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2.
BMC Res Notes ; 12(1): 558, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484585

RESUMO

OBJECTIVES: Medical records are critical to patient care, but often contain incomplete information. In UK hospitals, record-keeping is traditionally undertaken by junior doctors, who are increasingly completing early-career placements in psychiatry, but negative attitudes towards psychiatry may affect their performance. Little is known about the accuracy of medical records in psychiatry in general. This study aimed to evaluate the accuracy of Electronic Medical Records (EMRs) pertinent to clinical decision-making ("rationale") for prescribing completed by junior doctors during a psychiatry placement, focusing on the differences between psychotropic vs. non-psychotropic drugs and the temporal association during their placement. RESULTS: EMRs of 276 participants yielding 780 ward round entries were analysed, 100% of which were completed by Foundation Year or General Practice specialty training junior doctors rather than more senior clinicians. Compared with non-psychotropic drugs, documentation of prescribing rationale for psychotropic drugs was less likely (OR = 0.24, 95% CI 0.16-0.36, p < 0.001). The rate of rationale documentation significantly declined over time especially for psychotropic drugs (p < 0.001). Prescribing documentation of non-psychotropic drugs for people with mental illness is paradoxically more accurate than that of psychotropic drugs. Early-career junior doctors are therefore increasingly shaping EMRs of people receiving psychiatric care.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Educação de Pós-Graduação em Medicina/métodos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Psiquiatria/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Educação de Pós-Graduação em Medicina/normas , Registros Eletrônicos de Saúde/normas , Feminino , Grupos Focais/métodos , Grupos Focais/estatística & dados numéricos , Humanos , Internato e Residência/normas , Internato e Residência/estatística & dados numéricos , Masculino , Corpo Clínico Hospitalar/psicologia , Corpo Clínico Hospitalar/normas , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Psiquiatria/estatística & dados numéricos , Reprodutibilidade dos Testes , Estresse Psicológico/psicologia , Reino Unido , Adulto Jovem
3.
Semin Vasc Surg ; 32(1-2): 14-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540649

RESUMO

The recognition of vascular surgery as an independent surgical specialty is inevitable, but the pathway to full autonomy remains uncertain. Vascular surgery emerged from general surgery in the mid-1950s with the advent of synthetic grafts and microvascular techniques. By the early 1980s, Accreditation Council for Graduate Medical Education-approved fellowships were established in most large academic medical centers. The American Board of Surgery recognized this additional specialty training by awarding vascular graduates a Certificate of Special Qualifications distinguishing them from general surgeons. The emergence of endovascular surgery radically changed the face of vascular surgery from a general surgery subspecialty to a unique surgical specialty with a growing array of minimally invasive tools. With the establishment of a primary Certificate in Vascular Surgery and the subsequent development of integrated residencies, vascular surgery moved ever closer to recognition as an independent surgical specialty. Despite the remarkable progress that has been observed over the past 50 years, there is a desire in the vascular community for formal recognition of the unique body of knowledge and surgical skills that serve as the foundation of contemporary vascular care.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Autonomia Profissional , Conselhos de Especialidade Profissional , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/normas , Educação de Pós-Graduação em Medicina/tendências , Previsões , História do Século XX , História do Século XXI , Humanos , Conselhos de Especialidade Profissional/história , Conselhos de Especialidade Profissional/normas , Conselhos de Especialidade Profissional/tendências , Cirurgiões/história , Cirurgiões/normas , Cirurgiões/tendências , Estados Unidos , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/normas , Procedimentos Cirúrgicos Vasculares/tendências
4.
Semin Vasc Surg ; 32(1-2): 48-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540657

RESUMO

The evolving demands of surgical training have led to the successful implementation of skills examinations in the areas of laparoscopic and endoscopic surgery. Currently, there is no similar formal skills assessment in vascular surgery, despite endovascular intervention replacing open surgery in treatment of many vascular conditions. The adoption of less invasive techniques to treat aneurysm and occlusive disease has resulted in new training paradigms and technical challenges for trainees. The duty hour restriction for trainees and declining numbers of complex open vascular interventions have added to the challenges of vascular surgery training. Simulation is a promising avenue for both skills training and assessment. The ability to evaluate the fundamental skills of trainees would be an important step to ensure a degree of uniformity in trainees' technical abilities. The role of simulation-based training in acquiring, testing, and refining these skills is still in its infancy in the vascular surgery training paradigm. This article aims to impart a deeper understanding of the conditions for developing and implementing the fundamentals of vascular and endovascular surgery, and to provide guidance regarding the role of simulation-based training in a rapidly evolving specialty. There are various forms of simulation available, including benchtop models, high-fidelity simulators, and virtual-reality simulators, and each requires a different method of proficiency assessment. Both open surgery and endovascular skills can be assessed and the application of successful implementation in academic vascular surgery training program is presented.


Assuntos
Certificação , Instrução por Computador/métodos , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência , Treinamento por Simulação/métodos , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Certificação/normas , Competência Clínica , Instrução por Computador/normas , Currículo , Educação de Pós-Graduação em Medicina/normas , Humanos , Curva de Aprendizado , Treinamento por Simulação/normas , Cirurgiões/normas , Procedimentos Cirúrgicos Vasculares/normas
5.
Semin Vasc Surg ; 32(1-2): 5-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540658

RESUMO

The American Board of Surgery (ABS) has more than 80 years of both direct and indirect involvement in US surgical education, with its primary role being certification of graduates of Accreditation Council for Graduate Medical Education-approved surgical training programs. The ABS's impact on education has been at multiple levels, including the development of the content and administration of qualifying and certifying examinations; original education research based on the Board's unique data sets; and surgical training and education-related initiatives in partnership with multiple regulatory bodies and surgical societies. Within these efforts, by incremental steps, the specialty of vascular surgery attained recognition as a primary specialty of the ABS, and the Vascular Surgery Board of the ABS was established 20 years ago, in 1998. The 2 decades that followed have witnessed significant transformations in the evaluation and treatment of vascular disease, the paradigms for training vascular and endovascular surgeons, and the Vascular Surgery Board has partnered with stakeholder organizations to continually ensure quality education for the evolving vascular surgical workforce. Looking forward, while surgical education remains outside of its primary mission, the ABS and Vascular Surgery Board will continue as key stakeholders and leaders in the complex network of professional societies and training institutions that will guide the evolution of vascular surgery training.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Conselhos de Especialidade Profissional , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/normas , História do Século XX , História do Século XXI , Humanos , Conselhos de Especialidade Profissional/história , Conselhos de Especialidade Profissional/normas , Cirurgiões/história , Cirurgiões/normas , Estados Unidos , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/normas
6.
South Med J ; 112(8): 450-454, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31375843

RESUMO

OBJECTIVE: Although considerable emphasis is placed on the attainment of honors in core medical school clerkships, little is known about what student characteristics are used by attending physicians to earn this designation. The purpose of this study was to evaluate what values and characteristics that attending physicians consider important in the evaluation of Pediatrics and Internal Medicine clerkship students for clinical honors designation. METHODS: This cross-sectional survey study was framed around Accreditation Council for Graduate Medical Education (ACGME) competencies. It was administered at three tertiary care hospitals associated with one large medical school in an urban setting. Teaching ward attendings in Pediatrics and Internal Medicine who evaluated third-year medical students between 2013 and 2016 were surveyed. RESULTS: Overall, Pediatric and Internal Medicine faculty demonstrated close agreement in which competencies were most important in designating clinical honors. Both groups believed that professionalism was the most important factor and that systems-based practice and patient care were among the least important factors. The only competency with a significant difference between the two groups was systems-based practice, with Internal Medicine placing more emphasis on the coordination of patient care and understanding social determinants of health. CONCLUSIONS: Professionalism, communication skills, and medical knowledge are the most important characteristics when determining clinical honors on Pediatrics and Internal Medicine clerkships.


Assuntos
Estágio Clínico/métodos , Competência Clínica/normas , Educação de Pós-Graduação em Medicina/normas , Docentes de Medicina , Medicina Interna/educação , Assistência ao Paciente/normas , Pediatria/educação , Criança , Estudos Transversais , Currículo , Humanos , Estudos Retrospectivos , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos
7.
Diabetes Metab Syndr ; 13(4): 2647-2652, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405689

RESUMO

AIMS: The purpose of this study was to investigate the effectiveness of an inpatient diabetes care education during the first year of internal medicine residency training on inpatient glycemic control. METHODS: The program was comprised of 1-hr small group teaching per 4-week rotation and twice-a-week morning insulin round by an endocrinologist. Inpatient insulin management guideline leaflet was provided to all internal medicine residents. We retrospectively collected the point-of-care testing for glucose (POCT-glu) data in patients admitted to the general medicine wards and compared the mean of blood glucose (BG) before and after the education program. A total of 134438 POCT-glu values from 7055 patients were analyzed. RESULTS: After the initiation of the education program, mean BG levels significantly decreased during the first year and were lowest during the second year after education (Mean BG at baseline was 161.38 ±â€¯64.10 mg/dL; 1st year, 159.48 ±â€¯62.53 mg/dL and 2nd year, 155.60 ±â€¯64.94 mg/dL, p-value < 0.0001). The reduction of BG levels was more pronounced in the patients with previously undiagnosed diabetes mellitus than patients with underlying diabetes mellitus. The rates of severe hypoglycemia (defined by BG < 40 mg/dL or 2.2 mmol/L) were not significantly different before and after education (baseline 0.12%, 1st year 0.14%, and 2nd year 0.14%, p-value = 0.632). CONCLUSIONS: Lack of confidence and inadequate knowledge of insulin treatment in physicians were important barriers to glycemic management. Consistent education in internal medicine residents led to a significant improvement in inpatient glycemic control.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Educação de Pós-Graduação em Medicina/normas , Hiperglicemia/prevenção & controle , Hipoglicemia/prevenção & controle , Pacientes Internados/estatística & dados numéricos , Medicina Interna/educação , Guias de Prática Clínica como Assunto/normas , Idoso , Biomarcadores/análise , Glicemia/análise , Diabetes Mellitus/sangue , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Hospitalização , Humanos , Hipoglicemiantes/uso terapêutico , Internato e Residência , Masculino , Pessoa de Meia-Idade , Testes Imediatos , Prognóstico , Melhoria de Qualidade , Estudos Retrospectivos
9.
BMC Med Educ ; 19(1): 247, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277625

RESUMO

BACKGROUND: In Australia, the number of medical graduates per year has increased at a greater rate than the increase in the number of specialist training places. Consequently, competition for training positions is intensifying. There is anecdotal evidence to suggest that medical graduates are acquiring additional qualifications to compete with their peers Stevenson 2017 ( https://insightplus.mja.com.au/2017/36/specialty-training-places-the-other-looming-crisis/ ). Our study investigates this phenomenon of additional credentialing and demonstrates the number and type of postgraduate and research qualifications obtained by specialists in training in Australia. This is the first study to assess the number and type of credentials acquired by registrars in each specialty and to provide insight into differences between specialities. METHODS: Information on specialists in training was obtained through the Medicine in Australia: Balancing Employment and Life (MABEL) survey conducted between 2008 and 2014. The number of any additional qualifications and specific PhD, Master's degree, postgraduate diploma/certificate and research degrees from medical school were assessed for each specialist training scheme in the database. RESULTS: Overall, 995 registrars representing 13 specialties were included. Just under a third (30.4%) completed a research-based degree during their medical degree and almost half (46.7%) of specialist registrars obtained further qualifications after completing medicine. A significantly higher proportion of ophthalmology (78.6%) and paediatric (67.5%) registrars, and a lower percentage of emergency medicine (36.7%) registrars, held postgraduate qualifications. Overall, 2.4% of registrars held a PhD and 10.1% held a Master's degree. A higher percentage of either PhD or Master's was held by ophthalmology (64.3%) and surgical (30.6%) trainees and a lower percentage by anaesthetics (6.3%) and physician trainees (7.9%). Postgraduate diplomas or certificates were most common among paediatric (41.2%) and obstetrics and gynaecology (25.6%) registrars. CONCLUSION: This is the first study to investigate the additional qualifications of specialists in training in Australia. Almost half of specialists in training surveyed (46.7%) have completed some form of additional study, whether it is a PhD, Master's, postgraduate diploma/certificate or research degree from medical school. Trainees of specialist training schemes are more qualified than specialists who trained in the past Aust Fam Physician 32:92-4, 2003.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Definição da Elegibilidade , Especialização , Austrália , Estágio Clínico , Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional , Humanos , Internato e Residência , Estudos Longitudinais , Modelos Educacionais , Especialização/estatística & dados numéricos
10.
Dis Colon Rectum ; 62(9): 1071-1078, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31318771

RESUMO

BACKGROUND: Robotic surgery for colorectal cancer offers many potential benefits, but as with any new technology, there is a learning curve. OBJECTIVE: We sought to identify trends in the uptake of robotic resection and associated complication rates. DESIGN: This was a case sequence analysis of robotic surgery for colorectal cancer. SETTINGS: The study was conducted using the New York Statewide Planning and Research Cooperation System database. PATIENTS: Adults undergoing colorectal resection for cancer from 2008 through 2016 were identified in the New York Statewide Planning and Research Cooperative database. Case sequence analysis was used to describe surgeon experience, with cases grouped into quartiles based on the chronological order in which each surgeon performed them. MAIN OUTCOME MEASURES: Outcomes included in-hospital major events (myocardial infarction, pulmonary embolism, shock, and death) and iatrogenic complications. Generalized linear mixed models were used to estimate the relationship between case sequence and operative outcomes. RESULTS: A total of 2763 robotic procedures were included, with volume increasing from 76 cases in 2010 to 702 cases in 2015. The proportion of cases performed by surgeons earliest in their learning curve has increased to 18.2% in 2015. This quartile was composed of more black patients (11.4% earliest quartile vs 7.0% latest quartile; p < 0.001) and rectal resections (50.1% earliest quartile vs 38.9% latest quartile; p < 0.001). In adjusted analysis, major complications did not improve with increasing case sequence. However, with increasing cumulative surgeon case sequence iatrogenic complications were reduced, particularly in the highest volume quartile (OR = 0.29 (95% CI, 0.09-0.88); p = 0.03). Odds of prolonged length of stay (>75 percentile) were also decreased (OR = 0.50 (95% CI, 0.37-0.69); p < 0.001). LIMITATIONS: Data were derived from an administrative database. CONCLUSIONS: Robotic colorectal resection has been rapidly adopted. Surgeons earliest in their experience have increased iatrogenic complications and continue to make up a large proportion of cases performed. See Video Abstract at http://links.lww.com/DCR/A974. ANÁLISIS DE SECUENCIA DE CASOS DE LA CURVA DE APRENDIZAJE DE RESECCIÓN ROBÓTICA COLORRECTAL: La cirugía robótica para el cáncer colorrectal ofrece muchos beneficios potenciales, pero como con cualquier nueva tecnología, presenta una importante curva de aprendizaje. OBJETIVO: Se buscó identificar tendencias en la aceptación de la resección robótica y las tasas de complicaciones asociadas. DISEÑO:: Análisis de secuencia de casos de cirugía robótica para cáncer colorrectal AJUSTES:: Base de datos del Sistema de Cooperación para la Investigación y la Planificación del Estado de Nueva York. PACIENTES: Los adultos que se sometieron a una resección colorrectal en caso de cáncer desde 2008 hasta 2016 se identificaron en la base de datos de la Cooperativa de Investigación y Planificación del Estado de Nueva York. Se utilizó un análisis de secuencia de casos para describir la experiencia del cirujano, y los casos se agruparon en cuartiles según el orden cronológico en el que cada cirujano los operó. RESULTADOS PRINCIPALES: Los resultados incluyeron los eventos intrahospitalarios mayores (infarto de miocardio, embolia pulmonar, shock y muerte) y las complicaciones iatrogénicas. Se utilizaron modelos lineales generalizados mixtos para estimar la relación entre la secuencia de casos y los resultados operativos. RESULTADOS: Se incluyeron un total de 2.763 procedimientos robóticos, con un aumento del volumen de 76 casos en 2010 a 702 casos en 2015. La proporción de casos realizados por cirujanos en su primera curva de aprendizaje aumentó a 18.2% en 2015. Este cuartil estaba compuesto por una mayoría de pacientes de color (11.4% en el cuartil más temprano versus 7.0% en el último cuartil, p < 0.001) y de resecciones rectales (50.1% en el primer cuartil vs 38.9% en el último cuartil, p < 0.001). En el ajuste del análisis, las complicaciones mayores no mejoraron al aumentar la secuencia de casos. Sin embargo, al aumentar la secuencia acumulada de casos de cirujanos, se redujeron las complicaciones iatrogénicas, particularmente en el cuartil de mayor volumen (OR = 0,29; IC del 95%: 0,09 a 0,88; p = 0,03). Las probabilidades de una estadía hospitalaria prolongada (> percentil 75) también disminuyeron (OR 0,50; IC del 95%: 0,37 a 0,69; p < 0,001). LIMITACIONES: Los valores fueron derivados desde una base de datos administrativa. CONCLUSIONES: La resección colorrectal robótica ha sido adoptada rápidamente. Los cirujanos durante su experiencia inicial han presentado un elevado número de complicaciones iatrogénicas y éstas representan todavía, una gran proporción de casos realizados. Vea el Resumen del Video en http://links.lww.com/DCR/A974.


Assuntos
Colectomia/educação , Neoplasias Colorretais/cirurgia , Educação de Pós-Graduação em Medicina/normas , Curva de Aprendizado , Procedimentos Cirúrgicos Robóticos/educação , Cirurgiões/educação , Idoso , Colectomia/métodos , Feminino , Humanos , Masculino , Estudos Retrospectivos
11.
Br J Anaesth ; 123(3): 368-377, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31255289

RESUMO

BACKGROUND: Our goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable. METHODS: Sixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasound-guided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses. RESULTS: We developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78-0.89) and 0.90 (95% CI: 0.87-0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5-4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5-6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6-10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0-288]; P=0.048). Fixation count correlated negatively with steps (r=-0.60; P=0.04) and with errors (r=0.64; P=0.03). CONCLUSIONS: Our tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/métodos , Bloqueio Nervoso/normas , Pesquisa Médica Translacional/normas , Cadáver , Lista de Checagem , Técnica Delfos , Educação de Pós-Graduação em Medicina/normas , Humanos , Simulação de Paciente , Psicometria , Reprodutibilidade dos Testes , Escócia , Pesquisa Médica Translacional/métodos , Ultrassonografia de Intervenção/métodos
12.
BMC Med Educ ; 19(1): 250, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286962

RESUMO

BACKGROUND: Investment in research is high on the agenda of many countries in recognition of the fact that research is important for the development of society. Doctoral students have a vital role and represent a substantial part of this investment. It is therefore imperative to reduce the risk of students dropping out from doctoral studies. The aim of this qualitative study was to gain deeper insight into the working conditions of, and obstacles and opportunities for, doctoral students at an institute of medicine in Sweden. METHODS: Semi-structured interviews were conducted in 2013 with 17 doctoral students-of varying genders, professions and fields of research-from the Institute of Medicine, Sahlgrenska Academy, at the University of Gothenburg, Sweden. The recorded interviews were transcribed and analysed using systematic text condensation. RESULTS: Four categories emerged from the data. They were: Safety, Frustrating Structures, Others - not me, and the future. They included positive as well as negative perceptions. Among the positive perceptions were recognition of the importance of the supervisor, as well as secure conditions, and personal development. Frustrating structures in the academic culture, stress and differences in career building constituted the negative points. CONCLUSIONS: Our findings suggest that there is a need for structures within the university that support doctoral students who feel they are not receiving the assistance they need, who believe they have unreasonable working conditions, or who may need to change supervisors in order to complete their graduate research studies. Our study also highlights the fact that supervisors have a major influence on the work environment of doctoral students, and that the general and academic perception of the research area likewise has an effect on the successful completion of the research project and dissertation. Providing leadership training for supervisors could be an important measure that may help improve conditions for the doctoral students they supervise.


Assuntos
Pesquisa Biomédica/educação , Educação de Pós-Graduação em Medicina/normas , Docentes de Medicina , Pesquisadores/psicologia , Estudantes de Medicina/psicologia , Local de Trabalho/psicologia , Atitude do Pessoal de Saúde , Currículo , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Meio Social , Suécia , Orientação Vocacional/normas
13.
Educ Prim Care ; 30(4): 254-256, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31309860

RESUMO

In GP training, educational supervisors are responsible for collating evidence of a trainee's performance and progress to allow them to progress to the next stage of training. In hospital posts, they rely upon a clinical supervisor's report to help assess progress. Clinical supervisors are clinicians from various specialties who may not have an in-depth knowledge of the GP training programme, and anecdotally, our impression was that clinical supervisor reports were impersonal and not helpful in assessing a trainee's performance. We set out to evaluate the usefulness of a clinical supervisor's report in the context of completing and educational supervisor report for trainees in hospital posts. We reviewed clinical supervisor and educational supervisor reports for a cohort of 30 trainees in the Wessex Deanery, and conducted a questionnaire for their educational supervisors. All educational supervisors valued the clinical supervisor reports in completing their report, those with personal comments being the most useful. The majority of reports had a mixture of personal and generic comments. Overall, clinical supervisor reports provide additional information to evaluate performance, and they should continue to be used. To improve their use further, guidance can be given to clinical supervisors about the value of personal comments for trainees.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Feedback Formativo , Competência Clínica , Educação de Pós-Graduação em Medicina/normas , Humanos , Reino Unido
17.
Sultan Qaboos Univ Med J ; 19(1): e32-e37, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198593

RESUMO

Objectives: This study aimed to compare changes in medical students' research practices and perceptions of two cohorts of graduates. Methods: This cross-sectional comparative study was conducted from November 2014 to December 2017 and included the 2015 and 2017 medical graduates of King Abdulaziz University, Jeddah, Saudi Arabia. A validated self-administrated questionnaire, which included questions about participants' age and gender, research activities, and obstacles to and motivators for research involvement was used. Results: A total of 484 graduates were included in this study (response rate: 96.8%). A significant difference was found between the 2015 and 2017 graduates who had not started any research project (48.4% versus 35%; P <0.001) and a 20% increase in the 2017 graduates' confidence in their abilities to start their own projects was observed (P <0.001). Significantly more 2017 graduates were engaged in various research roles, other than 'author', compared to 2015 graduates (71.3% versus 55.4%; P <0.001). Career progression was the main motivator for both the 2015 and 2017 medical graduates to participate in research (79.5%). Reported obstacles to research included a lack of dedicated time for research and methodology training and a shortage of research project opportunities. Conclusion: This study highlights positive changes in attitudes towards and perceptions of research among medical graduates.


Assuntos
Pesquisa Biomédica/tendências , Educação de Pós-Graduação em Medicina/normas , Percepção , Estudantes de Medicina/psicologia , Adulto , Pesquisa Biomédica/métodos , Estudos Transversais , Educação de Pós-Graduação em Medicina/métodos , Feminino , Humanos , Masculino , Arábia Saudita , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Universidades/organização & administração
18.
Ann Surg Oncol ; 26(9): 2667-2674, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31168736

RESUMO

BACKGROUND: Complex general surgical oncology (CGSO) fellowships recently obtained Accreditation Council for Graduate Medical Education (ACGME) accreditation and board certification eligibility. We aimed to characterize the applicant pool and identify factors predictive of matching into our program. METHODS: We conducted a retrospective review of CGSO fellowship applications to a major cancer center from 2008 to 2018. Data were analyzed for trends over time, including a comparison of pre- versus post-American Board of Surgery (ABS) certification eligibility. RESULTS: A total of 846 applications were reviewed. Most applicants (86.2%) trained in a US residency program; 58.4% performed ≥ 1 research year during residency; 29.6% had a dual degree. Fewer applicants (34.5%) were female, a trend which did not change over time. Post-ABS, applicants were more likely to complete ≥ 1 year between residency and fellowship (20.9% versus 13.2%, p = 0.003), to be in practice at the time of application (12.2% versus 6.6%, p = 0.005), and to reapply (5.5% versus 1.0%, p < 0.001). Post-ABS applicants listed more peer-reviewed publications (8 [interquartile range (IQR) 4, 15] versus 5 [IQR 2, 10]; p < 0.001). On multivariable analysis, factors associated with matching into our program included: US allopathic medical school graduation [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.8-11.7], Alpha Omega Alpha (AOA) Honor Medical Society distinction (OR 2.7, 95% CI 1.6-4.7), dual degree (OR 2.0, 95% CI 1.1-3.4), and performance of a clinical/research rotation at our institution (OR 4.9, 95% CI 2.2-10.7). CONCLUSIONS: After establishment of CGSO board certification eligibility, applicants were more likely to apply while in practice and to reapply. A number of factors, including having a dual degree and rotating at our institution, were associated with matriculation.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Definição da Elegibilidade/estatística & dados numéricos , Bolsas de Estudo/normas , Internato e Residência/estatística & dados numéricos , Cirurgiões/educação , Cirurgiões/tendências , Oncologia Cirúrgica/normas , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Cirurgiões/provisão & distribução , Estados Unidos
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