Resident Attitudes and Experiences with a Novel Radiology-based Transgender Curriculum: A Qualitative Study.

RATIONALE AND OBJECTIVES: Transgender persons often experience healthcare disparities due to lack of provider knowledge. With increasing gender diversity awareness and prevalence of gender-affirming care, radiologists-in-training need to be aware of the unique health considerations for this patient population. Radiology residents have limited exposure to dedicated teaching on transgender medical care and imaging during training. Development and implementation of a radiology-based transgender curriculum can help close this gap in radiology residency education. The aim of this study was to explore radiology resident attitudes and experiences with a novel radiology-based transgender curriculum, guided by the conceptual framework of reflective practice. MATERIALS AND METHODS: A qualitative approach was employed using semi-structured interviews to explore resident perspectives of a curriculum covering transgender patient care and imaging over 4 monthly sessions. Ten residents at the University of Cincinnati radiology residency participated in interviews consisting of open-ended questions. Interviews were audiotaped, transcribed, and thematic analysis was conducted across all responses. RESULTS: Four themes emerged through the existing framework: 1) impactful/memorable aspects; things learned; increased awareness; and suggestions/feedback. Prominent subthemes included patient panel and stories, physician experts sharing knowledge and experiences, link to radiology and imaging, novel concept, gender-affirming surgeries and anatomy, appropriate radiology reporting, and patient interactions. CONCLUSION: Radiology residents found the curriculum to be an effective novel educational experience that was previously unaddressed during their training. This imaging-based curriculum can be further adapted and implemented in a variety of radiology curricular settings.

Qualitative assessment of nurse satisfaction in the paediatric cardiac ICU.

The objective of this qualitative assessment, utilising the constant comparative method, was to identify satisfiers and dissatisfiers that influence paediatric cardiac ICU nurse retention and recognise areas for improvement. Interviews for this study were performed in a single, large academic children's hospital from March of 2020 through July of 2020. Each bedside paediatric cardiac ICU nurse underwent a single semi-structured interview. Among 12 interviews, four satisfiers were identified: paediatric cardiac ICU patient population, paediatric cardiac ICU care team, personal accomplishment, and respect. Four dissatisfiers were identified: moral distress, fear, poor team dynamics, and disrespect. Through this process of inquiry, grounded theory was developed regarding strategies to improve paediatric cardiac ICU nurse retention. Tactics outlined here should be used to support retention in the unique environment of the paediatric cardiac ICU.

The strength of our stories: a qualitative analysis of a multi-institutional GME storytelling event.

Context: Storytelling is a powerful tool for encouraging reflection and connection among both speakers and listeners. While growing in popularity, studying the benefits of formal oral storytelling events within graduate medical education remains rare. Our research question was: could an oral storytelling event for GME trainees and faculty be an effective approach for promoting well-being and resilience among participants?Methods: We used multiple approaches to gather perspectives from physician participants (storytellers and audience members) at an annual oral storytelling event for residents, fellows, and faculty from seven academic health systems in Minnesota. Data sources included short reflections written by participants during the event, an immediate post-event survey exploring participants' experiences during the event, social media postings, and targeted follow-up interviews further exploring the themes of connection and burnout that were raised in post-event survey responses. We performed a qualitative analysis using both deductive and inductive coding to identify themes.Results: There were 334 participants, including 197 physicians. At the event, 129 real-time written reflections were collected. There were also 33 Twitter posts related to the event. Response rate for the post-event survey was 65% for physicians, with 63% of physician respondents volunteering for targeted follow-up interviews. Of those, 38% completed the follow-up interview. Themes that emerged from the multi-modal qualitative analysis included a sense of connection and community, re-connection with meaning and purpose in work, renewal and hope, gratitude, and potential impact on burnout.Conclusion: The large turnout and themes identified show how an oral storytelling event can be a powerful tool to build community in graduate medical education. Qualitative analysis from multiple sources obtained both in real-time at the event and upon deeper reflection afterwards showed the event positively impacted the well-being of participants and that oral storytelling events can be an effective approach for promoting resilience in GME.

The pediatrics milestones: initial evidence for their use as learning road maps for residents.

OBJECTIVE: As the next step in competency-based medical education, the Pediatrics Milestone Project seeks to provide a learner-centered approach to training and assessment. To help accomplish this goal, this study sought to determine how pediatric residents understand, interpret, and respond to the Pediatrics Milestones. METHODS: Cognitive interviews with 48 pediatric residents from all training levels at 2 training programs were conducted. Each participant reviewed one Pediatrics Milestone document (PMD). Eight total Pediatrics Milestones, chosen for their range of complexity, length, competency domain, and primary author, were included in this study. Six residents, 2 from each year of residency training, reviewed each PMD. Interviews were transcribed and coded using inductive methods, and codes were grouped into themes that emerged. RESULTS: Four major themes emerged through coding and analysis: 1) the participants' degree of understanding of the PMDs is sufficient, often deep; 2) the etiology of participants' understanding is rooted in their experiences; 3) there are qualities of the PMD that may contribute to or detract from understanding; and 4) participants apply their understanding by noting the PMD describes a developmental progression that can provide a road map for learning. Additionally, we learned that residents are generally comfortable being placed in the middle of a series of developmental milestones. Two minor themes focusing on interest and practicality were also identified. CONCLUSIONS: This study provides initial evidence for the Pediatrics Milestones as learner-centered documents that can be used for orientation, education, formative feedback, and, ultimately, assessment.