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1.
Medicine (Baltimore) ; 99(8): e19249, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080130

RESUMO

To study the prevalence of burnout and job satisfaction in Chinese pediatrics residents.Prospective participants were invited via a WeChat group to participate from October 1, 2018 to January 31, 2019. The Maslach Burnout Inventory-Human Services Survey was used to measure physician burnout, and the Minnesota Satisfaction Questionnaire was used to measure job satisfaction.A total of 380 residents (81.1% response rate) from 35 pediatric residency programs completed the cross-sectional web-based survey. Of the responders, 233 (61.3%) exhibited high levels of career burnout. Residents 24 to 29 years of age were less likely to report burnout than residents ≥30 years of age (50.9% vs74.7%; P < .05). In addition, residents with an annual income less than 80,000 RMB seem to have higher burnout levels (66.2%). Residents who reported that they felt sleep deprived had significantly higher rates of burnout than those who did not (P < .01). Logistic regression showed that age ≥30 years (odds ratio [OR] 3.74 [1.57-7.66], P < .01) and sleep deprivation (OR 4.11 [2.19-7.35], P < .01) were the 2 independent risk factors associated with burnout.Burnout is highly prevalent among Chinese pediatrics residents who also reported poor job satisfaction.


Assuntos
Esgotamento Profissional/epidemiologia , Internato e Residência/estatística & dados numéricos , Satisfação no Emprego , Pediatria/educação , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Internet , Modelos Logísticos , Masculino , Sono
2.
Am Surg ; 86(1): 65-72, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32077418

RESUMO

The reality of sexual harassment is unmasking in many fields, and medical trainees constitute a vulnerable and at-risk group. We report the prevalence of sexual harassment among GI, internal medicine, and pediatric residents, with a focus on identifying underlying reasons for lack of victim reporting. A modified previously validated Department of Defense survey on sexual harassment was e-mailed to 261 GI, 132 pediatric, and 271 internal medicine program directors. Three hundred eighty-one residents responded to the survey. Female trainees were more likely to be subject to sexual harassment (83% vs 44%, P <0 .0001). Offensive and/or suggestive jokes and comments were the most common type of harassment experienced. Most residents were unlikely to report the offender (87% females, 93% males). Although 77 per cent of residents believed they would be supported by their program if they reported a sexual harassment event, only 43 per cent were aware of institutional support in place for victims at their program. Although there is a persistently high incidence of harassment in training, the avenues in which to report it are largely unknown and underused. Further research should focus on evidence-based interventions to encourage reporting and to design institutional programs for victims of sexual harassment.


Assuntos
Educação de Pós-Graduação em Medicina , Medicina Interna/educação , Internato e Residência , Pediatria/educação , Assédio Sexual/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
3.
Urology ; 136: 218-224, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31765653

RESUMO

OBJECTIVE: To understand the extent to which pediatricians are providing advice on care of the uncircumcised penis and the advice they are providing. We hypothesized that pediatric residents lack preparedness to offer parents advice on caring for the uncircumcised penis and as such are unlikely to offer such advice. METHODS: An IRB approved, anonymous survey was administered to 244 pediatric residents in 5 urban training programs (Appendix). Descriptive statistics were used for clinical and demographic data and Fisher's exact and Kruskal-Wallis tests were used for comparative analysis. RESULTS: Eighty-three residents completed the survey for a response rate of 34%. Less than half (45%) of the residents surveyed were likely, or extremely likely to voluntarily offer advice to parents on care of the uncircumcised penis. On a scale of 0-100, the median confidence level in offering advice was 48 (interquartile range [IQR] 30-52). Forty-nine percent of residents reported never being taught care of the uncircumcised penis. Of those who received education, 72% reported learning informally from a senior resident or attending and only 9% learned from a formal lecture. Pediatric residents varied greatly on advice given to parents in regards to the frequency of retraction and 40% offered no advice. CONCLUSION: This study demonstrates that pediatric residents currently lack confidence in providing parents advice on preputial care and are unlikely to offer such advice. When offered, the advice given is highly variable. This study emphasizes the need for improved education of pediatric residents.


Assuntos
Cuidado da Criança , Aconselhamento Diretivo , Internato e Residência , Pais , Pediatria/educação , Pênis , Pré-Escolar , Circuncisão Masculina , Aconselhamento Diretivo/métodos , Aconselhamento Diretivo/normas , Aconselhamento Diretivo/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
4.
Ann R Coll Surg Engl ; 102(1): 49-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31755741

RESUMO

INTRODUCTION: Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency service assets. This study aimed to quantify higher surgical trainee operative experience and confidence in managing suspected testicular torsion in a single UK deanery (Wales). MATERIALS AND METHODS: Anonymised logbook data were obtained via the Intercollegiate Surgical Curriculum Programme version 10 using the head of school report function for all general surgery (n=53) and urology (n=15) higher surgical trainees, which were combined with the distribution of an electronic self-administered questionnaire. RESULTS: Median operative scrotal explorations recorded for all general surgery higher surgical trainees and senior general surgery higher surgical trainees (ST7+) was 7 (range 1-22) and 10 (range 1-22), compared with 21 (range 9-64, p=0.00104) and 24 (19-64, p<0.001) for urology higher surgical trainees. The questionnaire response rate was 64.6% (general surgery 31/50, urology 11/15). Confidence levels in assessing adult and paediatric patients were lower in general surgery when compared with urology higher surgical trainees: median adult confidence rate 7/10 compared with 9/10, and paediatric confidence rate 7/10 compared with 8/10 (p<0.001 and p=0.053, respectively). All higher surgical trainees preferred urology as the accountable hospital specialty when both assets were available. DISCUSSION AND CONCLUSION: General surgery higher surgical trainees receive less than 50% of the operative exposure of urology higher surgical trainees in emergency scrotal surgery, which has important implications for curriculum competence development and patient safety.


Assuntos
Cirurgia Geral/educação , Torção do Cordão Espermático/cirurgia , Urologia/educação , Adulto , Atitude do Pessoal de Saúde , Criança , Competência Clínica/normas , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Cirurgia Geral/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Humanos , Masculino , Pediatria/educação , Pediatria/estatística & dados numéricos , Inquéritos e Questionários , Urologistas/educação , Urologistas/normas , Urologia/estatística & dados numéricos , País de Gales
5.
Ann Otol Rhinol Laryngol ; 129(1): 46-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31466464

RESUMO

OBJECTIVES: To assess and compare the face (FV) and content validity (CV) of three ex vivo animal models for simulation training in pediatric laryngotracheal reconstruction (LTR). METHODS: Feasibility of performing LTR was assessed on the head and neck of three different animals (lamb/suckling-pig/rabbit) and laryngeal dimensions and qualitative observations were recorded. A 19-item five-point Likert scale questionnaire was completed for each model to assess FV and CV. Data was prospectively collected and analyzed using descriptive and nonparametric statistics. RESULTS: All three models were suitable for LTR simulation with laryngeal dimensions corresponding to 0-2 years (rabbit), 5-10 (pig) and >10 years (lamb model). Five trainees and five expert pediatric otolaryngologists performed LTR on each model. The overall median FV score was 5 for the lamb model (IQR 4-5), 3 for the rabbit (IQR 2-3), and 4 for the pig (IQR 4-4). The overall median CV score was 5 for the lamb (IQR 5-5), 2 for the rabbit (IQR 2-3), and 4 for the pig model (IQR 4-4). Comparison of the models demonstrated the lamb to be favored as the most realistic and practical model for simulation training in pediatric LTR, with both the lamb and the porcine model attaining validation thresholds. CONCLUSION: Our study is the first comparative validation assessment of animal models for use in pediatric LTR simulation and it supports the use of ex vivo lamb and porcine models for use in LTR surgical skills training. The lamb model was the favored simulation model while the rabbit was considered inferior for simulation training in pediatric LTR. LEVEL OF EVIDENCE: 3b.


Assuntos
Laringe/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/educação , Procedimentos Cirúrgicos Reconstrutivos/educação , Treinamento por Simulação , Traqueia/cirurgia , Animais , Criança , Pré-Escolar , Humanos , Lactente , Laringoestenose/cirurgia , Modelos Animais , Pediatria/educação , Coelhos , Ovinos , Suínos , Estenose Traqueal/cirurgia
6.
Pediatrics ; 144(5)2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31636144

RESUMO

Mental health disorders affect 1 in 5 children; however, the majority of affected children do not receive appropriate services, leading to adverse adult outcomes. To meet the needs of children, pediatricians need to take on a larger role in addressing mental health problems. The accompanying policy statement, "Mental Health Competencies for Pediatric Practice," articulates mental health competencies pediatricians could achieve to improve the mental health care of children; yet, the majority of pediatricians do not feel prepared to do so. In this technical report, we summarize current initiatives and resources that exist for trainees and practicing pediatricians across the training continuum. We also identify gaps in mental health clinical experience and training and suggest areas in which education can be strengthened. With this report, we aim to stimulate efforts to address gaps by summarizing educational strategies that have been applied and could be applied to undergraduate medical education, residency and fellowship training, continuing medical education, maintenance of certification, and practice quality improvement activities to achieve the pediatric mental health competencies. In this report, we also articulate the research questions important to the future of pediatric mental health training and practice.


Assuntos
Competência Clínica/normas , Educação Médica/métodos , Transtornos Mentais/terapia , Saúde Mental , Pediatria/educação , Adolescente , Criança , Humanos , Serviços de Saúde Mental , Pediatria/normas , Guias de Prática Clínica como Assunto , Sociedades Médicas , Conselhos de Especialidade Profissional
8.
Saudi Med J ; 40(10): 1040-1044, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588484

RESUMO

OBJECTIVES: To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. METHODS: A cross-sectional survey conducted with residents enrolled in pediatric residency programs across Saudi Arabia in February 2017 at the Saudi Commission For Health Specialties, Riyadh Saudi Arabia. We designed a self-administered questionnaire that was distributed using the Saudi Commission for Health Specialties E-mail groups. A 4-point Likert-type scale was used to rank the residents' responses; and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. RESULTS: A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%).    Conclusion: We found that the 24-hour on-call system negatively impacts residents' well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.


Assuntos
Internato e Residência/organização & administração , Segurança do Paciente , Pediatria/educação , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Admissão e Escalonamento de Pessoal , Arábia Saudita , Inquéritos e Questionários , Tolerância ao Trabalho Programado/fisiologia , Tolerância ao Trabalho Programado/psicologia
9.
Acta Cir Bras ; 34(7): e201900709, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31531529

RESUMO

PURPOSE: To develop a new low-cost, easy-to-make and available training model using chickens' intestine for infant intestinal anastomosis. METHODS: Segments of chicken intestine were used to create an intestinal anastomosis simulator. We tried to perform an end-to-end, end-to-side and side-to-side anastomosis. Handsewn sutured anastomosis were performed in single layered with interrupted prolene 5-0 suture. The parameters analyzed were cost, intestine's diameter and length, anastomosis patency and flow-through and leakage amount. RESULTS: In all cases it was possible to make the anastomosis in double layered without difficulties, different from the usual ones. There was a positive patency at all anastomoses after the end of the procedure, with no need for reinterventions. CONCLUSION: The new training model using chickens' intestine for infant intestinal anastomosis is low-cost, easy-to-make and easy available.


Assuntos
Anastomose Cirúrgica/educação , Intestinos/cirurgia , Pediatria/educação , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Animais , Galinhas , Criança , Humanos , Modelos Animais , Técnicas de Sutura
11.
J Laparoendosc Adv Surg Tech A ; 29(10): 1378-1382, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31539299

RESUMO

Purpose: Various studies have shown the benefit of three-dimensional (3D) systems over two-dimensional (2D) systems in endoscopic surgery. However, few studies have focused on pediatric endosurgery. The purpose of this study was to assess the impact of 2D and 3D environments on the time taken and forceps manipulation by comparing experts and trainees using a laparoscopic hepaticojejunostomy simulator. Methods: We have developed a simulator of laparoscopic hepaticojejunostomy for congenital biliary dilatation. Seventeen participants of pediatric surgeons (4 experts and 13 trainees) performed hepaticojejunostomy using our simulator in both 2D and 3D environment. We evaluated the required time, total path length, and average velocities of bilateral forceps in both situations. Results: Obtained results show the findings for the required time (seconds; 2D, experts: 810.43 ± 321.64 vs. trainees: 1136.02 ± 409.96, P = .17) (seconds; 3D, experts: 660.21 ± 256.48 vs. trainees: 1017 ± 280.93, P = .039), total path length of right forceps (mm; 2D, experts: 38838.23 ± 30686.63 vs. trainees: 52005.47 ± 31675.02, P = .48)(mm; 3D, experts: 24443.09 ± 12316.32 vs. trainees: 45508.09 ± 26926.27, P = .16), total path length of left forceps (mm; 2D, experts: 131635.54 ± 71669.94 vs. trainees: 245242.48 ± 130940.25, P = .48)(mm; 3D, experts: 88520.42 ± 56766.63 vs. trainees: 230789.75 ± 107315.85, P = .024), average velocities of right forceps (mm/second; 2D, experts: 44.80 ± 21.85 vs. trainees: 44.37 ± 18.92, P = .97) (mm/second; 3D, experts: 37.28 ± 16.49 vs. trainees: 42.58 ± 14.40, P = .54), average velocities of left forceps (mm/second; 2D, experts: 156.65 ± 38.69 vs. trainees: 202.58 ± 63.80, P = .20) (mm/second; 3D, experts: 125.64 ± 44.30 vs. trainees: 219.42 ± 43.82, P < .01). Conclusion: The experts performed more effectively when using the 3D system. Using 3D, the total path length of the left forceps of expert pediatric surgeons was significantly shorter than trainee pediatric surgeons, and the average velocities of the left forceps tip of expert pediatric surgeons was significantly slower than trainee pediatric surgeons. These results suggest that training of assisting hand is necessary for advanced pediatric endosurgery to avoid organ injury.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar/métodos , Cisto do Colédoco/cirurgia , Ducto Hepático Comum/cirurgia , Jejunostomia/métodos , Laparoscopia/métodos , Pediatria , Treinamento por Simulação/métodos , Procedimentos Cirúrgicos do Sistema Biliar/educação , Competência Clínica , Humanos , Imagem Tridimensional , Jejunostomia/educação , Jejuno/cirurgia , Laparoscopia/educação , Pediatria/educação , Pediatria/métodos , Instrumentos Cirúrgicos
12.
Ann Ist Super Sanita ; 55(3): 240-245, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31553316

RESUMO

AIM: This survey investigated the availability of training programs in pediatric palliative care (PPC) for Italian postgraduates specializing in pediatric medicine. METHODS: Two questionnaires were developed: (i) a questionnaire addressed to the Directors of Italian postgraduate pediatric medicine programs (n = 37); and (ii) a survey to the postgraduate students in pediatric medicine at the University Hospitals of Padua and Udine (n = 127). RESULTS: 14 directors participated (response rate: 37.8%). In 85.7% of cases (n = 12), lectures on PPC were offered, for a supposed maximum of 90 minutes/year. 116 students responded (response rate: 91%): they stated that, approximately 40 min/year of training on PPC was provided. In total, 37% of responders stated they attended a PPC Service during their training. The majority of responders (68.1%, n = 79) did not feel ready to care for a pediatric patient with life-limiting disease. CONCLUSIONS: Although PPC is well-recognized as part of a pediatrician's training, it receives poor attention.


Assuntos
Educação Médica/estatística & dados numéricos , Cuidados Paliativos , Pediatria/educação , Adulto , Criança , Estudos Transversais , Currículo , Autoavaliação Diagnóstica , Educação/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internato e Residência , Itália , Estudantes de Medicina , Inquéritos e Questionários
14.
South Med J ; 112(9): 487-490, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31485588

RESUMO

OBJECTIVES: Our hypothesis was that pediatric residents and medical students who participated in a structured forensic evidence collection course would have improved knowledge of prepubertal evidence collection practices and pubertal genital anatomy. METHODS: The course curriculum included a forensic evidence collection video created by the sexual assault nurse examiner directors. After watching the video, the participants simulated forensic evidence collection using forensic evidence collection kits and chain of evidence protocols in a hybrid simulation setting under the supervision of a pediatric sexual assault nurse examiner. The participants completed a multiple-choice test and a fill-in-the-blank anatomical diagram test before and after the course. RESULTS: Of an eligible 48 participants, 42 completed the course; therefore, our participant response rate was 87.5%. There was significant improvement in knowledge, with an average pretest score of 62% ± 20% and the average posttest score of 86% ± 9% (P < 0.001). Qualitative evaluations were overwhelmingly positive, with consistent scoring of 6/6 in a 6-point agree scale. Learning themes, which emerged from open-ended questions on the evaluations, included knowledge gained on evidence collection processes (n = 26), how to appropriately interact with abused patients (n = 8), hands-on nature of the experience and the benefits of walking through the examination (n = 7), and pubertal genital anatomy knowledge (n = 3). Participants suggested that more instruction on anatomy would be helpful. CONCLUSIONS: We found that pediatric residents' and medical students' knowledge of pediatric sexual abuse may be improved with a short simulation course focusing on forensic evidence collection.


Assuntos
Maus-Tratos Infantis/diagnóstico , Competência Clínica , Simulação por Computador , Currículo/normas , Educação de Pós-Graduação em Medicina/métodos , Medicina Legal/educação , Pediatria/educação , Criança , Humanos , Internato e Residência/métodos
15.
J Laparoendosc Adv Surg Tech A ; 29(10): 1362-1367, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31560642

RESUMO

Background: Most residents do not have a defined program for simulation training in video surgery in Brazil. The training takes place for the most part in vivo or in short courses. The goal of this article is to describe and evaluate a set of exercises using low-cost materials, created by the residents themselves, to enable basic skills training in video surgery. Materials and Methods: Seven exercises were elaborated aiming to simulate main maneuvers performed in video surgery. The residents were guided by a written and video description showing the execution of the exercises, performed the exercises, and answered a questionnaire. After 3 weeks of free training, the residents performed the exercises and answered the questionnaire again. Results: Seven residents started the study; however, 6 completed the two steps. Among the participants, 83% received in vivo video surgery training, and only 2 (33%) received some supervised simulation training in minimally invasive surgery before this time. All participants considered the set of seven exercises representative of the actual skills in video surgery. There was no difficulty in acquiring the materials or in assembling them to carry out the training. All the participants had a shorter training time than initially proposed, on average 1 day/week for 20 minutes. Conclusions: A simple set of exercises can be elaborated by the residents themselves and make feasible the simulated training in video surgery even without the availability of sophisticated and expensive materials. The presence of a tutor and the scheduling of exclusive training seem necessary for more satisfactory results.


Assuntos
Cirurgia Geral/educação , Internato e Residência , Pediatria/educação , Treinamento por Simulação/métodos , Criança , Competência Clínica , Humanos , Inquéritos e Questionários , Gravação em Vídeo
17.
An Pediatr (Barc) ; 91(3): 206.e1-206.e13, 2019 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-31395389

RESUMO

Point-of-care ultrasound (POCUS) has become an essential tool for clinical practice in recent years. It should be considered as an extension of the standard physical examination, which complements and enriches it without substituting it. POCUS enables the physician to answer specific clinical questions about the diagnosis, to understand better the pathophysiological context, to orientate the treatment, and to perform invasive procedures more safely. Despite its current use in many centres, and in most paediatric sub-specialties, there are currently no specific recommendations addressing educational aims in the different training areas, as well as methodology practice and the certification process in paediatrics. These ingredients are essential for POCUS implementation in daily practice, with a quality guarantee in terms of efficiency and safety. Several POCUS experts in different paediatric medicine environments performed a non-systematic review addressing the main paediatric POCUS applications in paediatrics. The lack of educational programs in POCUS in Spain is also discussed, and the experience in the United States of America in this topic is provided. Considering the current situation of POCUS in paediatrics, we strongly believe that it is urgent to establish evidence-based recommendations for POCUS training that should be the base to develop educational programs and to include POCUS in the paediatric residency training.


Assuntos
Pediatria/educação , Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia/métodos , Humanos , Internato e Residência/métodos , Espanha , Especialização
18.
R I Med J (2013) ; 102(6): 31-34, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31398966

RESUMO

Corporal punishment (CP) is defined as inflicting pain to redirect an undesired behavior. The objective of the current study is to assess Rhode Island physicians' perceptions, experiences and education regarding CP. Our data may be used to inform future research and education/training for health care providers on how to provide guidance and have conversations surrounding CP. We developed an anonymous survey that assessed the perceptions, experiences and training of Hasbro Children Hospital physicians regarding CP in the medical setting. A total of 58 physicians responded; participants responded that CP was never effective for improving behavior (67.2%) and never recommended CP (98.2%) to patient families. However, most participants reported never received education on CP (67.9%). Our findings highlight that pediatric providers do not find CP an appropriate method of discipline and underscore the need for standardized training and education surrounding this issue.


Assuntos
Atitude do Pessoal de Saúde , Relações Pais-Filho , Pediatria/educação , Médicos/psicologia , Punição , Adulto , Criança , Comportamento Infantil , Pré-Escolar , Feminino , Humanos , Relações Interpessoais , Masculino , Médicos/estatística & dados numéricos , Rhode Island , Inquéritos e Questionários
19.
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
20.
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
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