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1.
J Pak Med Assoc ; 71(Suppl 1)(1): S18-S22, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33582717

RESUMEN

OBJECTIVE: To assess the impact of coronavirus disease on surgical training. Methods: The cross-sectional study was conducted at the General Surgery Department of Liaquat National Hospital, Karachi, from August 2019 to May 2020, and comprised surgical trainees from year 1 to 4. The subjects were interviewed and inquired about their opinion regarding the impact of coronavirus disease on their training. Data was prospectively collected in two equal phases of 5 months each, separating the phases on the basis of the application of preventive measures and changes relating to coronavirus disease. Data of cases from log books was divided into major and minor cases. RESULTS: Of the 24 surgical trainees available, 18(75%) participated; 12(66.6%) females and 6(33.3%) males. There was a significant difference between the two phases, with the number of surgical case going down drastically in the second phase (p=0.005), affecting the training process. CONCLUSIONS: Considering the ongoing pandemic, it may be worthwhile to look into the possibility of increasing the duration of training.


Asunto(s)
Cirugía General , Internado y Residencia/estadística & datos numéricos , Cirujanos/educación , Cirujanos/estadística & datos numéricos , Estudios Transversales , Femenino , Cirugía General/educación , Cirugía General/organización & administración , Cirugía General/estadística & datos numéricos , Humanos , Masculino , Pakistán
2.
Actas urol. esp ; 45(1): 0-0, ene.-feb. 2021. tab, mapas, graf
Artículo en Español | IBECS | ID: ibc-194903

RESUMEN

OBJETIVO: La pandemia de la COVID-19 ha alterado sustancialmente las actividades de formación de los residentes. Si bien recientemente se han implementado nuevos programas de aprendizaje virtual, aún debe investigarse su utilidad desde la perspectiva de los aprendices de urología. MÉTODOS: Encuesta online transversal de 30 ítems, distribuida a través de Twitter, entre el 4 y el 18 de abril de 2020, con el objetivo de evaluar la perspectiva de los residentes de urología sobre las modalidades (videos pregrabados, seminarios web, podcasts y redes sociales [RRSS]) y contenidos (lecciones frontales, discusiones de casos clínicos, actualizaciones sobre guías y ensayos clínicos, videos quirúrgicos, clubes de revistas y seminarios sobre liderazgo y habilidades no técnicas) del aprendizaje inteligente (Smart learning). RESULTADOS: En total, 501 residentes de urología de 58 países completaron la encuesta. De estos, 78,4, 78,2, 56,9 y 51,9% consideraron los videos pregrabados, seminarios web interactivos, podcasts y RRSS, respectivamente, como modalidades de aprendizaje inteligente muy útiles. Los contenidos considerados como muy útiles por la mayor proporción de residentes fueron las actualizaciones de guías clínicas (84,8%) y videos quirúrgicos (81,0%). Además, más de la mitad de los residentes consideraron los seminarios de liderazgo y los de habilidades no técnicas (58,9 y 56,5%, respectivamente) como contenidos útiles para el aprendizaje inteligente. Las tres combinaciones preferidas de modalidad y contenido de aprendizaje inteligente fueron: videos quirúrgicos pregrabados, seminarios web interactivos sobre casos clínicos y videos pregrabados sobre guías. CONCLUSIÓN: Nuestro estudio proporciona la primera «visión global» de las modalidades y contenidos de aprendizaje inteligente que deben priorizarse con el objetivo de optimizar la educación virtual en urología. Aunque este estudio se llevó a cabo durante la pandemia de la COVID-19, nuestros hallazgos podrían tener un impacto aún mayor en el futuro


PURPOSE: The COVID-19 outbreak has substantially altered residents' training activities. While several new virtual learning programs have been recently implemented, the perspective of urology trainees regarding their usefulness still needs to be investigated. METHODS: A cross-sectional, 30-item, web-based Survey was conducted through Twitter from April 4th, 2020 to April 18th, 2020, aiming to evaluate the urology residents' perspective on smart learning (SL) modalities (pre-recorded videos, webinars, podcasts, and social media [SoMe]), and contents (frontal lessons, clinical case discussions, updates on Guidelines and on clinical trials, surgical videos, Journal Clubs, and seminars on leadership and non-technical skills). RESULTS: Overall, 501 urology residents from 58 countries completed the survey. Of these, 78.4, 78.2, 56.9 and 51.9% of them considered pre-recorded videos, interactive webinars, podcasts and SoMe highly useful modalities of smart learning, respectively. The contents considered as highly useful by the greatest proportion of residents were updates on guidelines (84.8%) and surgical videos (81.0%). In addition, 58.9 and 56.5% of responders deemed seminars on leadership and on non-technical skills highly useful smart learning contents. The three preferred combinations of smart learning modality and content were: pre-recorded surgical videos, interactive webinars on clinical cases, and pre-recorded videos on guidelines. CONCLUSION: Our study provides the first global «big picture» of the smart learning modalities and contents that should be prioritized to optimize virtual Urology education. While this survey was conducted during the COVID-19 outbreak, our findings might have even more impact in the future


Asunto(s)
Humanos , Masculino , Educación en Salud/métodos , Infecciones por Coronavirus , Urología/educación , Internado y Residencia/estadística & datos numéricos , Educación a Distancia , Pandemias , Neumonía Viral , Internado y Residencia/normas , Encuestas y Cuestionarios , Telemedicina , Procedimientos Quirúrgicos Urológicos/educación
4.
Acad Med ; 96(2): 186-192, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33492834

RESUMEN

Clerkship grades (like money) are a social construct that function as the currency through which value exchanges in medical education are negotiated between the system's various stakeholders. They provide a widely recognizable and efficient medium through which learner development can be assessed, tracked, compared, and demonstrated and are commonly used to make decisions regarding progression, distinction, and selection for residency. However, substantial literature has demonstrated how grades imprecisely and unreliably reflect the value of learners. In this article, the authors suggest that challenges with clerkship grades are fundamentally tied to their role as currency in the medical education system. Associations are drawn between clerkship grades and the history of the U.S. economy; 2 major concepts are highlighted: regulation and stock prices. The authors describe the history of these economic concepts and how they relate to challenges in clerkship grading. Using lessons learned from the history of the U.S. economy, the authors then propose a 2-step solution to improve upon grading for future generations of medical students: (1) transition from grades to a federally regulated competency-based assessment model and (2) development of a departmental competency letter that incorporates competency-based assessments rather than letter grades and meets the needs of program directors.


Asunto(s)
Prácticas Clínicas/normas , Economía/historia , Educación Médica/legislación & jurisprudencia , Evaluación Educacional/métodos , Internado y Residencia/ética , Prácticas Clínicas/estadística & datos numéricos , Competencia Clínica/normas , Evaluación Educacional/estadística & datos numéricos , Femenino , Historia del Siglo XX , Humanos , Internado y Residencia/estadística & datos numéricos , Masculino , Facultades de Medicina/organización & administración , Estudiantes de Medicina/estadística & datos numéricos , Estados Unidos/epidemiología
5.
Medicine (Baltimore) ; 100(2): e23540, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466120

RESUMEN

ABSTRACT: The independent plastic surgery pathway recruits candidates with 5 years of surgical training who are typically more advanced in research than their integrated counterparts. Research productivity helps to discriminate between applicants. However, no studies exist detailing the academic attributes of matched independent plastic surgery candidates.We performed a cohort study of 161 independent plastic surgery fellows from accredited residency programs from the 2015 to 2017 application cycles. We performed a bibliometric analysis utilizing Scopus, PubMed, and Google Scholar to identify research output measures at the time of application.The cohort was predominantly men (66%) with a median of 3 articles and a H-index of 1 at the time of application. Interestingly, 16% of successful candidates had no published articles at the time of application, and this did not change significantly over time (P = .0740). Although the H-index remained stable (R 0.13, P = .1095), the number of published journal articles per candidate significantly decreased over 3 consecutive application cycles (R -0.16, P = .0484). Analysis of article types demonstrated a significant increase in basic science articles (R 0.18, P = .0366) and a concurrent decrease in editorial-type publications (R = -0.18, P = .0374).Despite the decline in publication volume of matched independent plastic surgery fellows, the quality of their research portfolio has remained constant. Matched applicants appear to be shifting focus from faster-to-publish articles to longer but higher impact projects. In selecting a training route, applicants must weigh the highly competitive integrated path against the dwindling number of independent positions.


Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Becas/estadística & datos numéricos , Internado y Residencia/estadística & datos numéricos , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Cirugía Plástica/educación , Bibliometría , Investigación Biomédica/normas , Femenino , Médicos Graduados Extranjeros/estadística & datos numéricos , Humanos , Masculino , Factores de Tiempo
6.
J Surg Res ; 257: 246-251, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32862052

RESUMEN

BACKGROUND: Training diverse house staff, including those who are underrepresented in medicine, is vital to provide high-quality patient care for the communities that we serve. In 2018, the Accreditation Council for Graduate Medical Education announced new common program requirements for systematic efforts to recruit and retain a diverse workforce. However, questions remain about how to implement such efforts. MATERIALS AND METHODS: Electronic Residency Application Service (ERAS) data from eight residency programs spanning two recruitment cycles (2017-2018, 2018-2019) was reviewed. The number of candidates at each stage in the process (applicant, invited to interview, interviewed, and matched) was examined by self-identified race or ethnicity. These data were presented to residency program directors at our Graduate Medical Education committee meeting before the next recruitment cycle. Data were analyzed following the 2019-20 residency match. Odds ratios and Pearson's chi-squared test were used to assess statistical significance. RESULTS: A total of 10,445 and 10,982 medical students applied to our 8 core residency programs in 2017 and 2018, respectively. Medical students who applied and self-identified as Asian, Black or African American, and Hispanic or Latino or Spanish origin had lower odds of being invited to interview than those who self-identified as White. After data presentation, the odds of inviting Black or African American applicants to interview increased significantly. The odds of attending an interview once invited were the same across groups. CONCLUSIONS: Sharing ERAS data patterns with residency program directors was associated with a significant year over year change in interviewee diversity. Structured analysis of institutional ERAS data can provide insight into the resident selection process and may be a useful tool to improve house staff diversity.


Asunto(s)
Diversidad Cultural , Fuerza Laboral en Salud/organización & administración , Internado y Residencia/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Selección de Personal/organización & administración , Estudiantes de Medicina/estadística & datos numéricos , Afroamericanos/estadística & datos numéricos , Americanos Asiáticos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Estudios de Factibilidad , Fuerza Laboral en Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Internado y Residencia/organización & administración , Solicitud de Empleo , Selección de Personal/estadística & datos numéricos , Estados Unidos
7.
J Surg Res ; 257: 399-405, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32892137

RESUMEN

BACKGROUND: Variability exists in opioid prescribing practices among surgeons, frequently resulting in the prescription of excessive opioids. This study evaluated the ability of a single educational intervention targeted toward general surgery residents to reduce the quantity of postoperative opioids prescribed. MATERIALS AND METHODS: This retrospective cohort study evaluated opioid prescribing practices 12 mo prior to and 6 mo following a 30-min lecture for general surgery residents that discussed prescribing guidelines and multimodal analgesia. Opioid volumes (normalized to oral morphine equivalents, OME), opioid type, nonopioid pain medications, and refills requested were analyzed for opioid-naïve adult patients undergoing excisional breast biopsy (EB), mastectomy (M), laparoscopic appendectomy (LA), laparoscopic cholecystectomy (LC), open umbilical hernia repair (OUHR), open inguinal hernia repair (OIHR), or laparoscopic inguinal hernia repair (LIHR). RESULTS: 695 and 376 patients preintervention and postintervention were included, respectively. Median OME prescribed decreased for EB (150 mg to 75 mg, P < 0.001), M (225 mg to 150 mg, P = 0.85), LA (150 mg to 94 mg, P < 0.001), LC (150 mg to 82 mg, P < 0.001), OUHR (150 mg to 103 mg, P < 0.001), OIHR (175 mg to 100 mg, P = 0.001), and LIHR (200 mg to 113 mg, P < 0.001). Fewer patients received opioids alone and more patients received an opioid with two nonopioid adjuncts (P < 0.001). More patients received oxycodone as fewer received acetaminophen-containing opioid combinations (P < 0.001). Patients requiring refills decreased (11.9% to 7.2%) (P = 0.014). CONCLUSIONS: Following this targeted intervention, patients were discharged with fewer OME and more nonopioid analgesics, even as refill requests decreased. Educating residents on opioid prescription guidelines and multimodal therapy is effective and should be part of the annual didactic curriculum.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Cirugía General/educación , Internado y Residencia/estadística & datos numéricos , Dolor Postoperatorio/prevención & control , Pautas de la Práctica en Medicina/estadística & datos numéricos , Femenino , Cirugía General/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
8.
N Z Med J ; 133(1527): 15-25, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332325

RESUMEN

AIM: This paper outlines the results of the Royal Australian and New Zealand College of Radiologists (RANZCR) Faculty of Radiation Oncology (FRO) 2018 workforce census. Here we report the responses of New Zealand radiation oncologists and trainees in order to understand characteristics of the New Zealand radiation oncology workforce. METHOD: The workforce census was conducted online during July-September 2018. Distribution was by Survey Monkey to all radiation oncologists (fellows, life members, educational affiliates, retired) and trainees on the RANZCR membership database, including members from Australia, New Zealand and Singapore. All responses were aggregated for analysis. This paper addresses only responses from New Zealand members. The census was designed to explore issues relevant to the New Zealand workforce, and questions from previous workforce censuses were repeated in order to monitor trends. RESULTS: The response rate for New Zealand radiation oncologists was 73.3% (44/60). The majority (67%) were male. The average age was 50.8 years. Three-fifths (59.5%) reported New Zealand ethnicity. One-third obtained their specialist qualifications outside of Australia and New Zealand. Most worked in the public sector only (63.4%), with only two in exclusive private practice. Most radiation oncologists attained a consultant post immediately on completion of training, but there were 26 who pursued an overseas fellowship. Most worked one full-time equivalent or greater (FTE), with 17.5% working less than 1.0 FTE. Radiation oncologists reported working a median of 50.0 hours per week, with half working over 10 hours above their contracted hours. Most time was spent on clinical duties with minimal time spent on research. Radiation oncologists reported seeing an average of 235 new patients per year (median: 230). Leadership positions were held by 21/43 respondents. Within 15 years, 55% of the current workforce reported an intention to retire, including 30% of those currently practising highly specialised brachytherapy. Females in the workforce were less likely to work fulltime and spent less time in research and management activities. All trainees reported full-time work, although 50% expressed a desire for part-time training. Half of the trainees reported working 6-10 hours on call, and 60% reported two or less hours of protected teaching per week. Despite this, 90% of trainees were satisfied with their career choice. CONCLUSIONS: Radiation oncology is a small specialty in New Zealand, with a significant reliance on overseas-trained specialists. The specialty continues to work significant overtime hours while time spent on research and non-clinical duties remains low. The growth in staffing between the 2014 and 2018 census has been low. Trainee numbers do not appear sufficient to meet the demand for replacing staff, due to retirements and the reduction of hours. Radiation intervention rates are low in New Zealand, but growth would be reliant on an expansion of the workforce beyond simply replacing staff losses. The radiation oncology workforce in New Zealand remains vulnerable, and careful consideration must be given to expansion and retention to ensure a viable workforce for the future.


Asunto(s)
Fuerza Laboral en Salud/estadística & datos numéricos , Oncólogos de Radiación/estadística & datos numéricos , Oncología por Radiación/educación , Oncología por Radiación/estadística & datos numéricos , Adulto , Braquiterapia/estadística & datos numéricos , Censos , Empleo/estadística & datos numéricos , Becas/estadística & datos numéricos , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Práctica Privada/estadística & datos numéricos , Sector Público/estadística & datos numéricos , Oncólogos de Radiación/provisión & distribución , Jubilación/estadística & datos numéricos , Factores Sexuales , Encuestas y Cuestionarios , Adulto Joven
9.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(4): 130-135, oct.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-197639

RESUMEN

OBJETIVO: Evaluar y comparar la precisión diagnóstica de las Simple rules, el sistema de regresión logística LR2 de IOTA y la valoración subjetiva aplicados por residentes de ginecología en la clasificación de benignidad o malignidad de lesiones anexiales. MATERIAL Y MÉTODOS: Fueron evaluadas las imágenes ecográficas de 94 lesiones anexiales por 3residentes de ginecología con un año de experiencia y con un entrenamiento teórico y práctico previo similar. La benignidad o malignidad fue determinada mediante 3 métodos: valoración subjetiva, Simple rules y modelo LR2. El grado de precisión en la clasificación de las lesiones se valoró mediante la sensibilidad, la especificidad, el valor predictivo positivo y negativo y la likelihood ratio positiva y negativa. Fue aportado también un diagnóstico de presunción histológica por cada ecografista. RESULTADOS: De las 94 lesiones, 73 resultaron benignas y 21 malignas. Los resultados estadísticos fueron los siguientes: Simple rules, sensibilidad 84,2% y especificidad 79,7%; LR2, sensibilidad 71,4% y especificidad 74%; valoración subjetiva, sensibilidad 65% y especificidad 76,1%. CONCLUSIONES: Los sistemas ecográficos de clasificación objetiva de lesiones anexiales han mostrado en la bibliografía mejores resultados diagnósticos que la valoración subjetiva aplicados por ecografistas no expertos. Las Simple rules y el LR2 se han descrito como 2de los más precisos y de más sencilla aplicación, por lo que podrían incorporarse en la evaluación ecográfica de masas anexiales por residentes de ginecología. En nuestro estudio observamos esta tendencia de una mayor precisión diagnóstica de estos sistemas predictivos respecto a la valoración subjetiva por residentes de ginecología, aunque sin que resultara estadísticamente significativa


OBJECTIVE: To evaluate and compare the diagnostic accuracy of the Simple Rules, the second logistic regression system of IOTA (LR2) and the subjective assessment used by gynaecology residents in the classification of benign or malignant adnexal lesions. MATERIAL AND METHODS: The ultrasound images of 94 adnexal lesions were evaluated by 3gynaecology junior doctors with one year of experience and with similar theoretical and practical training. The benignity or malignancy was determined by 3methods: subjective assessment, Simple Rules, and model LR2. The assessment of the degree of accuracy in the classification of the lesions was made by determining sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio. A diagnosis of histological presumption was also provided by each ultrasound operator. RESULTS: Of the 94 lesions, 73 were benign and 21 malignant. The statistical results were the following: Simple rules sensitivity 84.2% and specificity 79.7%; LR2 sensitivity 71.4% and specificity 74%; subjective assessment 65% sensitivity and specificity 76.1%. CONCLUSION: The ultrasound systems for objective classification of adnexal lesions have shown better diagnostic results in the literature than subjective assessment applied by non-expert sonographers. The Simple Rules and the LR2 have been described as 2of the most precise and simplest to apply, so they could be incorporated into the ultrasound evaluation of adnexal masses by gynaecology junior doctors. In this study, this trend of greater diagnostic accuracy was observed in these predictive systems regarding subjective assessment by gynaecology junior doctors, although without being statistically significant


Asunto(s)
Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades de los Anexos/clasificación , Enfermedades de los Anexos/diagnóstico por imagen , Modelos Logísticos , Internado y Residencia/estadística & datos numéricos , Neoplasias Ováricas/diagnóstico , Sensibilidad y Especificidad , Valor Predictivo de las Pruebas , Ultrasonografía/clasificación , Ultrasonografía/instrumentación , Estudios Retrospectivos , Intervalos de Confianza
10.
Emergencias (Sant Vicenç dels Horts) ; 32(6): 403-408, dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-ET2-7628

RESUMEN

OBJETIVO: Investigar la presencia del cuerpo doctrinal de la Medicina de Urgencias y Emergencias (MUE) en el examen de acceso a médico interno residente (MIR) en España y su evolución en el tiempo. MÉTODO: Estudio longitudinal retrospectivo. Tres investigadores revisaron independientemente las preguntas de los exámenes MIR de los últimos 10 años (2010-2019) y las clasificaron por acuerdo mayoritario como directamente, indirectamente o no relacionadas con la MUE. La temática de las preguntas directamente relacionadas con la MUE se clasificó según el índice del libro de texto de MUE de Tintinalli y según la clasificación de las áreas de la base Science Citation Index Expanded (SCIE) de la Web of Science. La evolución temporal de la presencia y la temática de la MUE se analizó mediante regresión lineal simple. RESULTADOS: Se revisaron 2.300 preguntas: 487 (22%) estaban directamente relacionadas con la MUE (313 citaban específicamente el escenario de urgencias o emergencias). La presencia de preguntas directamente relacionadas con la MUE se mantuvo constante entre 2010-2019 (p = 0,172). Siguiendo la clasificación de Tintinalli, las temáticas más frecuentes de estas preguntas fueron urgencias cardiovasculares (12,2%), infecciosas (11,1%) y gastrointestinales (10,9%), sin cambios significativos entre 2010-2019, mientras que siguiendo la clasificación del SCIE, estas temáticas fueron urgencias (11,9%, que aumentó significativamente durante el periodo, p = 0,005), cardiovascular (11,3%, que descendió, p = 0,037) y enfermedades infecciosas (10,7%, sin cambios durante el periodo). CONCLUSIÓN: La MUE, a pesar de no estar reconocida como una especialidad formativa por la vía MIR, tiene una elevada relevancia para la administración sanitaria a la hora de seleccionar a los MIR, que inician su formación especializada en el sistema público de salud, a juzgar por su elevada presencia en el examen anual al que se somete a los candidatos


OBJETIVE: To investigate the presence of fundamental concepts in emergency medicine on the entrance examination taken by candidates for medical internships and residency training in Spain, and to identify changes over time. METHODS: Longitudinal retrospective study. Three independent researchers reviewed questions on the entrance examinations of the past 10 years (2010-2019) and classified them as directly, indirectly, or not related to emergency medicine. The topics of directly related questions were also classified according to the categories listed in Tintinalli's Emergency Medicine and subject areas in the Citation Index Expanded (SCIE) of the Web of Science. Changes in the number of questions and range of topics were analyzed with simple linear regression models. RESULTS: A total of 2300 questions were reviewed; 487 (22%) were directly related to emergency medicine, and 313 of them specifically referred to an emergency or urgent care setting. The proportion of directly related questions held steady over the 10-year period (P=.172). The most frequently mentioned categories listed by Tintinalli were cardiovascular (12.2%), infectious (11.1%), and gastrointestinal (10.9%) emergencies, and no significant differences were noted over time. However, proportions assigned to the SCIE categories did change over time, as follows. Questions about emergency care in general (11.9% during the period overall) increased significantly with time(P=.005) whereas cardiovascular questions (11.3%) decreased (P=.037). The proportion of infectious disease topics remained the same (10.7%). CONCLUSION: Even though emergency medicine is not a recognized specialty for medical residency training in the public health system, questions on emergencies are considered important for evaluating candidates, judging by the high percentage of questions on the examinations


Asunto(s)
Humanos , Rendimiento Académico/normas , Medicina de Emergencia/educación , Internado y Residencia/estadística & datos numéricos , Evaluación Educacional/métodos , Educación de Postgrado en Medicina/normas , Criterios de Admisión Escolar , Medicina de Emergencia/normas , Estudios Retrospectivos , Estudios Longitudinales , Modelos Lineales , Competencia Clínica
11.
Can J Surg ; 63(5): E454-E459, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33107817

RESUMEN

SUMMARY: Small surgical residency programs like plastic surgery can be challenging environments to accommodate parental leave. This study aimed to report the experiences, attitudes and perceived support of Canadian plastic surgery residents, recent graduates and staff surgeons with respect to pregnancy and parenting during training. Residents and staff surgeons were invited via email to participate in an online survey. The results presented here explore experiences of pregnancy and parental leave of current plastic surgery residents and staff surgeons. Residents' and staff surgeons' perceptions of program director support, policies, negative comments and the impact of parental leave on the workload of others were also explored. Although the findings suggest that there may be improvements in the support of program directors, there continues to be a negative attitude in surgical culture toward pregnancy during residency. The perceived confusion of respondents with respect to programspecific policies emphasizes the need for open conversations and standardization of parental leave.


Asunto(s)
Actitud del Personal de Salud , Internado y Residencia/estadística & datos numéricos , Permiso Parental/estadística & datos numéricos , Embarazo/psicología , Cirugía Plástica/educación , Adulto , Canadá , Femenino , Humanos , Internado y Residencia/organización & administración , Masculino , Persona de Mediana Edad , Ejecutivos Médicos/psicología , Políticas , Embarazo/estadística & datos numéricos , Cirujanos/psicología , Cirujanos/estadística & datos numéricos , Cirugía Plástica/psicología , Cirugía Plástica/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Carga de Trabajo/psicología , Carga de Trabajo/estadística & datos numéricos
12.
Prim Health Care Res Dev ; 21: e47, 2020 10 28.
Artículo en Inglés | MEDLINE | ID: mdl-33109285

RESUMEN

AIM: Family physicians are role models for their societies in disaster management and have an important place in it. This study was carried out during the specialty training of the residents, who are currently family physicians fighting against COVID-19 in the field, and was aimed to identify the awareness levels of residents regarding the roles and duties of family physicians before, during, and after disasters and to increase their awareness of disaster medicine and management. BACKGROUND: The duties and responsibilities of a family physician in disasters should be a part of their specialty training. This study has contributed to the limited literature, increased awareness, and opened a new avenue of research for studies to be conducted with family physicians by demonstrating the current situation of family physicians in disaster management. METHODS: This is an observational and descriptive study. The knowledge, experience, opinions, willingness, attitudes of the residents, and the awareness levels of the residents regarding their roles and duties in a disaster were evaluated along with their sociodemographic information. The surveys were applied in the family medicine clinics of the all residents by the interview method (n = 233). FINDINGS: Only 9.2% of the residents stated that they had received training on disaster medicine where they currently work. The knowledge level of the residents on this subject was found as 'Unsure'. In total, 80% of the residents stated that family physicians should have a role in disasters. It was found that 83.3% of the residents had never joined a disaster drill, 94.3% had never participated in making or applying a disaster plan, and 97.7% had never worked in any disaster. CONCLUSION: The residents participating in the study lacked not only information on disaster management but also experience. The residents' willingness to receive training, work voluntarily, significantly question the curriculum, and specialize in disaster medicine were a positive outcome.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Medicina de Desastres/métodos , Internado y Residencia/estadística & datos numéricos , Rol del Médico , Médicos de Familia/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Turquia , Adulto Joven
13.
Obstet Gynecol ; 136(5): 987-994, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33030868

RESUMEN

OBJECTIVE: To assess whether a pediatric and adolescent gynecology electronic learning (eLearning) module improves knowledge and clinical performance among obstetrics and gynecology residents. METHODS: We conducted a multi-institutional, single-blinded, randomized controlled trial across four university programs; three had pediatric and adolescent gynecology rotations, and two had pediatric and adolescent gynecology fellowship-trained faculty. Applying permutated block randomization, residents were randomized to no intervention or completion of a validated eLearning module on prepubertal bleeding. All residents subsequently completed a pediatric and adolescent gynecology-related knowledge assessment that queried understanding of prepubertal bleeding and an objective structured clinical examination that assessed history collection, performance of a prepubertal genital examination, vaginal culture, and vaginoscopy for a pediatric patient. Objective structured clinical examinations were videotaped and reviewed by two faculty, blinded to randomization group; interrater reliability score was 97%. We calculated descriptive frequencies and compared randomization groups using χ analyses and Fisher exact tests for categorical variables, and median tests for continuous variables; a value of P<.05 was considered significant. RESULTS: From July 2018 to June 2019, we invited 115 residents to participate; 97 (83%) completed both objective structured clinical examination and follow-up knowledge assessments. Most were female (91%) and the majority reported limited pediatric and adolescent gynecology didactic or clinical experience, with 36% reporting prior didactics on prepubertal vaginal bleeding and 33% reporting prior exposure to the prepubertal genital examination. Forty-five participants (46%) were randomized to the module and groups were similar across training levels. Residents assigned to the module scored significantly higher on the knowledge assessment (4/5 vs 2/5, P<.001) and objective structured clinical examination (13/16 vs 7/16, P<.001) and were more likely to avoid a speculum in the examination of a pediatric patient (95.6% vs 57.7%, P<.001). CONCLUSION: Our pediatric and adolescent gynecology eLearning module resulted in improved short-term resident knowledge and simulated clinical skills among obstetrics and gynecology residents. Applying this learning technique in other programs may help address deficiencies in pediatric and adolescent gynecology education and training.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Ginecología/educación , Internado y Residencia/estadística & datos numéricos , Pediatría/educación , Entrenamiento Simulado/métodos , Adolescente , Adulto , Niño , Curriculum , Evaluación Educacional , Becas/métodos , Becas/estadística & datos numéricos , Femenino , Ginecología/métodos , Humanos , Internado y Residencia/métodos , Pediatría/métodos , Reproducibilidad de los Resultados , Método Simple Ciego
15.
PLoS One ; 15(8): e0238239, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32866220

RESUMEN

INTRODUCTION: Residency applications via virtual-interview could potentially mitigate the extensive cost and time required for customary in-person interviews. We outline the perception of medical students and residents on the use of virtual-interview for residency applications in lieu of in-person interviews. METHODS: We obtained 1824 responses from medical students and residents through an online questionnaire between March2019-Feb2020 in Texas-United States. The survey had 11 statements (five in favor of in-person interviews and 6 in favor of virtual interviews) that respondents could rank on a 5-point Likert scale. All statements' scores were summed based on the response given by each participant to create a total score between 11 and 55. The perception of the two groups was analyzed using an independent sample T-test and ANOVA. RESULTS: We received a total of 1711 responses from medical students and 113 from medical residents. Respondents were more female (82.2% of medical students and 47.8% of residents), with a mean age of 22.87±3.42 years old for medical students and 28.72±4.35 years old for residents. Both groups preferred in-person interviews; however, the residents were significantly more in favor (P = 0.03). Both groups agree that virtual-interviews should be as an option, though this was considerably higher in the medical students (P = 0.001). In the multivariate analysis, "travel distance" and "type of medical school" had a significant impact on choosing the virtual-interviews in both groups (p<0.01). CONCLUSIONS: In-person interviews are favored by both medical students and residents compared to virtual-interview services in normal circumstances. However, both groups agree that programs should offer the option of having virtual-interviews as an available choice. Distance to an interview location and the type of medical school were the factors that had a significant impact on perception of using virtual-interviews. Knowing about the applicants' attitude toward residency interviews and the national circumstances are essential when preparing the interview guides. Our findings are limited by the small sample size and the low response rate. Further extensive studies are warranted to better understand the perception of residency applicants toward virtual-interviews to improve the interview process in the United States.


Asunto(s)
Entrevistas como Asunto/métodos , Selección de Personal/métodos , Estudiantes de Medicina/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Entrevistas como Asunto/estadística & datos numéricos , Masculino , Criterios de Admisión Escolar/estadística & datos numéricos , Facultades de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Texas , Estados Unidos , Adulto Joven
16.
Int J Radiat Oncol Biol Phys ; 108(2): 416-420, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-32890524

RESUMEN

PURPOSE: Telemedicine was rapidly and ubiquitously adopted during the COVID-19 pandemic. However, there are growing discussions as to its role postpandemic. METHODS AND MATERIALS: We surveyed patients, radiation oncology (RO) attendings, and RO residents to assess their experience with telemedicine. Surveys addressed quality of patient care and utility of telemedicine for teaching and learning core competencies. Satisfaction was rated on a 6-point Likert-type scale. The quality of teaching and learning was graded on a 5-point Likert-type scale, with overall scores calculated by the average rating of each core competency required by the Accreditation Council for Graduate Medical Education (range, 1-5). RESULTS: Responses were collected from 56 patients, 12 RO attendings, and 13 RO residents. Patient feedback was collected at 17 new-patient, 22 on-treatment, and 17 follow-up video visits. Overall, 88% of patients were satisfied with virtual visits. A lower proportion of on-treatment patients rated their virtual visit as "very satisfactory" (68.2% vs 76.5% for new patients and 82.4% for follow-ups). Only 5.9% of the new patients and none of the follow-up patients were dissatisfied, and 27% of on-treatment patients were dissatisfied. The large majority of patients (88%) indicated that they would continue to use virtual visits as long as a physical examination was not needed. Overall scores for medical training were 4.1 out of 5 (range, 2.8-5.0) by RO residents and 3.2 (range, 2.0-4.0) by RO attendings. All residents and 92% of attendings indicated they would use telemedicine again; however, most indicated that telemedicine is best for follow-up visits. CONCLUSIONS: Telemedicine is a convenient means of delivering care to patients, with some limitations demonstrated for on-treatment patients. The majority of both patients and providers are interested in using telemedicine again, and it will likely continue to supplement patient care.


Asunto(s)
Educación de Postgrado en Medicina/estadística & datos numéricos , Internado y Residencia/estadística & datos numéricos , Atención al Paciente/estadística & datos numéricos , Oncología por Radiación , Telemedicina , Infecciones por Coronavirus/epidemiología , Humanos , Pandemias , Neumonía Viral/epidemiología
19.
Anesth Analg ; 131(4): 1201-1209, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32925341

RESUMEN

BACKGROUND: The critical question of racial and gender diversity in pediatric anesthesia training programs has not been previously explored. The primary objective of this study was to evaluate trends by race/ethnicity and gender in pediatric anesthesiology fellowship training programs in the United States for the years 2000 to 2018. METHODS: Demographic data on pediatric anesthesiology fellows and anesthesiology residents were obtained from the self-reported data collected for the Journal of the American Medical Association's annual report on Graduate Medical Education for the years 2000 to 2018. Diversity was assessed by calculating the proportions of trainees per year by gender and racial/ethnic groups in pediatric anesthesiology fellowship and anesthesiology residency programs. Logistic regression equations were developed to estimate the annual growth rate of each racial/ethnic groups. RESULTS: The number of pediatric anesthesiology fellows increased from 57 trainees in 2000-2001 to 202 in 2017-2018 at an average rate of 9 fellows per year (95% confidence interval [CI], 8-10). These increases were primarily due to white trainees (54.4%-63.4%) as the proportions of black (7.0%-4.5%), Asian (26.3%-21.3%), and other minority (12.3%-10.9%) trainees have remained low. The number of anesthesiology residents increased from 3950 trainees in 2000-2001 to 5940 in 2017-2018 at an average rate of 99 residents per year (95% CI, 88-111). Within all anesthesiology trainees, these increases were due to white trainees (55.7%-61.3%) as the proportion of black (5.0%-6.0%), Asian (25.8%-24.1%), and other minority trainees (8.2%-8.5%) has remained fairly constant over the time period. Despite the overall lower proportion of female anesthesiology residents (range: 27.0%-37.5%), a steady increase in the number of women in pediatric anesthesiology fellowship programs has reversed the gender imbalance in this population as of 2010. CONCLUSIONS: While historic gains have been made in gender diversity in pediatric anesthesiology, there is persistent underrepresentation of black and Hispanic trainees in pediatric anesthesiology. It appears that their low numbers in anesthesiology residency programs (the reservoir) may be partly responsible. Efforts to increase ethnic/racial diversity in pediatric anesthesiology fellowship and anesthesiology residency training programs are urgently needed.


Asunto(s)
Anestesiología/educación , Grupos Étnicos/estadística & datos numéricos , Becas/estadística & datos numéricos , Internado y Residencia/estadística & datos numéricos , Pediatría/educación , Sexismo/estadística & datos numéricos , Adulto , Afroamericanos , Americanos Asiáticos , Niño , Estudios de Cohortes , Educación de Postgrado en Medicina , Grupo de Ascendencia Continental Europea , Femenino , Hispanoamericanos , Humanos , Masculino , Grupos Minoritarios , Apoyo a la Formación Profesional , Estados Unidos , Adulto Joven
20.
Artículo en Inglés | MEDLINE | ID: mdl-32916996

RESUMEN

This study aimed to explore changes in psychological responses (perceived stress, traumatic stress, stigma, coping) over time in residents, as well as their predictors. The level of perceived stress, traumatic stress, stigma, and coping responses were assessed using the Perceived Stress Scale, Impact of Event-Revised, Healthcare Workers Stigma Scale, and Brief Coping Orientation to Problems Experienced (COPE) Inventory, respectively. We collected responses from 274 residents at baseline and 221 residents at 3 months follow-up (timepoint 2) from the National Healthcare Group (NHG) residency programs in Singapore. All residents reported lower perceived stress and lower perceived stigma compared to baseline. Use of avoidance coping was associated with all three psychological responses (perceived stress, traumatic stress, and stigma) across the two timepoints. Compared to baseline, specific factors associated with perceived stress and traumatic stress at timepoint 2 were living alone, less problem solving, and seeking social support. Residency programs should encourage active coping strategies (e.g., seeking social support, positive thinking, problem solving) among residents, and proactively identify residents who may be at higher risk of psychological sequelae due to circumstances that contribute to isolation.


Asunto(s)
Adaptación Psicológica , Infecciones por Coronavirus/psicología , Internado y Residencia/estadística & datos numéricos , Médicos/psicología , Neumonía Viral/psicología , Estigma Social , Trastornos de Estrés Traumático/psicología , Estrés Psicológico/psicología , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Humanos , Estudios Longitudinales , Pandemias , Neumonía Viral/epidemiología , Singapur , Estrés Psicológico/etnología
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