Investigating Canadian Radiology Residents' Personal Financial Literacy: A Nation-Wide Assessment.

Purpose: Canadian resident physicians carry large debt to finance their education, which impacts their wellness and their future decision making. The objective of this observational study is to assess the financial literacy of Canadian radiology residents through testing their financial knowledge and examining their current financial status. Methods: A survey was designed to assess the financial literacy and current financial status of radiology residents, which was distributed to Canadian radiology residents via Google Forms. Descriptive analyses on preliminary data and the association between level of training and financial quiz scores were obtained. Results: 104 valid responses from 16 universities were received. The majority (53%) of residents indicated that their debt was greater than $150 000. Residents on average scored 71% on the financial quiz and the scores were not associated with training level (P = .71). The majority (89%) of residents indicated a strong interest in a formal financial literacy curriculum, with 80% preferring a physician-led curriculum. Conclusion: Overall, residents face a high debt burden. Current resident physicians value a formal financial literacy curriculum as a part of their residency program despite existing financial knowledge. Most importantly, residents feel that a curriculum created with involvement of other physicians would be optimal.

Diversity, Equity, and Inclusion in Orthopaedic Surgery: Local and National Efforts.

Orthopaedic surgery has not experienced the same increase in diversity as other surgical subspecialties over time. Professional orthopaedic societies across the nation, including the American Academy of Orthopaedic Surgeons, are now making sincere efforts to improve diversity, equity, and inclusion (DEI) within the field. Several national groups provide funding to support DEI -related research as well as scholarships to national meetings. Others are more focused on mentorship and mitigation of residency attrition amongst underrepresented minorities (URMs). Individual residency programs, including the Department of Orthopaedics at Brown University, are engaging in community outreach to attract more diverse candidates to orthopaedics and providing away rotation scholarship support for medical students that identify as female or URMs. These local and national efforts will hopefully lead to a more inclusive environment for all trainees and practitioners within orthopaedics and ultimately improved orthopaedic care for all patients.

Content validation of needs assessment survey for remote education initiative in Tanzania.

Background: Historically, educational initiatives in global health have involved expert lectures by visitors. However, incomplete understanding of the target population and resources can limit the efficacy of lectures by international faculty. Little data exists on the magnitude of this problem. The goal of this study was to create and validate a needs assessment tool to guide lecture development as part of a larger study to implement virtual lectures for a residency program in Tanzania by members of an American faculty. Methods: Two study authors familiar with the Tanzanian hospital and residency program derived surveys for local residents and faculty. An expert panel consisting of two faculty members and one resident from each institution evaluated the questions. Each item was rated from 1 to 4 for clarity and relevance respectively. A content validity index (CVI) was calculated for each item using the proportion of experts who rated it as valid. Items with a CVI < 0.8 were revised and resubmitted. A CVI was then calculated for each instrument. Results: On the initial resident survey, 20 of 26 items were clear and 25 of 26 items were relevant with a CVI > 0.8. One item was deemed irrelevant and deleted. For the faculty survey, 10 of 12 items were clear and all items were relevant with CVI > 0.8. Five questions from the resident survey and two from the faculty survey deemed relevant but unclear were rewritten and resubmitted to experts. They all achieved CVI>0.8. Each survey obtained a CVI of 1. Conclusions: Using this approach, we validated a needs assessment tool to guide the creation of didactics for audiences that practice in a different setting from the lecturer.  This validated tool is an important step in the creation of a process to develop appropriate content and could be replicated by other groups planning similar initiatives.

Assessment-Seeking Strategies: Navigating the Decision to Initiate Workplace-Based Assessment.

Phenomenon: Competency-based medical education (CBME) relies on workplace-based assessment (WBA) to generate formative feedback (assessment for learning-AfL) and make inferences about competence (assessment of learning-AoL). When approaches to CBME rely on residents to initiate WBA, learners experience tension between seeking WBA for learning and for establishing competence. How learners resolve this tension may lead to unintended consequences for both AfL and AoL. We sought to explore the factors that impact both decisions to seek and not to seek WBA and use the findings to build a model of assessment-seeking strategy used by residents. In building this model we consider how the link between WBA and promotion or progression within a program impacts an individual's assessment-seeking strategy. Approach: We conducted 20 semi-structured interviews with internal medicine residents at Queen's University about the factors that influence their decision to seek or avoid WBA. Using grounded theory methodology, we applied a constant comparative analysis to collect data iteratively and identify themes. A conceptual model was developed to describe the interaction of factors impacting the decision to seek and initiate WBA. Findings: Participants identified two main motivations when deciding to seek assessments: the need to fulfill program requirements and the desire to receive feedback for learning. Analysis suggested that these motivations are often at odds with each other. Participants also described several moderating factors that impact the decision to initiate assessments, irrespective of the primary underlying motivation. These included resident performance, assessor factors, training program expectations, and clinical context. A conceptual framework was developed to describe the factors that lead to strategic assessment-seeking behaviors. Insights: Faced with the dual purpose of WBA in CBME, resident behavior in initiating assessment is guided by specific assessment-seeking strategies. Strategies reflect individual underlying motivations, influenced by four moderating factors. These findings have broad implications for programmatic assessment in a CBME context including validity considerations for assessment data used in summative decision-making including readiness for unsupervised practice.

APDR Healthcare Disparities Curriculum Pilot: Helping Trainees Meet More Than a Milestone.

RATIONALE AND OBJECTIVES: In order to help program directors satisfy the Accreditation Council for Graduate Medical Education common program requirement for health care disparities (HCD) education, a comprehensive web-based curriculum on HCDs in Radiology was developed. The curriculum was designed to educate trainees about existing HCDs, stimulate discussion, and spur research about HCDs in radiology. The curriculum was piloted to assess its educational value and feasibility. MATERIAL AND METHODS: A comprehensive curriculum comprised of four modules (1) Introduction to HCDs in Radiology, (2) Types of HCDs in Radiology, (3) Actions to Address HCDs in Radiology, and (4) Cultural Competency was created and housed on the Associate of Program Directors in Radiology website. Various educational media including recorded lectures or PowerPoint presentations, small group discussions, and journal clubs were employed. A pilot program was initiated to evaluate the benefits of this curriculum for resident education and consisted of a pre- and post-curriculum test for trainees, an experience survey for trainees, and a pre- and post-administration survey for facilitators. RESULTS: Forty-seven radiology residency programs participated in the pilot of the HCD curriculum. Of those facilitating the curriculum, 83% indicated lack of standardized curriculum as a perceived barrier to implementing a HCD curriculum at their program on the pre-survey. Trainee knowledge scores increased from 65% (pre) to 67% (post) (p = 0.05). Following curriculum participation, residents indicated an increase in adequate understanding of HCDs in Radiology (81% post vs. 45% pre). Most program directors (75%) found the curriculum easy to implement. CONCLUSION: This pilot study demonstrated that the APDR Health Care Disparities curriculum increased trainee awareness of HCDs. The curriculum also provided a forum for important discussions about HCDs.

Critical gaps in knowledge and implementation of recommendations by the US Preventive Services Task Force.

Introduction: The United States Preventive Services Task Force (USPSTF) has issued 31 recommendations applicable to non-pregnant adults. We hypothesized variability in knowledge and implementation of these recommendations among US family medicine resident physicians. Methods: We performed two electronic surveys: a local survey, and then a nationally-representative, multicenter, survey. We evaluated self-reported knowledge and implementation of USPSTF recommendations related to non-pregnant adults. Results: 84 family medicine residents from 40 residency programs across 25 states participated. Knowledge and implementation of recommendations varied widely. Most residents lacked knowledge relating to breast cancer chemoprophylaxis (9.9 % "known in detail" or "mostly know"), BRCA-related genetic counseling (BRCA-GC) referral (30 %), tuberculosis (TB) screening (41 %), and sexually transmitted infection (STI) counseling (45 %). There is virtually no implementation of recommendations for breast cancer chemoprophylaxis (90 % never/rarely implement). Many residents never/rarely implement recommendations for BRCA-GC referral (75 %), TB screening (62 %), and HIV pre-exposure prophylaxis (61 %). This remained true even for residents in their final year of training. Relative to their male counterparts, female physicians more frequently implemented recommendations for BRCA-GC referral (11 % vs 0 % always/often implement, p = 0.019), cervical cancer screening (100 % vs 83 %, p = 0.019), and folic acid supplementation (60 % vs 29 %, p = 0.007). Knowledge and implementation of recommendations were strongly related (ß = 0.75, 95 % CI 0.50-1.00, p < 0.001, Spearman R2 = 0.56). Conclusion: Critical gaps exist in resident knowledge and implementation of USPSTF recommendations. We discuss urgent implications for cancer prevention, public health, and health equity.

The Early Effects of the Coronavirus Disease-19 Pandemic on Pediatric Resident Education: A National Assessment.

PURPOSE: Residency programs must ensure resident competence for independent practice. The coronavirus disease-19 (COVID-19) pandemic disrupted health care delivery, impacting pediatric residencies. This study examines the impact on pediatric resident education. METHODS: The authors conducted a mixed methods national survey of pediatric residency program directors (PDs) from May 2020 to July 2020. Data analysis included descriptive statistics, chi-square, and Wilcoxon rank sum tests. Multivariable modeling identified factors associated with resident preparation for more senior roles. Thematic analysis was performed on open-ended questions about PD COVID-19 pandemic recommendations to peers, Accreditation Council for Graduate Medical Education and American Board of Pediatrics. RESULTS: Response rate was 55% (110/199). PDs reported the COVID-19 pandemic negatively affected inpatient (n = 86, 78.2%), and outpatient education (n = 104, 94.5%), procedural competence (n = 64; 58.2%), and resident preparation for more senior roles (n = 50, 45.5%). In bivariate analyses, increasingly negative impacts on inpatient and outpatient education were associated with an increasingly negative impact on resident preparation for more senior roles (P = .03, P = .008), these relationships held true in multivariable analysis. Qualitative analysis identified 4 themes from PD recommendations: 1) Clear communication from governing bodies and other leaders; 2) Flexibility within programs and from governing bodies; 3) Clinical exposure is key for competency development; 4) Online platforms are important for education, communication, and support. CONCLUSIONS: The COVID-19 pandemic negatively impacted inpatient and outpatient education. When these were more negatively impacted, resident preparation for more senior roles was worse, highlighting the importance of competency based medical education to tailor experiences ensuring each resident is competent for independent practice.

A mixed-methods needs assessment to identify pharmacology education objectives for emergency medicine residents.

Objectives: Medication errors represent a significant threat to patient safety. Pharmacotherapy is one of the 23 Accreditation Council of Graduate Medical Education milestones for emergency medicine, yet there is minimal understanding of what content should be prioritized during training. The study aim was to develop objectives for a patient-safety focused pharmacology curriculum for emergency medicine residents. Methods: We incorporated data from a de-identified safety event database and survey responses of 30 faculty and clinical pharmacists at a single-site suburban university hospital with 24-hour emergency medicine pharmacists and an annual volume of approximately 70,000. We reviewed the database to quantify types and severity of medication errors over a 5-year period for a total of 370 errors. Anonymous surveys included categorical items that we analyzed with descriptive statistics and short answer questions that underwent thematic analysis by 2 coders. We summarized all data sources to identify curriculum gaps. Results: Common medication errors reported in our database were wrong dose (43%) and computer order entry errors (14%). Knowledge gaps were medication cost (63%), pregnancy risk information (60%), antibiotic stewardship (53%), interactions (47%), and side effects (47%). Qualitative analysis revealed the need to optimize computer order entry, understand the scope of critical medications, use references, and consult pharmacists. Integration of data suggested specific medications should be covered in curricular efforts, including antibiotics, analgesics, sedatives, and insulin. Conclusion: We developed objectives of pharmacology topics to prioritize during emergency medicine training to enhance prescribing safety. This study is limited due to its small sample and single institution source of data. Future studies should investigate the impact of pharmacology curriculum on minimizing clinical errors.

Psychiatry Resident Education in Neurocognitive Disorders: a National Survey of Program Directors in Psychiatry.

OBJECTIVE: As major neurocognitive disorders increase, little research has examined how psychiatry residents are prepared to provide neurocognitive care to patients. METHODS: A national survey was sent to program directors of general psychiatry in the USA and Canada, including questions about satisfaction, attitudes, and graduation expectations for training in major neurocognitive disorders. The authors examined descriptive statistics and a series of chi-squared analyses by training setting, residency type, and presence of subspecialty fellowships. The authors also collected free text responses about perceived needs for enhancing training. RESULTS: Program directors agreed that the scope of general psychiatry includes the evaluation of cognitive disorders (78.8%) and the treatment of cognitive symptoms (77.5%) and behavioral/psychological symptoms (78.8%). Required clinical rotations were the preferred method of teaching (63.7%), but didactics were most used (93.8%). The most frequently used clinical teaching setting was geriatric psychiatry (61.3%) and didactics were most frequently taught by geriatric psychiatrists (75.0%). Fifty-six percent were satisfied or very satisfied with their clinical training and 66.3% with their didactics. There were no significant differences in satisfaction or attitudes when compared by training setting, residency type, or presence of subspecialty fellowships. Additional trained faculty were most frequently listed as a need for improving clinical and didactic training. CONCLUSIONS: Psychiatry program directors view major neurocognitive disorders as part of the scope of psychiatric practice. The majority of training is provided within psychiatry rotations, especially geriatric psychiatry. Program directors reported several unmet needs for optimal training, particularly related to clinical training services.

A randomized controlled trial of simulation-based mastery learning to teach the extended focused assessment with sonography in trauma.

BACKGROUND: Mastery learning has gained popularity for training residents in procedural skills due to its demonstrated superiority over traditional methods. However, no studies have compared the efficacy of traditional versus mastery learning methods in residency point-of-care ultrasound education. We hypothesized that mastery learning would improve residents' skills in performing the extended focused assessment with sonography in trauma (eFAST). METHODS: All first-year emergency medicine (EM) resident physicians at a single university hospital underwent a crossover randomized controlled trial to receive mastery-learning eFAST training either at the beginning of the academic year or 6 months into intern year. Participants were taught using a checklist validated by a panel of experts using Mastery Angoff methods and were given feedback on missed tasks until each trainee completed the eFAST with a minimum passing standard (MPS). Our primary outcome was technical proficiency between the two groups for eFAST examinations performed in the emergency department during the academic year. RESULTS: Sixteen interns were enrolled; eight were randomized to each group. The group that received mastery training at the beginning of the year had mean clinical eFAST proficiency scores above the MPS in the first two quarters of the academic year, while the control group did not. Once the control group underwent eFAST mastery training at the midpoint of the year, both groups had mean proficiency scores above the MPS for the remainder of the year. CONCLUSION: Simulation-based mastery learning is an effective method of teaching the eFAST examination. This training during intern orientation conferred early proficiency in clinical performance of eFAST among EM residents. This difference in proficiency was no longer present after the control group received mastery learning education halfway through the academic year.

Identifying the Gaps: Needs Assessment to Guide Development of a Dedicated Toxicology Curriculum for Emergency Medicine Residents.

INTRODUCTION: The American Board of Emergency Medicine identifies medical toxicology as an essential curricular element for emergency medicine (EM) residencies; however, access to medical toxicology education varies widely by institution. We hypothesized that EM residents are uncomfortable with core toxicology content and would be interested in  a dedicated toxicology curriculum. METHODS: An electronic needs assessment survey developed by experts in EM and medical toxicology was sent to residents and program leadership at nine EM programs participating in the Emergency Medicine Education Research Alliance (EMERA), a geographically diverse sampling of academic EM residency programs. We queried the presence of a current toxicology curriculum, interest in a dedicated toxicology curriculum, and comfort with core toxicology concepts for board examinations and in clinical practice.  RESULTS: A total of 148 residents and 8 faculty leadership completed the survey.  Only 29% of resident respondents felt comfortable with toxicology concepts, and only 66% of respondents reported access to a toxicology curriculum. Of those without a known toxicology curriculum, most were interested in a formal curriculum. Faculty respondents reported 6/8 programs offered a toxicology curriculum. Faculty at the two programs without a formal curriculum expressed interest in a dedicated curriculum. CONCLUSIONS: Emergency medicine residents remain uncomfortable with the core toxicology content in clinical practice. The majority of residents without a known toxicology curriculum would be interested in a dedicated toxicology curriculum.

Attainment of an Additional Graduate Degree Is Associated With Sustained Scholarly Activity Beyond Surgical Residency.

OBJECTIVE: To determine whether attainment of an additional graduate-level degree during general surgery residency, such as an MSc, MPH, MBA, or PhD, is associated with increased research productivity beyond completion of training. DESIGN: Observational cohort study comparing publication productivity of general surgery residency graduates who did and did not obtain a degree. PubMed queries and the Web of Science Core Collection were used to capture publication metrics. Graduate characteristics, including degree attainment, were obtained from an institutional database. Practice webpages were reviewed to designate an academic surgical practice, defined as an assistant, associate, or full professorship appointment. SETTING: Single academic general surgery residency program. PARTICIPANTS: Categorical general surgery residency graduates who performed at least 1 year of dedicated research. RESULTS: 1768 total publications, representing 1500 unique publications, were authored by 54 residents, of which 18 (33.3%) residents attained an additional graduate-level degree during dedicated research. 1369 (91.3%) publications had identifiable Journal Impact Factors and citation data. Degree attainers were more likely to be female (55.6% vs. 25.0%, p = 0.03) and spend more time in dedicated research (mean 2.2 vs. 1.8 years, p = 0.02). Overall, degree attainers published more frequently during residency (median 4.4 vs. 2.1 publications/year, p < 0.001) and fellowship (median 2.0 vs. 1.0 publications/year, p = 0.046). Analysis of the first 4 post-training years demonstrated degree attainers produced 1.2 more publications per year among all graduates (2.3 vs. 1.1 publications/year, p = 0.02) and 1.6 more publications per year among graduates practicing academic surgery (3.3 vs. 1.7 publications/year, p = 0.02). There were no differences in the Journal Impact Factor or publication citations per year among degree and nondegree attaining graduates. CONCLUSIONS: Attainment of an additional graduate-level degree was associated with increased research productivity that was sustained beyond surgical residency. Programs with the goal of training academic surgeons should support professional degrees during dedicated research years.

Ex Vivo Porcine Model for Robot-Assisted Partial Nephrectomy Simulation at a High-Volume Tertiary Center: Resident Perception and Validation Assessment Using the Global Evaluative Assessment of Robotic Skills Tool.

Introduction: With increased demands on surgeon productivity and outcomes, residency robotics training increasingly relies on simulations. The objective of this study is to assess the validity and effectiveness of an ex vivo porcine training model as a useful tool to improve surgical skill and confidence with robot-assisted partial nephrectomy (RAPN) among urology residents. Methods: A 2.5 cm circular area of ex vivo porcine kidneys was marked as the area of the tumor. Tumor excision and renorrhaphy was performed by trainees using a da Vinci Si robot. All residents ranging from postgraduate year (PGY) 2 to 5 participated in four training sessions during the 2017 to 2018 academic year. Each session was videorecorded and scored using the global evaluative assessment of robotic skills (GEARS) by faculty members. Results: Twelve residents completed the program. Initial mean GEARS score was 16.7 and improved by +1.4 with each subsequent session (p = 0.008). Initial mean excision, renorrhaphy, and total times were 8.2, 13.9, and 22.1 minutes, which improved by 1.6, 2.0, and 3.6 minutes, respectively (all p < 0.001). Residents' confidence at performing RAPN and robotic surgery increased after completing the courses (p = 0.012 and p < 0.001, respectively). Overall, residents rated that this program has greatly contributed to their skill (4/5) and confidence (4.1/5) in robotic surgery. Conclusions: An ex vivo porcine simulation model for RAPN and robotic surgery provides measurable improvement in GEARS score and reduction in procedural time, although significant differences for all PGY levels need to be confirmed with larger study participation. Adoption of this simulation in a urology residency curriculum may improve residents' skill and confidence in robotic surgery.

A randomized controlled trial of suicide prevention training for primary care providers: a study protocol.

BACKGROUND: Suicide is a national public health crisis and a critical patient safety issue. It is the 10th leading cause of death overall and the second leading cause of death among adolescents and young adults (15-34 years old). Research shows 80% of youth who died by suicide saw their primary care provider within the year of their death. It is imperative that primary care providers develop the knowledge and skills to talk with patients about distress and suicidal thoughts, and to assess and respond in the context of the ongoing patient - primary care provider relationship. METHODS: This study examines the effectiveness of simulation on suicide prevention training for providers-in-training by comparing two conditions: 1) a control group that receives online teaching on suicide prevention in primary care via brief online videos and 2) an experimental group that includes the same online teaching videos plus two standardized patient (SP) interactions (face-to-face and telehealth, presentation randomized). All SP interactions are video-recorded. The primary analysis is a comparison of the two groups' suicide prevention skills using an SP "test case" at 6-month follow-up. DISCUSSION: The primary research question examines the impact of practice (through SP simulation) over and above online teaching alone on suicide prevention skills demonstrated at follow-up. We will assess moderators of outcomes, differences among SP simulations (i.e., face-to-face vs. telehealth modalities), and whether the experimental group's suicide prevention skills improve over the three SP experiences. TRIAL REGISTRATION: The study was registered on Clinical Trials Registry ( clinicaltrials.gov ) on December 14, 2016. The Trial Registration Number is NCT02996344 .

Assessment of Radiology Training During Radiation Oncology Residency.

A strong foundation in diagnostic imaging is essential to the practice of radiation oncology. This study evaluated radiology training in radiation oncology residency. An online survey was distributed to current radiation oncology residents in the USA by e-mail in 2017. Responses were summarized using frequency and percentages and compared with chi-square test and Spearman's rank correlation when appropriate. One hundred five residents completed the survey. Although most residents felt that a strong knowledge base in diagnostic radiology was moderately or extremely important (87%, n = 90/104), the majority were only somewhat confident in their radiology skills (61%, n = 63/104) and were only somewhat, minimally, or not at all satisfied with their training (79%, n = 81/103). Although there was an association between increasing post-graduate training and confidence level (p = 0.01062, ρ = 0.24959), the majority of graduating residents feel only somewhat confident in radiology skills (63%, n = 12/19). Residents were most commonly exposed to radiology via multidisciplinary conferences (96%, n = 100/104), though only 15% (n = 16/104) of residents ranked these as the most beneficial component of their radiology training and 13% (n = 13/101) of residents felt these were the least beneficial. Most residents (60%, n = 63/105) believe there is a need for dedicated radiology training during residency, preferring monthly formal didactics (68%, n = 71/105) co-taught by a radiologist and radiation oncologist (58%, n = 61/105). Radiation oncology residents feel their radiology training is suboptimal, suggesting a need for more guidance and standardization of radiology curriculum. A preferred option may be monthly didactics co-taught by radiologists and radiation oncologists; however, future studies should assess the effectiveness of this model.

Diagnostic radiology resident perspectives on fellowship training and career interest in emergency radiology.

PURPOSE: (1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents. MATERIALS AND METHODS: A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach. RESULTS: Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10.2%). Gender proportion was nationally representative (female = 24.5%; p = 0.57), with a slight R1 predominance (p = 0.034). Of the residents, 88.8% were aware that an ER subspecialty exists, 82.0% were aware that ER fellowships exist, but only 51.7% were aware that the American Society of Emergency Radiology (ASER) exists. Nearly a quarter reported no ER division or ER resident rotation. Residents in a program without an ER division or rotation were nearly twice as likely to be unaware of the existence of ER subspecialty, ER fellowships, and ASER compared to others (p = 0.017). The presence of an ER division and rotation significantly increases the knowledge of ASER (65.5% vs. 40.7%, p < 0.001) and increases residents' ratings of their ER training (p < 0.001). The following factors were ranked as the most important for fellowship choice: (1) personal interest, (2) intellectually stimulating, and (3) work hours. When asked if ER had an appealing work schedule, the mean response was 56 out of 100 (0 = disagree, 100 = agree). CONCLUSION: US radiology residents with the greatest exposure to ER during residency are more familiar with ER training, ER career opportunities, and ASER and had a more favorable perception of the field. Subspecialty leaders should focus on ER's inherent intellectual appeal and reframe its nontraditional schedule as positive (flexible).

A Program for Promoting Clinical Scholarship in General Surgery.

OBJECTIVE: The Accreditation Council for Graduate Medical Education mandates resident physician training in the principles and applications of research. To provide a robust early foundation for effective engagement in scholarship, we designed a novel clinical scholarship program (CSP) for PGY1 general surgery residents. SETTING, DESIGN AND OUTCOMES: In a general surgery residency training program, we assessed resident academic productivity (i.e., presentations, publications, and sustained engagement in clinical research) and self-efficacy to conduct clinical research, as well as the overall satisfaction of both residents and faculty mentors. The clinical research appraisal inventory was administered both before and after completion of the CSP rotation. RESULTS: Totally, 44 categorical general surgery trainees and 23 faculty research mentors participated in the CSP from 2011 to 2016; 26 residents (59%) presented at regional or national meetings. Of the 35 residents who were 24 or more months beyond their PGY1 training period, 16 (46%) have published their CSP project, 5 (14%) report continued commitment towards publication, and 22 (63%) have ≥1 clinical research publications beyond their CSP participation during residency, excluding publications arising from subsequent formal research fellowships. Clinical research appraisal inventory responses indicate significant improvement (p < 0.005) in clinical research self-efficacy. CONCLUSIONS: A structured CSP increases the confidence of trainees to perform clinical research and leads to significant contributions directed at addressing clinically meaningful problems in surgery. Faculty-guided resident research at a very early stage of clinical training supplements other mentorship experiences and encourages the development of surgeons who will engage in life-long clinical problem solving.

Training Neurosurgery and Radiation Oncology Residents in Stereotactic Radiosurgery: Assessment Gathered from Participants in AANS and ASTRO Training Course.

OBJECTIVE: Stereotactic radiosurgery (SRS) represents an expanding approach for neurosurgeons and radiation oncologists. We evaluate educational gaps of senior residents drawn from each specialty as part of a focused SRS course. We also evaluate the strengths and limitations of SRS training in current residency programs of the course residents and faculty. METHODS: The American Association of Neurological Surgeons and American Society of Radiation Oncology jointly held a senior resident course in SRS. Residents were nominated by program directors from across the United States. Thirty residents were chosen to participate in the course. The residents were surveyed before and after the course. Faculty (n = 14) were also surveyed to ascertain their perspectives on current training in SRS. RESULTS: Most (96.7%) of the residents planned to perform SRS when finished, and 94% anticipated SRS indications to expand. Regarding SRS technique, 47% reported average/above average understanding of intracranial SRS; only 17% expressed similar understanding of spinal SRS. Before the course, 76.6% noted below average/average ability to recognize and manage SRS complications. Twenty-three percent of the faculty indicated that graduating residents from their programs were unprepared to perform radiosurgery. Residents' self-assessed understanding of brain SRS indication (P = 0.000693), SRS techniques (P = 0.000021), spinal SRS indications (P = 0.000050), spinal SRS techniques (P = 0.000019), and complication recognition and management (P = 0.00033) significantly improved following the course. CONCLUSIONS: Knowledge and training gaps in SRS appear evident to the senior residents and faculty of both specialties. We believe that other educational opportunities for SRS experience are necessary to optimize clinical competency, as well as meet future clinical staffing needs for this expanding, multidisciplinary approach. Further evaluation of gaps in SRS is necessary through a larger, nationwide survey of U.S. neurosurgeons, program directors, and residents.

A simple assessment tool for evaluation of cadaveric temporal bone dissection.

EDUCATIONAL OBJECTIVE: Objective metrics in skilled-based educational courses allow trainees and instructors to assess performance and monitor progress. The objective is to validate a concise, easy-to-use instrument for assessment of resident skill during a timed cadaveric temporal-bone (CTB) dissection. STUDY DESIGN: Retrospective analysis. METHODS: An instrument was developed to assess resident performance on a yearly timed microdissection of CTB. Five neurotologists participated in the assessment. Each reviewer's score was compared to the score given by the senior neurotologist each year for every resident. Spearman's correlation analysis was then used to assess the reproducibility of the instrument in assessing resident performance. The ability of the instrument to distinguish among experienced and novice trainees and to demonstrate improvement with experience were also assessed. RESULTS: The instrument was created and used for 6 years. Thirty residents were assessed. Correlation of scores between the senior neurotologist and the other neurotologist together was very high (r = 0.883, P < 0.001). Three specific tasks distinguished novice from senior dissectors: posterior canal, opening the membranous labyrinth, and disruption of the ossicular chain. CONCLUSION: A new instrument for assessment of resident skill on CTB dissection is presented. The instrument is easy to use, and scores derived from it are consistent across reviewers. The new instrument distinguishes experienced trainees from novice trainees, is sensitive to individual experience, and has proved useful in providing trainees with objective performance measures. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:451-455, 2018.

2016 RAD-AID Conference on International Radiology for Developing Countries: Gaps, Growth, and United Nations Sustainable Development Goals.

The 2016 RAD-AID Conference analyzed the accelerated global activity in the radiology community that is transforming medical imaging into an effective spearhead of health care capacity building in low- and middle-income countries. Global health efforts historically emphasized disaster response, crisis zones, and infectious disease outbreaks. However, the projected doubling of cancer and cardiovascular deaths in developing countries in the next 15 years and the need for higher technology screening and diagnostic technologies in low-resource regions, as articulated by the United Nations' new Sustainable Development Goals of 2016, is heightening the role of radiology in global health. Academic US-based radiology programs with RAD-AID chapters achieved a threefold increase in global health project offerings for trainees in the past 5 years. RAD-AID's nonprofit radiology volunteer corps continue to grow by more than 40% yearly, with a volunteer base of 5,750 radiology professionals, serving in 23 countries, donating close to 20,000 pro bono hours globally in 2016. As a high-technology specialty interfacing with nearly all medical and surgical disciplines, radiology underpins vital health technology infrastructure, such as digital imaging archives, electronic medical records, and advanced diagnosis and treatment, essential for long-term future health care capacity in underserved areas of the world.