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2.
BMC Med Educ ; 24(1): 556, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773571

RESUMO

BACKGROUND: Primary care in the US faces challenges with clinician recruitment, retention, and burnout, with further workforce shortages predicted in the next decade. Team-based care can be protective against clinician burnout, and opportunities for interprofessional education (IPE) on professional development and leadership could encourage primary care transformation. Despite an increasingly important role in the primary care workforce, IPE initiatives training physician assistants (PAs) alongside physicians are rare. We describe the design, curriculum, and outcomes from an interprofessional primary care transformation fellowship for community-based primary care physicians and PAs. METHODS: The Community Primary Care Champions (CPCC) Fellowship was a one-year, part-time fellowship which trained nine PAs, fourteen physicians, and a behavioralist with at least two years of post-graduate clinical experience in six content pillars: quality improvement (QI), wellness and burnout, mental health, social determinants of health, medical education, and substance use disorders. The fellowship included a recurring schedule of monthly activities in self-study, lectures, mentoring, and community expert evening discussions. Evaluation of the fellowship included pre, post, and one-year follow-up self-assessments of knowledge, attitudes, and confidence in the six content areas, pre- and post- wellness surveys, lecture and discussion evaluations, and midpoint and exit focus groups. RESULTS: Fellows showed significant improvement in 24 of 28 self-assessment items across all content areas post-fellowship, and in 16 of 18 items one-year post-fellowship. They demonstrated reductions in emotional exhaustion and depersonalization post-fellowship and increased confidence in working in interprofessional teams post-fellowship which persisted on one-year follow-up assessments. All fellows completed QI projects and four presented their work at national conferences. Focus group data showed that fellows experienced collaborative, meaningful professional development that was relevant to their clinical work. They appreciated the flexible format and inclusion of interprofessional community experts in evening discussions. CONCLUSIONS: The CPCC fellowship fostered an interprofessional community of practice that provided an effective IPE experience for physicians and PAs. The learning activities, and particularly the community expert discussions, allowed for a flexible, relevant experience, resulting in personal and professional growth along with increased confidence working within interprofessional teams.


Assuntos
Bolsas de Estudo , Assistentes Médicos , Atenção Primária à Saúde , Humanos , Assistentes Médicos/educação , Currículo , Esgotamento Profissional/prevenção & controle , Feminino , Avaliação de Programas e Projetos de Saúde , Masculino , Relações Interprofissionais , Médicos de Atenção Primária/educação , Educação Interprofissional
3.
Hepatology ; 79(6): 1241-1242, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38758103
4.
Med Educ Online ; 29(1): 2352953, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38720561

RESUMO

BACKGROUND: A multitude of factors are considered in an infectious disease (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes. METHODS: In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (1 July 2013- 30 June 2022). Data abstracted included demographics, degrees, honor society membership, visa/citizenship status, medical school, residency training program, United States Medical Licensure Exam (USMLE) scores, letters of recommendation, in-training examination (ITE) scores, fellowship track, academic rank, career choice, number of honors, awards, and abstracts/publications prior to fellowship, during training, and within 2 years of graduation. RESULTS: Younger fellows had higher USMLE step 1 scores, pre and in-fellowship scholarly productivity, and higher ITE performance. Female fellows had significantly higher USMLE step 3 scores. Prior research experience translated to greater in-fellowship scholarly productivity. Higher USMLE scores were associated with higher ID ITE performance during multiple years of fellowship, but USMLE step 2 clinical knowledge and 3 scores were associated with higher pre and in-fellowship scholarly productivity and receiving an award during fellowship. The USMLE step 1 score did not correlate with fellowship performance beyond year 1 and 2 ITE scores. CONCLUSIONS: Multiple aspects of a prospective fellow's application must be considered as part of a holistic review process for fellowship selection. USMLE step 2 CK and 3 scores may predict fellowship performance across multiple domains.


Assuntos
Sucesso Acadêmico , Bolsas de Estudo , Humanos , Bolsas de Estudo/estatística & dados numéricos , Estudos Retrospectivos , Feminino , Masculino , Avaliação Educacional/estatística & dados numéricos , Fatores Etários , Fatores Sexuais , Escolha da Profissão , Infectologia/educação , Internato e Residência/estatística & dados numéricos , Adulto , Estados Unidos
5.
Med Educ Online ; 29(1): 2347762, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38691015

RESUMO

Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education's online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution's DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution's DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties' webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.


Assuntos
Diversidade Cultural , Dermatologia , Bolsas de Estudo , Internet , Dermatologia/educação , Humanos , Internato e Residência , Educação de Pós-Graduação em Medicina , Grupos Minoritários/educação , Grupos Minoritários/estatística & dados numéricos
7.
Artigo em Inglês | MEDLINE | ID: mdl-38775597

RESUMO

BACKGROUND: Orthopaedic surgery has consistently remained one of the least diverse specialties in medicine. There are limited data on the match rate by sex into orthopaedic fellowships. PURPOSE: The goals of this study were to determine (1) how the percentage of women applying to orthopaedic fellowships has changed from 2011 to 2021, (2) whether there was a correlation between sex and the likelihood of a successful fellowship match, and (3) which subspecialties tend to have a greater proportion of female applicants and fellows. METHODS: The San Francisco (SF) Match service was used to obtain US orthopaedic fellowship applicant data from 2010 to 2021. San Francisco Match has run the match for the orthopaedic fellowship match since 2010. International medical graduates' applications, incomplete applications, or withdrawn applications were excluded. The following variables were collected and assessed: sex, subspecialty choice (except for hand because they do not use SF Match services), and match outcome. The number of female applicants and matches was recorded by year and compared with the number of male applicants and matches. Chi-square analysis was used to analyze categorical variables. RESULTS: A total of 6969 applicants to all orthopaedic specialties within SF Match were included during the study period. Overall, 859 were female (12.3%), and 6110 were male (87.7%). The number of female applicants had an increasing trend over the 10-year period from 65 applicants in 2011 to 111 in 2021. The overall proportion of female applicants was between 10.1% and 14.4%. The annual match rate for female applicants was 90.7% to 100% during the study period while the match rate for male applicants was 93.7% to 97.3%. Regarding successful matches, pediatrics had the highest proportion of women (range: 30.2% to 46.2%), followed by foot and ankle (range: 9.8% to 26.4%). Spine (range: 3.2 to 10.9%) and adult reconstruction (range: 3.9% to 9%) had the least number of women among matched applicants. DISCUSSION: This study found that the number of female applicants to orthopaedic fellowships has increased over the past 10 years. The difference in fellowship match rates among male versus female applicants did not statistically differ during this 10-year period; however, the proportion of female fellows is not equally distributed among subspecialties, with a higher proportion of women matching into pediatrics and foot and ankle and lower proportion in reconstruction and spine. These data can provide a benchmark for department chairs and society leadership to ensure they are recruiting, interviewing, and selecting candidates who are representative of the current sex demographics of orthopaedic fellowship graduates.


Assuntos
Bolsas de Estudo , Ortopedia , Médicas , Humanos , Feminino , Ortopedia/educação , Masculino , Médicas/tendências , Médicas/estatística & dados numéricos , Internato e Residência , Escolha da Profissão , Estados Unidos
9.
S Afr Fam Pract (2004) ; 66(1): e1-e8, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38572879

RESUMO

The 'Mastering your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination.


Assuntos
Competência Clínica , Bolsas de Estudo , Humanos , Medicina de Família e Comunidade/educação , Médicos de Família , África do Sul
10.
S Afr Fam Pract (2004) ; 66(1): e1-e8, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38572871

RESUMO

The series 'Mastering your Fellowship' provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series aims to help family medicine registrars (and supervisors) prepare for this examination.


Assuntos
Avaliação Educacional , Bolsas de Estudo , Humanos , Competência Clínica , Medicina de Família e Comunidade/educação , Médicos de Família
11.
Med Educ Online ; 29(1): 2336332, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38560892

RESUMO

BACKGROUND: The scholarship of teaching and learning (SoTL) is a field of academic research that focuses on improving learning through reflective and informed teaching. Currently, most SoTL-related work is faculty-driven; however, student involvement in SoTL has been shown to benefit both learners and educators. Our study aims to develop a framework for increasing medical students' interest, confidence, and engagement in SoTL. METHODS: A student-led SoTL interest group was developed and a year-round program of SoTL was designed and delivered by student leaders of the group under the guidance of a faculty advisor. Individual post-session surveys were administered to evaluate participants' perceptions of each session. Pre- and post-program surveys were administered to evaluate the program impact. RESULTS: The year-round SoTL program consistently attracted the participation of medical students and faculty. Survey responses indicated strong medical student interest in the program and positive impact of the program. Increased interest and confidence in medical education research were reported by the student participants. The program design provided opportunities for student participants to network and receive ongoing feedback about medical education research they were interested or involved in. CONCLUSION: Our study provides insights for developing a framework that other institutions can reference and build upon to educate and engage students in SoTL.


Assuntos
Estudantes de Medicina , Humanos , Bolsas de Estudo , Aprendizagem , Docentes , Retroalimentação , Ensino , Currículo
12.
West J Emerg Med ; 25(2): 186-190, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38596916

RESUMO

Introduction: Virtual interviews (VI) are now a permanent part of pediatric emergency medicine (PEM) recruitment, especially given the cost and equity advantages. Yet inability to visit programs in person can impact decision-making, leading applicants to apply to more programs. Moreover, the cost advantages of VI may encourage applicants to apply to programs farther away than they might otherwise have been willing or able to travel. This could create unnecessary strain on programs. We conducted this study to determine whether PEM fellowship applicants would apply to a larger number of programs and in different geographic patterns with VI (2020 and 2021) as compared to in-person interviews (2018 and 2019). Methods: We conducted an anonymous national survey of all PEM fellows comparing two cohorts: current fellows who interviewed inperson (applied in 2018/2019) and fellows who underwent VIs in 2020/2021 (current fellows and those recently matched in 2021). The study took place in March-April 2022. Questions focused on geographic considerations during interviews and the match. We used descriptive statistics, chi-square and t-tests for analysis. Results: Overall response rate was 42% (231/550); 32% (n = 74) interviewed in person and 68% (n = 157) virtually. Fellows applied to a median of 4/6 geographic regions (interquartile range 2, 5). Most applied for fellowship both in the same region as residency (216, 93%) and outside (192, 83%). Only the Pacific region saw a statistically significant increase in applicants during VI (59.9% vs 43.2%, P = 0.02). There was no statistical difference in the number of programs applied to during in-person vs VI (mean difference (95% confidence interval 0.72, -2.8 - 4.2). A majority matched in their preferred state both during VI (60.4%) and in-person interviews (65.7%). The difference was not statistically significant (P = 0.45). Conclusion: While more PEM fellowship applicants applied outside the geographic area where their residency was and to the Pacific region, there was no overall increase in the number of programs or geographic areas PEM applicants applied to during VI as compared to in-person interview seasons. As this was the first two years of VI, ongoing data collection will further identify trends and the impactof VI.


Assuntos
Internato e Residência , Medicina de Emergência Pediátrica , Criança , Humanos , Coleta de Dados , Bolsas de Estudo
13.
West J Emerg Med ; 25(2): 175-180, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38596914

RESUMO

Introduction: Emergency medicine (EM) is one of few specialties with variable training lengths. Hiring a three-year graduate to continue fellowship training in a department that supports a four-year residency program can lead to conflicts around resident supervision. We sought to understand hiring and clinical supervision, or staffing, patterns of non-Accreditation Council for Graduate Medical Education (ACGME) fellowships hosted at institutions supporting four-year residency programs. Methods: We performed a web-based, cross-sectional survey of non-ACGME fellowship directors (FD) hosted at institutions supporting four-year EM residency programs. We calculated descriptive statistics. Our primary outcome was the proportion of programs with four-year EM residencies that hire non-ACGME fellows graduating from three-year EM residencies. Results: Of 119 eligible FDs, 88 (74%) completed the survey. Seventy FDs (80%) indicated that they hire graduates of three-year residencies. Fifty-six (80%) indicated that three-year graduates supervise residents. Most FDs (74%) indicated no additional requirements exist to supervise residents outside of being hired as faculty. The FDs cited department policy, concerns about quality and length of training, and resident complaints as reasons for not hiring three-year graduates. A majority (10/18, 56%) noted that not hiring fellows from three-year programs negatively impacts recruitment and gives them access to a smaller applicant pool. Conclusion: Most non-ACGME fellowships at institutions with four-year EM programs recruit three-year graduates and allow them to supervise residents. This survey provides programs information on how comparable fellowships recruit and staff their departments, which may inform policies that fit the needs of their learners, the fellowship, and the department.


Assuntos
Internato e Residência , Humanos , Estados Unidos , Bolsas de Estudo , Estudos Transversais , Educação de Pós-Graduação em Medicina , Inquéritos e Questionários , Recursos Humanos
16.
J Pediatr Gastroenterol Nutr ; 78(4): 948-956, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38591669

RESUMO

A standard curriculum for pediatric colonoscopy training has neither been required nor universally implemented in North American fellowship programs. This qualitative study assessed the needs of colonoscopy training in pediatric gastroenterology to determine the standardized components of procedural teaching. Focus groups with pediatric gastroenterology attendings, fellows, procedural nurses, and interviews with advanced endoscopists, all practicing at a single institution, were conducted between March and June 2018. Data were analyzed using thematic analysis principles. Four themes emerged: (1) lack of standardization of colonoscopy performance, (2) lack of professional development of procedure teaching skills, (3) need for teaching behaviors that promote learner's performance, and (4) barriers to effective teaching and learning. A conceptual framework was created for developing a standardized "train-the-trainer" curriculum. Our needs assessment supports expansion of efforts to make this comprehensive training available to all pediatric gastroenterologists involved in procedure teaching.


Assuntos
Currículo , Docentes , Humanos , Criança , Educação de Pós-Graduação em Medicina/métodos , Colonoscopia , Padrões de Referência , Bolsas de Estudo
17.
J Prof Nurs ; 51: 58-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38614675

RESUMO

DNP-prepared faculty report challenges and barriers to achieving success in academic roles when criteria for promotion includes scholarship. The purpose of this evidence-based initiative was to explore thoughtful scholarship standards for DNP-prepared faculty which can be adapted and transferred across academic institutions with the goal of elevating faculty scholarship. Given a paucity of available research evidence, a review and synthesis of non-research evidence was conducted. DNP scholarship standards from high-ranking intuitions were critically appraised, and this evidence, along with the diverse and collective expertise of the authors, was translated into recommendations for an inclusive model of rigor for DNP-prepared faculty scholarship. A template for appraising the scholarship of DNP-prepared faculty based on strategic evaluation of impact is included. Academic institutions may use this work to expand the fundamental level of evolving scholarship, determine parameters, and provide clarity and support to DNP-prepared faculty as they seek to progress in rank.


Assuntos
Docentes , Bolsas de Estudo , Humanos , Instituições Acadêmicas , Universidades
18.
J Prof Nurs ; 51: 16-26, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38614669

RESUMO

BACKGROUND: Boyer's framework of scholarship, the basis of many academic models for faculty promotion, is comprised of the components of discovery, teaching, integration, application, and engagement. Yet, the scholarship component of application (containing goal-based clinical practice) is undervalued by many academic models. PURPOSE: This study explores the nursing activities currently qualifying as scholarship in several international academic models. METHODS: Using the Delphi approach, an international nine-member panel from seven countries participated in a six-question, structured brainstorming session to explore the nursing activities qualifying as scholarship by academic models. Follow-up sessions were attended by six panel members. RESULTS: Panel members reported that the nursing activities, which most often were recognized as scholarship, fit the scholarship components of discovery, teaching and integration but few fit the components of application or engagement. Although this project originally focused on clinical practice, far more recommendations for an academic model targeted the scholarship component of engagement. CONCLUSION: Academic models' lack of appreciation for the scholarship components of application (goal-based clinical practice) and engagement (partnering with community groups) discourages faculty from participating in these activities. Yet, these nursing activities demonstrate scholarship and are essential for the continued development of the nursing profession and discipline.


Assuntos
Academia , Bolsas de Estudo , Humanos , Docentes , Organizações
19.
Acad Psychiatry ; 48(3): 238-243, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38619806

RESUMO

OBJECTIVE: This study examined the current state of forensic education among child and adolescent psychiatry (CAP) fellowship programs, regarding specific forensic topics, teaching resources, methods, and experiences. The authors aimed to gather and analyze this data to assess the need for additional standardization of forensic psychiatry education in CAP fellowship, such as broader access to resources, and/or inform the development of a standardized curriculum, including milestones, in child and adolescent forensic psychiatry. METHODS: The authors collaboratively developed a survey instrument on child and adolescent forensic psychiatry education, which was then sent to 135 accredited CAP fellowship programs. The items included in the survey instrument were designed based on literature review, expert consensus, and a 1992 American Association of Directors of Psychiatric Residency Training survey on teaching ethics and forensic psychiatry. RESULTS: Completed response data was returned by 25 of the 135 programs surveyed. Complete responses came primarily from academic institutions (52% public, 36% private) with small- or medium-sized programs (1-12 total fellows, 88%; 11-29 faculty members, 56%). Programs reported on CAP forensic rotation sites, faculty members' level of expertise and involvement in forensic CAP, common forensic topics and experiences offered, and programs' attitudes towards specific topics and experiences. CONCLUSIONS: Child and adolescent psychiatrists must gain a clear understanding of the essential components of CAP forensic psychiatry during CAP fellowship, to mitigate discomfort when interacting with the legal system and meet the rising need for forensic CAP expertise across systems and structures impacting youth populations.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Currículo , Bolsas de Estudo , Psiquiatria Legal , Humanos , Psiquiatria do Adolescente/educação , Psiquiatria Legal/educação , Psiquiatria Infantil/educação , Adolescente , Inquéritos e Questionários , Criança , Estados Unidos
20.
J Surg Educ ; 81(6): 872-879, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38677897

RESUMO

BACKGROUND: Open reduction and internal fixation are the gold-standard treatment for displaced patellar fractures. The current literature remains inconclusive on the relationship between resident participation in the operating room and optimal patient outcomes. We hypothesize that surgeries performed solely by residents, without attending supervision, can provide similar outcomes to those performed by fellowship-trained orthopedic surgeons, providing new insights into the relationship between resident autonomy and surgical outcomes in the field of orthopedic trauma. METHODS: A tertiary trauma center cohort was retrospectively reviewed for all surgically treated patellar fractures between 2015 and 2020. The cohort was divided into 2 groups: patients operated by residents and patients operated by orthopedic trauma specialists. Demographics, surgical parameters, and radiographs were compared between the groups to evaluate complications and reoperation rates, radiographic outcomes (such as hardware failure, or loss of reduction), and clinical outcomes (including residual pain, painful hardware, decreased range of motion, and infections). RESULTS: A total of 129 patellar fractures were included in the study. Demographics and ASA were similar between the groups. There were no significant differences in complications (p = 0.900) or reoperation rates (p = 0.817), with an average follow-up time of 8 months (SD ± 5.3). Residents had significantly longer surgery duration (p =0.002). However, the overall length of stay was shorter in the resident group (p < 0.001). CONCLUSION: The study shows patellar fracture surgery performed by adequately trained residents can provide similar outcomes to those performed by fellowship-trained orthopaedic trauma surgeons. These findings highlight the significance of surgical autonomy in residency and its role in contemporary surgical education.


Assuntos
Bolsas de Estudo , Fraturas Ósseas , Internato e Residência , Patela , Humanos , Estudos Retrospectivos , Masculino , Feminino , Fraturas Ósseas/cirurgia , Patela/cirurgia , Patela/lesões , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Competência Clínica , Educação de Pós-Graduação em Medicina/métodos , Fixação Interna de Fraturas/educação , Cirurgiões Ortopédicos/educação , Cirurgiões Ortopédicos/estatística & dados numéricos
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