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2.
Medicina (B Aires) ; 79(5): 384-390, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31671388

RESUMO

According to the Association of American Medical Colleges, there are thirteen core Entrustable Professional Activities (EPAs) that medical graduates should be able to perform in their first day of residency, without direct supervision. In Argentina EPAs are not clearly defined. Moreover, there is no local data about the need of supervision regarding these activities. The aim of this study was to assess residents' and teaching physicians' estimations about the level of supervision that physicians in their first month of residency needed in order to perform EPAs. A cross-section study was conducted. First-year medical residents and teaching physicians were included. Electronic or paper surveys were sent, asking the level of supervision the participants estimated that residents needed to perform the 13 core EPAs, during their first month of residency. Participation was voluntary and anonymous. There were significant differences between the opinion of residents (n = 71) and teaching physicians (n = 39), for 11 out of 13 EPAs. More than half of the teaching physicians considered that residents needed direct supervision when performing EPAs, except for asking clinical questions and looking for evidence. Most residents thought that they required direct supervision in 6 EPAs. In conclusion, medical residents perceived the need of lower levels of supervision when compared to teaching physicians, who considered that medical graduates were not capable of performing most EPAs without direct supervision upon entering residency. Thus, it would be important to improve the procedures to evaluate the competences of medical graduates in order to establish more accurate supervision levels.


Assuntos
Docentes de Medicina/estatística & dados numéricos , Internato e Residência/organização & administração , Internato e Residência/estatística & dados numéricos , Corpo Clínico Hospitalar/organização & administração , Corpo Clínico Hospitalar/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Adulto , Argentina , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Avaliação Educacional/estatística & dados numéricos , Feminino , Humanos , Masculino , Valores de Referência , Inquéritos e Questionários , Adulto Jovem
3.
Acta Chir Orthop Traumatol Cech ; 86(4): 281-285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31524590

RESUMO

PURPOSE OF THE STUDY The specialty of orthopedics and traumatology that is completed in the 5 years period in our country is a challenging educational process and our purpose in this study is to demonstrate through a survey training conditions of the orthopedic assistants in our country and the effects of this process on assistants. MATERIAL AND METHODS 524 (70.05%) of 748 assistants who receive specialization training in Turkey were reached. There were 20 multiple choice questions ( 1 mark each) and 3 questions (more than 1 mark each) in the survey consisting of twenty-three questions. Our study group was formed by doctors who have still worked as assistant in our country and have accepted to participate in the study. The doctors who finished assistantship with any reason and did assistantship for time less than 6 months and did not exactly fill the questionnaire form were excluded from the study. RESULTS 524 (71.97%) of 728 assistant who are in 40 (100%) of 40 provinces where assistant training given in Turkey were reached. 474 (90.45%) participants were satisfied to do orthopedic specialization. When considering working hours, it was observed that 337 (64.31%) participants had over 90 hours weekly including night shift and 521 (99.42%) participants had to work after night shift. The majority of participants (361 persons 68.89%) were receiving salaries between TL 4000-6000. When looking at the entire working group, the rate of participants who said that scientific training is weak or there is no scientific training was 427 (81.48%). CONCLUSIONS Our survey study is one of the first statistical study which investigating professional and social problems of orthopedic assistants. Some of important problems as training satisfaction, abuse by patients and/or manager, the average monthly income and psychological status assessment is emphasized. Orthopedics and Traumatology assistantship is a challenging process to cause physical and psychological problems with the hard working conditions in our Turkey. Key words:residency training, orthopedic surgery, life quality, salary.


Assuntos
Internato e Residência/normas , Estresse Ocupacional , Ortopedia/educação , Traumatologia/educação , Humanos , Internato e Residência/organização & administração , Ortopedia/organização & administração , Ortopedia/normas , Admissão e Escalonamento de Pessoal , Jornada de Trabalho em Turnos/psicologia , Jornada de Trabalho em Turnos/normas , Inquéritos e Questionários , Fatores de Tempo , Traumatologia/organização & administração , Traumatologia/normas , Turquia
4.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31383816

RESUMO

BACKGROUND AND OBJECTIVES: There is an urgent need to advance mental health (MH) education and/or training in pediatric residency programs, yet no consensus on how to achieve this. We created an operational framework from ideas provided by a diverse group of stakeholders on how to advance MH education. METHODS: Concept-mapping methodology was used, which involves brainstorming ideas by completing a focus prompt, sorting ideas into groups, and rating them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis grouped ideas into clusters. Average importance and feasibility were calculated for each statement and cluster and compared statistically in each cluster and between subgroups. RESULTS: Ninety-nine ideas were generated. Sorted ideas yielded a 7-cluster concept map: (1) modalities for MH training, (2) prioritization of MH, (3) systems-based practice, (4) self-awareness and/or relationship building, (5) training in clinical assessment of patients, (6) training in treatment, and (7) diagnosis-specific skills. Two hundred and sixteen participants rated ideas for importance and 209 for feasibility. Four clusters had a statistically significant difference between their importance and feasibility ratings (P < .001). Suburban and rural area respondents (versus urban) rated clusters higher in importance and feasibility (P < .004), trainees rated all clusters higher in feasibility than practicing clinicians, and MH professionals rated prioritization of MH higher in feasibility (3.42 vs 2.98; P < .001). CONCLUSIONS: This comprehensive set of ideas, especially those rated highly in both importance and feasibility, should inform curricular and policy initiatives. Differences between importance and feasibility may explain why there has been little progress in this field.


Assuntos
Internato e Residência/organização & administração , Saúde Mental , Pediatria/educação , Desenvolvimento de Programas , Análise por Conglomerados , Consenso , Currículo , Humanos , Participação dos Interessados , Estados Unidos
5.
Surgery ; 166(4): 572-579, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31399217

RESUMO

BACKGROUND: For surgery residents, opportunities to systematically learn about surgical equipment are limited. Our facility holds a simulation-based boot camp for incoming, first-year general surgery residents. The aim of this study was to assess the effectiveness of this boot camp at increasing resident confidence and improving technical skills. METHODS: Boot camp for incoming surgery residents is held annually and provides hands-on simulation relating to endoscopy, laparoscopy, bronchoscopy, and abdominal access. Before the boot camp, participants completed a pretest, which includes self-confidence, experience, and a skills-assessment. Identical assessments of self-confidence and skills were completed after the boot camp as a posttest. Data was accrued from 2016 to 2018. RESULTS: A total of 26, first-year, general surgery residents participated in the boot camp. Most participants had never used an endoscopic simulator (61.5%), handled a colonoscope (57.7%), a gastroscope (80.8%), or gained operative access to the abdomen (76.9%). The assessments of self-confidence and skills demonstrated a mean increase in all 4 topics. All differentials demonstrated statistical significance (P <. 001). CONCLUSION: A 1-day, simulation-based boot camp for incoming surgery residents with a focus on endoscopy, laparoscopy, and abdominal access increases resident confidence as well as several basic aspects of technical skill.


Assuntos
Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/organização & administração , Cirurgia Geral/educação , Internato e Residência/organização & administração , Treinamento por Simulação/métodos , Adulto , Estudos de Coortes , Endoscopia/educação , Feminino , Humanos , Laparoscopia/ética , Masculino , Avaliação de Programas e Projetos de Saúde , Autoimagem , Fatores de Tempo
6.
J Bone Joint Surg Am ; 101(15): 1420-1427, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31393436

RESUMO

BACKGROUND: The importance of research in resident education has been emphasized in the orthopaedic surgery community, and a number of residency programs have incorporated a year or more of protected research time into their training. However, limited information exists as to what programs are looking for in applicants to research-track residency programs or the perceived benefits of completing such a program. METHODS: We identified orthopaedic surgery programs that have tracks involving at least 1 year of protected research time and sent surveys to their program directors and to the 2012 through 2016 research-track graduates. RESULTS: Twenty-three programs with research tracks were identified, and 19 program directors (83%) responded to the survey. The survey revealed that only 2 (11%) of these program directors were willing to accept lower scores and grades among applicants to their research track compared with their primary clinical (categorical) track. While most of the program directors (14 [74%]) preferred that applicants have an interest in academics, only a few (3 [16%]) considered it a failure if their research-track residents did not pursue academic careers. We obtained the e-mail addresses of 82 research-track graduates, and 66 (80%) responded to the survey. The survey revealed that those who went into academic careers were more likely than those who went into private practice to view completing a research track as beneficial for fellowship (73% versus 35%, respectively) and job (73% versus 22%, respectively) applications, believed that the income lost from the additional year of residency would be compensated for by opportunities gained from the research year (50% versus 17%, respectively), and said that they would pursue a research-track residency if they had to do it over again (81% versus 39%, respectively; all p values <0.05). CONCLUSIONS: The majority of program directors preferred that applicants to their research-track program have an interest in academics, although most did not consider it a failure if their research-track residents entered nonacademic careers. Graduates of research-track residency programs who entered academics more frequently viewed the completion of a research track as being beneficial compared with those who went into private practice.


Assuntos
Pesquisa Biomédica/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Procedimentos Ortopédicos/educação , Inquéritos e Questionários , Feminino , Humanos , Internato e Residência/organização & administração , Masculino , Diretores Médicos/organização & administração , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Estados Unidos
8.
J Grad Med Educ ; 11(4 Suppl): 100-103, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31428265

RESUMO

Background: The quality of the learning environment in the operating room (OR) is vital for the training of surgical residents. Tools with validity evidence exist to measure resident perceptions of the operative learning environment, yet to date no studies have assessed this environment for obstetrics and gynecology residency programs in the United Arab Emirates (UAE). Objective: We explored perceptions of obstetrics and gynecology residents regarding their operative learning environment in 2 hospitals in Abu Dhabi, UAE. Methods: Our cross-sectional study was conducted in 2018 using the validated Surgical Theater Educational Environmental Measure (STEEM) questionnaire for trainee assessments in the OR learning environment. The 4 STEEM subscales measure teaching and training, learning opportunities, overall atmosphere, and supervision, workload, and support, respectively. Cronbach's alpha and intraclass correlation were used to establish the internal consistence and reliability of the questionnaire. We calculated an overall score and compared scores between the 2 institutions using Student's t test. Results: Thirty-one residents completed the questionnaire (18 at Corniche Hospital and 13 at Al Ain Hospital). The overall average STEEM score was 142.1. The score for residents at Corniche Hospital was 134.9 and that for Al Ain Hospital was 152.2, with better overall scores on 3 STEEM domains at Al Ain Hospital. Conclusions: Our study showed that obstetrics and gynecology residents in the UAE have a positive perception of their operative learning environment. We also identified areas for improvement.


Assuntos
Ginecologia/educação , Internato e Residência/organização & administração , Aprendizagem , Obstetrícia/educação , Salas Cirúrgicas , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Procedimentos Cirúrgicos Operatórios , Inquéritos e Questionários , Emirados Árabes Unidos
9.
J Grad Med Educ ; 11(4): 439-446, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31440339

RESUMO

Background: Changes to assessment efforts following the shift to milestones-based assessment in the ACGME Next Accreditation System have not been fully characterized. Objective: This study describes themes in initial milestones-based assessment practices with the goal of informing continued implementation and optimization of milestones-based assessment. Methods: Semistructured interviews were conducted with 15 residency program leaders in 6 specialties at 8 academic medical centers between August and December 2016. We explored what was retained, what was added, and what was changed from pre-milestones assessment efforts. We also examined the perceived impact of the shift to milestones-based assessment on the programs. Thematic analysis began after the first 5 interviews and ended once thematic sufficiency was reached. Two additional authors reviewed the codes, offered critical input, and informed the formation and naming of the final themes. Results: Three themes were identified: (1) program leaders faced challenges to effective implementation; (2) program leaders focused on adaptability and making milestones work in what felt like a less than ideal situation for them; and (3) despite challenges, program leaders see value and utility in their efforts to move to milestones-based assessment. We describe a number of strategies that worked for programs during the transition, with perceived benefits acknowledged. Conclusions: While adaptation to milestones has occurred and benefits are noted, negative impacts and challenges (eg, perceived lack of implementation guidance and faculty development resources) persist. There are important lessons learned (eg, utilizing implementation experiences formatively to improve curricula and assessment) in the transition to milestones-based assessment.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/organização & administração , Internato e Residência/organização & administração , Avaliação de Programas e Projetos de Saúde/normas , Currículo , Educação de Pós-Graduação em Medicina/organização & administração , Docentes de Medicina , Humanos , Entrevistas como Assunto , Desenvolvimento de Pessoal
10.
J Grad Med Educ ; 11(4): 475-478, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31440345

RESUMO

Background: The Medical School Performance Evaluation (MSPE) is an important factor for application to residency programs. Many medical schools are incorporating recent recommendations from the Association of American Medical Colleges MSPE Task Force into their letters. To date, there has been no feedback from the graduate medical education community on the impact of this effort. Objective: We surveyed individuals involved in residency candidate selection for internal medicine programs to understand their perceptions on the new MSPE format. Methods: A survey was distributed in March and April 2018 using the Association of Program Directors in Internal Medicine listserv, which comprises 4220 individuals from 439 residency programs. Responses were analyzed, and themes were extracted from open-ended questions. Results: A total of 140 individuals, predominantly program directors and associate program directors, from across the United States completed the survey. Most were aware of the existence of the MSPE Task Force. Respondents read a median of 200 to 299 letters each recruitment season. The majority reported observing evidence of adoption of the new format in more than one quarter of all medical schools. Among respondents, nearly half reported the new format made the MSPE more important in decision-making about a candidate. Within the MSPE, respondents recognized the following areas as most influential: academic progress, summary paragraph, graphic representation of class performance, academic history, and overall adjective of performance indicator (rank). Conclusions: The internal medicine graduate medical education community finds value in many components of the new MSPE format, while recognizing there are further opportunities for improvement.


Assuntos
Desempenho Acadêmico/normas , Competência Clínica/normas , Medicina Interna/educação , Internato e Residência/organização & administração , Faculdades de Medicina/normas , Educação Médica , Humanos , Diretores Médicos/organização & administração , Estudantes de Medicina , Inquéritos e Questionários
11.
Lakartidningen ; 1162019 Aug 27.
Artigo em Sueco | MEDLINE | ID: mdl-31454058

RESUMO

The Swedish Parliament and Government has recently sanctioned a new 6 year undergraduate medical degree leading directly to license, followed by a 12 month introduction to work as a certified doctor. The undergraduate education is internationally harmonized and the 23 learning outcomes address competence needs in future Swedish and international health-care. Particular attention is given to professional competence, critical thinking, team-work and health promotion. All 23 learning outcomes must be documented before the University can issue a MD degree. After license, the doctor applies for a 12 month introduction to employment as doctor in the Swedish health-care system. This introduction is mandatory for all, regardless of the country where the license was issued. The introduction comprises clinical service in general medicine, emergency medicine and elective disciplines. Assessment of 10 learning outcomes is carried out in a formative wav by experienced and trained clinicians during the clinical service. After the introduction, the doctor is duly qualified to apply for specialist training.


Assuntos
Educação de Graduação em Medicina/organização & administração , Competência Clínica/normas , Humanos , Internacionalidade , Internato e Residência/organização & administração , Aprendizagem , Licenciamento em Medicina/normas , Suécia
12.
Ann Thorac Surg ; 108(3): 929-934, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31353035

RESUMO

BACKGROUND: Recent studies in noncardiac surgery have described worse outcomes in the first month of training. However, the "July effect" in the context of cardiac surgery outcomes is not well understood. We examined whether patient outcomes after cardiac surgery were affected by procedure month or academic year quartile. METHODS: Using the National Inpatient Sample, we isolated all coronary artery bypass grafting (CABG), surgical aortic valve replacement (AVR), mitral valve repair or replacement (MV), and isolated thoracic aortic aneurysm (TAA) replacement procedures between 2012 and 2014. For each procedure, overall trends in in-hospital mortality and hospital complications were compared by academic year quartiles (ie, between the first academic year quartile vs the fourth quartile) and by procedure month. Outcomes between teaching and nonteaching hospitals were also compared. RESULTS: Overall, 301,105 CABG, 111,260 AVR, 54,985 MV, and 2,655 TAA procedures met inclusion criteria. In-hospital mortality for each procedure did not vary by procedure month or academic year quartile, even after risk adjustment (all P > .05). Teaching status did not influence risk-adjusted mortality for CABG and isolated TAA replacement (both P > .05). However, teaching hospitals had significantly lower adjusted mortality than nonteaching hospitals for AVR and MV surgery (both P < .01). CONCLUSIONS: The July effect is not evident for cardiac surgery despite preexisting notions. Teaching hospitals performed at least equivalent, if not better, for major cardiac surgery procedures. These findings highlight the pivotal role of hospital support systems to ensure the safe transition of resident classes without compromising on patient outcomes.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/métodos , Competência Clínica , Mortalidade Hospitalar , Corpo Clínico Hospitalar/tendências , Qualidade da Assistência à Saúde , Centros Médicos Acadêmicos/organização & administração , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Estudos de Coortes , Bases de Dados Factuais , Educação de Pós-Graduação em Medicina/organização & administração , Feminino , Hospitais de Ensino/organização & administração , Humanos , Pacientes Internados/estatística & dados numéricos , Internato e Residência/organização & administração , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Risco Ajustado , Estações do Ano , Estados Unidos
13.
BMC Med Educ ; 19(1): 266, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319836

RESUMO

BACKGROUND: Active learning has been shown to improve knowledge retention, facilitate feedback, and motivate learners. Despite this evidence, lecture, a passive mode of instruction, is the most widely utilized instructional method for residency educational conferences. Team-based learning fosters active learning but is infrequently used during residency training. METHODS: Three team-based learning sessions (one introductory and two content-based) were held during noon conferences in a pediatrics residency program. A pre-post static-group design was used to evaluate learner satisfaction and knowledge gains. Additional data was collected about facilitator preparation, session attendance, and readiness assurance test scores. Descriptive statistics and qualitative content analyses were conducted. RESULTS: Forty-seven residents and students participated (81%, 47 of 58). Prior to the introductory session, the majority of participants (55%) were not familiar with team-based learning. After the three sessions, 65% of residents and students reported high levels of satisfaction with team-based learning. When compared to traditional, lecture-based noon conferences, 76% of participants reported more engagement and 48% perceived more learning in team-based learning sessions. Challenges included low completion rates of the assigned reading prior to the session and abridged discussions due to time limitations during sessions. Each session required 10 hours of preparation for curriculum development. CONCLUSIONS: Team-based learning resulted in greater satisfaction and engagement among learners when compared to lecture-based formats. However, it did not prove to be a feasible instructional method during one-hour residency conferences. Adaptations that promote learner preparation for sessions and overcome time limitations during sessions may improve the feasibility and impact of team-based learning during one-hour conferences. TRIAL REGISTRATION: Not applicable.


Assuntos
Competência Clínica , Educação de Pós-Graduação em Medicina/organização & administração , Internato e Residência/organização & administração , Pediatria/educação , Aprendizagem Baseada em Problemas/métodos , Centros Médicos Acadêmicos , Adulto , Congressos como Assunto , Feminino , Humanos , Masculino , Equipe de Assistência ao Paciente/organização & administração , Projetos Piloto , Avaliação de Programas e Projetos de Saúde
14.
Am Surg ; 85(6): 606-610, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267901

RESUMO

The objective of this study was to assess the results of a structured remediation program for surgical residents scoring poorly on the American Board of Surgery In-Training Examination®. Residents scoring below the threshold (<20th percentile) were placed in a remediation program consisting of textbook-based review and mandatory weekly quizzes overseen by the program director. The effects of the program were assessed over a five-year period (2014-2018). Of 168 tests taken, 23 (13.7%) instances of scoring below the threshold occurred (average percentile 11, range 1-19). Postremediation scores in the subsequent year improved with a median (IQR) percentile increase of 29 [23.5, 46] (P < 0.001). Two residents scored below the threshold twice; all others continued to score above the threshold. Participation in a structured remediation program results in dramatic improvement in American Board of Surgery In-Training Examination® performance, and a single occurrence of poor performance does not necessarily lead to a permanent handicap in academic performance.


Assuntos
Competência Clínica , Educação de Pós-Graduação em Medicina/organização & administração , Cirurgia Geral/educação , Internato e Residência/organização & administração , Ensino de Recuperação/organização & administração , Adulto , Currículo , Bases de Dados Factuais , Avaliação Educacional , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Inquéritos e Questionários , Estados Unidos
15.
Am Surg ; 85(6): 663-670, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267909

RESUMO

Ineffective communication between surgical trainees and attending surgeons is a significant contributor to patient harm. The aim of this study was to evaluate a tool to improve resident-to-attending communication regarding changes in patient clinical status. Ten critical patient events were compiled into a list of triggers for direct attending surgeon notification at a single academic institution. Residents and faculty were surveyed to assess communication before and after implementation of the list. Institution of the triggers list was associated with a nonstatistically significant increase in resident-to-attending notification regarding 7 of 10 critical patient events. There was no reported change in frequency of calls associated with the list's implementation. Most residents felt that the list improved patient care and increased their comfort with calling attending surgeons. Comments were generally positive; however, both groups expressed concern that the list could negatively impact resident autonomy and supervision. Implementing a list of triggers for attending notification of critical patient events subjectively improved resident-to-attending communication in an environment with high baseline levels of communication.


Assuntos
Internato e Residência/organização & administração , Corpo Clínico Hospitalar/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Melhoria de Qualidade , Inquéritos e Questionários , Centros Médicos Acadêmicos , Adulto , Educação de Pós-Graduação em Medicina/organização & administração , Feminino , Humanos , Comunicação Interdisciplinar , Relações Interprofissionais , Masculino , Erros Médicos/prevenção & controle , Pessoa de Meia-Idade , Ohio
17.
Urologe A ; 58(8): 870-876, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31168674

RESUMO

The current version of the urology training program will concentrate on the mediation of competences and skills in various fields of action for outpatient urology instead of persisting on the minimum and reference numbers of surgical and diagnostic procedures. However, the following fields of action must be fulfilled: microbiology, andrology and systemic cancer therapy. There is justifiable concern that various institutions will lose their permission for a complete 5­year residency program based on the above-mentioned demands since not all institutions have all subspecialties in urology. Those institutions need to define new ways of residency training such as interdisciplinary programs within their own institution between disciplines like pediatric surgery, gynecology and medical oncology. Other options are combined training programs between regional urology departments with different main focuses or training programs between institutions and urologists in private practice. There is an unmet need to improve residency training as well as board examinations by new structures and a reliable curriculum. Based on the changed main focuses of the new version of urology training, we need to discuss the future of residency programs. It might be helpful to discuss two different types of urology training with a common trunk for the first three years followed by a more outpatient-based residency training for the general urologist and a more specialized training for the inpatient urologist to be educated in complex treatment modalities. An open mind to broadening our own horizon, respectful discussion with other departments and the development of common, reliable and interdisciplinary contents represent indispensable prerequisites to realize such an innovative future training program.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/organização & administração , Internato e Residência/tendências , Urologia/educação , Andrologia , Criança , Currículo , Previsões , Ginecologia , Humanos , Oncologia , Pediatria
18.
BMC Med Educ ; 19(1): 188, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170966

RESUMO

BACKGROUND: One third of UK medical students undertake an intercalated degree, typically in traditional academic disciplines. It is less usual for students to undertake intercalated degrees that are directly aligned to a clinical speciality with longitudinal placements. This cross sectional survey aims to explore the self-reported experiences of students, alumni and supervisors associated with a clinically oriented intercalated degree in emergency care featuring a longitudinal placement in a hospital emergency department over a 9-month academic year. Themes for exploration include student clinical and academic development, effect on career choice, supervisor experience and the effect on host institutions. METHODS: Current students, previous alumni, and clinical placement supervisors associated with a single intercalated degree programme in urgent and emergency care since 2005 were identified from records and using social media. Separate online surveys were then developed and distributed to current students/ previous alumni and consultant physician supervisors, between May and August 2016. Results are presented using basic descriptive statistics and selected free text comments. RESULTS: Responses were obtained from 37 out of 46 contactable students, and 14 out of 24 supervisors (80 and 63%, respectively). Students self-reported increased confidence in across a range of clinical and procedural competencies. Supervisors rated student competence in clinical, inter-professional and academic writing skills to be commensurate with, or in many cases exceeding, the level expected of a final year medical student. Supervisors reported a range of benefits to their own professional and personal development from supervising students, which included improved teaching and mentoring skills, providing intellectual challenge, and helping with the completion of audits and service improvement projects. CONCLUSIONS: Students report the acquisition of a range of clinical, academic, and inter-professional skills following their intercalated BSc year. A positive experience was reported by supervisors, extending to host institutions. Students reported feeling more enthusiastic about emergency medicine careers on completion. However, as students embarking on this degree naturally bring pre-existing interest in the area, it is not possible to attribute causation to these associations. Further investigation is also required to determine the longer term effect of clinically oriented intercalated degrees on career choice.


Assuntos
Educação Médica/métodos , Medicina de Emergência/educação , Escolha da Profissão , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Internato e Residência/métodos , Internato e Residência/organização & administração , Estudantes de Medicina
19.
Thorac Surg Clin ; 29(3): 269-277, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31235295

RESUMO

Resident education in the operating room and surgical resident autonomy represent two enormous challenges within cardiothoracic (CT) training programs. The goal of surgical educators and CT trainees is to ensure the graduating resident's ability to safely operate independently at the completion of training. The field has come a long way from the notion of see one, do one, teach one, which was once the norm. Cardiothoracic surgery continues to become more specialized and the patients more complex with greater scrutiny of outcomes. There are many challenges that are faced in contemporary CT training to make intraoperative teaching harder than ever.


Assuntos
Internato e Residência , Cirurgia Torácica/educação , Procedimentos Cirúrgicos Torácicos/educação , Competência Clínica , Medicina Defensiva , Humanos , Internato e Residência/organização & administração , Salas Cirúrgicas , Autonomia Profissional , Fatores de Tempo
20.
BMC Med Educ ; 19(1): 202, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196084

RESUMO

BACKGROUND: A balance between autonomy and supervision can be difficult to obtain in medical education. In this study, we sought to determine whether the presence and level of supervision of ophthalmology resident outpatient clinic correlates with metrics of resident success, professionalism and stress. METHODS: A survey was emailed to all US ophthalmology program directors requesting it be forwarded to PGY4 residents. Questions included whether their program provided a resident-hosted outpatient clinic, and if so, whether residents were mandated to discuss every patient with faculty. Residents were assigned to three categories based on this question (0: no clinic, 1: mandated faculty input, 2: discretionary faculty input). Success metrics included numbers of manuscripts submitted, OKAP scores and success in obtaining fellowships. Professionalism metrics included rating comfort obtaining informed consent, breaking bad news, managing time in clinic, and confidence in providing care in various settings. Residents affirming participation in a continuity clinic also provided perceptions of the level of supervision and how the clinic affected stress. RESULTS: Category 1 residents perceived somewhat too much supervision, while category 2 residents felt that they had somewhat insufficient supervision. The majority of residents in either category did not feel that the continuity clinic affected their overall stress, although those who reported a change in stress usually indicated that the presence of the clinic increased stress. There were no other statistically significant differences between the responses from any category. CONCLUSIONS: The presence of a resident-hosted continuity clinic neither adds nor detracts from the success or sense of professionalism of ophthalmology residents. However, when such a clinic is present, the degree of supervision appears to correlate inversely with resident perception of autonomy. These results suggest that the decision of a training program to offer a clinic hosted by residents offering comprehensive continuity care can be informed primarily by faculty and trainee philosophy and personal preferences without comprising education quality, clinical efficiency, residents' perception of stress or their success in fellowship matching.


Assuntos
Instituições de Assistência Ambulatorial , Internato e Residência/organização & administração , Oftalmologia/educação , Autonomia Profissional , Humanos , Inquéritos e Questionários
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