Proactive Coaching in General Surgery Internship: Incorporating Well-being Practices into Resident Professional Life.

OBJECTIVE: Coaching can provide learners with space to reflect on their performance while ensuring well-being and encouraging professional achievement and personal satisfaction outside of traditional mentorship and teaching models. We hypothesized that a proactive coaching program for general surgery interns coupled with individualized learning plans would help build foundational skills necessary for residency success and facilitate the incorporation of well-being practices into resident professional life. Here, we present the development, implementation, and outcomes of a novel well-being coaching program for surgical interns. DESIGN AND SETTING: A well-being coaching program was developed and implemented from July 2020 through June 2021 at a single university-based surgical residency program. To assess impact of the coaching program, we designed a mixed-methods study incorporating end-of-program survey results as well as participant narratives from commitment-to-act statements for thematic content. PARTICIPANTS: All 32 general surgery interns participated in aspects of the coaching program. RESULTS: The end-of-program survey was completed by 19/32 (59%) interns and commitment-to-act statements were completed by 22/32 (69%). The majority (89%) of survey respondents "agreed" or "strongly agreed" that the longitudinal intern coaching program helped them reach goals they had set for themselves this academic year; 15/19 (79%) noted that the coaching experience was effective in promoting well-being practices in their life. Well-being and professional goals were identified as major themes in the end-of-the-year commitment-to-act statements. Statements specifically mentioned resources highlighted and skills taught in our coaching program such as mindfulness techniques, gratitude journals, and self-compassion strategies. CONCLUSIONS: Our study illustrates the effectiveness of a coaching pilot program on promoting well-being practices in a university-based general surgery internship and can be a roadmap with proven efficacy and measurable outcomes.

The impact of the COVID-19 pandemic on family medicine residency training.

BACKGROUND: Family physicians have played a unique clinical role during the COVID-19 pandemic. We hypothesized that the pandemic would be associated with significant deleterious effects on clinical activity, educational training, personal safety and well-being. OBJECTIVE: We conducted a national survey to obtain preliminary data that would assist in future targeted data collection and subsequent evaluation of the impact of the pandemic on family medicine residents and teaching faculty. METHODS: An anonymous online survey of residents and faculty was distributed via the Association of Family Medicine Residency Directors list serve between 5/21/2020 and 6/18/2020. Survey questions focused on clinical and educational activities, safety and well-being. RESULTS: One hundred and fifty-three residents and 151 teaching faculty participated in the survey. Decreased clinical activity was noted by 81.5% of residents and 80.9% of faculty and the majority began conducting telehealth visits (97.9% of residents, 91.0% of faculty). Distance learning platforms were used by all residents (100%) and 39.6% noted an overall positive impact on their education. Higher levels of burnout did not significantly correlate with reassignment of clinical duties (residents P = 0.164; faculty P = 0.064). Residents who showed significantly higher burnout scores (P = 0.035) and a decline in levels of well-being (P = 0.031) were more likely to participate in institutional well-being support activities. CONCLUSIONS: Our preliminary data indicate that family medicine residents and teaching faculty were profoundly affected by the COVID-19 pandemic. Future studies can be directed by current findings with focus on mitigation factors in addressing globally disruptive events such as COVID-19.

Family physicians have played a unique clinical role during the COVID-19 pandemic. We hypothesized that the pandemic would be associated with significant deleterious effects on clinical activity, educational training, personal safety and well-being. Towards setting a foundation for further studies, we conducted a national survey to obtain preliminary data that would assist in future targeted data collection and subsequent evaluation of the impact of the pandemic on family medicine residents and teaching faculty. Our preliminary data indicate that family medicine residents and teaching faculty were profoundly affected by the COVID-19 pandemic in all domains studied. Future studies can be directed by current findings with focus on mitigation factors in addressing globally disruptive events such as COVID-19.

The Evolution of Resident Remedial Teaching at One Institution.

Residency program directors and teaching faculty invest an enormous amount of time, energy, and resources in providing underperforming at-risk learners with remedial teaching. A remediation program was created and centralized at the University of Colorado School of Medicine in 2006 and 2012, respectively, that consolidated expertise in and resources for learner assessment and individualized teaching for struggling learners, particularly those placed on probation or receiving letters of warning (called focused review letters) from their residency programs. Since the implementation of the program, the authors have observed a decrease in the number of residents being placed on probation, and, of those on probation, more are graduating and obtaining board certification. In this Article, the authors aim to describe the development and outcomes of the program and to explore possible reasons for the improved outcomes.

Academic Remediation: Why Early Identification and Intervention Matters.

At our institution, we have developed a remediation team of strong, focused experts who help us with struggling learners in making the diagnosis and then coaching on their milestone deficits. It is key for all program directors to recognize struggling residents because early recognition and intervention gives the resident the best chance of success.

35 Years of Experience From the American Association for Women Radiologists: Increasing the Visibility of Women in Radiology.

Women radiologists remain in minority, unchanged for the past several decades. In 1981, the American Association for Women Radiologists (AAWR) was founded to address the problems that women radiologists were experiencing in being subordinate to male radiologists in the workplace and at the national level in organizations with respect to political power and financial compensation, as well as additional issues unique to women in radiology. The AAWR defined goals to meet the needs of women in radiology: improve the visibility of women radiologists, advance the professional and academic standing of women in radiology, and identify and address issues faced by women in radiology. AAWR efforts have included providing opportunities for career development and award recognition, hosting educational programs at national meetings, and publishing numerous manuscripts on issues faced by women in radiology. The AAWR recognizes that although there has been significant progress in the standing of women in radiology over the past 35 years, there is much room for improvement. The AAWR will continue to advocate for the needs of women in radiology.

Association of Characteristics, Deficits, and Outcomes of Residents Placed on Probation at One Institution, 2002-2012.

PURPOSE: To describe the population of residents placed on probation, identify learner characteristics associated with being placed on probation, and describe immediate and long-term career outcomes for those placed on probation as compared with matched controls. METHOD: The authors collected data for residents at the University of Colorado School of Medicine placed on probation from July 2002 to June 2012, including postgraduate year placed on probation, deficits identified, mandated evaluation for physical and mental health, duration of probation, disability accommodations requested, and number of additional training months required. They were retrospectively compared with 102 controls matched for specialty, matriculation, and postgraduate year. Variables assessed included demographics, academic performance, license status, specialty, state board certification, and board citations. RESULTS: Of 3,091 residents, 3.3% were placed on probation (88 residents; 14 fellows). Compared with controls, those on probation were more likely to be international medical graduates, married, not Caucasian, older (all P < .001), male (P = .01), to have transferred from another graduate medical education training program, and to have taken time off between medical school and residency (all P < .001). Among those currently in practice, 53 (63.9%) were board certified compared with 93 (100%) of the controls. Placement on probation was associated with failure to graduate and lack of board certification. All 7 graduates cited by state medical boards were in the probation group. CONCLUSIONS: Further research is needed to understand these associations and to determine whether changes in curricula or remediation programs may alter these outcomes.

2010 ACR Presidential Address: Patient-focused radiology: taking charge of radiation dose.

Radiology and radiation oncology accidents involving radiation overexposure have caused increased scrutiny by the media, lawyers, our patients, and most recently the US Food and Drug Administration. We should add a new pillar for the ACR called "patient-focused radiology." We have reached new heights of quality in imaging, but at the same time, we have dramatically increased the radiation dose to the US population. We need to take charge of radiation dose and demonstrate that radiology expertise is essential to safe imaging. We need to introduce computerized order entry software that protects patients and educates physicians about the indications and contraindications of radiology examinations. We need to support the ACR in requesting federally mandated accreditation of all "advanced imaging" and radiation oncology accreditation, whether inpatient or outpatient. We need to support the ACR in requesting that Congress mandate a national CT dose registry, which will give alerts to each facility daily for radiation dose outliers and proactively protect patients from radiation overdoses.

Subspecialization in radiology and radiation oncology.

Practicing radiologists, radiation oncologists, and trainees were surveyed regarding the current state of subspecialization in practice and in training curricula. The authors present the results of these surveys, establish trends compared with previous survey data, and compare the plans of trainees with current postgraduate practice. Subspecialization is increasing in both radiology and radiation oncology. There remain substantial numbers of practitioners who perform work they deem "general" in nature. The authors also present a method to more accurately measure subspecialization and workload.

Radiologic history exhibit: the American Association for Women Radiologists (AAWR): 25 years of promoting women in radiology.

On the 25th anniversary of the American Association for Women Radiologists (AAWR), the association's accomplishments in promoting the careers of women radiologists were reviewed. Programs that feature opportunities for women to balance their careers and their personal lives have contributed greatly to promoting networking opportunities at national meetings. Highlights of women's accomplishments in national radiology organizations underline how far women have advanced in the specialty. Future initiatives for the organization center on increasing women's involvement in recruiting and mentoring other women in radiology.

The disruptive professional case scenarios.

This article examines certain critical aspects relating to the clinical competency of professionalism. A discussion is presented which is centered on an analysis of two fictional scenarios explored from the standpoint of a current and a former program director, an associate dean, a department chair, and a lawyer. These cases are followed by a series of questions and a legal discussion which can then be used for either individual study or group discussion.

Diagnostic Radiology Residency Review Committee program citations and how to avoid them.

The Diagnostic Radiology Residency Review Committee gives citations when a program is out of compliance with the residency program requirements of the Accreditation Council for Graduate Medical Education. Several common and some serious citations can be avoided with proactive planning by residency program directors and chairs to be in compliance. These citations include a low American Board of Radiology pass rate, a low faculty/resident ratio, a lack of timely resident evaluations, a lack of written annual evaluations of faculty members, a lack of evaluation of program curriculum and rotation objectives, inadequate faculty teaching and supervision, inadequate faculty scholarly activity, and night floats that may interfere with education.

Suggestions for practice to accompany neonatal encephalopathy and cerebral palsy.

Based largely on the data in the 2003 The American College of Obstetricians and Gynecologists/American Academy of Pediatrics publication, Neonatal Encephalopathy and Cerebral Palsy, we offer 12 suggestions for practice. Familiarity with the publication and implementation of these suggested practices-by all personnel in an obstetric-neonatal unit-are important risk management techniques.