Virtual interviewing in the MedPhys match: Experiences of applicants and programs.

PURPOSE: The purpose of this survey study is to compare the experiences of programs and applicants in the MedPhys Match (MPM) in the 2020-21 match cycle with experiences reported from previous match cycles. The 2020-21 match cycle was unique in that recruitment and interviewing were almost exclusively virtual during the COVID-19 pandemic. METHODS: A survey was sent to all applicants and programs registered for the 2020-21 MPM. Survey questions asked about the pre-interview screening, interview, ranking, and post-match stages of the residency match process. Survey data were analyzed using graphical methods and spreadsheet tools. RESULTS: Advantages and disadvantages to the virtual interviewing experience were reported by applicants and program directors (PDs). The advantages included reduced cost and greater scheduling flexibility with fewer scheduling conflicts, allowing applicants to consider more programs. These advantages greatly outweighed the disadvantages such as the inability to meet faculty/staff and current residents in person and gauge the feel of the program. PDs recognized the advantages of minimal costs and time savings for applicants. Programs reported it was difficult to convey workplace culture and the physical environment and to gauge personality and interpersonal skills of the applicants. CONCLUSION: The virtual interviewing environment for residency recruitment in medical physics is strongly preferred by applicants over required in-person interviews. The advantages identified by applicants outweigh the disadvantages, allowing applicants to feel confident in their ranking decisions and overall satisfied with their match results. PDs acknowledge the greater equity of access to interviews for applicants in the virtual environment, however, they are overall less satisfied with their ability to showcase their program's strengths and to assess the personality of applicants. Caution is urged when considering a hybrid interview model to ensure fair assessments that do not depend on whether an applicant chooses to accept an optional in-person interview or site visit.

The Recognition of Whispered Speech in Real-Time.

OBJECTIVES: Whispered speech offers a unique set of challenges to speech perception and word recognition. The goals of the present study were twofold: First, to determine how listeners recognize whispered speech. Second, to inform major theories of spoken word recognition by considering how recognition changes when major cues to phoneme identity are reduced or largely absent compared with normal voiced speech. DESIGN: Using eye tracking in the Visual World Paradigm, we examined how listeners recognize whispered speech. After hearing a target word (normal or whispered), participants selected the corresponding image from a display of four-a target (e.g., money), a word that shares sounds with the target at the beginning (cohort competitor, e.g., mother), a word that shares sounds with the target at the end (rhyme competitor, e.g., honey), and a phonologically unrelated word (e.g., whistle). Eye movements to each object were monitored to measure (1) how fast listeners process whispered speech, and (2) how strongly they consider lexical competitors (cohorts and rhymes) as the speech signal unfolds. RESULTS: Listeners were slower to recognize whispered words. Compared with normal speech, listeners displayed slower reaction times to click the target image, were slower to fixate the target, and fixated the target less overall. Further, we found clear evidence that the dynamics of lexical competition are altered during whispered speech recognition. Relative to normal speech, words that overlapped with the target at the beginning (cohorts) displayed slower, reduced, and delayed activation, whereas words that overlapped with the target at the end (rhymes) exhibited faster, more robust, and longer lasting activation. CONCLUSION: When listeners are confronted with whispered speech, they engage in a "wait-and-see" approach. Listeners delay lexical access, and by the time they begin to consider what word they are hearing, the beginning of the word has largely come and gone, and activation for cohorts is reduced. However, delays in lexical access actually increase consideration of rhyme competitors; the delay pushes lexical activation to a point later in processing, and the recognition system puts more weight on the word-final overlap between the target and the rhyme.

School-Age Children Adapt the Dynamics of Lexical Competition in Suboptimal Listening Conditions.

Although the ability to understand speech in adverse listening conditions is paramount for effective communication across the life span, little is understood about how this critical processing skill develops. This study asks how the dynamics of spoken word recognition (i.e., lexical access and competition) change during soft speech in 8- to 11-year-olds (n = 26). Lexical competition and access for speech at lower intensity levels was measured using eye-tracking and the visual world paradigm. Overall the results suggest that soft speech influences the magnitude and timing of lexical access and competition. These results suggest that lexical competition is a cognitive process that can be adapted in the school-age years to help cope with increased uncertainty due to alterations in the speech signal.

Visual and haptic responses as measures of word comprehension and speed of processing in toddlers: Relative predictive utility.

Early vocabulary knowledge and speed of word processing are important foundational skills for the development of preschool and school-age language and cognition. However, the variance in outcomes accounted for by parent-reported receptive or expressive vocabulary is generally modest. Recent research suggests that directly assessed, decontextualized vocabulary predicts developmental outcomes, including general language ability and kindergarten readiness, accounting for additional variance above and beyond parent-reported vocabulary. The current research extends this finding by exploring prediction from both decontextualized vocabulary and speed of word processing at 2 years of age to vocabulary during the preschool period. At age 2, children completed a two-alternative forced-choice task that yielded a measure of decontextualized vocabulary (number of correct touch responses) and two measures of speed of processing: latency to fixate the target (visual response latency) and latency to touch (haptic response latency). Results reveal that age 2 vocabulary and visual response latency, but not haptic response latency, independently predict vocabulary at ages 3 and 4. Furthermore, only decontextualized vocabulary remains a significant predictor when controlling for speed of processing, but not vice versa. This suggests that the number of early, stable word-referent associations and the efficiency with which these are processed are important to vocabulary outcomes. However, it also suggests that decontextualized vocabulary may be a more robust unique predictor of downstream outcomes.

MPLA Case 3: Don't criticize me in public!

This work of fiction re-enacts a scenario in which a medical physics resident was not able to address a physics call during patient simulation and was criticized by the supervising faculty physicist in front of the team and the patient. The resident and the faculty agreed to meet afterwards to debrief the situation, in the hope of establishing a better working relationship. The intended use of this case, through group discussion, self-study, or role-play, is to encourage readers to discuss the situation at hand, inspire professionalism and leadership thinking, and allow the practice of conflict management. Facilitator's notes are available upon request to the MPLA Cases Subcommittee. This case study falls under the scope of and is supported by the Medical Physics Leadership Academy (MPLA), a committee in the American Association of Physicists in Medicine (AAPM).

The MedPhys match survey: Search criteria and advice for programs and applicants.

PURPOSE: The purpose of this study was to gauge the experiences of applicants and program directors (PDs) in the Medical Physics (MedPhys) Match (MPM) and to determine the most important characteristics and factors that influence decision-making for applicants and programs when screening, interviewing, and ranking in the MPM. Opinions were also solicited from applicants and PDs on the status of medical physics residencies and the selection process, such as the availability of residency positions and satisfaction with the match process. METHODS: A survey was sent to all applicants registered for the 2015-2018 MPM and to all PDs registered for the 2015-2017 MPM. Survey questions asked about the pre-interview screening, interview, and ranking stages of the residency match process. Survey data were analyzed using graphical methods and spreadsheet tools. RESULTS: An increasing percentage of applicants are female and/or hold a PhD as their highest degree. The over all number of interview invitations per applicant has increased, leading some applicants to decline interviews with the top reasons being cost of travel and scheduling conflicts. The top considerations for applicants in ranking programs were residency program/institution reputation, program structure/organization, and facilities/equipment available. The primary considerations identified by PDs for ranking applicants included impressions from the interview, personality fit, and clinical potential. While two-thirds of applicants agreed or strongly agreed with the statement that a residency position was difficult to obtain, roughly one-third of PDs agree that the current residency placement rate is a problem. CONCLUSION: Four years of survey data on the experiences of applicants and PDs participating in the MPM is useful to future participants navigating the residency match system. It is hoped that the data will be helpful to inform improvements and to enhance understanding of the residency match system and how it shapes our profession.

AAPM medical physics practice guideline 3.b.: Levels of supervision for medical physicists in clinical training.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: (1) Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. (2) Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

The organization of words and environmental sounds in the second year: Behavioral and electrophysiological evidence.

The majority of research examining early auditory-semantic processing and organization is based on studies of meaningful relations between words and referents. However, a thorough investigation into the fundamental relation between acoustic signals and meaning requires an understanding of how meaning is associated with both lexical and non-lexical sounds. Indeed, it is unknown how meaningful auditory information that is not lexical (e.g., environmental sounds) is processed and organized in the young brain. To capture the structure of semantic organization for words and environmental sounds, we record event-related potentials as 20-month-olds view images of common nouns (e.g., dog) while hearing words or environmental sounds that match the picture (e.g., "dog" or barking), that are within-category violations (e.g., "cat" or meowing), or that are between-category violations (e.g., "pen" or scribbling). Results show both words and environmental sounds exhibit larger negative amplitudes to between-category violations relative to matches. Unlike words, which show a greater negative response early and consistently to within-category violations, such an effect for environmental sounds occurs late in semantic processing. Thus, as in adults, the young brain represents semantic relations between words and between environmental sounds, though it more readily differentiates semantically similar words compared to environmental sounds.

Assessing a continuum of lexical-semantic knowledge in the second year of life: A multimodal approach.

Behavioral dissociations in young children's visual and haptic responses have been taken as evidence that word knowledge is not all-or-none but instead exists on a continuum from absence of knowledge, to partial knowledge, to robust knowledge. This longitudinal study tested a group of 16- to 18-month-olds, 6months after their initial visit, to replicate results of partial understanding as shown by visual-haptic dissociations and to determine whether partial knowledge of word-referent relations can be leveraged for future word recognition. Results show that, like 16-month-olds, 22-month-olds demonstrate behavioral dissociations exhibited by rapid visual reaction times to a named referent but incorrect haptic responses. Furthermore, results suggest that partial word knowledge at one time predicts the degree to which that word will be understood in the future.

Ethical violations and discriminatory behavior in the MedPhys Match.

PURPOSE: The purpose of this survey study is to investigate behaviors in conflict with the ethical standards of the Medical Physics Residency (MedPhys) Match (MPM) process as stated in the MPM rules (a) and with the nondiscrimination regulations of the Equal Employment Opportunity Commission (EEOC) (b), in addition to other behaviors that may in other ways erode the fairness of the system. METHODS: A survey was sent to all applicants and program directors registered for the 2015 and 2016 MPM. Survey questions asked about application, interview, and postinterview experiences, match results, and overall satisfaction with the process. RESULTS: Thirteen percent of 2015 respondents and 20% of 2016 respondents were asked by at least one program how highly they planned to rank them or which program they would rank first. Thirty-seven percent of 2015 and 40% of 2016 program directors indicated that candidates communicated to the program their rank intent, with 22.0% in 2015 and 12.5% in 2016 being told that their program would be ranked first. Twenty-three percent of 2015 respondents indicated being asked by at least one program during the interview about children or plans to have children; including 19% of males and 33% of females. In 2016, these values were 28% overall, 22% male, and 36% female. Fifty-seven percent of 2015 respondents who were asked this question indicated being uncomfortable or very uncomfortable answering, including 27.3% of males and 88.9% of females. In 2016, 42.9% of all respondents indicated being uncomfortable or very uncomfortable answering, including 10.0% of males and 80.0% of females. CONCLUSIONS: In the first two years of the MPM, there were widespread instances of ethical violations and discriminatory questioning during the interview process. Educating both interviewers and candidates on the MPM rules and general EEOC guidelines should decrease these instances and increase the fairness of the residency selection process.

A patient safety education program in a medical physics residency.

Education in patient safety and quality of care is a requirement for radiation oncology residency programs according to accrediting agencies. However, recent surveys indicate that most programs lack a formal program to support this learning. The aim of this report was to address this gap and share experiences with a structured educational program on quality and safety designed specifically for medical physics therapy residencies. Five key topic areas were identified, drawn from published recommendations on safety and quality. A didactic component was developed, which includes an extensive reading list supported by a series of lectures. This was coupled with practice-based learning which includes one project, for example, failure modes and effect analysis exercise, and also continued participation in the departmental incident learning system including a root-cause analysis exercise. Performance was evaluated through quizzes, presentations, and reports. Over the period of 2014-2016, five medical physics residents successfully completed the program. Evaluations indicated that the residents had a positive experience. In addition to educating physics residents this program may be adapted for medical physics graduate programs or certificate programs, radiation oncology residencies, or as a self-directed educational project for practicing physicists. Future directions might include a system that coordinates between medical training centers such as a resident exchange program.

Navigating the medical physics education and training landscape.

PURPOSE: The education and training landscape has been profoundly reshaped by the ABR 2012/2014 initiative and the MedPhys Match. This work quantifies these changes and summarizes available reports, surveys, and statistics on education and training. METHODS: We evaluate data from CAMPEP-accredited program websites, annual CAMPEP graduate and residency program reports, and surveys on the MedPhys Match and Professional Doctorate degree (DMP). RESULTS: From 2009-2015, the number of graduates from CAMPEP-accredited graduate programs rose from 210 to 332, while CAMPEP-accredited residency positions rose from 60 to 134. We estimate that approximately 60% of graduates of CAMPEP-accredited graduate programs intend to enter clinical practice, however, only 36% of graduates were successful in acquiring a residency position in 2015. The maximum residency placement percentage for a graduate program is 70%, while the median for all programs is only 22%. Overall residency placement percentage for CAMPEP-accredited program graduates from 2011-2015 was approximately 38% and 25% for those with a PhD and MS, respectively. The disparity between the number of clinically oriented graduates and available residency positions is perceived as a significant problem by over 70% of MedPhys Match participants responding to a post-match survey. Approximately 32% of these respondents indicated that prior knowledge of this situation would have changed their decision to pursue graduate education in medical physics. CONCLUSION: These data reveal a substantial disparity between the number of residency training positions and graduate students interested in these positions, and a substantial variability in residency placement percentage across graduate programs. Comprehensive data regarding current and projected supply and demand within the medical physics workforce are needed for perspective on these numbers. While the long-term effects of changes in the education and training infrastructure are still unclear, available survey data suggest that these changes could negatively affect potential entrants to the profession.

Fourteen-month-olds' decontextualized understanding of words for absent objects.

The majority of research examining infants' decontextualized word knowledge comes from studies in which words and pictures are presented simultaneously. However, comprehending utterances about unseen objects is a hallmark of language. Do infants demonstrate decontextualized absent object knowledge early in the second year of life? Further, to what extent do words evoke strictly prototypical representations of absent objects? To investigate these questions we analyzed 14-month-olds' comprehension of labels for absent entities without contextual support. In a novel, auditory-visual priming paradigm, infants heard passages containing two target words and then saw four animations - two that matched the meaning of the target words and two they had not heard in the passages. We found that by age 1;2, spoken words evoke prototypical representations of absent entities. Additionally, our findings demonstrate a promising new method for exploring absent object comprehension in infants.

Electron beam energy QA - a note on measurement tolerances.

Monthly QA is recommended to verify the constancy of high-energy electron beams generated for clinical use by linear accelerators. The tolerances are defined as 2%/2 mm in beam penetration according to AAPM task group report 142. The practical implementation is typically achieved by measuring the ratio of readings at two different depths, preferably near the depth of maximum dose and at the depth corresponding to half the dose maximum. Based on beam commissioning data, we show that the relationship between the ranges of energy ratios for different electron energies is highly nonlinear. We provide a formalism that translates measurement deviations in the reference ratios into change in beam penetration for electron energies for six Elekta (6-18 MeV) and eight Varian (6-22 MeV) electron beams. Experimental checks were conducted for each Elekta energy to compare calculated values with measurements, and it was shown that they are in agreement. For example, for a 6 MeV beam a deviation in the measured ionization ratio of ± 15% might still be acceptable (i.e., be within ± 2 mm), whereas for an 18 MeV beam the corresponding tolerance might be ± 6%. These values strongly depend on the initial ratio chosen. In summary, the relationship between differences of the ionization ratio and the corresponding beam energy are derived. The findings can be translated into acceptable tolerance values for monthly QA of electron beam energies.

Looking and touching: what extant approaches reveal about the structure of early word knowledge.

The goal of the current study is to assess the temporal dynamics of vision and action to evaluate the underlying word representations that guide infants' responses. Sixteen-month-old infants participated in a two-alternative forced-choice word-picture matching task. We conducted a moment-by-moment analysis of looking and reaching behaviors as they occurred in tandem to assess the speed with which a prompted word was processed (visual reaction time) as a function of the type of haptic response: Target, Distractor, or No Touch. Visual reaction times (visual RTs) were significantly slower during No Touches compared to Distractor and Target Touches, which were statistically indistinguishable. The finding that visual RTs were significantly faster during Distractor Touches compared to No Touches suggests that incorrect and absent haptic responses appear to index distinct knowledge states: incorrect responses are associated with partial knowledge whereas absent responses appear to reflect a true failure to map lexical items to their target referents. Further, we found that those children who were faster at processing words were also those children who exhibited better haptic performance. This research provides a methodological clarification on knowledge measured by the visual and haptic modalities and new evidence for a continuum of word knowledge in the second year of life.

Speech Sound Categories Affect Lexical Competition: Implications for Analytic Auditory Training.

OBJECTIVES: We provide a novel application of psycholinguistic theories and methods to the field of auditory training to provide preliminary data regarding which minimal pair contrasts are more difficult for listeners with typical hearing to distinguish in real-time. DESIGN: Using eye-tracking, participants heard a word and selected the corresponding image from a display of four: the target word, two unrelated words, and a word from one of four contrast categories (i.e., voiced-initial [e.g., peach-beach], voiced-final [e.g., back-bag], manner-initial [e.g., talk-sock], and manner-final [e.g., bat-bass]). RESULTS: Fixations were monitored to measure how strongly words compete for recognition depending on the contrast type (voicing, manner) and location (word-initial or final). Manner contrasts competed more for recognition than did voicing contrasts, and contrasts that occurred in word-final position were harder to distinguish than word-initial position. CONCLUSION: These results are an important initial step toward creating an evidence-based hierarchy for auditory training for individuals who use cochlear implants.

Inhibition of lexical representations after violated semantic predictions.

There is a consensus that humans predict upcoming words during sentence processing. Prediction makes language comprehension fast and efficient if this anticipatory processing is accurate. However, often times, predictions are not correct. There is a lack of research investigating the cognitive operations at play when predictions are violated. According to several proposals, such violations lead to an inhibition of the predicted word to facilitate the integration of the unexpected word. Across four experiments, we have tested whether predicted words are indeed inhibited when listeners encounter unexpected stimuli, and whether the linguistic status (word or sound) and semantic congruency of a word (plausible or implausible) influences this purported inhibitory process. Using a Cross-Modal Lexical Priming paradigm, we showed that when predictions are violated, the activation of the predicted word is inhibited, resulting in increased reaction times. These inhibitory effects appear to be language specific, in that they are only observed after unexpected words, as opposed to non-linguistic sounds (tones). However, contrary to a long-held assumption in the field of sentence processing, inhibitory effects are not modulated by the semantic congruency of the unexpected word (i.e., whether the unexpected word is plausible within the sentence context). Indeed, in the current study, any linguistic information that violated listeners' semantic prediction resulted in the inhibition of the predicted word. Thus, the current findings are more compatible with a view in which unexpected linguistic events that are meaningful engage inhibitory processes with the specific purpose of inhibiting the predicted, though out-of-date, word.

2021 AAPM Equity, Diversity, and Inclusion Climate Survey Executive Summary.

PURPOSE: The American Association of Physicists in Medicine (AAPM) shares the results, conclusions, and recommendations from the initial Equity, Diversity, and Inclusion Climate Survey conducted in 2021. METHODS AND MATERIALS: The climate survey targeted medical physicists who are full members of the AAPM and included demographic inquiries and questions intended to assess the working environmental climate in terms of a sense of belonging and inclusion, experiences of discrimination and harassment, and obstacles to participation within the AAPM. The survey invitation was sent to 5,500 members. Responses were collected from 1385 members (response rate of 25%) between January and February 2021. RESULTS: Overall, the medical physics workplace climate was positive. However, some demographic and professional subgroups reported lower levels of agreement with positive characteristics of their workplace climates. Compared with men, women ranked lower 7 of 8 categories that characterized the workplace climate. Other subgroups that also ranked the workplace climate descriptors lower included individuals not originally from the United States and Canada (3/8). Most respondents strongly agreed/agreed that the climate within the AAPM was welcoming. However, 17% of respondents reported personally experiencing or witnessing microaggressions within the AAPM. Overall, medical physicists reported low levels of agreement that opportunities within the AAPM were available to them, from 34% to 60% among 8 categories, including opportunities to volunteer, join committees, and compete for leadership positions within the AAPM. Several subgroups reported even lower levels of agreement that these opportunities are available. Asian and Asian American respondents (3/8) and physicists with origins in countries outside the United States and Canada (7/8) reported fewer opportunities to participate in the AAPM. Medical physicists reported their experiences of discrimination and sexual harassment in their workplaces and within the AAPM. For those who reported personal experiences of sexual harassment, only 24% (15/63) felt comfortable reporting when it occurred within their workplaces, and 35% (9/26) felt comfortable reporting when it occurred within the AAPM. CONCLUSIONS: The report concludes with several recommendations for action.

A First Look at Equity, Diversity, and Inclusion of Canadian Medical Physicists: Results From the 2021 COMP EDI Climate Survey.

PURPOSE: In 2021, the Canadian Organization of Medical Physicists (COMP) conducted its first equity, diversity, and inclusion Climate Survey. The membership's experiences of inclusion, belonging, professional opportunities, discrimination, microaggressions, racism, and harassment in their professional lives are presented. METHODS AND MATERIALS: The ethics-reviewed survey was distributed in English and French to full members of COMP. Participants responded to questions covering demographics and professional climate. Simple descriptive statistics were used to measure frequency of responses. Data pertaining to impressions on the climate within the profession were compared using nonparametric statistical tests. RESULTS: The survey was distributed to 649 eligible members; 243 (37%) responded, and 214 (33%) provided full response sets. From the full response sets, findings showed that in general, age, highest academic degree, and racial and ethnic distribution trends of medical physicists were comparable with previously collected data and/or the Canadian population. The experiences of respondents relating to harassment in the workplace and perception of climate are reported and provide a useful benchmark for future assessments of interventions or training programs. In the workplace, fewer women (58%) reported having professional opportunities compared with men (70%). The survey also found that 17% of respondents (most of whom were women) directly or indirectly experienced sexual harassment in the workplace within the past 5 years. Finding that 23% of survey respondents identified as having a disability is a valuable reminder that accommodations in the workplace are necessary for more than 1 in every 5 medical physicists working in clinics. CONCLUSIONS: This study provided insight into the diversity and experiences of medical physicists in Canada. The majority of respondents had positive perceptions about their professional environment. However, equity-lacking groups were identified, such as women, underrepresented minorities, Indigenous peoples, and people with visible and invisible disabilities.