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@#The availability of ophthalmologists is vital to making eyecare accessible to everyone. Medical education and ophthalmology residency training in China was reduced to address the high demand for ophthalmologists. This is something the Philippines can consider to increase the number of ophthalmologists in the country. However, decreasing the duration, together with insufficient monitoring of medical education and ophthalmology residency training, were not without consequences in eyecare in China.
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Education, Medical , China , PhilippinesABSTRACT
Objective@#This study was designed to assess the impact of the COVID-19 pandemic on ophthalmology training from the perspective of ophthalmology residents and fellows in the Philippines. @*Methods@#A 55-item online survey on the COVID-19 pandemic’s impact on ophthalmology training was sent to 168 ophthalmologists-in-training from March 15, 2021 to April 19, 2021. Participants from all ophthalmology training programs in the Philippines were selected via random sampling and proportional allocation.@*Results@#A total of 158 ophthalmologists-in-training (138 residents and 20 fellows) completed the survey. The areas of ophthalmology training that were found to be most disrupted during the COVID-19 pandemic were surgical training (95%), clinical activity (94%), and in-person interaction with consultants in the out-patient department (94%) and operating room (85%). In contrast, trainees found an increase in didactic teaching activities (75%) and research activities (39%). Overall, 78% of the trainees felt that the pandemic had a negative impact on their ophthalmology training. The aspects which were most frequently found to be negatively impacted by the pandemic were mental health (70%), followed by technical skills (69%), and clinical skills (61%). No major differences were found on the impact of COVID-19 on training when compared across year levels and across institutions compared by location (National Capital Region vs. non-National Capital Region) and funding type (government vs. private funding). Ninety-nine percent (99%) of institutions shifted most of their didactic teaching activities to online platforms. Surgical video conferences and simulator training or skills labs were thought to be helpful to surgical training by 89% and 81% of the trainees, respectively. Majority of trainees attended to patients via telemedicine averaging 40% of their clinic consults. However, only 16% reported confidence in handling their patients through telemedicine.@*Conclusion@#The COVID-19 pandemic has had an overall negative impact on ophthalmology training in the Philippines. It caused significant disruption in trainees' clinical and surgical activities, and affected their mental health. Despite this, the situation provided an opportunity to boost trainees' theoretical knowledge. Majority are receptive to new technology-based learning tools to preserve the effectiveness of their training. Efforts to re-evaluate current training programs are needed to ensure sustainability and quality of ophthalmology training in the Philippines.
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COVID-19 , Ophthalmology , Surveys and QuestionnairesABSTRACT
@#Introduction: Smart Phone Chat Apps (SPCA) is an integral part of people’s daily routine including orthopaedic education. SPCA facilitates efficient communication and learner-based management especially now as remote flexible learning is becoming the new norm in this COVID-19 pandemic medical training. The study described the use of a chat app (Viber) as experienced by residents and consultants in the Section of Adult Orthopaedics of the institution of the principal author. It described the mode and dynamics of the chat discussion amongst its participants, its perceived usefulness in teaching and learning specifically its relevance and applicability, its potential as a supplementary assessment tool, as well as its perceived effects. Materials and methods: This is a phenomenological study and strictly adhered to data privacy. The principal author conducted a participant observation of residents’ threemonth clinical rotation at the study site. Mobile phone screenshots of the chat interactions and focus group discussions with consultants and residents were done. Residents were also requested to complete a questionnaire. All qualitative data were iteratively content analysed and emerging themes were summarised using NViVO-12. Frequencies and percentage distribution were used to analyse quantitative data. Results: Respondents included eleven senior, four junior residents, and nine consultants. Results show that SPCA is a useful, applicable, and relevant teaching and assessment tool. Influxes of multiple ideas per case were discussed realtime as the chat exchanges and interactions helped in the planning of the surgical management and eventual decisionmaking. SPCA also served as an effective surgical case log and online library, as well as an efficient, rapid, economical mode of information dissemination. The residents reported that it helped in developing their emotional maturity through self-reflection and self-criticism in the performance of their cases. The consultants concurred and added that they too were updated professionally in certain fields in orthopaedics. Conclusion: The SPCA is a helpful, relevant, and acceptable adjunct teaching and learning tool for clinical teaching and can be, to a certain extent, a supplementary formative assessment tool of the resident’s communication skills, work ethics, initiative, and diligence.
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Objective:To investigate the current status of psychosomatic medical service competence and training needs among general practice resident physicians.Methods:An online questionnaire survey was conducted from August to September 2021, among general practice resident physicians selected by cluster sampling from 4 affiliated hospitals of Tongji University. The questionnaire contained the basic information, the self-assessment and training needs of psychosomatic medical service competence of participants, and psychosomatic medical service requirements of patients in the community.Results:A total of 159 questionnaires were distributed, and 140 were collected (88.1%). The survey showed that 25.7% (36/140) of participants believed that 50% or more patients had physical symptoms accompanied by emotional problems; 29.3% (41/140) thought that 50% or more patients had sleep problems, but 60.0% (84/140) of them failed to provide appropriate treatment. The rate of "core knowledge and concepts of psychosomatic medicine" was 47.5% (665/1 400) and the correct rate of "common psychosomatic diseases" was (64.6±23.4)%. Merely 21.4% (30/140) participants reported satisfaction with the psychosomatic medical service competence; 62.8% (88/140) respondents believed that the coverage rate of the above-mentioned competence training in the current general practice residential training program was less than 50%, and 66.4% (93/140) supported that more psychosomatic training was "necessary". The acceptance rate of online training, workshops, MDT, and clinical practice ranged from 56.4% (79/140) to 63.4% (89/140).Conclusions:The survey indicates that there are large needs for psychosomatic medical services among patients in community, but the competence and confidence of general practice resident physicians to provide the service are significantly insufficient. Therefore, it is suggested to strengthen the training of psychosomatic medical service competence in the general practice residency training program.
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Forty two general practice residents who participated in the standardized training in Suzhou Municipal Hospital from April to December 2022 were randomly divided into two groups with 21 in each group. The control group received the traditional teaching method, and the study group received additional training with a special management model for chronic obstructive pulmonary disease. After 3 months of training, the teaching effects were evaluated with the improved Mini Clinical Evaluation Exercise (Mini CEX) in two groups and the teaching satisfaction was also assessed. Compared with the control group, the study group showed significant better performance in outpatient service, including the treatment and rehabilitation planning ( t=3.82, P<0.001), humanistic care ( t=4.83, P<0.001), health education ( t=9.56, P<0.001), communication skills ( t=3.34, P=0.002), and overall performance ( t=3.13, P=0.003). The satisfaction of teaching in study group was also higher than that in the control group ( Z=-2.02, P=0.044). The study shows that incorporating the "specialized management of chronic obstructive pulmonary disease" model into the general practice standardized residency training can significantly improve the teaching effects.
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Objective:To explore the application of Miller's pyramid theory combined with Bahrain's team activities in the standardized residency training (SRT) of burn surgeons.Methods:Seventy-four residents who were on the SRT program in the Department of Burns & Wound Care in The Second Affiliated Hospital of Zhejiang University were enrolled in the study. The students were divided into control group and observation group according to the teaching methods. Thirty-seven students in the control group were provided with conventional teaching, and 37 students in the observation group were provided with training based on Miller' pyramid theory combined with Bahrain's team activities. The two groups were evaluated for teaching effectiveness and doctor-patient communication skills. SPSS22.0 was used for the chi-square test and t test. Results:The evaluation outcome of teaching effectiveness in the observation group was better than that in the control group ( t=3.01, 3.47, 3.49, 3.32, and 2.54; P=0.004, 0.001, 0.001, 0.001, and 0.013). After the training, the scores of Set Elicit Give Understand End scale in the two groups increased, with significantly higher scores achieved in the observation group than in the control group ( t=3.23, 2.99, 2.07, 3.62, 3.00, and 7.89; P=0.002, 0.004, 0.042, 0.001, 0.004, and <0.001). Conclusion:The application of Miller's pyramid theory and Bahrain's team activities in the SRT of burn surgeons can improve students' evaluation of teaching effectiveness and improve their doctor-patient communication skills.
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The standardized residency training is an important stage in the training of physicians. Shanghai East Hospital has explored the system of the whole-process tutor management in the residency training. To explore the specific methods of carrying out the whole-process tutor training for residents in the whole hospital, gradually the whole-process tutor system is built with qualification certification, mutual selection of teachers and students, tutor empowerment, plan implementation and assessment and evaluation. Meanwhile, a supporting informatization platform is being developed to provide necessary tool support for the implementation and promotion of the whole-process tutor of residency training. And information tools are used to carry out implementation management, process optimization and quality monitoring, so as to form a closed management loop.
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Objective:To investigate the effect of homogeneous management combined with staged teaching on physicians receiving standardized training of hepatobiliary surgery.Methods:A total of 46 physicians who received standardized training in Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, from January to March 2020 were selected as control group and were given conventional teaching, and 50 physicians who received standardized training from April to June 2020 were selected as observation group and were given homogeneous management combined with staged teaching. The two groups were compared in terms of professional level, clinical ability, and the degree of satisfaction with teaching before and after teaching. SPSS 24.0 was used to perform the independent samples t-test, the paired t-test, the chi-square test, and the rank sum test. Results:After teaching, both groups had significant increases in the scores of theoretical examination and operation skill examination, and compared with the control group, the observation group had significantly higher scores of theoretical examination (94.57±3.28 vs. 90.32±2.12) and operation skill examination (94.37±4.18 vs. 91.25±3.46). After teaching, both groups had significant increases in the scores of clinical consultation, physical examination, humanistic concern, clinical diagnosis, communication ability, organizational ability, and overall evaluation, and the observation group had significantly higher scores of the above seven aspects than the control group (6.98±0.94/6.45±0.14/6.95±0.88/6.65±0.93/6.53±0.26/6.84±0.92/6.58±0.35 vs. 6.13±0.31/6.21±0.76/6.21±0.42/6.18±0.35/6.32±0.61/6.33±0.24/6.25±0.71). The observation group had a significantly higher overall satisfaction rate than the control group [94.00% (47/50) vs. 78.26% (36/46)].Conclusion:In the standardized training and teaching of hepatobiliary surgery, homogeneous management combined with staged teaching can improve the professional level and clinical ability of physicians and enhance the degree of satisfaction with teaching.
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Objective:To explore the application effect of laparoscopic surgery skills training course in the standardized residency training of surgery.Methods:A total of 40 standardized trainees of surgical residents rotating in general surgery were selected as the research objects, and randomly divided into the experimental group and the control group. The experimental group was offered laparoscopic surgery skills training course. The course content includes theoretical teaching module, simulated teaching module, virtual teaching module and clinical surgery practice teaching module. The control group was taught by traditional theory teaching and clinical surgery practice teaching. At the end of the courses, the two groups of students were assessed for their skills in laparoscopic grasping and pass, suture and knotting. At the same time, a questionnaire survey was conducted among the students and teachers. The t-test was performed using SPSS 22.0 statistical software. Results:The theoretical scores of the experimental and control groups were (67.90±13.24) and (69.70±13.46), respectively, with no statistically significant difference ( P > 0.05). After the courses, the performance of grasping and pass, suture and knotting of the experimental group (15.25±3.24 and 5.45±2.14) was higher than that of the control group (11.25±2.12 and 2.75±1.16), and the difference was statistically significant ( P < 0.01).The questionnaire survey showed that the proportion of "better" feedback from students and teachers on laparoscopic skills training courses was significantly higher than that of "general" and "poor". Conclusion:The laparoscopic surgery skills training course can improve the laparoscopic surgery skills of the trainees in the standardized residency training of surgery, shorten the learning curve, and make the training standardized and homogeneous. It is worthy of wide promotion and application in the standardized training base.
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Objective:To investigate the current status of job burnout among trainees in the standardized residency training of pediatrics (short for "pediatric residents") in the hope of identifying the problems involved, and proposing corresponding countermeasures and suggestions based on these current situations and problems.Methods:This study conducted a questionnaire survey among the pediatric residents who received the standardized residency training in The Children's Hospital, Zhejiang University School of Medicine. The questionnaire consisted of two parts: general information survey and Maslach job burnout survey. The generated data were analyzed using IBM SPSS 26.0. Chi-square test was used to determine the equilibrium of the groupings for the basic situation of the data. If the normal distribution of the data in two groups was satisfactory, the t-test was used for inter-group comparison; otherwise, the Kruskal-Wallis H test was employed. For more than two groups, if the data met the normal distribution and the variance was homogeneous, one-way analysis of variance was used for inter-group comparison; otherwise, the Kruskal-Wallis H test was used. Multiple linear regression analysis was used for multivariate analysis. Results:A total of 138 pediatric residents participated in this survey. The detection rate of job burnout was 65.2% (90/138), of which 45 (32.6%), 29 (21.0%) and 16 (11.6%) were mild, moderate and severe, respectively. In univariate analysis, there was a statistically significant difference in job burnout among pediatric residents in different grades ( H=7.22, P=0.027), and the low achievement score (27.90±8.48) of the first-year pediatric residents was higher than that of the second-year pediatric residents (23.54±6.79), and the difference was statistically significant ( t=-2.25, P=0.025). Multiple linear regression analysis regression model showed no statistically significant difference. Conclusion:The level of job burnout among pediatric residents is high, and relevant departments should pay attention to the problem of job burnout of the pediatric residents, and take various measures to prevent the occurrence of job burnout.
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Objective:To explore the effectiveness of PDCA (plan, do, check, action) cycle management method in improving the completion rate of after-department examination in pediatric professional base.Methods:Through the residency management system platform, the completion rate of after-department examination from February 2019 to March 2019 differed greatly. Referring to the PDCA cycle management methods, according to the analysis of fishbone diagram, relevant reasons were obtained and a series of rectification measures were implemented including the formulation of relevant programs from the four aspects such as department, resident, rules and regulations and tools. The rectification courses were taken for 5 months. SPSS 17.0 was used for Chi-square test.Results:April to August 2019 was the main rectification execution stage, during which the monthly completion rate of after-department examination increased, but fluctuated (66.70%-89.70%).Compared with the rectification courses before (in February), the completion rate of after-department examination was significantly increased after rectification (in October) [(96.00%) vs. (42.11%)], with statistical significance ( P < 0.01). Conclusion:PDCA cycle management method can effectively improve the completion rate of after-department examination in pediatric professional base, which should be further widely promoted.
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This article intends to explore the application and implementation effect of network platform teaching in the standardized residency training of rheumatology and immunology. Through the implementation of online platform teaching (micro-class, online PBL teaching, and air class) for the training residents rotating in the rheumatology and immunology department, the questionnaire survey was carried out. The results showed that the satisfaction of the residents with the online platform teaching reached 96.88% (31/32), and more than 90.00% of the residents believed that their self-learning ability and clinical thinking ability have been improved, and their learning initiative and enthusiasm have also been improved, which deserves further promotion.
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Objective:To evaluate the effect of ladder teaching of problem-based learning (PBL) after theoretical lecture in the standardized training of ophthalmology.Methods:This study collected the data of the resident trainees in the ophthalmology standardized training base of the PLA General Hospital from September 2015 to June 2020. According to the accepted teaching methods, they were divided into the ladder teaching method group (ladder group) and the pure PBL teaching method group (PBL group). The exam results of the first and second stages of the trainees, the pass rate of the first stage exam (ophthalmology theory), the pass rate of the second stage exam (clinical application), and the overall pass rate of the first and second stages were recorded for statistical analysis. Quantitative evaluation on the teaching effect of the "ladder teaching method of theory teaching followed by PBL" in the standardized training of ophthalmology in this training base was made. SPSS 24.0 was used to conduct t-test, rank-sum test and Chi-square test. Results:The results of the first stage examination (ophthalmology theory) in the ladder group were higher than those in the PBL group [(87.22±8.45) vs. (74.47±10.68)], with a statistically significant difference ( P < 0.01); the pass rate of the first stage examination (ophthalmology theory) in the ladder group was higher than that in the PBL group (95.83% vs. 85.00%), with no significant difference ( P = 0.213). The pass rate of the second stage examination (clinical application) in the ladder group was higher than that in the PBL group (95.65% vs. 76.47%), with no significant difference ( P = 0.070); the overall pass rate of routine training (first and second stages) in the ladder group was higher than that in the PBL group (91.67% vs. 65.00%), with a statistically significant difference ( P = 0.029). Conclusion:The ladder teaching of PBL after the theory teaching has a satisfactory effect in the standardized training of ophthalmology. This teaching method is easier to help the students to successfully complete the standardized training and pass the standardized training examination.
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Taking the Department of Pathology of Duke University as an example, this paper compares and analyzes the training mode of pathology residents in China and the United States. It is found that the organization and management system and supervision and assessment system of residency training in China have been improved, but it is still necessary to strengthen the in-depth implementation of humanistic education and training subjects for residents. Pathologist training should be based on "elite education" as the guiding ideology, to cultivate high-quality, high-level outstanding clinical pathology personnel as the specific goal, to build a solid foundation of clinical medicine.
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To train homogeneous and excellent anesthesiologists who understand basic theory and clinical specialty, and response quickly and precisely to the emergency clinical condition. The Department of Anesthesiology, The First Affiliated Hospital of Army Medical University applied the integrated medical education mode combined with problem-based learning (PBL) to conduct the teaching of standardized residency training. We have always integrated relevant knowledge with "the alteration of pathophysiology" as the core, and standardized training teaching ideas with cases as the main line. A patient case bank has been set up based on the concept of integrated medical education, PBL training as the center, and the pathophysiological changes during anesthesia operation as the main line, which effectively achieves the goal of integrating theoretical knowledge with clinical practice. It is not only train high-quality anesthesiologists, but also improve their ability to find, analyze, and solve problems, so that the trainees form a habit of self-learning and continuous learning through the training.
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Objective:To investigate the application of scenario simulation teaching rounds in the residency training of teachers.Methods:A total of 56 faculty members in the surgical system were divided into the traditional method group and the scenario simulation group. The traditional method group adopted the training including multimedia centralized training, live rounds demonstration and observation, discussion and summary, while the scenario simulation group adopted the training including multimedia centralized training, scenario simulation demonstration and observation followed by step-by-step discussion and demonstration, review and summary. After the training, the training satisfaction questionnaires of the participants were collected. The participants were evaluated for teaching rounds before and after the training. The data were analyzed using Graphpad prism 7.Results:There were no significant differences between the two groups in terms of professional title, teaching years and gender ( P > 0.05). The average scores of teaching rounds before and after training in the scenario simulation group were (80.17±0.99) and (87.38±0.52). The average scores of teaching rounds before and after training in the traditional method group were (78.27±0.82) and (83.24±0.53). The teaching ability had improved after the teacher training in both groups, while the scenario simulation group performed significantly better than the traditional method group ( P < 0.05). The questionnaire survey showed that the satisfaction and training effect of the scenario simulation group were much higher than those of the traditional method group, and the difference was statistically significant ( P < 0.05). Conclusion:The scenario simulation teaching rounds training significantly improves the competency of teaching rounds of residential training teachers, as well as the scenario simulation capabilities of demonstration teachers and volunteers, which makes it worthy of further promotion in order to have a better performance on standardized residency training.
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Based on the in-depth analysis of the defects of the existing traditional chair-side teaching and simulation examination for the oral residency training students, this paper designs an online typical case teaching module for teaching practice. After the teaching, the examination results reveal that the use of online teaching tool can improve the clinical thinking and decision-making ability, and strengthen the clinical thinking process. The questionnaire results show that most residents are satisfied with the online teaching. All in all, the online teaching mode in this study is conducive to increasing the breadth and depth of case teaching, facilitating the process and visualization of clinical thinking, and improving the clinical decision-making ability of the typical cases of the residency training students, so as to achieve the goal of training residents with great post competences.
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Objective:To understand the current situation and influencing factors of depression among residents in Chongqing, and to explore the relationship between depression and administration satisfaction of the standardized residency training.Methods:Stratified random cluster sampling was used to select 372 residents currently participating the standardized residency training in Chongqing. The patient health questionnaire (PHQ-9) and administration satisfaction of residency training questionnaire were used to conduct a cross-sectional survey on the depression status and satisfaction of residents in Chongqing. SPSS 21.0 software package was used for partial correlation analysis and binary logistic regression analysis to explore the relationship between depression and administration satisfaction of the standardized residency training.Results:Among the 372 residents, 218 had mild depression and above (58.60%). There was a significant difference in the incidence of depression among residents of different ages, educational background, marital status, working hours and administration satisfaction of residency training ( χ2 = 23.02, 17.35, 12.24, 21.70, 95.20; P = 0.028, 0.027, 0.016, 0.041, <0.001 respectively). Partial correlation analysis showed that there was a negative correlation between the total score of depression and the five aspects of the administration satisfaction (total score, instructors, training base, managers and training income) ( r=-0.52, -0.45, -0.47, -0.45, -0.40, all P<0.01). In the binary logistic regression analysis of depression and satisfaction,the satisfaction had a negative impact on depression, and its B value was -1.71, and OR value was 0.18, P<0.001. Conclusion:The incidence of depression among residents in Chongqing is high. Age, educational background, marital status, working hours and administration satisfaction are related to the degree of depression. And the higher the degree of depression, the lower the administration satisfaction of residents. Relevant departments should pay attention to the mental health of residents and improve the quality of standardized residency training.
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Objective:To explore the application of artificial intelligence (AI) assistant system combined with case-based learning (CBL) in the teaching of strabismus specialty for ophthalmic residents.Methods:Forty ophthalmic residents who were trained in the Department of Ophthalmology of the People's Hospital of Peking University from January 2020 to December 2021 were divided into control group and experimental group, with 20 people in each group. The control group used the traditional teaching mode, and the experimental group used AI assistant system combined with CBL teaching. At the end of specialized training, the two groups were assessed for theoretical knowledge, clinical skills, clinical thinking and questionnaire survey, and the teaching effect was evaluated. SPSS 26.0 was used for Chi-square test, one-way ANOVA and independent-samples t-test. Results:The scores of theoretical knowledge [(34.10±1.33) points], clinical skills [(24.75±1.02) points] and clinical thinking [(24.80±0.77) points] in the experimental group were significantly higher than those in the control group [(33.15±1.35) points, t=2.24, P=0.031; (23.60±0.82) points, t=3.93, P<0.001; (24.20±0.83) points, t=2.37, P=0.023]. For the evaluation of teaching effect, the experimental group improved the learning interest ( t=11.47, P<0.001), clinical thinking ability ( t=9.36, P<0.001), knowledge and skill level ( t = 17.71, P < 0.001), knowledge sharing ( t=31.17, P< 0.001) and overall satisfaction ( t=10.60, P<0.001), and these 5 aspects were scored higher in experimental group compared with the control group. Conclusion:The teaching mode combining AI assistant system and CBL teaching can improve the independent diagnosis and treatment ability of ophthalmic residents for strabismus diseases, establish a correct clinical thinking path, and obtain a better teaching effect than the traditional teaching mode.
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Objective:To analyze the research progress, hot spots and future trends of standardized residency training of Traditional Chinese Medicine from 1998 to now by using CiteSpace knowledge map software.Methods:The related literature on standardized residency training of Traditional Chinese Medicine were retrieved on CNKI. And after Refworks format conversion, using CiteSpace 5.6 R3 software for the construction of knowledge map, the author cooperation, institutional cooperation, keyword co-occurrence, and time-sharing research hot spots views of related literature on standardized residency training of Traditional Chinese Medicine were drawn respectively.Results:A total of 259 papers were obtained, with 253 authors. Ren Xianqing and Cui Jin published the most articles (each with 4 papers), and Beijing University of Chinese Medicine published the most articles (with 23 papers). There were 259 keywords in total, and 16 keywords with frequency greater than 5 and centrality greater than 0.1. There were 14 keyword cluster tags, and 15 burst terms were detected in total, and the trend discussion was carried out accordingly.Conclusion:The research trend of the standardized residency training of Traditional Chinese Medicine mainly follows the relevant policies issued by the functional departments of the government, and the research hot spots depend on the obstacles and difficulties encountered in the practical application of each training base.