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4.
Acad Med ; 96(1): 108-112, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33394662

RESUMO

PURPOSE: Combined baccalaureate-MD programs exist to fulfill a variety of educational missions, including to promote the development of physician-scientists, increase workforce diversity, promote primary care careers, and meet the needs of underserved patients. The authors sought to determine the demographics of combined program graduates, as well as their intention to practice in primary care (IPPC) and intention to work with the medically underserved (IWMU), as compared with graduates of traditional MD programs. METHOD: Data from the 2010-2017 Association of American Medical Colleges Graduation Questionnaire, a national survey of graduating medical students, were recategorized (e.g., as combined program or traditional program) before analysis. Logistic regression models on the 2 primary outcomes (IPPC and IWMU) were conducted to estimate odds ratios for the effects of covariates and predictors (e.g., gender, underrepresented in medicine [URM] group member, type of medical degree program). RESULTS: Data from a total of 109,028 respondents were included (3,182 from combined and 105,846 from traditional programs). Compared with students in traditional programs, those in combined programs were more likely to be younger (age at graduation ≤ 29: 3,143, 98.8% vs 89,688, 84.7%) and female (1,813, 57.0% vs 52,013, 49.1%) but less likely to identify as a URM group member (276, 8.7% vs 14,757, 13.9%). In an adjusted logistic regression model, graduating from a combined program, identifying as female, and IWMU predicted significantly greater odds of IPPC, while identifying as a URM, identifying as female, and having debt predicted significantly greater odds of IWMU. Graduating medical students who indicated family medicine as a career specialty were more likely to indicate an IWMU. CONCLUSIONS: Medical students graduating from combined programs were more likely to indicate an IPPC but were no more likely to indicate an IWMU than traditional program graduates.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/tendências , Educação de Graduação em Medicina/estatística & dados numéricos , Educação de Graduação em Medicina/tendências , Avaliação Educacional/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Adulto , Escolha da Profissão , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
5.
Rheumatol Int ; 41(3): 503-508, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33502553

RESUMO

During the COVID-19 pandemic, rheumatology educational programs around the world, face the daunting challenge of maintaining education for their trainees. Reduced in-person clinic exposures and social distancing requirements have significantly affected trainee education. Similar to programs around the USA, in early March 2020, our program was faced with an urgent need to pivot both our clinical and educational programs to virtual platforms. Within these limitations, we harnessed innovative educational models and restructured our curriculum to ensure adequate clinical and didactic exposure. We divided trainee's clinical rotations into four blocks, which include Inpatient consult service, Outpatient in-person and procedure clinics, Telehealth Clinics and Research/Elective week. By assigning specific rotations, we were able to ensure fellows were seeing adequate numbers of patients both through telemedicine and inperson while ensuring we complied with social distancing requirements. We further were able to ensure that trainee hands-on procedure training was not compromised. Acknowledging challenges presented by the COVID-19 pandemic and learner engagement in virtual environment, we designed an innovative educational portfolio. Utilizing synchronous and asynchronous learning methods, we have developed multiple complementary educational initiatives including: Rocket Rheumatology, Board Games, At the Elbow, Radiology Reading Rheum, Ultrasound Buddies, The History Rheum, and Rapid-Fire Journal Club. Virtual learning methods will become a cornerstone of medical education moving forwards. The GW Division of Rheumatology has rapidly incorporated innovative educational tools into our curriculum. Our approach will help Rheumatology training programs across the globe enhance rheumatology training.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/organização & administração , Reumatologia/educação , /epidemiologia , Educação de Pós-Graduação em Medicina/tendências , Humanos , Pandemias , Telemedicina/métodos
6.
Anaesthesia ; 76 Suppl 1: 53-64, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33426656

RESUMO

Over the past two decades, regional anaesthesia and medical education as a whole have undergone a renaissance. Significant changes in our teaching methods and clinical practice have been influenced by improvements in our theoretical understanding as well as by technological innovations. More recently, there has been a focus on using foundational education principles to teach regional anaesthesia, and the evidence on how to best teach and assess trainees is growing. This narrative review will discuss fundamentals and innovations in regional anaesthesia training. We present the fundamentals in regional anaesthesia training, specifically the current state of simulation-based education, deliberate practice and curriculum design based on competency-based progression. Moving into the future, we present the latest innovations in web-based learning, emerging technologies for teaching and assessment and new developments in alternate reality learning systems.


Assuntos
Anestesia por Condução/métodos , Anestesia por Condução/tendências , Anestesiologia/educação , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/tendências , Anestesiologia/tendências , Competência Clínica , Educação Baseada em Competências , Currículo , Humanos , Treinamento por Simulação
7.
Urol Clin North Am ; 48(1): 137-146, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218588

RESUMO

The use of robotic surgery in urology has grown exponentially in the past 2 decades, but robotic surgery training has lagged behind. Most graduating residents report a lack of comfort independently performing common robotic urologic surgeries, despite an abundance of available resources. There is a general consensus on the key components of a comprehensive robotics curriculum, and well-validated tools have been developed to assess trainee competency. However, no single curriculum has emerged as the gold standard on which individual programs can build their own robotics curricula.


Assuntos
Educação de Pós-Graduação em Medicina/tendências , Procedimentos Cirúrgicos Robóticos/educação , Procedimentos Cirúrgicos Urológicos/educação , Urologia/educação , Competência Clínica , Currículo/normas , Currículo/tendências , Previsões , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Procedimentos Cirúrgicos Robóticos/normas , Procedimentos Cirúrgicos Robóticos/tendências , Procedimentos Cirúrgicos Urológicos/normas , Procedimentos Cirúrgicos Urológicos/tendências , Urologia/normas , Urologia/tendências
12.
Pain Physician ; 23(4S): S367-S380, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32942794

RESUMO

BACKGROUND: The unexpected COVID-19 crisis has disrupted medical education and patient care in unprecedented ways. Despite the challenges, the health-care system and patients have been both creative and resilient in finding robust "temporary" solutions to these challenges. It is not clear if some of these COVID-era transitional steps will be preserved in the future of medical education and telemedicine. OBJECTIVES: The goal of this commentary is to address the sometimes substantial changes in medical education, continuing medical education (CME) activities, residency and fellowship programs, specialty society meetings, and telemedicine, and to consider the value of some of these profound shifts to "business as usual" in the health-care sector. METHODS: This is a commentary is based on the limited available literature, online information, and the front-line experiences of the authors. RESULTS: COVID-19 has clearly changed residency and fellowship programs by limiting the amount of hands-on time physicians could spend with patients. Accreditation Council for Graduate Medicine Education has endorsed certain policy changes to promote greater flexibility in programs but still rigorously upholds specific standards. Technological interventions such as telemedicine visits with patients, virtual meetings with colleagues, and online interviews have been introduced, and many trainees are "techno-omnivores" who are comfortable using a variety of technology platforms and techniques. Webinars and e-learning are gaining traction now, and their use, practicality, and cost-effectiveness may make them important in the post-COVID era. CME activities have migrated increasingly to virtual events and online programs, a trend that may also continue due to its practicality and cost-effectiveness. While many medical meetings of specialty societies have been postponed or cancelled altogether, technology allows for virtual meetings that may offer versatility and time-saving opportunities for busy clinicians. It may be that future medical meetings embrace a hybrid approach of blending digital with face-to-face experience. Telemedicine was already in place prior to the COVID-19 crisis but barriers are rapidly coming down to its widespread use and patients seem to embrace this, even as health-care systems navigate the complicated issues of cybersecurity and patient privacy. Regulatory guidance may be needed to develop safe, secure, and patient-friendly telehealth applications. Telemedicine has affected the prescribing of controlled substances in which online counseling, informed consent, and follow-up must be done in a virtual setting. For example, pill counts can be done in a video call and patients can still get questions answered about their pain therapy, although it is likely that after the crisis, prescribing controlled substances may revert to face-to-face visits. LIMITATIONS: The health-care system finds itself in a very fluid situation at the time this was written and changes are still occurring and being assessed. CONCLUSIONS: Many of the technological changes imposed so abruptly on the health-care system by the COVID-19 pandemic may be positive and it may be beneficial that some of these transitions be preserved or modified as we move forward. Clinicians must be objective in assessing these changes and retaining those changes that clearly improve health-care education and patient care as we enter the COVID era.


Assuntos
Infecções por Coronavirus , Assistência à Saúde/tendências , Educação de Pós-Graduação em Medicina/tendências , Pandemias , Pneumonia Viral , Telemedicina/tendências , Adulto , Betacoronavirus , Assistência à Saúde/métodos , Educação de Pós-Graduação em Medicina/métodos , Bolsas de Estudo/métodos , Bolsas de Estudo/tendências , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Masculino , Telemedicina/métodos
19.
JCO Oncol Pract ; 16(9): e943-e947, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32407178

RESUMO

The COVID-19 pandemic has wreaked havoc and created challenges in various subspecialty training programs, including hematology/oncology fellowship programs. The challenge of social distancing, providing care for those infected by COVID-19, continuing appropriate treatment of time-sensitive diseases, and the looming threat of health care worker infections required swift planning and restructuring of training programs. The Accreditation Council for Graduate Medical Education provided leeway to tackle the challenges faced by institutions and training programs in the setting of the COVID-19 pandemic. Currently, there is no established guideline specific to hematology and oncology fellowship programs. While understanding that there is no one-size-fits-all, shared experiences can assist training programs to incorporate best practices and customize their programs to provide an active educational environment that balances patient care needs, didactics, scholarly activities, and wellbeing during the process of rapid changes and adaptation. We share our hematology/oncology fellowship program's restructuring approach in response to the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Educação de Pós-Graduação em Medicina/tendências , Bolsas de Estudo , Pandemias , Pneumonia Viral/epidemiologia , Acreditação , Betacoronavirus/patogenicidade , Infecções por Coronavirus/virologia , Currículo , Serviço Hospitalar de Emergência , Hematologia/educação , Humanos , Oncologia/educação , Michigan/epidemiologia , Pneumonia Viral/virologia
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