to implementation and after years 1 and 2, measuring satisfaction with the scholarly environment and opportunities, and confidence and participation in specific scholarly activities using Likert scales from 1 (least confidence) to 5. RESULTS: Compared to baseline (n=28), after 2 years (n=27) of the curriculum, residents reported increased mean confidence in critical appraisal of scientific articles (2.6±1.1 to 3.3±0.7, P=.007), carrying out a scholarly project (2.5±0.8 to 3.4±1.0, P=.005), and writing an abstract (3.0±0.8 to 3.8±0.7, P=.002). As compared to the first year, more residents in the second year participated in quality improvement projects (7.1% vs 29.6%, P=.031) and wrote conference abstracts (10.7% vs 37.0%, P=.022). Over the same period, those very satisfied with the scholarly environment increased from 0 (0%) to 8 (29.6%, P=.017). The June 2020 survey identified increased interest in scholarship because of the antiracism movement (51.9%) and COVID-19 pandemic (40.7%). CONCLUSIONS: Implementation of a redesigned scholarship curriculum was associated with increases in family medicine resident scholarship confidence and satisfaction.
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Educação de Pós-Graduação em Medicina/organização & administração , Medicina de Família e Comunidade/educação , Bolsas de Estudo/organização & administração , Internato e Residência/organização & administração , Competência Profissional , Pesquisa Biomédica/estatística & dados numéricos , Currículo , Humanos , Avaliação de Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de SaúdeRESUMO
OBJECTIVE: To evaluate the experience and perceptions of reproductive endocrinology and infertility fellowship applicants and program directors (PDs) regarding the current and future use of web-based interviews (WBIs). DESIGN: Cross-sectional study. SETTING: Nationwide cohort. PATIENT(S): Reproductive endocrinology and infertility fellowship applicants and PDs participating in the 2020 application cycle. INTERVENTION(S): Anonymous survey sent to applicants and PDs. MAIN OUTCOME MEASURE(S): Descriptive study evaluating the experience and satisfaction of applicants and PDs with WBIs. RESULT(S): Forty-six percent of applicants and eligible PDs responded to our survey. Most applicants and PDs responded that WBIs were adequate for conveying a sense of a program's strengths, faculty, diversity, clinical training, and research opportunities, but less than half responded that WBIs were adequate in providing a sense of the program's clinical site and facilities. After WBIs, both applicants (73%) and PDs (86%) were able to rank with confidence. The cost of WBIs was significantly lower for both applicants (median: $100) and programs (median: $100) than the costs previously reported for in-person interviews. The applicants interviewed at more programs than they would have if the interviews were on-site, and Zoom was the highest rated platform used. Most applicants and PDs responded that WBIs were an adequate substitute, and that they should continue after the coronavirus disease 2019 pandemic. Furthermore, most of the PDs were planning to continue to use WBIs in some capacity. CONCLUSION(S): Both applicants and PDs had favorable experiences with and perceptions of WBIs, and most endorse the continued use of this interview modality. The findings of this study can help guide and optimize future WBI practices.
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Endocrinologia/organização & administração , Bolsas de Estudo/organização & administração , Entrevistas como Assunto/métodos , Médicos/psicologia , Medicina Reprodutiva/organização & administração , Adulto , COVID-19/epidemiologia , Estudos Transversais , Endocrinologia/educação , Endocrinologia/métodos , Bolsas de Estudo/métodos , Feminino , Humanos , Infertilidade/terapia , Internet , Internato e Residência/métodos , Internato e Residência/organização & administração , Relações Interpessoais , Entrevistas como Assunto/estatística & dados numéricos , Candidatura a Emprego , Masculino , Pessoa de Meia-Idade , Pandemias , Percepção , Satisfação Pessoal , Médicos/estatística & dados numéricos , Medicina Reprodutiva/educação , Medicina Reprodutiva/métodos , SARS-CoV-2 , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The global burden of disease treatable by surgical subspecialists remains an outstanding area of need, and yet little is known about the subspecialist workforce worldwide, especially in sub-Saharan Africa. This study aims to quantify the subspecialty surgical workforce and number of subspecialty training programs in West Africa and to identify socioeconomic factors predicting the number of subspecialists in West African countries. METHODS: West African subspecialists and accredited fellowship training programs in 17 West African countries were quantified using membership data from the West African College of Surgeons and compared with publicly available workforce data from the United States, the United Kingdom, and East, Central, and Southern Africa. Spearman's coefficients were calculated to identify socioeconomic predictors of subspecialist surgical workforce. RESULTS: Of 2,181 surgeons, 712 (32.6%) were surgical subspecialists. Three (18%) of 17 West African countries had greater than 11 subspecialists. There were 174 subspecialty training programs in the region, though 13 countries (76%) had no programs. The number of subspecialists correlated most strongly with the number of subspecialty training programs (rS = 0.68, P = .003) but also correlated significantly with gross population and number of medical schools (rS = 0.50-0.52, P ≤ .05). CONCLUSION: Subspecialist surgeons represent one third of surgeons in West Africa, though most countries have fewer than 12 providers. The number of subspecialists is significantly correlated with the number of subspecialty training programs, and yet many West African countries lack accredited programs. These results suggest that investing in training programs is the most valuable potential strategy to address the shortage of surgical subspecialists in West Africa.
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Educação de Pós-Graduação em Medicina/organização & administração , Bolsas de Estudo/organização & administração , Especialidades Cirúrgicas/educação , Especialidades Cirúrgicas/organização & administração , Cirurgiões/provisão & distribuição , África Ocidental , Humanos , Fatores SocioeconômicosAssuntos
Licença para Cuidar de Pessoa da Família/legislação & jurisprudência , Bolsas de Estudo/organização & administração , Internato e Residência/organização & administração , Formulação de Políticas , Salários e Benefícios/legislação & jurisprudência , Direitos Civis/legislação & jurisprudência , Feminino , Humanos , Internato e Residência/economia , Masculino , Gravidez , Estados UnidosRESUMO
The authors conducted a scoping review to investigate the structure, content, and potential impact of post-residency medical education fellowships. The authors searched eight databases to identify English-language articles describing longitudinal, post-residency medical fellowships that both focused on medical education and described the structure and content of the curriculum. The authors summarized the findings of each article and, for those articles that included a program evaluation, assessed the potential impact of the program via the Kirkpatrick's Four-Level Training Evaluation Model and the Medical Education Research Study Quality Instrument. Nine articles, describing a total of ten post-residency medical education fellowships, met inclusion criteria. Half of the programs were dedicated medical education fellowships and half were medical education tracks within a subspecialty fellowship. The content and educational strategies varied, with no two programs having the same curriculum. Most programs most focused on teaching skills, adult learning theory, curricular development, and medical education research/scholarship. Most programs used project-based learning, workshops, and faculty mentorship as educational strategies. Six of the articles included an evaluation of their program(s), all of which suggested positive changes, at least at the level of fellow behavior (Kirkpatrick level 3), and designs limited the strength of any conclusions drawn. This scoping review highlights the variation among medical education fellowships and the need for common curricular components, as well as program evaluation, across and within these fellowships. Additional assessment at higher levels of trainee outcomes will help guide the creation and revision of medical education fellowships, and inform the development of a core curriculum shared across programs. Such a core curriculum could then serve as the foundation for a certification program, by which a medical educator's expertise could be recognized, thus elevating medical education to the stature it deserves within the academic mission.
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Bolsas de Estudo/organização & administração , Internato e Residência/organização & administração , Pesquisa Biomédica/educação , Currículo , Educação Médica/organização & administração , Educação de Pós-Graduação em Medicina , Docentes de Medicina/organização & administração , Humanos , Aprendizagem , Tutoria/organização & administração , Aprendizagem Baseada em Problemas , Avaliação de Programas e Projetos de Saúde , EspecializaçãoRESUMO
I begin with my impressions of a narrative of redemption that is caught up in the formation of new environmental, social, and political aspirations for the aftermath of the COVID-19 pandemic. I then reflect on, first, pre-pandemic scholarship on "biosecurity" and, second, taking up a variation of the syndemic approach to understanding the COVID-19 pandemic. I end by arguing that we should not expect to live with "new normals" for living in a post-COVID-19 world that leaves intact "old normals" that have historically contributed to the rise of anthropogenic environmental harms and inegalitarian social arrangements in the world today.