Creation and Implementation of an Online Tool for Feedback on Resident Teaching: A Pilot Study.

OBJECTIVE: There are few assessments of the competence and growth of surgical residents as educators. We developed and piloted an observation-based feedback tool (FT) to provide residents direct feedback during a specific teaching session, as perceived by medical students (MS). We hypothesized that residents' performance would improve with frequent, low stakes, observation-based feedback. SETTING: This prospective study took place at an academic general surgery program. PARTICIPANTS: Focus groups of MS, surgical residents, and faculty informed FT development. MS completed the FT regarding resident teaching. DESIGN: The FT utilized 5 slider-bar ratings (0 to 100) about the teaching encounter and a checklist of 16 desirable teaching behaviors. QR codes and weekly email links were distributed for 12 months (6 clerkship blocks) to promote use. Residents were sent their results after each block. A survey after each block assessed motivation for use and gathered feedback on the FT. Descriptive statistics were used for analysis (medians, IQRs). Primary measures of performance were median of the slider-bar scores and the number of teaching behaviors. RESULTS: The FT was used 111 times; 37 of 46 residents were rated by up to 65 MS. The median rating on the slider-bars was 100 and the median number of desirable teaching behaviors was 12; there were no differences based on gender or PGY level. 10 residents had 5 or more FT observations during the year. Four residents had evaluations completed in 4 or more blocks and 19 residents had evaluations completed in at least 2 blocks. Over time, 13 residents had consistent slider-bar scores, 1 resident had higher scores, and 5 residents had lower scores (defined as a more than 5-point change from initial rating). Frequency of use of the FT decreased over time (38, 32, 9, 21, 7, 5 uses per block). The post-use survey was completed by 24 MS and 19 residents. Most common reasons for usage were interest in improving surgical learning environment, giving positive feedback (MS), and improving teaching skills (residents). Most common reasons for lack of usage from residents were "I did not think I taught enough to ask for feedback," "I forgot it existed," and "I did not know it existed." CONCLUSIONS: The FT did not lead to any meaningful improvement in resident scores over the course of the year. This may be due to overall high scores, suggesting that the components of the FT may require reevaluation. Additionally, decreased utilization of the instrument over time made it challenging to assess change in performance of specific residents, likely due to lack of awareness of the FT despite frequent reminders. Successful implementation of observation-based teaching assessments may require better integration with residency or clerkship objectives.

Patient Abuse, Neglect, and Exploitation: Why Physicians Need to Be Trauma-Informed.

Introduction: Many people experience trauma, and its cumulative effects throughout the life span can alter health, development, and well-being. Despite this, few publications focusing on interpersonal trauma include a holistic understanding of the nature and widespread exposure of trauma experiences for patients. We developed an educational resource to teach residents about identifying and intervening with patients who experience trauma across the life span using a trauma-informed care (TIC) perspective. Methods: We created a 4-hour educational session for residents that included didactics, a virtual visit with a domestic violence shelter, a discussion with a person who had experienced trauma, and role-playing. A pretest/posttest retrospective survey assessed resident confidence level in identifying and intervening with patients who may have experienced trauma. We used the Wilcoxon signed rank test to compare pretest and posttest scores and the Kruskal-Wallis test to compare responses by residency type and year. Free-text questions were analyzed for thematic content. Results: During the 2021-2022 academic year, 72 of 90 residents (80%) from four residency programs attended and evaluated the session. More than 90% of respondents reported the session met their educational needs and provided them with new ideas, information, and practical suggestions to use in their clinical endeavors. The results demonstrated significantly increased confidence on most of the metrics measured. Discussion: This session significantly improved residents' confidence in identifying and intervening with patients who have had trauma experiences using a TIC perspective, which may lead them to provide improved patient care to those who have experienced trauma.

Use of Simulation For Training Advanced Colorectal Procedures.

OBJECTIVE: Simulation training for minimally invasive colorectal procedures is in developing stages. This study aims to assess the impact of simulation on procedural knowledge and simulated performance in laparoscopic low anterior resection (LLAR) and robotic right colectomy (RRC). DESIGN: LLAR and RRC simulation procedures were designed using human cadaveric models. Resident case experience and simulation selfassessments scores for operative ability and knowledge were collected before and after the simulation. Colorectal faculty assessed resident simulation performance using validated assessment scales (OSATS-GRS, GEARS). Paired t-tests, unpaired t-tests, Pearson's correlation, and descriptive statistics were applied in analyses. SETTING: Barnes-Jewish Hospital/Washington University School of Medicine in St. Louis, Missouri. PARTICIPANTS: Senior general surgery residents at large academic surgery program. RESULTS: Fifteen PGY4/PGY5 general surgery residents participated in each simulation. Mean LLAR knowledge score increased overall from 10.0 ±  2.0 to 11.5  ±  1.6 of 15 points (p = 0.0018); when stratified, this increase remained significant for the PGY4 cohort only. Mean confidence in ability to complete LLAR increased overall from 2.0 ±  0.8 to 2.8  ± 0.9 on a 5-point rating scale (p = 0.0013); when stratified, this increase remained significant for the PGY4 cohort only. Mean total OSATS GRS score was 28  ±  6.3 of 35 and had strong positive correlation with previous laparoscopic colorectal experience (r = 0.64, p = 0.0092). Mean RRC knowledge score increased from 9.4 ±  2.2 to 11.1 ±  1.5 of 15 points (p = 0.0030); when stratified, this increase again remained significant for the PGY4 cohort only. Mean confidence in ability to complete RRC increased from 1.9 ±  0.9 to 3.2  ±  1.1 (p = 0.0002) and was significant for both cohorts. CONCLUSIONS: Surgical trainees require opportunities to practice advanced minimally invasive colorectal procedures. Our simulation approach promotes increased procedural knowledge and resident confidence and offers a safe complement to live operative experience for trainee development. In the future, simulations will target trainees on the earlier part of the learning curve and be paired with live operative assessments to characterize longitudinal skill progression.

Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning.

OBJECTIVE: Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly resident assessments of clinical care across multiple domains (case summary, complications, error analysis, Clavien-Dindo Harm, cognitive bias, standard of care, and ACGME core competencies). We hypothesized that incorporation of this system into the residency program's core curriculum would allow for identification of areas of cognitive weakness or strength and provide a longitudinal evaluation of critical thinking development. DESIGN: A validated, password-protected electronic platform linked to our electronic medical record was used to collect cases weekly in which surgical adverse events occurred. General surgery residents critiqued 1932 cases over a 4-year period from 3 major medical centers within our system. These data were reviewed by teaching faculty, corrected for accuracy and graded utilizing the software's critique algorithm. Grades were emailed to the residents at the time of the review, collected prospectively, stratified, and analyzed by post-graduate year (PGY). Evaluation of the resident scores for each domain and the resultant composite scores allowed for comparison of critical thinking skills across post-graduate year (PGY) over time. SETTING: Data was collected from 3 independently ACGME-accredited surgery residency programs over 3 tertiary hospitals within our health system. PARTICIPANTS: General surgery residents in clinical PGY 1-5. RESULTS: Residents scored highest in properly identifying ACGME core competencies and determining Clavien-Dindo scores (p < 0.006) with no improvement in providing accurate and concise clinical summaries. However, residents improved in recording data sufficient to identify error (p < 0.00001). A positive linear trend in median scores for all remaining domains except for cognitive bias was demonstrated (p < 0.001). Senior residents scored significantly higher than junior residents in all domains. Scores > 90% were never achieved. CONCLUSIONS: The use of an electronic standardized critique algorithm in the evaluation and assessment of adverse surgical case outcomes enabled the measure of residents' critical thinking skills. Feedback in the form of teaching faculty-facilitated discussion and emailed grades enhanced adult learning with a steady improvement in performance over PGY. Although residents improved with PGY, the data suggest that further improvement in all categories is possible. Implementing this standardized critique algorithm across PGY allows for evaluation of areas of individual resident weakness vs. strength, progression over time, and comparisons to peers. These data suggest that routine complication reporting may be enhanced as a critical thinking assessment tool and that improvement in critical thinking can be quantified. Incorporation of this platform into M&M conference has the potential to augment executive function and professional identity development.

The efficacy of ultrasonography on learning curve and inter-subject performance variability in radial artery cannulation in standardized training for residents: a randomized controlled trial.

AIM: To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation. MATERIAL AND METHODS: Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided into two groups: anatomy group or US group. After training of relevant anatomy, US recognition and puncture skill, residents selected 10 patients either under US or anatomical localization performing radial artery catheterization. The number and time of successful cases of catheterization were recorded, success rate of first attempt and catheterization, as well as the total success rate of catheterization were calculated. The learning curve and inter-subject performance variability of residents were also calculated. Complications and the residents' satisfaction for teaching and self-confidence before puncture were also recorded. RESULTS: Compared to the anatomy group, total success rate and the success rate at first attempt were higher in US-guided group (88% vs. 57%, 94% vs. 81%). The average performance time in the US group was significantly less (2.9±0.8 min vs. 4.2±2.1 min) and the mean number of attempts was 1.6, while 2.6 for the anatomy group. With performing cases increasing, the average puncture time of residents in the US group decreased by 19s, while 14s in the anatomy group. More local hematoma occurred in the anatomy group. The satisfaction and confidence degree of residents were higher in US group ([98.5±6.5] vs [68.5±7.3], [90.2±8.6] vs [56.3±5.5]). CONCLUSION: US can significantly shorten the learning curve, reduce the inter-subject performance variability, improve the first attempt and total success rate of radial artery catheterization for non-anesthesiology residents.

Guía de elaboración de preguntas de examen múltiple choice

Esta guía es un instrumento para la elaboración de preguntas de opción múltiple. Se trata de un documento para orientar la tarea de construcción de los exámenes de ingreso al Sistema de Residencias del Sistema de Salud del Gobierno de la Ciudad Autónoma de Buenos Aires. Este examen tiene como función principal permitir la confección de un ranking u orden de mérito de postulantes en base a su nivel de conocimientos disciplinares y transversales a todas la profesiones que se desarrollan en el sistema sanitario. La confiabilidad del examen como instrumento evaluador y ordenador depende de la calidad de las preguntas que se utilicen. Preguntas "demasiado fáciles" o, por el contrario, "muy difíciles", discriminan deficientemente entre un mayor y menor nivel de conocimientos. A fin de aportar a la confiabilidad y calidad del examen, esta guía presenta pautas de armado de las preguntas que se consideran son puntos clave para construir un producto de calidad que aporte a cumplir con la función del examen de ingreso al Sistema de formación en servicio. (AU)

Desarrollo de la ciencia y la tecnología en las habilidades del internado rotatorio de Cirugía General / Development of science and technology in the skills of a General Surgery rotatory internship

Introducción: El desarrollo científico técnico mundial impone nuevos retos sociales y económicos, y responde a una educación de calidad, que permita la aplicación de este avance en las nuevas tecnologías. Objetivo: Exponer el desarrollo de la ciencia y la tecnología en el mejoramiento de la enseñanza de las habilidades teórico-prácticas en los estudiantes de medicina del internado rotatorio de Cirugía General. Métodos: El estudio empleó la contrastación de métodos teóricos como el histórico-lógico, el análisis documental y la sistematización teórica, para la recolección de información, la construcción, el desarrollo y la conformación final del producto. Conclusiones: Se actualizaron los fundamentos filosóficos, y los conocimientos teóricos del aprendizaje y las nuevas tecnologías para el mejoramiento de la enseñanza de las habilidades teórico-prácticas en los estudiantes de medicina del internado rotatorio de Cirugía General. El desarrollo tecnológico, la enseñanza y la práctica de la ética médica permiten solucionar los problemas de salud de la población en los distintos niveles de atención, lo cual contribuye con la formación integral del futuro médico general(AU)

Introduction: The global scientific-technical development imposes new social and economic challenges, as well as it responds to a quality education, which allows for the application of this advance to new technologies. Objective: To expose the development of science and technology for improving the theoretical-practical skills of medical students during a general surgery rotatory internship. Methods: The study used the opposition of theoretical methods such as the historical-logical, document analysis and theoretical systematization, for the collection of information, construction, development and final conformation of the product. Conclusions: The philosophical foundations were updated, together with the theoretical knowledge about learning and new technologies for improving the teaching of theoretical-practical skills among medical students during a general surgery rotatory internship. Technological development, teaching and practice of medical ethics allow solving the health problems of the population at different levels of care, which contributes to the integral formation of the future general physician(AU)

Improving Resident Knowledge of Ergonomics Guidelines.

OBJECTIVE: To improve resident knowledge of ergonomics guidelines for surgery, vaginal deliveries and repairs, and documentation. PROJECT SUMMARY: We consulted with a licensed occupational therapist at our institution regarding our difficulties with maintaining proper ergonomics while operating, performing deliveries, and documenting. We conducted two separate sessions: one in the obstetrics workroom regarding techniques to improve the ergonomics of our documentation and one in the operating room and labor and delivery unit to address techniques to avoid injury and promote long-term wellness. The sessions were conducted during morning report at our institution, and the obstetrics and gynecology teams attended both sessions. The sessions were available by videoconference for the entire residency program. Handouts were created to present basic ergonomics guidelines and were provided at the conclusion of the sessions. The handouts summarized the information provided during the sessions and included recommendations for adjustments that could be made in the workroom, operating room, and delivery room. The sessions were conducted during ACOG Wellness Week. OUTCOME: Adjustments were made in the obstetric and gynecology team workrooms to improve ergonomic function. Sessions improved resident knowledge of ergonomics recommendations for vaginal deliveries. Recommendations included guidelines for arm and shoulder position, tucked chins, and appropriate bed height (sitting vs standing). Adjustments were made in the workroom to position the top of the monitor just below eye level and arm's length away, and chairs were adjusted so that the keyboard and mouse height were just below elbow height. Residents were encouraged to keep arms and wrists in a relaxed, neutral position and to sit all the way back in the chair with back supported and feet firmly on the floor. Residents improved their knowledge of ergonomics guidelines and increased awareness of posture and positioning both on the labor and delivery unit and in the operating room. RELEVANCE TO WOMENS HEALTH OR PHYSICIANS IN PRACTICE: Work-related musculoskeletal disorders are prevalent among surgeons and can have a significant effect on productivity and career longevity. If we are able to implement evidence-based guidelines developed by high-quality ergonomics research, we can potentially protect obstetricians and gynecologists from injury and improve overall wellness.

Programa MIR. ¿De dónde venimos? / MIR program. Where do we come from?

En 1976 se implantó el sistema formativo MIR (médicos internos residentes) en España. Su aceptación y sus resultados han sido un éxito. Sin embargo, hemos vivido momentos de incertidumbre (por ejemplo, la fallida implantación del proyecto de troncalidad) y conflicto (por ejemplo, la prueba de acceso, el método de elección de plazas, etc.).En tiempos en los que se reflexiona sobre cambiar la estructura o los contenidos de la formación médica especializada parece útil recordar de dónde venimos. Conocer el prototipo de residencia quirúrgica tradicional permite reflexionar y tomar decisiones.El sistema MIR español es una extrapolación del modelo norteamericano de “aprender trabajando”. En 1889 nació el primer programa moderno de residencia quirúrgica, desarrollado bajo la influencia de William Stewart Halsted (1852-1922) en el hospital Johns Hopkins (Baltimore, Maryland, Estados Unidos).El concepto de residencia de Halsted, muy influido por sus experiencias y su personalidad, era muy rígido (sistema piramidal) y severo (muchos años y a tiempo completo). No obstante, logró excelentes resultados académicos entre sus discípulos, muchos de los cuales superaron al maestro. Ellos difundieron el modelo hastediano de residencia por toda Norteamérica.La adaptación del modelo residencial “tipo Halsted” ha sido la base de los programas formativos de excelencia que actualmente existen.(AU)

In 1976 the MIR training system (resident intern medical) was introduced in Spain. Its acceptance and results have been a success. However, we have experienced moments of uncertainty (e.g. failed implementation of the trunk project) and conflict (e.g. entrance exam, method of choice of places, etc.).In times when it is considered to change the structure and/or contents of specialized medical training, it seems useful to remember where we come from. Knowing the prototype of the classic surgical residency allows you to reflect and make decisions.The Spanish MIR system is an extrapolation of the North American model of “learn by working”. In 1889 the first modern surgical residency program was born, developed under the influence of William Stewart Halsted (1852-1922) at Johns Hopkins Hospital (Baltimore, Maryland, USA).Halsted's concept of residence, greatly influenced by his experiences and personality, was very rigid (pyramidal system) and severe (many years and full time). However, he achieved excellent academic results among his disciples, many of whom surpassed the teacher; they spread the Hastedian model of residence throughout North America.The adaptation of the residential model “Halsted type” has been the basis of the training programs of excellence that currently exist.(AU)

Impact of Bedside Rounding on Attending Teaching Evaluations.

OBJECTIVE: To examine associations between bedside rounding (BSR) and other rounding strategies (ORS) with resident evaluations of teaching attendings and self-reported attending characteristics. METHODS: Faculty from three academic medical centers who attended resident teaching services for ≥4 weeks during the 2018-2019 academic year were invited to complete a survey about personal and rounding characteristics. The survey instrument was iteratively developed to assess rounding strategy as well as factors that could affect choosing one rounding strategy over another. Survey results and teaching evaluation scores were linked, then deidentified and analyzed in aggregate. Included evaluation items assessed resident perceptions of autonomy, time management, professionalism, and teaching effectiveness, as well as a composite score (the numeric average of each attending's scores for all of the items at his or her institution). BSR was defined as spending >50% of rounding time in patients' rooms with the team. Hallway rounding and conference room rounding were combined into the ORS category and defined as >50% of rounding time in these settings. All of the scores were normalized to a 10-point scale to allow aggregation across sites. RESULTS: A total of 105 attendings were invited to participate, and 65 (62%) completed the survey. None of the resident evaluation scores significantly differed based on rounding strategy. Composite scores were similar for BSR and ORS (difference of <0.1 on a 10-point scale). Spearman correlation coefficients identified no statistically significant correlation between rounding strategy and evaluation scores. An exploratory analysis of variance model identified no single factor that was significantly associated with composite teaching scores (P > 0.45 for all) or the domains of teaching efficacy, professionalism, or autonomy (P > 0.13 for all). Having a formal educational role was significantly associated with better evaluation scores for time management, and the number of lectures delivered per year approached statistical significance for the same domain. CONCLUSIONS: Conducting BSR did not significantly affect resident evaluations of teaching attendings. Resident perception of teaching effectiveness based on rounding strategy should be neither a motivator nor a barrier to widespread institution of BSR.

Training Surgery Residents to be Leaders: Construction of a Resident Leadership Curriculum.

SUMMARY: Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plastic surgery residents who had served as chief residents before plastic surgery training. Their maturity emotionally and surgically allowed them to immediately concentrate on the new language and principles of plastic surgery. They had led others and were capable of leading themselves in a new surgical discipline. Today, medical students typically match into surgical specialties directly out of medical school and need to spend their time learning basic surgical skills and patient care because of the contracted time afforded to them. Formal leadership training has historically been limited in surgical training. The authors set out to delineate the creation, implementation, and perceptions of a leadership program within a surgical residency and provide guideposts for the development of engaged, conscious, and dedicated leaders within the residencies they lead.

Atenção secundária em Odontologia e a articulação no processo de referência na Rede de Atenção em Saúde Bucal / Secondary care in Dentistry and the articulation of the referral process in the Oral Health Care Network

Os residentes do Programa de Residência Multiprofissional em Saúde da Família (PRMSF) da Universidade Federal do Paraná (UFPR) atuam em um município da região Sul, sendo a Odontologia uma das áreas que compõem o programa. Esses possuem campo prático diversificado, estando inseridos tanto na Atenção Primária à Saúde (APS), primeiro nível de atenção e coordenadora do cuidado, quanto na atenção secundária, atuando no serviço de cirurgia oral menor, inserido no Centro de Especialidades de Piraquara (CESP) no Paraná, uma vez que não há possibilidade de estruturação de um Centro de Especialidades Odontológicas (CEO). Dessa forma, é possível acompanhar o processo de referência e contra referência dos pacientes no serviço. Essa realidade também é observada em outras regiões do Brasil, consequência da falta de condições logísticas, estruturais e de recursos humanos, o que demanda aprimoramento do planejamento, orientação e consolidação de políticas públicas em saúde bucal. O objetivo desse estudo é relatar a experiência dos residentes cirurgiões-dentistas do PRMSF da UFPR em um Centro de Especialidades de um município da região metropolitana de Curitiba, capital do estado do Paraná, que mesmo não se qualificando nos parâmetros propostos pelo Ministério da Saúde brasileiro para implementação do CEO, apresentou a iniciativa de incorporar especialidades odontológicas mais urgentes para a população. Portanto, é importante o enfrentamento de problemas específicos, como ausência de levantamento epidemiológico municipal, tempo de espera, distância geográfica entre os serviços e comunicação entre profissionais da atenção básica e especializada (AU).

Residents of the Multiprofessional Residency Program in Family Health (MRPFH) at the Federal University of Paraná (UFPR) work in a city in the South region, where Dentistry is one of the areas included in the program. These have a diversified practical field, inserted both in Primary Health Care (PHC), first level of care and care coordinator;and in secondary care, working in the minor oral surgery serviceat the Piraquara Specialty Center (CESP) in Paraná, since there is no possibility of structuring a Center of Dental Specialties (CEO). Thus, it is possible to monitor the referral and counter-referral process of patients in the service. This reality is also observed in other Brazilian regions, as a result of the lack of logisticalandstructural conditions and human resources, which demands improvement in planning, guidance and consolidation of public policies in oral health. This study aimed to report the experience of dental professionals, residents of MRPFHat UFPR in a Specialty Center in a city in the metropolitan region of Curitiba, capital of the state of Paraná, which, despite not qualifying in the parameters proposed by the Brazilian Ministry of Healthfor the implementation of CEO, presented the initiative to incorporate the most urgent dental specialties for the population. Therefore, it is important to consider specific problems, such as the absence of a municipal epidemiological survey, waiting time, geographical distance between services and communication between primary and specialized care professionals (AU).

Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training.

OBJECTIVES: To determine if training residents in a structured communication method elicits specific behaviors in a laboratory model of interaction with vaccine-hesitant parents. STUDY DESIGN: Standardized patients portraying vaccine-hesitant parents were used to assess the effectiveness of training in the Announce, Inquire, Mirror, Secure (AIMS) Method for Healthy Conversations. Blinded pediatric residents were pseudorandomized to receive AIMS or control training and underwent pre- and post-training encounters with blinded standardized patients. Encounters were assessed by blinded raters using a novel tool. Participant confidence and standardized patient evaluations of the participants' general communication skills were assessed. RESULTS: Ratings were available for 27 AIMS and 26 control participants. Statistically significant increases in post-training scores (maximum = 30) were detected in AIMS, but not in control, participants (median, 21.3 [IQR, 19.8-24.8] vs 18.8 [IQR, 16.9-20.9]; P < .001). Elements (maximum score = 6) with significant increases were Inquire (0.67 [IQR, 0-1.76] vs -0.33 [IQR, -0.67 to 0.33]; P < .001); Mirror (1.33 [IQR, 0 to 2] vs -0.33 [IQR, -0.92 to 0]; P < .001) and Secure (0.33 [IQR, 0 to 1.67] vs -0.17 [IQR, -0.67 to 0.33]; P = .017). Self-confidence increased equally in both groups. Standardized patients did not detect a difference in communication skills after training and between groups. Internal consistency and inter-rater reliability of the assessment tool were modest. CONCLUSIONS: Standardized patients proved useful in studying the effectiveness of structured communication training, but may have been limited in their ability to perceive a difference between groups owing to the predetermined encounter outcome of vaccine refusal. AIMS training should be studied in real-world scenarios to determine if it impacts vaccine acceptance.

Perceived Benefits of a Cadaver-Based Ultrasound Procedure Workshop for Physical Medicine and Rehabilitation Trainees.

ABSTRACT: Ultrasound-guided musculoskeletal and spasticity injections have become common procedures in physical medicine and rehabilitation practices, but there are currently no guidelines for teaching these procedures in residency and fellowship training programs. As part of a quality improvement initiative, the authors aimed to assess the educational value of a hands-on cadaver-based workshop for enhancing these skills in residents and fellows. Twenty-seven physical medicine and rehabilitation trainees in a single institution were asked to complete surveys before and after the workshop to assess self-perceived benefits. After the workshop, the overwhelming majority felt improvement in their overall knowledge of ultrasound-guided musculoskeletal (93%) and spasticity (78%) procedures. In addition, the workshop improved the level of comfort of trainees both in planning (70%) and performing (59%) the procedures independently. Improving these skills is especially important considering most trainees plan to incorporate ultrasound-guided musculoskeletal (81%) and spasticity (74%) procedures into their future practices. The framework for this workshop can serve as a template for other programs to incorporate into their own training.