Virtual interviewing in the COVID-19 era: A survey of graduate program directors.

PURPOSE/OBJECTIVE: Due to the coronavirus pandemic, virtual interviews became a mainstay of graduate dental and medical education selection processes. To gain a handle on how to navigate lingering uncertainties about how interviews should be conducted in the future, this study examined the benefits and pitfalls of the virtual interview process (VIP) and assessed program plans to implement in the next interview cycle. METHODS: An anonymous online survey, for completion by one program representative (director or associate director), was sent to graduate medical education (GME) and advanced dental education programs at West Virginia University (N = 74). RESULTS: Fifty-two (52) of the programs (70%) completed the survey. Zoom was the most frequently used interview platform (78.8%). Approximately two thirds (65.4%) of the interviewers thought VIP allowed the program to promote the university, the school, and their program and also reported experiencing video-conferencing fatigue. About six in 10 perceive VIP can introduce bias in selecting applicants (59.6%) and potentially disadvantage some applicants (67.3%). Compared to the previous in-person cycle, 67.4% of programs invited more applicants, and 73.1% interviewed more applicants. Regarding the 2021-2022 interview cycle, 55.8% of programs plan to offer either an in-person or VIP, while 7.7% plan to keep their process completely virtual. CONCLUSION: Graduate programs in this study demonstrated the indispensability of technology in transitioning from in-person to virtual interviews during COVID-19 pandemic. VIP has several advantages and disadvantages; this style of interview is forecasted to have a presence in applicant selection in the future.

The influence of medical insurance on obstetrical care.

Maternal and obstetrical outcomes vary widely within the United States. The impact of insurance type on health care disparities and its influence on obstetrical care and maternal outcome is not clear. We report the impact of health care insurance on obstetrical and maternal outcomes in a tertiary care health care system. Our maternal quality care database (n = 4199) was queried comparing commercial insurance to government sponsored insurance from July 1, 2015 through June 30, 2018. Parturients with commercial insurance were older, weighed more, presented with less gravidity and parity, had more advanced gestation, and had a higher neonatal 5-minute Apgar score than government insured parturients. Additionally, government insured parturients were less likely to be admitted for induction with oxytocin, receive labor epidural analgesia, and have a primary caesarean delivery. Similarly, government insured parturients were more likely to be of African American descent, be a current known smoker, have a positive urine drug screen, and receive a general anesthetic. We conclude obstetrical and maternal health care disparities exist based on medical insurance type.

Lower-Third SLOE Rankings Impede, But Do Not Prevent, A Match in Emergency Medicine Residency Training.

OBJECTIVE: Emergency medicine program directors (PD) value the standardized letter of evaluation (SLOE) as the most important aspect of a residency application when making both invitation and ranking decisions. This study aims to determine whether the presence of any lower-third in either SLOE global assessment (GA) question impacted the ability of an applicant to match into EM. We hypothesized that any lower-third ranking would be associated with increased odds of not matching into EM. METHODS: We conducted a retrospective cohort study evaluating allopathic applicants from medical schools in the United States (US allopathic applicants) to a single EM residency program during the 2018/2019 match cycles. GA SLOE rankings from all applications were tabulated and compared to the applicant's National Resident Matching Program (NRMP) match outcome. Comparative analyses were conducted between SLOE groupings and odds ratios (OR) were calculated. RESULTS: A total of 2,017 SLOEs from 781 US allopathic applicants were analyzed during the study period. Of the total, 277 (35%) applicants in our sample had any lower-third GA ranking, which significantly decreased an applicant's odds of matching in EM by 79% (OR 0.21, 95% CI, 0.12-0.34). Having more than one lower-third GA ranking did not further statistically decrease the odds of a successful EM match (OR 0.60, 95% CI 0.31-1.17). As a secondary finding of the study, results demonstrate that those applicants having no lower-third GA rankings had a nearly 5 times increased odds of an EM match (OR 4.84, 95% CI, 2.91-8.03). CONCLUSION: Having any lower-third GA ranking significantly reduced an applicant's chances of matching into an EM program. Faculty advisors should be aware of the increased risk of not matching for any applicant with any lower-third GA ranking and advise students appropriately, while maintaining the integrity of the SLOE and not divulging the confidential information contained within.

Hospital Spiritual Care Can Complement Graduate Medical Trainee Well-Being.

BACKGROUND: Burnout and depression among physician trainees is increasing at an alarming rate. Promoting well-being is of utmost importance for graduate medical education. The primary objective was to determine if spiritual care staff/chaplaincy can assist in building emotional well-being and resiliency within medical residency education. METHODS: For the academic year of July 2017 through June 2018, all graduate medical trainees in our institution were given the option of attending either an individual or group spiritual care session as part of a universal "Call to Wellness" curriculum. A Post-Wellness Survey was administered to measure perceptions about the program. RESULTS: 49% (N = 258) of residents chose to participate in a spiritual care session. Prior to the session, 51% (N = 132) rated their overall well-being as neutral and 25% (N = 64) rated their overall well-being as slightly positive, positive, or very positive. After their spiritual care session, significant improvement was seen. 25% (N = 64) rated their overall well-being as neutral, and 51% (N = 132) rated their overall well-being as slightly positive, positive, or very positive (p < 0.001). CONCLUSION: Spiritual care staff/chaplaincy can have a positive influence on emotional well-being for physicians during residency training.

A Review of Continuous Quality Improvement Processes at Ten Medical Schools.

The Liaison Committee on Medical Education now expects all allopathic medical schools to develop and adhere to a documentable continuous quality improvement (CQI) process. Medical schools must consider how to establish a defensible process that monitors compliance with accreditation standards between site visits. The purpose of this descriptive study is to detail how ten schools in the Association of American Medical Colleges' (AAMC) Southern Group on Educational Affairs (SGEA) CQI Special Interest Group (SIG) are tackling practical issues of CQI development including establishing a CQI office, designating faculty and staff, charging a CQI committee, choosing software for data management, if schools are choosing formalized CQI models, and other considerations. The information presented is not meant to certify that any way is the correct way to manage CQI, but simply present some schools' models. Future research should include defining commonalities of CQI models as well as seeking differences. Furthermore, what are components of CQI models that may affect accreditation compliance negatively? Are there "worst practices" to avoid? What LCME elements are most commonly identified for CQI, and what are the successes and struggles for addressing those elements? What are identifiable challenges relating to use of standard spreadsheet software and engaging information technology for support? How can students be more engaged and involved in the CQI process? Finally, how do these major shifts to a formalized CQI process impact the educational experience?

An Internet-based pediatric clerkship examination.

A traditional paper final exam was expensive and time consuming to create, administer and grade at two separate training sites. Our goal was to determine whether restructuring the final pediatric clerkship examination using Internet technology could lower costs and be more efficient, reliable and preferred by students. Costs and coordinator time were compared with the prior year of traditional testing. Student satisfaction was determined by an electronic post-test survey. To evaluate for reliability, the scores on our Internet test were compared with United States Medical Licensing Examination (USMLE) shelf scores. An estimated 1200 US dollars per year of department costs was saved, and coordinator time was greatly reduced. The post-test survey indicated the students were very satisfied with this testing. When compared with USMLE scores the Cronbach's alpha was 0. 70, and the Pearson Correlation was r = 0.414 (p<0. 001). It is concluded that a well-designed Internet-based test has advantages over a traditional paper exam. It reduces incremental department costs, is reliable,preferred by students and can be given simultaneously at multiple locations.

Community service, learning and the medical student.

CONTEXT: Medical students need learning experiences outside the classroom, clinic room and hospital room if they are to become integral parts of the communities in which they will practice medicine. Service-learning incorporated into the traditional medical school curriculum can provide a vehicle to accomplish this goal, and provide an avenue to enhance the professional development of the physician in training. METHODS: This paper describes efforts to incorporate community service and service-learning into a traditional medical school curriculum. The unique nature of our location in a rural state with several required rural rotations with our local community partners has facilitated this effort. CONCLUSION: Incorporation of service-learning into a medical curriculum can be accomplished and will enhance the professional development of the students.