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2.
South Med J ; 115(2): 129-135, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35118502

RESUMO

OBJECTIVES: Moral elevation is the underlying emotion that arises when witnessing admirable acts, and it is theorized to be the psychological mechanism driving the impact that positive clinical role models have on medical students' professional identity formation (eg, growth in professional virtues, higher sense of meaning, and well-being). This proof-of-concept study explores the development of the Moral Elevation Scale in Medicine by testing the association of moral elevation with various markers of professional identity formation. METHODS: A secondary data analysis of two nationally representative samples of 960 medical students and 2000 physicians was performed. Respondents completed validated measures of moral elevation as well as markers of professional identity formation, including patient-centered virtues (empathic compassion, interpersonal generosity, mindfulness) and measures of well-being (life meaning, life satisfaction, spirituality, burnout). RESULTS: The study obtained adjusted response rates of 56.2% (1047/1863, physician survey) and 48.7% (448/919, student survey). The national estimates for mean moral elevation in medical students and physicians are 4.34/5.00 and 4.22/5.00, respectively. In medical students and physicians, high moral elevation was associated with higher empathic compassion (student odds ratio [OR] 1.30, 95% confidence interval [CI] 1.02-1.67; physician OR 1.22, 95% CI 1.23-1.65) and, similarly, generosity. In addition, higher moral elevation in the physician cohort was associated with greater life meaning (OR 2.03, 95% CI 1.25-3.32) and similarly spirituality. CONCLUSIONS: In medical students and practicing physicians, self-reported experiences of high moral elevation with physician role models were associated with higher self-reported measures of patient-centered virtues, spirituality, and life meaning. Our Moral Elevation Scale in Medicine demonstrates preliminary promise as a measure to assess environmental precursors needed for virtue development in professional identity formation, but further reliability and validity testing of this measure is needed.


Assuntos
Papel do Médico/psicologia , Médicos/psicologia , Profissionalismo/tendências , Identificação Social , Adulto , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Feminino , Humanos , Masculino , Mentores/psicologia , Mentores/estatística & dados numéricos , Princípios Morais , Médicos/tendências , Autorrelato , Inquéritos e Questionários
4.
J Vasc Surg ; 75(1): 316-322.e2, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34197947

RESUMO

OBJECTIVE: Integrated vascular surgery residency (IVSR) applicant perspective about the match process has been rarely studied, yet this has important implications on trainee recruitment. We sought to better understand the nature of the interview process and post-interview communication and its impact on students' ranking choices. METHODS: A voluntary and anonymous survey was sent to students who matched to IVSR in 2020, inquiring about interviews, post-interview communications, and factors influencing students' rank lists. RESULTS: Seventy of the 73 matched students completed the survey (96% response rate; 23 female and 47 male respondents). Applicants reported they were asked questions about other programs of interest (81.4%), top choice programs (65.7%), marital status (32.9%), family planning (7.1%), and religion (1.4%) during interviews. Female applicants were more frequently asked questions about family planning (17.4% vs 2.1%; P < .01) and marital status (52.5% vs 23.4%; P < .01) compared with male applicants. After interviews, 92.9% of applicants notified their top choice program of their ranking preference. Of applicants, 61.4% received post-interview communication with regards to ranking from at least one program, initiated by program directors in 81.3% of instances. Among these applicants, 58.1% reported that the post-interview communication had an impact on their rank list, and 46.5% matched at a program by which they were contacted. Of applicants, 5.7% were asked by a program to reveal their ranking of the program, and 11.4% were promised by a program to be ranked first if the applicant reciprocally ranked them first. Female and male applicants weighed program culture, operative volume, mentorship, and prestige equally in making their rank list. Male applicants weighed the sub-internship experience more significantly; however, female applicants weighed the sub-internship experience, personal relationships in certain cities, dedicated professional development years, and large female representation in the program more heavily (P < .02). CONCLUSIONS: This study provides insight into the interview experience and impactful factors for the vascular surgery match. Both female and male applicants were asked a high number of questions about personal matters unrelated to medical school performance. Female applicants, however, experienced a higher proportion of these instances, particularly regarding family planning. These findings demonstrate the factors that are important to applicants in the match process and raises awareness of potential challenges in the interview and recruitment process.


Assuntos
Internato e Residência/estatística & dados numéricos , Seleção de Pessoal/estatística & dados numéricos , Especialidades Cirúrgicas/educação , Procedimentos Cirúrgicos Vasculares/educação , Adulto , Comunicação , Feminino , Humanos , Masculino , Mentores/estatística & dados numéricos , Fatores Sexuais , Especialidades Cirúrgicas/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
5.
J Vasc Surg ; 75(1): 10-19.e1, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34324973

RESUMO

OBJECTIVE: We hypothesized a potential gender disparity within a regional society like the Southern Association of Vascular Surgery (SAVS) when compared with vascular surgery demographics in the region. To assess this, we analyzed meeting and membership participation at the SAVS compared with regional data from the Society of Vascular Surgery as well as board certification in vascular surgery published by the American Board of Surgery (ABS). METHODS: The published programs from the SAVS Annual Meeting from 2012 to 2019 were analyzed for membership, presenter gender, type, topic, discussant gender, moderator gender, postgraduate course presenter gender, and manuscript publication demographics. The ABS was petitioned and yearly Vascular Surgery diplomate (ABS-VS) gender from member states of the SAVS was examined for the same period. Fisher's exact Student's t-test and analysis of covariance were used. RESULTS: There were 257 total presentations (184 podium, 71.6%; 73 poster, 28.4%). A total of 61.4% (n = 43) of presentations by females were podium presentations, compared with 75.4% (n = 141) by males (P = .03). Females were less likely to be published when compared with their male counterparts (41.8% vs 58.7%, P = .02). The percentage of female gendered presenters statistically increased over the time period examined compared with a decrease in male presenters (R2 = 0.61, m = 1.27 vs R2 = 0.08, m = -0.35, P = .02). Female presenters had a female discussant 10.5% of the time compared with male presenters who had a male discussant 95.1% of the time (P < .0001). Females comprised 3.8% ± 1.1% of SAVS yearly membership compared with 12.0% ± 4.6% ABS-VS diplomates among SAVS member states (P < .0001). SAVS female membership significantly lagged behind the increase in ABS-VS female diplomate rate (P = .001). Only 39.1% of SAVS members were cross-listed in Society of Vascular Surgery membership rolls, with a total of 464 potential SAVS members, 11.2% or 52 of whom are female. CONCLUSIONS: We found that female presenters at the SAVS Annual Meeting were less likely to be podium presenters, interface with other female discussants, and publish manuscripts when compared with their male counterparts. Statistically, female members were underrepresented within the SAVS membership rolls when compared with known boarded female vascular surgeons among southern member states. This gender gap highlights a unique opportunity to enhance and potentially increase mentorship opportunities for female trainees who are presenting and/or attending this regional vascular surgery meeting.


Assuntos
Congressos como Assunto/estatística & dados numéricos , Médicas/estatística & dados numéricos , Sociedades Médicas/estatística & dados numéricos , Especialidades Cirúrgicas/estatística & dados numéricos , Procedimentos Cirúrgicos Vasculares , Feminino , Humanos , Liderança , Masculino , Mentores/estatística & dados numéricos , Sociedades Médicas/organização & administração , Especialidades Cirúrgicas/organização & administração , Estados Unidos
6.
Am J Surg ; 223(1): 53-57, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34332743

RESUMO

BACKGROUND: Effects of the institutional macrocosm on general surgery resident wellbeing have not been well studied. We sought to identify organizational factors that impact resident wellness and burnout. METHODS: Using a modified Delphi technique, an open-ended survey and two subsequent iterations were distributed to wellness stakeholders at two institutions to identify and stratify institutional factors in six burnout domains. RESULTS: Response rates for each survey round were 29/106 (27%), 30/46 (65%) and 21/30 (70%). Top factors identified in each domain were: CONCLUSION: A modified Delphi technique prioritized institutional wellness and burnout factors. Top factors identified were compensation, vacation time, and autonomy. These results can direct future scholarship of barriers/facilitators of resident wellbeing.


Assuntos
Esgotamento Profissional/epidemiologia , Cirurgia Geral/educação , Internato e Residência/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Esgotamento Profissional/prevenção & controle , Técnica Delfos , Feminino , Cirurgia Geral/estatística & dados numéricos , Humanos , Internato e Residência/economia , Masculino , Mentores/psicologia , Mentores/estatística & dados numéricos , Autonomia Profissional , Fatores de Risco , Salários e Benefícios/estatística & dados numéricos , Cirurgiões/educação , Cirurgiões/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
7.
J Vasc Surg ; 75(1): 20-28, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34450243

RESUMO

OBJECTIVE: Prior research in vascular surgery has identified significant gender disparities in leadership positions, but few data exist regarding gender disparities in vascular publications. This study aims to evaluate authorship trends by gender in the three highest impact factor vascular surgery journals. METHODS: In this bibliometric analysis, PubMed was searched for articles published in the European Journal of Vascular and Endovascular Surgery, the Journal of Vascular Surgery, and Annals of Vascular Surgery from 2015 to 2019. The web-based application Genderize used predictive algorithms to classify names of first and last authors as male or female. Statistical analyses regarding trends in authorship were performed using Stata16. RESULTS: A total of 6457 articles were analyzed, with first author gender predicted with >90% confidence in 83% (4889/5796) and last author gender in 88% (5078/5796). Overall, 25% (1223/4889) of articles had women first authors, and 10% (501/5078) had women last authors. From 2015 to 2019, there was a slight increase in the proportion of articles written by women first authors (P = .001), but no increase in the proportion of articles written by women last authors (P = .204). The proportion of articles written by women last authors was lower than the proportion of active women vascular surgeons in 2015 (8% of articles vs 11% of surgeons; P = .015), 2017 (9% of articles vs 13% of surgeons; P < .001), and 2019 (11% of articles vs 15% of practicing surgeons; P < .001). The average number of last-author publications was higher for men (2.35 ± 3.76) than for women (1.62 ± 1.88, P = .001). The proportion of unique authors who were women was less than the proportion of active women vascular surgeons in 2017 (10% unique authors vs 13% surgeons; P = .047), but not in 2015 (9% unique authors vs 11% surgeons; P = .192) or 2019 (13% unique authors vs 15% surgeons; P = .345). Notably, a woman last author was associated with 1.45 higher odds of having a woman first author (95% confidence interval, 1.17-1.79; P = .001). CONCLUSIONS: Over the past 5 years, there has been no significant increase in women last authors among top-tier journals in vascular surgery. Women remain under-represented as last authors in terms of proportion of published articles, but not in terms of proportion of unique authors. Nevertheless, women last authors are more likely to publish with women first authors, indicating the importance of women-led mentorship in achieving publication gender equity. Support for women surgeons through grants and promotions is essential not only for advancing last authorship gender equity, but for advancing junior faculty and trainee academic careers.


Assuntos
Bibliometria , Médicas/tendências , Sexismo/tendências , Cirurgiões/tendências , Procedimentos Cirúrgicos Vasculares , Feminino , Humanos , Masculino , Mentores/estatística & dados numéricos , Médicas/estatística & dados numéricos , Sexismo/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos
8.
J Vasc Surg ; 75(1): 5-9, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34619315

RESUMO

Gender diversity in medicine continues to be a critical topic, and gender diversity within surgical fields remains an overarching challenge. In the following review, we objectively address the data available in terms of training slots for women in general and vascular surgery and within the vascular surgery workforce. Overall, women comprise 36% of active physicians in the 2019 Association of American Medical Colleges data. The number of women in surgical fields is lower representing 22% in general surgery, 9% in neurosurgery, 6% in orthopedic surgery, 17% in plastic surgery, 8% in thoracic surgery, and 15% in vascular surgery. Also notable is the lower academic ranks held by women in surgery. The proportion of women instructors in surgery in 2020 was 61%, assistant professors 30%, associate professors 23%, and full-time professors only 13.5%. There are multiple opportunities across the divisional/institutional/societal domains in which mentorship and sponsorship can promote gender equity and inclusion. Recruitment and retention of women and minorities into the vascular academic and private practices is essential to ensure best patient outcomes and quality of care for our patients. We hope that by shedding light on this topic, there will be greater awareness and improved strategies to address the disparities within institutions.


Assuntos
Diversidade Cultural , Médicas/estatística & dados numéricos , Sexismo/estatística & dados numéricos , Especialidades Cirúrgicas/estatística & dados numéricos , Feminino , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Mentores/estatística & dados numéricos , Sexismo/prevenção & controle , Especialidades Cirúrgicas/educação , Estudantes de Medicina/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Estados Unidos
9.
Plast Reconstr Surg ; 148(3): 667-677, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34432703

RESUMO

SUMMARY: Mentorship is a critical tool for professional development and career success. In academic surgery, supportive mentorship affords higher job satisfaction, academic productivity, and diversity and inclusion. It protects against burnout and increasing academic surgery attrition rates. Women, underrepresented minorities, and junior plastic surgeons report lower job satisfaction and fewer mentorship opportunities. Given the unique challenges these groups face in a constantly changing health care system, the importance of mentorship cannot be overstated. Through a survey of American Society of Plastic Surgeons members, this study evaluated different aspects of mentorship to describe the current state in plastic surgery. Despite 94.05 percent of plastic surgeons believing that mentorship is valuable, only 15.16 percent reported a structured mentorship system, often without evaluation. Male and female participants agree that mentorship is needed for both professional (clinical judgment) and personal (work-life balance) development. Interestingly, women plastic surgeons felt it was important for mentees to have gender and race/ethnicity concordance to their mentors (p < 0.001). There was no agreement regarding the most effective method to implement mentorship programs, highlighting the challenges of this problem. Through thoughtful planning and commitment, mentorship programs can be instituted to benefit not just the mentee, but the mentor as well.


Assuntos
Docentes de Medicina/estatística & dados numéricos , Tutoria/estatística & dados numéricos , Cirurgia Plástica/educação , Docentes de Medicina/psicologia , Feminino , Humanos , Satisfação no Emprego , Masculino , Mentores/psicologia , Mentores/estatística & dados numéricos , Sociedades Médicas , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , Equilíbrio Trabalho-Vida
11.
Urology ; 157: 64-70, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34139250

RESUMO

OBJECTIVE: To examine female author representation within publications in the field of urology from the United States from 2000-2019. METHODS: All 25,787 articles with a U.S. correspondence address published in the two largest U.S. headquartered general urology journals, Urology and Journal of Urology, were analyzed from 2000-2019. Gender was assigned to each first and last author based on the author's first name. First names were matched to a database of U.S. Social Security Administration data to determine gender. RESULTS: Overall female authorship, female senior authorship, and female first authorship exhibited a significant upward trend from 2000 to 2019 (P <0.001, P <0.001, P = 0.002). As the number of female last authors increased, female last authors were significantly more likely to publish with female first authors, and significantly less likely publish with male first authors (P <0.001, P <0.001). Furthermore, we found a significant difference for female authors being less likely to get cited than male authors (p = 0.02), despite the greater proportion of females that authored research articles with higher citation counts compared to males (P <0.05). CONCLUSION: Despite the significant progress in female representation within urological publications, female-authored publications continue to constitute a smaller proportion of the urological literature and are less likely to be cited. Our study provides the first evidence on the current status of female underrepresentation within academic urology and literature productivity at this watershed moment. As the number of female urologists evolves, these findings will be of significant impact in the advancement of female investigators in urology.


Assuntos
Autoria , Pesquisa Biomédica , Cirurgia Geral/educação , Mentores/estatística & dados numéricos , Editoração/estatística & dados numéricos , Feminino , Humanos , Masculino , Distribuição por Sexo
12.
Acad Med ; 96(11): 1580-1585, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-33951683

RESUMO

PROBLEM: Mentorship is valuable to medical students undergoing professional identity formation. Many institutions lack infrastructure to facilitate the personalized mentoring that supports students' integration of new professional identities with their personal identities and values. APPROACH: The authors developed a novel mentorship platform called Weave via a multistep, iterative design process, incorporating in-person and survey-based student and faculty feedback. Features of Weave include clear communication of mentorship offerings and expectations, plus opportunities to engage mentors based on professional and personal (identity-based) attributes. Faculty at Harvard Medical School who created a mentor profile within the first 3 months of launch and students who visited the website within the same period were invited to complete usability surveys in February 2019; students were invited to complete impact surveys in August 2020. OUTCOMES: Fifty-two of 132 invited faculty members (39.4%) and 80 of 185 students (43.2%) completed the usability surveys. Most of these faculty (86.5%) and students (73.8%) reported navigating the website was easy/very easy; 36 faculty (69.2%) created a mentor profile within 10 minutes. Key innovations highlighted by faculty and students were the listing of personal attributes and identities of diverse faculty; centralized, increased access to faculty mentors; ease of use; and provision of clear expectations. Nearly all students who completed the impact surveys agreed that Weave allowed them to connect with a faculty mentor whom they would not have found through other sources and to learn about the dimensions of diverse faculty. NEXT STEPS: Weave is a customizable online mentorship platform that fosters empowered vulnerability and increases dialogue between medical students and faculty based on professional and personal interests and identities. Weave may be expanded to other mentoring contexts and adapted for implementation at other institutions to help cultivate an institutional culture that values mentoring and to strengthen broader diversity and inclusion efforts.


Assuntos
Docentes de Medicina/estatística & dados numéricos , Tutoria/métodos , Mentores/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Boston , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Comunicação , Educação de Graduação em Medicina , Empoderamento , Feedback Formativo , Humanos , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2/genética , Faculdades de Medicina/organização & administração , Identificação Social , Inquéritos e Questionários
14.
J Bone Joint Surg Am ; 103(22): e90, 2021 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-34019494

RESUMO

BACKGROUND: The National Institutes of Health (NIH) supports mentored research career development awards (K awards) to increase the pipeline of independently funded scientists. This study analyzed the portfolio of K grants that were awarded to orthopaedic surgery departments and characterized the factors that were associated with successful transition to independent NIH research funding, including R01 grants. METHODS: This was a retrospective cohort study of K-award recipients in orthopaedic surgery departments in the United States from 1996 to 2018. A query was performed on the NIH Research Portfolio Online Reporting Tools (RePORT) database for NIH grants that were awarded to departments of orthopaedic surgery, general surgery, otolaryngology, obstetrics and gynecology, ophthalmology, and urology. Rates of transition to independent research funding were compared by specialty for K grants that were awarded from 1996 to 2011. The percentage of faculty with mentored research career development awards and the return on investment (ROI) were calculated. An internet and Scopus (Elsevier) database search determined the investigator characteristics. The factors that were associated with successful transition to independent funding were determined via chi-square and unpaired t tests. RESULTS: Sixty K-award recipients were identified in orthopaedic surgery departments. Most were men (77%) and research scientists (53%). Fifty percent of the K-award recipients transitioned to independent research funding. Research scientists had the highest rate of transition to independent research funding (71%, p = 0.016) relative to clinicians (0%) and orthopaedic surgeons (40%). Higher levels of publication productivity were associated with successful transition to independent research funding. Similar rates of transition to independent research funding existed among surgical specialties (p = 0.107). Orthopaedic surgery had the lowest percentage of faculty with a K award (1.4%) but had the highest ROI (198%) of these awards. CONCLUSIONS: Orthopaedic surgery had similar rates of transition to independent research funding when compared with other surgical specialties but had a lower prevalence of K awards among faculty. Orthopaedic surgeon-scientists have lower rates of transition to independent research funding when compared with their research-scientist colleagues. These findings highlight a need for greater support to foster the pipeline of future NIH-funded orthopaedic investigators. CLINICAL RELEVANCE: As the largest support of biomedical research in the U.S., the NIH is an important stakeholder in orthopaedic innovations and discoveries. This study highlights barriers in the procurement of NIH funding across surgical specialties and affirms the need for greater resources toward supporting NIH funding in orthopaedic surgery.


Assuntos
Pesquisa Biomédica/economia , Financiamento Governamental/economia , National Institutes of Health (U.S.)/economia , Procedimentos Ortopédicos/economia , Pesquisadores/estatística & dados numéricos , Pesquisa Biomédica/estatística & dados numéricos , Docentes/estatística & dados numéricos , Feminino , Financiamento Governamental/estatística & dados numéricos , Humanos , Masculino , Mentores/estatística & dados numéricos , National Institutes of Health (U.S.)/estatística & dados numéricos , Procedimentos Ortopédicos/estatística & dados numéricos , Pesquisadores/economia , Estudos Retrospectivos , Cirurgiões/economia , Cirurgiões/estatística & dados numéricos , Estados Unidos
15.
PLoS One ; 16(3): e0247260, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33735280

RESUMO

Maternal and neonatal mortality in Bihar, India was far higher than the aspirational levels set out by the Sustainable Development Goals. Provider training programs have been implemented in many low-resource settings to improve obstetric and neonatal outcomes. This longitudinal investigation assessed diagnoses and management of postpartum hemorrhage (PPH), hypertensive disorders of pregnancy, birth asphyxia (BA), and low birth weight (LBW), as part of the CARE's AMANAT program in 22 District Hospitals in Bihar, between 2015 and 2017. Physicians and nurse mentors conducted clinical instruction, simulations and teamwork and communication activities, infrastructure and management support, and data collection for 6 consecutive months. Analysis of diagnosis included 11,259 non-referred and management included 11,800 total (non-referred and referred) admissions that were observed. Data were analyzed using the chi-square test for trend. PPH was diagnosed in 3.7% with no significant trend but diagnosis of hypertensive disorders increased from 1.0% to 1.7%, (ptrend = 0.04), over the 6 months. BA was diagnosed in 5.8% with no significant trend but LBW diagnoses increased from 11% to 16% (ptrend<0.01). Among PPH patients, 96% received fluids, 85% received uterotonics and 11% received Tranexamic Acid (TXA). There was a significant positive trend in the number of patients receiving TXA for PPH (6% to 13.8%, ptrend = 0.03). Of all neonates with BA, there were statistically significant increases in the proportion who were initially warmed, dried, and stimulated (78% to 94%, ptrend = 0.02), received airway suction (80% to 93%, ptrend = 0.03), and supplemental oxygen without positive pressure ventilation (73% to 86%, ptrend = 0.05). Diagnoses of hypertensive disorders and LBW as well as initial management of BA increased during the AMANAT program. However, underdiagnoses of PPH and hypertensive disorders relative to population levels remain critical barriers to improving maternal morbidity and mortality.


Assuntos
Educação em Enfermagem/métodos , Tutoria/métodos , Cuidado Pós-Natal/métodos , Asfixia Neonatal/diagnóstico , Feminino , Hospitais de Distrito , Humanos , Hipertensão Induzida pela Gravidez/diagnóstico , Índia , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Mentores/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Hemorragia Pós-Parto/diagnóstico , Gravidez , Treinamento por Simulação
16.
J Surg Res ; 263: 258-264, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33735686

RESUMO

BACKGROUND: There is a growing deficit of rural surgeons, and preparation to meet this need is inadequate. More research into stratifying factors that specifically influence choice in rural versus urban practice is needed. METHODS: An institutional review board-approved survey related to factors influencing rural practice selection and increasing rural recruitment was distributed through the American College of Surgeons. The results were analyzed descriptively and thematically. RESULTS: Of 416 respondents (74% male), 287 (69%) had previous rural experience. Of those, 71 (25%) did not choose rural practice; lack of professional or hospital support (30%) and lifestyle (26%) were the primary reasons. A broad scope of practice was most important among surgeons (52%), who chose rural practice without any previous rural experience. Over 60% of urban practitioners agreed that improved lifestyle and financial advantages would attract them to rural practice. The thematic analysis suggested institutional support, affiliation with academic institutions, and less focus on subspecialty fellowship could help increase the number of rural surgeons. CONCLUSIONS: Many factors influence surgeons' decisions on practice location. Providing appropriate hospital support in rural areas and promoting specific aspects of rural practice, including broad scope of practice to those in training could help grow interest in rural surgery. Strong collaboration with academic institutions for teaching, learning, and mentoring opportunities for rural surgeons could also lead to higher satisfaction, security, and potentially higher retention rate. These results provide a foundation to help focus specific efforts and resources in the recruitment and retention of rural surgeons.


Assuntos
Atitude do Pessoal de Saúde , Escolha da Profissão , Mão de Obra em Saúde/estatística & dados numéricos , Serviços de Saúde Rural/provisão & distribuição , Cirurgiões/psicologia , Competência Clínica , Feminino , Mão de Obra em Saúde/economia , Humanos , Satisfação no Emprego , Masculino , Mentores/estatística & dados numéricos , Seleção de Pessoal/estatística & dados numéricos , Serviços de Saúde Rural/economia , Cirurgiões/economia , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
17.
Malar J ; 20(1): 115, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33632208

RESUMO

BACKGROUND: In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. METHODS: A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1 and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. CONCLUSION: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy.


Assuntos
Serviços de Diagnóstico/estatística & dados numéricos , Testes Diagnósticos de Rotina/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Malária/diagnóstico , Mentores/estatística & dados numéricos , Microscopia/estatística & dados numéricos , Competência Profissional/estatística & dados numéricos , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
18.
J Nurs Adm ; 51(3): 149-155, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33570372

RESUMO

Healthcare organizations must be intentional and purposeful in creating diversity programs. A nursing leader mentorship program for racial and ethnic minority nurse managers was introduced at a large academic medical center to meet this need. The program design was based on the successful Leadership Institute for Black Nurses, first conducted at a university school of nursing. The participants in the 4-month program were 16 nurse managers from 2 city hospitals and their mentors.


Assuntos
Currículo , Bacharelado em Enfermagem/organização & administração , Etnicidade/educação , Tutoria/organização & administração , Mentores/estatística & dados numéricos , Grupos Minoritários/educação , Enfermeiras Administradoras/educação , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Cidade de Nova Iorque , Adulto Jovem
19.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 24(1): 21-25, ene.-feb. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-202417

RESUMO

INTRODUCCIÓN: La tutoría clínica se define hoy como una actividad académica, que constituye un campo de transformación del conocimiento que implica a los estudiantes y docentes. El presente estudio describe las percepciones acerca de las competencias en la conducción del proceso tutorial de los protagonistas respecto a este espacio de verdadera transformación y crecimiento en este proceso educativo. Sujetos y métodos: Estudio descriptivo en el cual la variable percepción de la competencia docente del tutor clínico se evaluó en estudiantes y docentes del ciclo clínico de la Facultad de Odontología de la Universidad Finis Terrae, en Chile. La percepción se operacionalizó en tres factores y se evaluó por medio de dos instrumentos: el Council of European Chief Dental Officers (estudiantes) y el Knowledge and Prior Study Inventory (docentes). Los datos se analizaron a través de medidas de tendencia central y la prueba no paramétrica t de Student. RESULTADOS: La percepción de los docentes y la de los estudiantes respecto a las competencias para conducir la tutoría clínica presentan diferencias significativas en dos de los tres factores, como también en el desglose de ítems por factor, lo que da cuenta de los aspectos en los cuales las autopercepciones de los docentes son mejores que las percepciones de los estudiantes. CONCLUSIÓN: Se reconocen deficiencias del ejercicio del tutor que son percibidas por los estudiantes y que podrían ser mejoradas, como la autonomía, el razonamiento clínico y la efectividad de la retroalimentación, por lo que se sugiere diseñar un programa de capacitación sobre competencias docentes dirigido a tutores clínicos que responda a las debilidades percibidas


INTRODUCTION: Clinical tutoring/mentoring is defined today as an academic activity, which constitutes a transformation of knowledge field that involves students and teachers. The present study describes the perceptions about the competencies in the conduct of the tutorial process of the protagonists regarding this space of true transformation and growth of this educational process. Subjects and methods: Descriptive study in which the variable perception of the clinical tutor's teaching competence was evaluated in students and teachers of the clinical cycle of the Faculty of Dentistry of the Finis Terrae University, Chile. The perception was operationalized in three factors, and was evaluated by means of two instruments: CECD-O (students) and KPSI (teachers). The data were analyzed through measures of central tendency and the non-parametric Student's t test. RESULTS: The perception of teachers and students regarding the skills to conduct clinical tutoring, shows significant differences in two of the three factors, as well as in the breakdown of items by factor, accounting on the aspects in which the teachers'self-perceptions they are better than those perceived by students. CONCLUSION: There are recognized deficiencies in the tutor's exercise that are perceived by the students and that could be improved, such as autonomy, clinical reasoning and feedback effectiveness, which is why it is suggest designing a training program on teaching competencies aimed at clinical tutors in response to perceived weaknesses


Assuntos
Humanos , Educação em Odontologia/tendências , Capacitação de Professores/tendências , Avaliação Educacional/métodos , Mentores/estatística & dados numéricos , Estudantes de Odontologia/estatística & dados numéricos , Docentes de Odontologia/estatística & dados numéricos , Autoavaliação (Psicologia) , Estudos Transversais , Competência Profissional/estatística & dados numéricos
20.
J Nurs Educ ; 60(1): 25-28, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33400804

RESUMO

BACKGROUND: The purpose of this study was to explore the perceptions of African American mentors and mentees about the mentorship experience and examine mentorship as a blueprint for success in a nursing school. METHOD: Using a concurrent nested mixed-method, purposeful, and criterion-sampling technique, we surveyed participants from a 4-year public institution's mentorship program about the impact of the program and its effects on college progression. RESULTS: Four themes emerged from our analysis of the African American nursing students and the role of mentor-ship: challenges, desire for guidance, sharing of knowledge, and positive outcomes. CONCLUSION: On the basis of our findings, we developed a set of hypothetical practices involved in establishing mentorship programs and evaluated mentorship potential as a strategy to promote engagement and retention of African American undergraduate nursing students to increase diversity within the profession of nursing. [J Nurs Educ. 2021;60(1):25-28.].


Assuntos
Negro ou Afro-Americano , Tutoria , Mentores , Estudantes de Enfermagem , Negro ou Afro-Americano/estatística & dados numéricos , Bacharelado em Enfermagem , Humanos , Tutoria/estatística & dados numéricos , Mentores/estatística & dados numéricos , Percepção , Estudantes de Enfermagem/estatística & dados numéricos
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