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OBJECTIVES: Opportunities to learn advanced airway management skills on pediatric patients in the emergency department are limited. Current strategies have focused largely on traditional didactics coupled with procedural skills training using simulation. However, these approaches are limited in their exposure to anatomic variation and realism. Here, we describe the development and assessment of an advanced airway curriculum that integrates videolaryngoscopic recordings obtained during actual patient intubations into a series of interactive educational sessions. METHODS: Trainees and attending physicians were surveyed anonymously to assess the impact of participation in the curriculum. A mixed methods approach to statistical analysis was used. Rating questions were used to evaluate the relative impact of this approach over other traditional strategies and recurrent themes within open-ended questions were identified. RESULTS: Participants reported this to be a highly effective means of learning about pediatric laryngoscopy and endotracheal intubation and regarded it more highly than other traditional educational approaches. Identified benefits included repetitive exposure, approaches to laryngoscopy, the realism of teaching using real and varied anatomy, and the opportunities to identify and troubleshoot difficulty in a learning environment. CONCLUSIONS: An advanced pediatric airway curriculum that integrates intubation videos obtained during videolaryngoscopy was highly regarded by pediatric emergency medicine providers. Content emphasis can be shifted to meet the needs of pediatric emergency medicine providers with all levels of skill and experience.
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Endoscopía Capsular/métodos , Intubación Intratraqueal/métodos , Laringoscopía/educación , Neumología/educación , Servicio de Urgencia en Hospital , Becas/métodos , HumanosRESUMEN
The advancement of knowledge and development of policy in the field of medical education require critical academic discourse among the most intelligent medical educators; and critical academic discourse requires coffee. In this essay, we reflect on the state of professional development conferences in the field of medical education and the rituals that surround their success. Having begun in ancient Greece, symposia were ripe with debauchery. Today, sedated by the light brown walls of hotel conference centres, symposia are more serious endeavours, engaging men and women in the sometimes turbulent waters of epistemological debate. The abstract submission process (summed up by: 'Yay! It was accepted for presentation' [Deep breath] 'Oh no it was accepted for presentation'), the 'juggling act' of parent attendees, the acting prowess of abstract presenters and the unapologetic approach to buffet eating are all by-products of the collision of true intellects among medical education scholars. We hold these rituals in high regard and argue that they are required to advance the field of medical education. These rituals bind the walls supporting true progressive thought and innovative research, all fuelled by the glass of wine purchased with that one coveted drink ticket.
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Congresos como Asunto , Conocimientos, Actitudes y Práctica en Salud , Carteles como Asunto , Investigación Biomédica , Educación Médica , HumanosRESUMEN
Medical education reform is underway, but the optimal course for change has yet to be seen. While planning for the redesign of a renal physiology course at the Duke School of Medicine, the authors used a Q-sort survey to assess students' attitudes and learning preferences to inform curricular change. The authors invited first-year medical students at the Duke School of Medicine to take a Q-sort survey on the first day of renal physiology. Students prioritized statements related to their understanding of renal physiology, learning preferences, preferred course characteristics, perceived clinical relevance of renal physiology, and interest in nephrology as a career. By-person factor analysis was performed using the centroid method. Three dominant factors were strongly defined by learning preferences: "readers" prefer using notes, a textbook, and avoid lectures; "social-auditory learners" prefer attending lectures, interactivity, and working with peers; and "visual learners" prefer studying images, diagrams, and viewing materials online. A smaller, fourth factor represented a small group of students with a strong predisposition against renal physiology and nephrology. In conclusion, the Q-sort survey identified and then described in detail the dominant viewpoints of our students. Learning style preferences better classified first-year students rather than any of the other domains. A more individualized curriculum would simultaneously cater to the different types of learners in the classroom.
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Curriculum , Educación de Pregrado en Medicina/métodos , Riñón/fisiología , Fisiología/educación , Q-Sort , Actitud , Selección de Profesión , Evaluación Educacional , Análisis Factorial , Femenino , Humanos , Masculino , Nefrología/educación , Estudiantes de Medicina/psicología , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged. PURPOSES: This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care. METHODS: This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis. RESULTS: Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism. CONCLUSIONS: Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.
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Teléfono Celular/estadística & datos numéricos , Grupo de Atención al Paciente , Adulto , Conducta Cooperativa , Eficiencia , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , North Carolina , Proyectos Piloto , Encuestas y CuestionariosRESUMEN
BACKGROUND: Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior. METHODS: Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions. RESULTS: 76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions.Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork. CONCLUSION: Defining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful. A shared understanding of what constitutes professional behavior is an important first step.
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Ética Médica , Internado y Residencia , Competencia Profesional , Conflicto de Intereses , Recolección de Datos , Femenino , Humanos , Internado y Residencia/ética , Masculino , North Carolina , Rol del Médico , Factores SexualesRESUMEN
BACKGROUND: Little is known about medical school requirements for faculty development related to teaching (FDT) in medical education. This study examined the national landscape and local faculty perceptions of their own institution's FDT requirement. METHODS: An electronic survey was disseminated to Faculty Affairs Offices in US medical schools to assess FDT requirements. A second survey was distributed to faculty within one medical school to gauge faculty perceptions related to existing FDT requirements. RESULTS: Responses were received from approximately 33% of US medical schools and 36% of local faculty. Few responding medical schools had formal FDT requirements. There was a wide range variation of hours and activities necessary to satisfy existing requirements and consequences for noncompliance. For respondents from schools that did not have a requirement, many saw value in considering a future requirement. Many local faculty agreed that the FDT requirement improved their teaching skills. When asked to share other thoughts about the FDT requirement, several qualitative themes emerged. CONCLUSION: This study helps establish a national benchmark for the status of FDT requirements in medical education and revealed information on how to optimize and/or improve such requirements. The authors offer five recommendations for schools to consider regarding FDT.
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BACKGROUND: Minimal research has explored the pandemic's impact on health professions educators (HPEs). Given that health professions educator academies provide centralised support and professional development to HPEs through communities of practice and promoting education at their institutions, it is important to examine how academies met HPEs' needs during the pandemic. This study investigates the COVID-19 pandemic's effects on HPEs and examines how academies supported HPEs' educational roles during the pandemic. METHODS: Using a mixed-methods approach, the authors surveyed United States educator academy members on changes in HPEs' activities, emphasising clinical and educational tasks and work-life integration. Participants shared their academies' innovations and support responses. Data were analysed using chi-square and content analyses. FINDINGS: Twenty percent of 2784 recipients (n = 559) completed the survey. Most respondents indicated the pandemic caused them to spend more time on clinical and education leadership/administration than before the pandemic. HPEs integrated innovative instructional strategies, yet many shifted away from teaching, mentoring and scholarship. Over half were dissatisfied with work-life integration during the pandemic. Females, especially, reported that professional work was compromised by personal caregiving. Academies increased their range of member services; however, they did not fully meet their members' needs, including providing expanded professional development and advocating on HPE's behalf for increased protected time dedicated to educator responsibilities. DISCUSSION: HPEs faced unprecedented challenges in their personal and professional lives during the COVID-19 pandemic. Neglecting the needs of HPEs amidst global crises poses a substantial threat to the quality of education for upcoming generations of health care professionals.
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COVID-19 , Humanos , COVID-19/epidemiología , Femenino , Masculino , Estados Unidos , Pandemias , SARS-CoV-2 , Adulto , Persona de Mediana Edad , Encuestas y Cuestionarios , LiderazgoRESUMEN
OBJECTIVE: Providing meaningful evaluation to trainees rotating through the pediatric emergency medicine is important yet challenging. Information systems can be used to autopopulate an electronic case log, which can be leveraged to assist in the evaluation process. The objective of this study was to determine if a novel educational initiative using an automated case log improved faculty evaluation of trainees. METHODS: This retrospective study examined faculty completion rate, as well as the content of medical student evaluations over a 3-academic-year study period. Three phases of evaluation were utilized: written, electronic, and electronic enhanced with individualized case reports created with the automated case log. The primary outcome was faculty response rate. Secondary outcomes included word count and the number of themes identified following qualitative analysis of narrative responses. Logistic regression was performed. RESULTS: Forty-one faculty members completed evaluations of 43 students. The rates of completion for the written, electronic, and automated case log phases were 18%, 16%, and 62%, respectively. Faculty in the automated case log phase were significantly more likely to complete evaluations compared with those in the written evaluation phase (odds ratio, 7.6; 95% confidence interval, 4.5-13.0). The median word counts across the 3 phases were 19, 36, and 43, respectively. The median numbers of themes identified during the 3 phases were 3, 4, and 5, respectively. The differences in the word count and median number of themes between the written and automated case log phases were significantly different (P < 0.001). CONCLUSIONS: The process of trainee evaluation can be improved by utilizing an automated case log to provide faculty members with individualized reports of shared patient encounters.
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Recolección de Datos/métodos , Educación de Pregrado en Medicina/métodos , Evaluación Educacional , Sistemas de Registros Médicos Computarizados , Pediatría/educación , Competencia Clínica , Medicina de Emergencia/educación , Femenino , Humanos , Aprendizaje , Modelos Logísticos , Masculino , Estudios RetrospectivosRESUMEN
OBJECTIVE: Physician training is associated with stressors which contribute to burnout. Individual and institutional level strategies can be employed to address resident burnout; however, time is an often-reported barrier in initiating recommended well-being activities. We hypothesize that brief bursts of well-being activities that are conducive to a resident schedule can mitigate burnout. DESIGN: This is a prospective observational study following burnout after implementation of an institution-wide, well-being initiative called "Take 10." SETTING: In the present study, the "Take 10" initiative, meditating or exercising for a minimum of 10 minutes per day 3 times a week, was encouraged at Vanderbilt University Medical Center, a tertiary care center in Nashville, Tennessee. PARTICIPANTS: Following implementation of the initiative, 254 residents from surgical, procedural, and non-procedural specialties were invited to complete surveys assessing compliance with encouraged "Take 10" activities as well as rates of burnout over a 5-month period. A total of 201 surveys were completed during the study period. RESULTS: Overall, burnout rates were worse for females (Odds Ratio [OR]â¯=â¯3.7 | Confidence Interval [CI]â¯=â¯1.57, 9.05), better for those living with others (ORâ¯=â¯0.22 | CIâ¯=â¯0.07, 0.64), and better for those participating in "Take 10" initiatives (ORâ¯=â¯0.71 | CIâ¯=â¯0.58, 0.86). There was a significant difference in resident-reported burnout (Controlâ¯=â¯85.3% vs Interventionâ¯=â¯58.2% | p < 0.01) and Resident Well-Being Index score (Controlâ¯=â¯3.73 vs Intervention=2.93 | p < 0.01), when "Take 10" initiatives were employed. CONCLUSIONS: "Take 10" is a low cost and low intensity initiative for individuals and programs to use to mitigate burnout.
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Agotamiento Profesional , Internado y Residencia , Médicos , Agotamiento Profesional/prevención & control , Femenino , Humanos , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
BACKGROUND: This study assessed the national impact of the COVID-19 pandemic on the education of medical students assigned to surgery clerkship rotations, as reported by surgery clerkship directors(CDs). STUDY DESIGN: In the spring of 2020 and 2021, the authors surveyed 164 CDs from 144 LCME-accredited US medical schools regarding their views of the pandemic's impact on the surgery clerkship curriculum, students' experiences, outcomes, and institutional responses. RESULTS: Overall survey response rates, calculated as no. respondents/no. surveyed were 44.5%(73/164) and 50.6%(83/164) for the spring 2020 and 2021 surveys, respectively. Nearly all CDs(>95%) pivoted to virtual platforms and solutions. Most returned to some form of in-person learning by winter 2020, and pre-pandemic status by spring 2021(46%, 38/83). Students' progression to the next year was delayed by 12%(9/73), and preparation was negatively impacted by 45%(37/83). Despite these data, CDs perceived students' interest in surgical careers was not significantly affected(89% vs. 77.0%, p=0.09). Over the one-year study, the proportion of CDs reporting a severe negative impact on the curriculum dropped significantly(p<0.0001) for most parameters assessed except summative evaluations(40.3% vs. 45.7%,p=0.53). CDs(n=83) also noted the pandemic's positive impact with respect to virtual patient encounters(21.7%), didactics(16.9%), student test performance(16.9%), continuous personal learning(14.5%), engagement in the clerkship(9.6%) and student interest in surgery as a career(7.2%). CONCLUSION: During the pandemic, the severe negative impact on student educational programs lessened and novel virtual curricular solutions emerged. Student interest in surgery as a career was sustained. Measures of student competency and effectiveness of new curriculum, including telehealth, remain areas for future investigation.
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BACKGROUND: A previous survey documented the severe disruption of the coronavirus disease 2019 pandemic on surgical education and trainee well-being during the initial surge and systemic lockdowns. Herein, we report the results of a follow-up survey inclusive of the 2020 to 2021 academic year. STUDY DESIGN: A survey was distributed to education leaders across all surgical specialties in summer 2021. We compared the proportion of participants reporting severe disruption in key areas with those of the spring 2020 survey. Aggregated differences by year were assessed using chi-square analysis. RESULTS: In 2021, severe disruption of education programs was reported by 14% compared with 32% in 2020 (p < 0.0001). Severe reductions in nonemergency surgery were reported by 38% compared with 87% of respondents in 2020. Severe disruption of expected progression of surgical trainee autonomy by rank also significantly decreased to 5% to 8% in 2021 from 15% to 23% in 2020 among respondent programs (p < 0.001). In 2021 clinical remediation was reported for postgraduate year 1 to 2 and postgraduate year 3 to 4, typically through revised rotations (19% and 26%) and additional use of simulation (20% and 19%) maintaining trainee promotion and job placement. In 2021, surgical trainees' physical safety and health were reported as less severely impacted compared with 2020; however, negative effects of isolation (77%), burnout (75%), and the severe impact on emotional well-being (17%) were prevalent. CONCLUSIONS: One year after the initial coronavirus disease 2019 outbreak, clinical training and surgical trainee health were less negatively impacted. Disruption of emotional well-being remained high. Future needs include better objective measures of clinical competence beyond case numbers and the implementation of novel programs to promote surgical trainee health and well-being.
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COVID-19 , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Educación de Postgrado en Medicina/métodos , Estudios de Seguimiento , Humanos , Pandemias/prevención & control , Encuestas y CuestionariosRESUMEN
BACKGROUND: The time course and longitudinal impact of the COVID -19 pandemic on surgical education(SE) and learner well-being (LWB)is unknown. MATERIAL AND METHODS: Check-in surveys were distributed to Surgery Program Directors and Department Chairs, including general surgery and surgical specialties, in the summer and winter of 2020 and compared to a survey from spring 2020. Statistical associations for items with self-reported ACGME Stage and the survey period were assessed using categorical analysis. RESULTS: Stage 3 institutions were reported in spring (30%), summer (4%) [pâ¯<â¯0.0001] and increased in the winter (18%). Severe disruption (SD) was stage dependent (Stage 3; 45% (83/184) vs. Stages 1 and 2; 26% (206/801)[pâ¯<â¯0.0001]). This lessened in the winter (23%) vs. spring (32%) pâ¯=â¯0.02. LWB severe disruption was similar in spring 27%, summer 22%, winter 25% and was associated with Stage 3. CONCLUSIONS: Steps taken during the pandemic reduced SD but did not improve LWB. Systemic efforts are needed to protect learners and combat isolation pervasive in a pandemic.
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COVID-19/epidemiología , Control de Enfermedades Transmisibles/normas , Educación Médica/estadística & datos numéricos , Pandemias/prevención & control , Especialidades Quirúrgicas/educación , COVID-19/prevención & control , COVID-19/psicología , COVID-19/transmisión , Educación Médica/organización & administración , Educación Médica/normas , Humanos , Aprendizaje , Especialidades Quirúrgicas/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: As the COVID-19 pandemic dynamically changes our society, it is important to consider how the pandemic has affected the training and wellness of surgical residents. Using a qualitative study of national focus groups with general surgery residents, we aim to identify common themes surrounding their personal, clinical, and educational experiences that could be used to inform practice and policy for future pandemics and disasters. DESIGN: Six 90-minute focus groups were conducted by a trained qualitative researcher who elicited responses on six predetermined topics. De-identified transcripts and audio recordings were later analyzed by two independent researchers who organized responses to each topic into themes. SETTING: Focus groups were conducted virtually and anonymously. PARTICIPANTS: General surgery residents were recruited from across the country. Demographic information of potential participants was coded, and subjects were randomly selected to ensure a diverse group of participants. RESULTS: The impact of the COVID-19 pandemic on residents' clinical, educational, and personal experiences varied depending on the institutional response of the program and the burden of COVID-19 cases geographically. Many successes were identified: the use of telehealth and virtual didactics, an increased sense of camaraderie amongst residents, and flexibility in scheduling. Many challenges were also identified: uncertainty at work regarding personal protective equipment and scheduling, decreased case volume and educational opportunities, and emotional trauma and burnout associated with the pandemic. CONCLUSIONS: These data gathered from our qualitative study highlight a clear, urgent need for thoughtful institutional planning and policies for the remainder of this and future pandemics. Residency programs must ensure a balanced training program for surgical residents as they attempt to master the skills of their craft while also serving as employed health care providers in a pandemic. Furthermore, a focus on wellness, in addition to clinical competency and education, is vital to resident resilience and success in a pandemic setting.
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COVID-19 , Internado y Residencia , Humanos , Pandemias , Equipo de Protección Personal , SARS-CoV-2RESUMEN
Duke University Hospital Office of Graduate Medical Education and Duke University's Fuqua School of Business collaborated to offer a Health Policy lecture series to residents and fellows across the institution, addressing the "Systems-based Practice" competency.During the first year, content was offered in two formats: live lecture and web/podcast. Participants could elect the modality which was most convenient for them. In Year Two, the format was changed so that all content was web/podcast and a quarterly live panel discussion was led by module presenters or content experts. Lecture evaluations, qualitative focus group feedback, and post-test data were analyzed.A total of 77 residents and fellows from 8 (of 12) Duke Graduate Medical Education departments participated. In the first year, post-test results were the same for those who attended the live lectures and those who participated via web/podcast. A greater number of individuals participated in Year Two. Participants from both years expressed the need for health policy content in their training programs. Participants in both years valued a hybrid format for content delivery, recognizing a desire for live interaction with the convenience of accessing web/podcasts at times and locations convenient for them. A positive unintended consequence of the project was participant networking with residents and fellows from other specialties.
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Curriculum , Tecnología Educacional , Política de Salud , Educación de Postgrado en Medicina , Grupos Focales , Humanos , North Carolina , Competencia Profesional , Evaluación de Programas y Proyectos de SaludRESUMEN
BACKGROUND: The COVID-19 pandemic disrupted the delivery of surgical services. The purpose of this communication was to report the impact of the pandemic on surgical training and learner well-being and to document adaptations made by surgery departments. STUDY DESIGN: A 37-item survey was distributed to educational leaders in general surgery and other surgical specialty training programs. It included both closed- and open-ended questions and the self-reported stages of GME during the COVID-19 pandemic, as defined by the ACGME. Statistical associations for items with stage were assessed using categorical analysis. RESULTS: The response rate was 21% (472 of 2,196). US stage distribution (n = 447) was as follows: stage 1, 22%; stage 2, 48%; and stage 3, 30%. Impact on clinical education significantly increased by stage, with severe reductions in nonemergency operations (73% and 86% vs 98%) and emergency operations (8% and 16% vs 34%). Variable effects were reported on minimal expected case numbers across all stages. Reductions were reported in outpatient experience (83%), in-hospital experience (70%), and outside rotations (57%). Increases in ICU rotations were reported with advancing stage (7% and 13% vs 37%). Severity of impact on didactic education increased with stage (14% and 30% vs 46%). Virtual conferences were adopted by 97% across all stages. Severity of impact on learner well-being increased by stage-physical safety (6% and 9% vs 31%), physical health (0% and 7% vs 17%), and emotional health (11% and 24% vs 42%). Regardless of stage, most but not all made adaptations to support trainees' well-being. CONCLUSIONS: The pandemic adversely impacted surgical training and the well-being of learners across all surgical specialties proportional to increasing ACGME stage. There is a need to develop education disaster plans to support technical competency and learner well-being. Careful assessment for program advancement will also be necessary. The experience during this pandemic shows that virtual learning and telemedicine will have a considerable impact on the future of surgical education.
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COVID-19 , Educación de Postgrado en Medicina/tendencias , Estado de Salud , Especialidades Quirúrgicas/educación , Estudiantes , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Educación de Postgrado en Medicina/métodos , Educación de Postgrado en Medicina/organización & administración , Cirugía General/educación , Cirugía General/tendencias , Humanos , Aprendizaje , Pandemias , Especialidades Quirúrgicas/tendencias , Estudiantes/psicología , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
Traditional peer review remains the gold standard for assessing the merit of scientific scholarship for publication. Challenges to this model include reliance on volunteer contributions of individuals with self-reported expertise; lack of sufficient mentoring and training of new reviewers; and the isolated, noncollaborative nature of individual reviewer processes.The authors participated in an Association of American Medical Colleges peer-review workshop in November 2015 and were intrigued by the process of group peer review. Subsequent discussions led to shared excitement about exploring this model further. The authors worked with the staff and editors of Academic Medicine to perform a group review of 4 submitted manuscripts, documenting their iterative process and analysis of outcomes, to define an optimal approach to performing group peer review.Individual recommendations for each manuscript changed as a result of the group review process. The group process led to more comprehensive reviews than each individual reviewer would have submitted independently. The time spent on group reviews decreased as the process became more refined. Recommendations aligned with journal editor findings. Shared operating principles were identified, as well as clear benefits of group peer review for reviewers, authors, and journal editors.The authors plan to continue to refine and codify an effective process for group peer review. They also aim to more formally evaluate the model, with inclusion of feedback from journal editors and authors, and to compare feedback from group peer reviews versus individual reviewer feedback. Finally, models for expansion of the group-peer-review process are proposed.
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Procesos de Grupo , Revisión de la Investigación por Pares/métodos , Humanos , Manuscritos Médicos como AsuntoRESUMEN
BACKGROUND: Role clarity is important for patient care but challenging in graduate medical education (GME). METHODS: Badge buddies were integrated for all GME trainees at a single institution, and surveys were conducted prior to and 5 months following implementation. RESULTS: There were 932 pre- and 498 postimplementation respondents. Following implementation, both trainees and nurses reported improved awareness of GME training level, but there were no changes in patient/family perceptions. CONCLUSIONS: Badge buddies improved caregiver awareness of GME training level but did not impact patient/family perception. Patients appear to be focused primarily on relationships with caregivers and communication skills rather than a provider's specific role.
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OBJECTIVE: Surgeon educators in departments of surgery play key roles in leading and advancing surgical education. Their activities include ensuring sound curricula and evaluation systems, monitoring education resources, overseeing faculty development, and providing mentorship. For more than 25 years, the American College of Surgeons (ACS) has offered a comprehensive "Surgeons as Educators" (SAE) course to address fundamental topics in surgical education. This study aims to identify future career needs of SAE graduates to inform the development of an American College of Surgeons Certificate in Applied Surgical Education Leadership program. DESIGN: An IRB exempt, anonymous electronic survey was developed to determine educational roles, career aspirations, and needs of SAE Graduates. SETTING AND PARTICIPANTS: Participants included all 763 1993-2016 SAE graduates. RESULTS: One hundred and thirty-five responses were received from 600 (22.5%) graduates with valid email addresses. Sixty (45%) respondents completed the SAE Course > 5 years prior to the study (M5YRS) and 75 (55%) within the last 5 years (L5YRS). L5YRS respondents were less likely to be full professors (8% vs. 44%) or to serve as program directors (32% vs. 57%), and more likely to be associate program directors (25% vs. 17%) or clerkship directors (40% vs. 18%). High percentages of both L5YRS and M5YRS reported not pursuing additional educational opportunities post-SAE due to time and fiscal constraints. One-fifth of respondents were unaware of additional opportunities and 19% of M5YRS versus 6% of L5YRS stated that existing programs did not meet their needs. Overall improving skills as educational leaders, developing faculty development programs, and conducting educational research were noted as priorities for future development. Differences were observed between the L5YRS and M5YRS groups. The dominant preferences for course format were full-time face-to-face (41%) or a combination of full-time face-to-face with online modules (24%). The most important considerations in deciding to pursue a certificate course were course content, and interest in advancing career and time constraints. CONCLUSIONS: An SAE graduate survey has confirmed the need for additional formal training in surgical education leadership in order to permit surgeon educators meet the demands of the changing landscape of surgical education. The needs of early career faculty may differ from those of more senior surgeon educators.
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Certificación , Docentes Médicos , Cirugía General/educación , Evaluación de Necesidades , Facultades de Medicina , Liderazgo , Estados UnidosRESUMEN
BACKGROUND: Medical education program evaluation allows for curricular improvements to both Undergraduate (UME) and Graduate Medical Education (GME). UME programs are left with little more than match rates and self-report to evaluate success of graduates in The Match. OBJECTIVE: This manuscript shares a novel method of program evaluation through a systematic assessment of Match outcomes. DESIGN: Surveys were developed and distributed to Program Training Directors (PTDs) at our institution to classify residency programs into which our UME graduates matched using an ordinal response scale and open-ended responses. Outcomes-based measures for UME graduates were collected and analyzed. The relationship between PTD survey data and UME graduates' outcomes were explored. Open-ended response data were qualitatively analyzed using iterative cycles of coding and identifying themes. RESULTS: The PTD survey response rate was 100%. 71% of our graduates matched to programs ranked as 'elite' (36%) or 'top' (35%) tier. The mean total number of 'Honors' grades achieved by UME graduates was 2.6. Data showed that graduates entering elite and top GME programs did not consistently earn Honors in their associated clerkships. A positive correlation was identified between USMLE Step 1 score, number of honors, and residency program rankings for a majority of the programs. Qualitative analysis identified research, faculty, and clinical exposure as necessary characteristics of 'elite' programs:. Factors considered by PTDs in the rating of programs included reputation, faculty, research, national presence and quality of graduates. CONCLUSIONS: This study describes a novel outcomes-based method of evaluating the success of UME programs. Results provided useful feedback about the quality of our UME program and its ability to produce graduates who match in highly-regarded GME programs. The findings from this study can benefit Clerkship Directors, Student Affairs and Curriculam Deans, and residency PTDs as they help students determine their competitiveness forspecialties and specific residency programs.
Asunto(s)
Educación de Pregrado en Medicina/organización & administración , Educación de Pregrado en Medicina/estadística & datos numéricos , Internado y Residencia/estadística & datos numéricos , Investigación Biomédica/organización & administración , Prácticas Clínicas/organización & administración , Educación de Postgrado en Medicina/normas , Educación de Postgrado en Medicina/estadística & datos numéricos , Educación de Pregrado en Medicina/normas , Docentes Médicos/organización & administración , Humanos , Internado y Residencia/normas , Evaluación de Programas y Proyectos de Salud , Criterios de Admisión EscolarRESUMEN
After participating in a group peer-review exercise at a workshop presented by Academic Medicine and MedEdPORTAL editors at the 2015 Association of American Medical Colleges Medical Education Meeting, the authors realized that the way their work group reviewed a manuscript was very different from the way by which they each would have reviewed the paper as an individual. Further, the group peer-review process yielded more robust feedback for the manuscript's authors than did the traditional individual peer-review process. This realization motivated the authors to reconvene and collaborate to write this Commentary to share their experience and propose the expanded use of group peer review in medical education scholarship.The authors consider the benefits of a peer-review process for reviewers, including learning how to improve their own manuscripts. They suggest that the benefits of a team review model may be similar to those of teamwork and team-based learning in medicine and medical education. They call for research to investigate this, to provide evidence to support group review, and to determine whether specific paper types would benefit most from team review (e.g., particularly complex manuscripts, those receiving widely disparate initial individual reviews). In addition, the authors propose ways in which a team-based approach to peer review could be expanded by journals and institutions. They believe that exploring the use of group peer review potentially could create a new methodology for skill development in research and scholarly writing and could enhance the quality of medical education scholarship.