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1.
J Surg Oncol ; 124(2): 216-220, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245574

RESUMO

Team training and crisis management derive their roots from fundamental learning theory and the culture of safety that burgeoned forth from the industrial revolution through the rise of nuclear energy and aviation. The integral nature of telemedicine to many simulation-based activities, whether to bridge distances out of convenience or necessity, continues to be a common theme moving into the next era of surgical safety as newer, more robust technologies become available.


Assuntos
Educação à Distância/métodos , Educação de Pós-Graduação em Medicina/métodos , Equipe de Assistência ao Paciente , Assistência Perioperatória/educação , Treinamento por Simulação/métodos , Especialidades Cirúrgicas/educação , Procedimentos Cirúrgicos Operatórios/educação , Competência Clínica , Educação à Distância/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Emergências , Humanos , Tutoria/métodos , Tutoria/organização & administração , Salas Cirúrgicas/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Segurança do Paciente/normas , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Treinamento por Simulação/organização & administração , Especialidades Cirúrgicas/normas , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/normas , Telemedicina/métodos , Telemedicina/organização & administração , Estados Unidos
2.
J Surg Oncol ; 124(2): 246-249, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245577

RESUMO

The effective integration of robotic technology and surgical tools has played a vital role in advancing surgical care by enabling telepresence in surgery to provide mentorship and surgical care across long distances in the absence of surgeons. This article describes our experiences with advancing surgical education and innovation through telementoring community surgeons, establishing the world's first telerobotic surgical service, and the integration of Artificial Intelligence and robotics to provide remote surgical care and training.


Assuntos
Automação/métodos , Educação à Distância/métodos , Educação Médica Continuada/métodos , Cirurgia Geral/educação , Tutoria/métodos , Procedimentos Cirúrgicos Robóticos/educação , Telemedicina/métodos , Inteligência Artificial , Canadá , Competência Clínica , Educação à Distância/organização & administração , Educação Médica Continuada/organização & administração , Humanos , Missões Médicas , Tutoria/organização & administração , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Telemedicina/organização & administração
3.
J Surg Oncol ; 124(2): 250-254, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245580

RESUMO

Tele-education assisted mentorship in surgery (TEAMS) is a novel methodology for surgical skills training with remote, hands-on, high-fidelity, and low-cost simulation-based education and one-to-one mentorship with longitudinal assessments. We review the background, methodology, and our experience with implementing TEAMS as an adjunct to traditional methods of surgical education and mentorship.


Assuntos
Educação à Distância/métodos , Educação Médica Continuada/métodos , Cirurgia Geral/educação , Tutoria/métodos , Treinamento por Simulação/métodos , Telemedicina/métodos , Competência Clínica , Educação à Distância/organização & administração , Educação Médica Continuada/organização & administração , Cirurgia Geral/métodos , Humanos , Tutoria/organização & administração , Treinamento por Simulação/organização & administração , Telemedicina/organização & administração , Estados Unidos
5.
Med Educ Online ; 26(1): 1939842, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34114941

RESUMO

Despite many advances in medical education, medical students continue to mostly shadow on inpatient rotations like Neurology. They seldom receive face-to-face feedback or mentorship from attending physicians. This results from not training attending physicians how to integrate medical students into clinical activities in a way that does not detract from patient rounds. The 'active feedback program' is a framework for inpatient rotations that immerses medical students in clinical activities with the attending physician providing mentorship and feedback that emphasizes brevity. Expectations are laid out early. Students pick up 2-3 patients, performing daily oral reports and focused neurological exams with immediate feedback. Feedback includes items to not only correct the treatment plan, but also improve the student's oral presentation and neurological exam skills. Students also receive formal individual feedback twice during the rotation that includes constructive criticism and specific task-oriented praise. The active feedback program awaits formal testing, but seems to result in medical students learning at an accelerated rate. Neurology residents also appear to benefit by learning from critiques of the medical students and taking on higher level responsibilities. Patient rounds move quickly, leaving time for the attending physician to keep up with other obligations. As academic Neurologists we have a duty to transfer our skills to the next generation of physicians. If proven in future studies, wide adoption of the active feedback program will allow us to finally move medical students out of the shadows and come closer to achieving this noble goal.


Assuntos
Feedback Formativo , Corpo Clínico Hospitalar/organização & administração , Estudantes de Medicina/psicologia , Visitas com Preceptor/organização & administração , Competência Clínica , Educação Médica , Humanos , Tutoria/organização & administração , Motivação
6.
Med Educ Online ; 26(1): 1920084, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33970808

RESUMO

The authors conducted a scoping review to investigate the structure, content, and potential impact of post-residency medical education fellowships. The authors searched eight databases to identify English-language articles describing longitudinal, post-residency medical fellowships that both focused on medical education and described the structure and content of the curriculum. The authors summarized the findings of each article and, for those articles that included a program evaluation, assessed the potential impact of the program via the Kirkpatrick's Four-Level Training Evaluation Model and the Medical Education Research Study Quality Instrument. Nine articles, describing a total of ten post-residency medical education fellowships, met inclusion criteria. Half of the programs were dedicated medical education fellowships and half were medical education tracks within a subspecialty fellowship. The content and educational strategies varied, with no two programs having the same curriculum. Most programs most focused on teaching skills, adult learning theory, curricular development, and medical education research/scholarship. Most programs used project-based learning, workshops, and faculty mentorship as educational strategies. Six of the articles included an evaluation of their program(s), all of which suggested positive changes, at least at the level of fellow behavior (Kirkpatrick level 3), and designs limited the strength of any conclusions drawn. This scoping review highlights the variation among medical education fellowships and the need for common curricular components, as well as program evaluation, across and within these fellowships. Additional assessment at higher levels of trainee outcomes will help guide the creation and revision of medical education fellowships, and inform the development of a core curriculum shared across programs. Such a core curriculum could then serve as the foundation for a certification program, by which a medical educator's expertise could be recognized, thus elevating medical education to the stature it deserves within the academic mission.


Assuntos
Bolsas de Estudo/organização & administração , Internato e Residência/organização & administração , Pesquisa Biomédica/educação , Currículo , Educação Médica/organização & administração , Educação de Pós-Graduação em Medicina , Docentes de Medicina/organização & administração , Humanos , Aprendizagem , Tutoria/organização & administração , Aprendizagem Baseada em Problemas , Avaliação de Programas e Projetos de Saúde , Especialização
7.
Med Educ Online ; 26(1): 1856464, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33978568

RESUMO

Background: Current efforts incompletely address the educational, social, and developmental aspects of a learner's transition from medical school to residency.Objective: To determine the feasibility and acceptability of a transition to residency (TTR) coaching program.Designs: In March 2019, we designed, implemented, and evaluated a TTR coaching program for students who matched into residency programs at our institution. Goals were to stimulate reflection on successes and challenges encountered during medical school, develop strategies to problem-solve barriers and address concerns, identify professional and personal resources, improve confidence, and make an action plan.Results: Of eligible learners, 42% (10/24) enrolled in TTR coaching. Learners were most interested in coaching in the following areas: wellbeing (70%, 7/10), interpersonal/communication skills (60%, 6/10), and learning plan development (50%, 5/10). The majority (90%; 9/10) expressed satisfaction with the program and would recommend participation. One month after starting internship, 90% (9/10) of learners stated the program helped facilitate their transition. Learners who did not enroll in TTR cited concerns around the coach selection process (72%, 8/11), upcoming travel (45%, 5/11), insufficient time/competing demands (27%, 3/11), and lack of perceived benefit (18%, 2/11).Conclusion: This pilot study demonstrated preliminary feasibility and acceptability for TTR coaching.


Assuntos
Internato e Residência/organização & administração , Tutoria/organização & administração , Comunicação , Educação de Pós-Graduação em Medicina/organização & administração , Objetivos , Humanos , Relações Interpessoais , Projetos Piloto , Resolução de Problemas
8.
Med Educ Online ; 26(1): 1929045, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34024270

RESUMO

Given the well-documented inequities in health care outcomes by race, ethnicity, and gender, many health career pipeline programs have focused on supporting the development of a diverse and inclusive workforce. The State of Utah, is vast, but sparsely populated outside the Salt Lake City metropolitan area. More than 96% of our nearly 85,000 square miles is designated rural (<100 people/square mile) or frontier (<7 people/square mile). The Salt Lake City area is home to the Hunsman Cancer Institute, the only NCI-designated Comprehensive Cancer Center in the region, also noted the limited diversity in the biomedical cancer research workforce. Our primary objective was to increase the number of underrepresented trainees who pursue higher education with the goal of a career in cancer research. PathMaker is a regional, competitive pipeline program that nurtures high school or undergraduate trainees from historically underrepresented backgrounds towards a career in cancer research. Our faculty and staff team collaboratively developed a cohort model curriculum that increased student awareness of research career options; provided academic and professional development, cultural and social support, evolutionary success strategies, active mentorship, and leadership skill development; and fostered an environment of continuous evaluation and improvement. Since pilot program initiation in May 2016, the PathMaker Research Program (PathMaker) has engaged a total of 44 underrepresented trainees in cancer research labs at Huntsman Cancer Institute, the majority still in college. Eleven trainees graduated college: five employed in STEM, one pursuing a PhD in STEM; two in medical school, and three are lost to follow-up. Alumni report high levels of satisfaction with PathMaker and will be followed and supported for academic success. PathMaker is a replicable model to increase diversity and inclusion in the biomedical cancer research workforce.


Assuntos
Pesquisa Biomédica/educação , Institutos de Câncer/organização & administração , Tutoria/organização & administração , Grupos Minoritários/educação , Apoio ao Desenvolvimento de Recursos Humanos/organização & administração , Escolha da Profissão , Competência Cultural , Currículo , Feminino , Humanos , Liderança , Masculino , Apoio Social , Fatores Socioeconômicos , Universidades , Utah , Recursos Humanos , Adulto Jovem
9.
Acad Med ; 96(7): 974-978, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33769338

RESUMO

The COVID-19 pandemic has disrupted medical research, pushing mentors and mentees to decide if COVID-19 research would be germane to the early career investigator's developing research portfolio. With COVID-19 halting hundreds of federal trials involving non-COVID-19 research, mentors and mentees must also consider the broader moral calling of contributing to COVID-19 research. At the time of writing, the National Institutes of Health had responded to the pandemic with significant funding for COVID-19 research. However, because this pandemic is a new phenomenon, few mentors have expertise in the disease and relevant established resources. As a result, many mentors are unable to provide insight on COVID-19 research to early career investigators considering a pivot toward research related to this disease. The authors suggest 4 ways for mentees and mentors to respond to the changes the pandemic has brought to research funding and opportunities: (1) include COVID-19 research in existing portfolios to diversify intellectual opportunities and reduce funding risks; (2) negotiate the mentor-mentee relationship and roles and expectations early in project discussions-considering, as relevant, the disproportionate burden of home responsibilities often borne by early career faculty members who are women and/or from a minority group; (3) address any mentor limitations in content expertise; and (4) if the decision is to pivot to COVID-19 research, select projects with implications generalizable beyond this pandemic to other infectious outbreaks or to the redesign of health care delivery. Mentors and mentees must weigh the relevance of COVID-19 research projects to the postpandemic world and the amount of available funding against the developing interests of early career investigators. Academic medical centers nationwide must enable seasoned and early career researchers to contribute meaningfully to COVID-19 and non-COVID-19 research.


Assuntos
Pesquisa Biomédica , COVID-19 , Escolha da Profissão , Tomada de Decisões , Docentes de Medicina , Tutoria , Mentores , Centros Médicos Acadêmicos/organização & administração , Pesquisa Biomédica/métodos , Pesquisa Biomédica/organização & administração , Docentes de Medicina/organização & administração , Docentes de Medicina/psicologia , Humanos , Relações Interprofissionais , Tutoria/métodos , Tutoria/organização & administração , Mentores/psicologia , Apoio à Pesquisa como Assunto , Estados Unidos
11.
GMS J Med Educ ; 38(1): Doc8, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33659613

RESUMO

Objectives: The COVID-19 pandemic has led to major adjustments in health care systems and significantly affected medical education. Accordingly, our mentoring program MeCuM-Mentor had to expand its virtual elements, in order to continue to meet the needs for mentoring at the medical faculty of the Ludwig-Maximilians-University Munich. Methods: Here we report on our recently implemented online formats to facilitate training for currently coached peer mentors, as well as the introduction of an online consultation hour and a new social mentoring event called PubQuiz. Results: First results demonstrated feasibility of the above-mentioned virtual formats, which were positively rated by the participants in small voluntary evaluation questionnaires. Utilization rates indicate existing need for mentoring during the pandemic. In addition, the new event PubQuiz promotes social interaction among peers during isolation due to COVID-19. Conclusion: With the transition to online formats, mentoring at the Medical Faculty could be continued during COVID-19. The newly introduced mentoring event PubQuiz will be repeated. However, it remains unclear to what extent online formats can replace in-person one-to-one mentoring conversations or peer mentoring meetings.


Assuntos
COVID-19/epidemiologia , Educação Médica/organização & administração , Docentes de Medicina/organização & administração , Tutoria/organização & administração , Grupo Associado , Humanos , Internet , Mentores , Pandemias , SARS-CoV-2
12.
Nurs Adm Q ; 45(2): 152-158, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33570882

RESUMO

This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.


Assuntos
COVID-19/enfermagem , Liderança , Tutoria/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , COVID-19/epidemiologia , Enfermagem Baseada em Evidências/organização & administração , Hospitais Comunitários/organização & administração , Humanos , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/educação , Pandemias , Desenvolvimento de Programas/métodos , Melhoria de Qualidade , SARS-CoV-2
13.
Nurs Adm Q ; 45(2): 169-174, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33570883

RESUMO

Responding to the coronavirus disease-2019 (COVID-19) pandemic is likely to exacerbate anxiety, burnout, fatigue, and distress already being experienced by nurses in ever greater numbers. An innovative Wellness Partner Program was developed with an aim to enhance the health and well-being of nurses on the front lines during the COVID-19 pandemic and beyond. Nurses across the country opted in to the program, and were paired with advanced practice nursing (APN) graduate students who served as the nurses' wellness partners. Areas emphasized in the program included (1) personalized support for wellness; (2) prioritizing physical activity, healthy eating, sleep, and stress management; and (3) establishment of strength-based, sustainable solutions to improve health and well-being. Partnerships were implemented for 188 nurses who were coached by 49 APN students; 104 nurses participated for 6 weeks. In the program evaluation, 98% of nurses shared that the wellness support program helped them engage in self-care and wellness, and 94.7% agreed or strongly agreed that The Wellness Partner Program helped them improve their mental and physical health. In the midst of the pandemic, nurses were supported to cope with stress, focus on self-care and wellness goals, and address challenges to their well-being.


Assuntos
COVID-19/enfermagem , Tutoria/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Adaptação Psicológica , Esgotamento Profissional/prevenção & controle , COVID-19/epidemiologia , Humanos , Pandemias , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2
14.
Ann R Coll Surg Engl ; 103(2): 130-133, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559548

RESUMO

INTRODUCTION: Laparoscopic pyloromyotomy is now an accepted procedure for the treatment of pyloric stenosis. However, it is clear that during the implementation period there are significantly higher incidences of mucosal perforation and incomplete pyloromyotomy. We describe how we introduced a new laparoscopic procedure without the complications associated with the learning curve. MATERIALS AND METHODS: Five consultants tasked one surgeon to pilot and establish laparoscopic pyloromyotomy before mentoring the others until they were performing the procedure independently; all agreed to use exactly the same instruments and operative technique. This involved a 5mm 30-degree infra-umbilical telescope with two 3mm instruments. Data were collected prospectively. RESULTS: Between 1 January 2013 and 31 December 2017, 140 laparoscopic pyloromyotomies were performed (median age 27 days, range 13-133 days, male to female ratio 121:19). Fifty-five per cent of procedures were performed by trainees. Complications were one mucosal perforation and one inadequate pyloromyotomy. There were no injuries to other organs, problems with wound dehiscence or other significant complications. The median time of discharge was one day (range one to six days). CONCLUSION: Our rate of perforation and incomplete pyloromyotomy was 1.4%, which is equivalent to the best published series of either open or laparoscopic pyloromyotomy. We believe that this resulted from the coordinated implementation of the procedure using a single technique to reduce clinical variability, increase mentoring and improve training. This approach appears self-evident but is rarely described in the literature of learning curves. In this age of increased accountability, new technologies should be incorporated into routine practice without an increase in morbidity to patients.


Assuntos
Laparoscopia/educação , Tutoria/organização & administração , Complicações Pós-Operatórias/epidemiologia , Estenose Pilórica/cirurgia , Piloromiotomia/educação , Consultores , Feminino , Implementação de Plano de Saúde , Humanos , Lactente , Recém-Nascido , Laparoscopia/efeitos adversos , Laparoscopia/instrumentação , Curva de Aprendizado , Tempo de Internação , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Piloromiotomia/efeitos adversos , Piloromiotomia/instrumentação , Piloromiotomia/métodos , Estudos Retrospectivos , Cirurgiões/educação , Gravação em Vídeo
15.
J Nurs Adm ; 51(3): 149-155, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33570372

RESUMO

Healthcare organizations must be intentional and purposeful in creating diversity programs. A nursing leader mentorship program for racial and ethnic minority nurse managers was introduced at a large academic medical center to meet this need. The program design was based on the successful Leadership Institute for Black Nurses, first conducted at a university school of nursing. The participants in the 4-month program were 16 nurse managers from 2 city hospitals and their mentors.


Assuntos
Currículo , Bacharelado em Enfermagem/organização & administração , Grupos Étnicos/educação , Tutoria/organização & administração , Mentores/estatística & dados numéricos , Grupos Minoritários/educação , Enfermeiras Administradoras/educação , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Cidade de Nova Iorque , Adulto Jovem
17.
Acad Med ; 96(1): 86-92, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32941251

RESUMO

PROBLEM: Dissemination and implementation (D&I) science provides the tools needed to close the gap between known intervention strategies and their effective application. The authors report on the Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program-a D&I training program for postdoctoral or early-career cancer prevention and control scholars. APPROACH: MT-DIRC was a 2-year training institute in which fellows attended 2 annual Summer Institutes and other conferences and received didactic, group, and individual instruction; individualized mentoring; and other supports (e.g., pilot funding). A quasi-experimental design compared changes in 3 areas: mentoring, skills, and network composition. To evaluate mentoring and D&I skills, data from fellows on their mentors' mentoring competencies, their perspectives on the importance of and satisfaction with mentoring priority areas, and their self-rated skills in D&I competency domains were collected. Network composition data were collected from faculty and fellows for 3 core social network domains: contact, mentoring, and collaboration. Paired t tests (mentoring), linear mixed models (skills), and descriptive analyses (network composition) were performed. OUTCOMES: Mentors were rated as highly competent across all mentoring competencies, and each mentoring priority area showed reductions in gaps between satisfaction and importance between the 6 and 18 months post-first Summer Institute. Fellows' self-rated skills in D&I competencies improved significantly in all domains over time (range: 42.5%-52.9% increase from baseline to 18 months post-first Summer Institute). Mentorship and collaboration networks grew over time, with the highest number of collaboration network ties for scholarly manuscripts (n = 199) in 2018 and for research projects (n = 160) in 2019. NEXT STEPS: Building on study findings and existing literature, mentored training of scholars is an important approach for building D&I skills and networks, and thus to better applying the vast amount of available intervention evidence to benefit cancer control.


Assuntos
Pesquisa Biomédica/organização & administração , Atenção à Saúde/organização & administração , Disseminação de Informação/métodos , Tutoria/organização & administração , Neoplasias/prevenção & controle , Pesquisadores/educação , Pesquisa Médica Translacional/educação , Adulto , Currículo , Educação Médica Continuada/organização & administração , Feminino , Humanos , Masculino , Mentores , Pessoa de Meia-Idade , Pesquisa Médica Translacional/organização & administração
20.
Am J Surg ; 221(2): 263-269, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32958155

RESUMO

BACKGROUND: While teaching evaluation systems are common in academia, very little information is available regarding formal coaching and peer review of teaching performance in surgery. This article is a report on the development and implementation of a peer review of operative teaching program. METHODS: Our process was designed using a multistep sequential model which included developing a peer review of teaching instrument that was piloted to study the efficacy and utility of the tool. RESULTS: Thirty-nine peer reviews of teaching were conducted. Among the most frequent challenges that faculty identified were allowing residents to struggle/give autonomy, judging when to take over the case, communicating effectively, being patient, balancing education and patient safety, and giving feedback. CONCLUSIONS: Our peer review of teaching program is systematic, feasible, and can be adopted by other surgery departments. Faculty's identified strengths and challenges have been incorporated into our faculty development curricula.


Assuntos
Docentes de Medicina/organização & administração , Revisão por Pares/métodos , Especialidades Cirúrgicas/educação , Procedimentos Cirúrgicos Operatórios/educação , Ensino/organização & administração , Competência Clínica , Humanos , Internato e Residência/organização & administração , Tutoria/organização & administração , Modelos Organizacionais , Projetos Piloto , Autonomia Profissional , Avaliação de Programas e Projetos de Saúde
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