Representation of Women and Minority Faculty and Fellows in Academic Pediatric Cardiology Training Programs.

BACKGROUND: Studies have shown that diverse care teams optimize patient outcomes. Describing the current representation of women and minorities has been a critical step in improving diversity across several fields. OBJECTIVES: To address the lack of data specific to pediatric cardiology, the authors conducted a national survey. METHODS: U.S. academic pediatric cardiology programs with fellowship training programs were surveyed. Division directors were invited (July 2021 to September 2021) to complete an e-survey of program composition. Underrepresented minorities in medicine (URMM) were characterized using standard definitions. Descriptive analyses at the hospital, faculty, and fellow level were performed. RESULTS: Altogether, 52 of 61 programs (85%) completed the survey, representing 1,570 total faculty and 438 fellows, with a wide range in program size (7-109 faculty, 1-32 fellows). Although women comprise approximately 60% of faculty in pediatrics overall, they made up 55% of fellows and 45% of faculty in pediatric cardiology. Representation of women in leadership roles was notably less, including 39% of clinical subspecialty directors, 25% of endowed chairs, and 16% of division directors. URMM comprise approximately 35% of the U.S. population; however, they made up only 14% of pediatric cardiology fellows and 10% of faculty, with very few in leadership roles. CONCLUSIONS: These national data suggest a "leaky pipeline" for women in pediatric cardiology and very limited presence of URRM overall. Our findings can inform efforts to elucidate underlying mechanisms for persistent disparity and reduce barriers to improving diversity in the field.

Framework to Guide Health Professions Faculty Towards Increased Scholarship: Recommendations from the ASAHP Research, Discovery & Innovation Committee.

The Research, Discovery, and Innovation Publications (RDI-P) Task Force met from October 2020 to March 2022 to discuss ways in which the Association of Schools Advancing Health Professions (ASAHP) can help to guide institutional leaders to assign faculty effort and resources to enable success with the scholarship mission. The purpose of this White Paper is to propose a guiding framework for institutional leaders to determine their faculty's individual or team scholarly goals, assign appropriate percent efforts (funded/unfunded), and guide an overall faculty mix that balances required teaching loads with scholarly activities. The Task Force identified seven modifiable factors that can influence workload allocation for scholarship: 1. Limited range of the spectrum for effort distribution; 2. Matching expectations with reality; 3. Clinical training undervalued as adequate prep for translational or implementation research; 4. Limited support for mentorship availability; 5. Richer collaborations needed; 6. Finding resources and matching them to individual faculty needs; and 7. Further time for training needed. We then provide a set of recommendations to address the seven issues described. Finally, we describe four foci of scholarly activity (evidence-based educator; evidence-based clinical application; evidence-based collaborator; and evidence-based principal leader) with which a leader can develop strategies to align faculty interests and growth opportunities towards advancing scholarship.

Faculty Professional Development Strategies Supporting Increased Scholarship.

In this article, we describe the implementation of two nursing continuing professional development activities and a 15-week online Writing for Publication course for faculty using American Nurses Credentialing Center accreditation program criteria. The application of the criteria ensured quality continuing nursing education and assisted the provider unit in meeting its goals and outcomes. Evaluation data for the activities were collected and analyzed to determine whether the learning outcomes were met and to prepare course adjustments. [J Contin Educ Nurs. 2023;54(3):121-129.].

Direct anterior versus direct lateral hip approach in total hip arthroplasty with the same perioperative protocols one year post fellowship training.

BACKGROUND: Variable results have been reported regarding the clinical outcomes in Total hip arthroplasty (THA) based on the surgical approach. The aim of this study is to compare the clinical outcomes between Direct anterior (DA) and direct lateral (DL) approaches in THA when performed immediately after fellowship training. METHODS: During the 1st year of practice, all consecutive patients who underwent THA via DA and DL hip approaches were retrospectively investigated. Patients'demographics, diagnosis, American society of Anesthesiology (ASA) score, route of anesthesia, length of hospital stay (LOS), leg length discrepancy (LLD), radiographic parameters, operative time, number of opioids refills postoperatively, and complications were collected and compared between the two groups. The short form of Hip Disability and Osteoarthritis Outcome score, Joint Replacement (HOOS, JR) was prospectively collected pre and postoperatively. The minimum follow-up period was 2 years. RESULTS: Forty patients in DA group and 38 patients in DL group were included. No statistically significant difference was found between the two groups in terms of demographics, diagnosis, ASA scores, route of anesthesia at the time of THA, postoperative radiographic parameters, LOS, LLD, opioid refills and HOOS scores (p > 0.05). Patients in the DA group had shorter operative time (83 ± 17 min) when compared to the DL group (93 ± 24 min) (p = 0.03). No major complications were found except for one early deep infection patient in DL group. CONCLUSION: Both DA and DL approaches resulted in satisfactory outcomes in THA when performed by a fellowship trained surgeon.

Best practices in scholarly publishing for promotion or tenure: Avoiding predatory journals.

BACKGROUND: Predatory publishing has adverse impacts on scientific literature including nursing literature. These publishers have been described as having questionable publication standards. Many faculty have expressed challenges associated with assessing publisher and journal quality. PURPOSE: The purpose of this article is to describe the development and implementation of faculty retention, promotion, and tenure guidelines offering explicit instructions and guidance for faculty on assessing the quality of publishers and journals. METHOD: An appointed committee representing research, teaching, and practice scholarship performed a literature review on the topics of journal quality, scholarship for promotion and tenure, and best practices for evaluating scholarship in academic institutions. RESULTS: The committee developed additional guidance to support and assist faculty assessing journal quality. Based on these guidelines, the faculty retention, promotion, and tenure guidelines for each of the research, teaching, and practice tracks were edited to reflect these practices. CONCLUSIONS: The guidelines provided clarity for our promotion and tenure review committee and faculty.

A novel use of an artificially intelligent Chatbot and a live, synchronous virtual question-and answer session for fellowship recruitment.

INTRODUCTION: Academic departments universally communicate information about their programs using static websites. In addition to websites, some programs have even ventured out into social media (SM). These bidirectional forms of SM interaction show great promise; even hosting a live Question and Answer (Q&A) session has the potential for program branding. Artificial Intelligence (AI) usage in the form of a chatbot has expanded on websites and in SM. The potential use of chatbots, for the purposes of trainee recruitment, is novel and underutilized. With this pilot study, we aimed to answer the question; can the use of an Artificially Intelligent Chatbot and a Virtual Question-and-Answer Session aid in recruitment in a Post-COVID-19 era? METHODS: We held three structured Question-and-Answer Sessions over a period of 2 weeks. This preliminary study was performed after completion of the three Q&A sessions, in March-May, 2021. All 258 applicants to the pain fellowship program were invited via email to participate in the survey after attending one of the Q&A sessions. A 16-item survey assessing participants' perception of the chatbot was administered. RESULTS: Forty-eight pain fellowship applicants completed the survey, for an average response rate of 18.6%. In all, 35 (73%) of survey respondents had used the website chatbot, and 84% indicated that it had found them the information they were seeking. CONCLUSION: We employed an artificially intelligent chatbot on the department website to engage in a bidirectional exchange with users to adapt to changes brought on by the pandemic. SM engagement via chatbot and Q&A sessions can leave a favorable impression and improve the perception of a program.

Current and Future Trends in Driver Behaviour and Traffic Safety Scholarship: An African Research Agenda.

Road traffic accidents are strongly associated with driver behaviour. Africa, as a region, has the highest road accident fatality rate, but there is very little research dealing with this critical issue on the continent. This paper, therefore, sought to establish the state of driver behaviour and road safety scholarship in Africa to determine current research trends as well as potential future research directions. To this end, two bibliometric analyses were conducted, one which considered the issue from an African perspective and the other which considered the broader body of work. The analysis revealed a critical shortage of research related to driver behaviour in Africa. The existing body of research primarily focused on the identification of issues and tended to focus on narrow research problems within limited geographical areas. A need was identified for the collection of broader macro-level data and statistical analyses thereof to indicate regional traffic crash patterns; causes and effects; country-level studies, particularly countries with high traffic fatality rates and low levels of research; cross-country comparisons; and modelling. Future research directions should also include the link between driver behaviour, traffic safety and the sustainable developments goals, as well as policy-related research to determine current and potential future country-level policies.

Advancing biomedical science through investments in elite training.

How can governments invest in the public good of science in a way that accelerates advancement and encourages innovation at the frontier of science-all the while acknowledging that investing in science means investing in scientists? The Ruth L. Kirschstein National Research Service Award (NRSA) program is a research-training program administered by the National Institutes of Health (NIH) that makes such investments. This study examines the impact of NRSA postdoctoral fellowships on subsequent career outcomes using NIH administrative records on applicants for the fellowship from 1996 to 2008. It finds that fellowships increased the probability of receiving subsequent research awards from 4.0 to 6.3 percentage points and of achieving a major independent research award from 2.6 to 4.6 percentage points. The findings demonstrate that federally funded fellowships promote the retention of scientists in the biomedical research workforce.

Gender Representation in U.S. Urogynecology Fellowship Program Leadership.

IMPORTANCE: The proportion of female physicians in the workforce has been steadily increasing, but the proportion of women in department leadership roles across the United States remains low. Urogynecology has the highest representation of women in leadership roles across obstetrics and gynecology and urology subspecialties; however, the proportion of women in leadership roles within urogynecology fellowship programs has not been described previously. OBJECTIVES: Our objective was to investigate gender representation within urogynecology fellowship program leadership positions. STUDY DESIGN: This was a cross-sectional observational study where urogynecology fellowship program websites were queried for the geographic state as well as the gender expression of the program director and division chair. RESULTS: A total of 68 American Council for Graduate Medical Education-accredited urogynecology fellowship programs were queried. Of these, 53 are obstetrics and gynecology-based programs and 15 are urology-based programs. Overall, women represent 67.6% of fellowship directors and 59.2% of division directors. One in 4 female fellowship directors concurrently hold the role of division chair. Women are significantly more likely to be fellowship directors in obstetrics and gynecology-based programs compared with urology-based urogynecology programs (75.4% versus 40.0%; odds ratio, 4.1; 95% confidence interval, 1.20-14.0). Women are also more likely to be division chairs in obstetrics and gynecology-based compared with urology-based urogynecology programs, although this did not reach statistical significance (63.4% versus 37.5%; odds ratio, 2.9, 95% confidence interval, 0.60-13.8). CONCLUSIONS: Across urogynecology fellowship programs, women are the majority of division chairs and fellowship directors. However, female representation in leadership roles is lagging at urology-based urogynecology programs.

The next frontier of acute care general surgery: fellowship training.

Acute care surgery (ACS) is an area of surgical specialization within general surgery and a model for clinical care delivery that has proliferated over the last 2 decades. Models of ACS in Canada exist in both academic and community settings and are used to manage patients in need of emergency general surgery (EGS) care, with or without the provision of trauma care. The implementation of the ACS model has changed the landscape of patient care, surgical education and the workforce, providing an option for some general surgeons to exclude EGS care from their regular practice. The rise of ACS as a concentration of surgical skill and content expertise has resulted in the establishment of dedicated ACS fellowship training programs. This is a landmark in the evolution of general surgery, as well as a stepping stone on the path to improving patient care, surgical education and scholarly endeavour in this field.

Research focused doctoral nursing education in the 21st century: Curriculum, evaluation, and postdoctoral considerations.

The AACN position statement on The Research-Focused Doctoral Program in Nursing: Pathways to Excellence was revised in 2022 by an AACN Task Force charged with creating a new vision for the PhD and similar programs in nursing. This document, which was informed by hundreds of academic nursing stakeholders, yields expectations and recommendations for PhD program curriculum, program evaluation, post-doctoral competencies, and resources. Results of an AACN 2021 survey indicated increased enrollment in PhD programs 2017-2000. Fifteen percent of students were enrolled in BSN-PhD, programs, 70 % of schools reported external review, and overall average time to degree completion was 5 years. Considerations for the education for the research doctorate include development of curriculum that fosters the scholarship of discovery and scientific inquiry and implements systematic evaluation of program outcomes while advancing postdoctoral competencies and resources, including the post-doctoral fellowship. Comprehensive assessment of the PhD program promotes ongoing program analysis and quality. Postdoctoral fellowships advance the science of nursing via the creation of a culture and workforce for nursing research. Successful postdoctoral programs have mentors, resources, and infrastructure to adequately enable the fellow to progress in their line of inquiry and develop as an investigator.

Highlighting an Advanced Practice Fellowship for Leadership Transition.

As the advanced practice provider (APP) workforce continues to rapidly grow in healthcare, there is a greater need for APP leadership positions. Often, these positions are organically designated to the best clinicians on the team, who may not have leadership experience. Stanford Health Care Center for Advanced Practice embarked on formalized leadership training using a newly developed administration specialty within the APP Fellowship Program to support new leader transition.

Should We Hire Our Current Fellow? Hiring Trends and Preferences in Spine Surgery.

OBJECTIVE: To provide insight into hiring trends/preferences in Academic Orthopaedic Spine Surgery after fellowship training. METHODS: Fellowship directors (FDs) listed by the North American Spine Society were surveyed regarding new faculty hiring preferences. Surveys were analyzed/stratified by response using the Kruskal-Wallis with Dunn multiple comparisons test, the Fisher exact test, and the Mann-Whitney U test for univariate comparisons. RESULTS: Thirty-two of 52 (61.5%) FDs responded. 32.3% of graduated fellows pursued academic medicine, which was preferred by FDs (3.59 ± 0.67; 1 to 5 scale). From 2015 to 2020, of the 2.25 ± 1.46 faculty members hired per program, 45.8% were former residents/fellows. Top listed hiring qualities were "strong recommendation from a trusted colleague" (84.4%), "prior personal experience, as a resident/fellow" (78.1%), and "amicable personality" (53.1%). Twelve (38%) answered "no", six (19%) "yes", and 14 (44%) "other", regarding if hiring former residents/fellows benefits the field of spine surgery. "Other" answers endorsing in-house hiring most commonly mentioned consistency/stability (28.6%) while those opposed most commonly mentioned lack of diversity of training/novel techniques (42.9%). When considering programmatic size, while the stated perception of FDs regarding in-house hiring at larger (>2 fellows) versus smaller (1 to 2 fellows) programs was equivalent, the mean percentage of in-house hires at larger programs (67.8% ± 35.8%) was significantly greater than that of smaller programs (33.3% ± 44.8%, P = 0.04). CONCLUSIONS: In-house hiring in spine surgery appears to occur more commonly than perceived by program leadership, particularly at larger fellowship programs. Further study of hiring preferences and their impact on the field of spine surgery is warranted. STUDY DESIGN: Prospective Survey Study.

Critical Review Two-Years Thereafter of the Effectiveness of the Revolutionary Changes in a Gastroenterology Division at A Medical School Teaching Hospital in Response to the COVID-19 Pandemic: Medical School, Residency, and Gastrointestinal Fellowship Education and Clinical Practice of Gastroenterology Attendings and Gastrointestinal Endoscopy.

Profound and pervasive GI divisional changes maximized clinical resources devoted to COVID-19-infected patients and minimized risks of transmitting infection. Academic changes degraded by massive cost-cutting while offering institution to about 100 hospital systems and eventually "selling" institution to Spectrum Health, without faculty input.

Academic Training in Oral and Maxillofacial Surgery - when and how to enter the pathway.

Entering into surgical academia can seem a daunting prospect for an oral and maxillofacial surgery (OMFS) trainee. However, the streamlining of academic training by the NIHR to create the integrated academic training (IAT) pathway has simplified academic training and more clearly defined academic positions and entry points for trainees. In this article we review the current NIHR IAT pathway and the various grades and entry points available to OMF surgeons, both pre- and post-doctoral. We highlight the unique challenges facing OMF trainees and provide advice and insight from both junior and senior OMFS academics. Finally, we focus on the planning and application for a doctoral research fellowship - discussing funding streams available to OMF surgeons.

Novel Design and Implementation of an Integrated Burn Rehabilitation Clinical Fellowship.

ABSTRACT: Postgraduate medical burn rehabilitation training has been limited, with very few academic physiatrists specializing in burn rehabilitation. As a result, there are no existing models for postgraduate burn rehabilitation education. A 12-mo comprehensive clinical fellowship in burn rehabilitation was offered through a tertiary burn center with formal university accreditation. In this article, the clinical, educational, and skill-based goals developed and implemented for this novel fellowship was outlined to serve as a blueprint for future fellowships in burn rehabilitation, as well as reflections on the experience.

Mastering Your Fellowship: Part 1, 2023.

The series 'Mastering your Fellowship' provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars (and their supervisors) in preparing for this examination.

The American Society of Pediatric Hematology Oncology workforce, productivity, and fellowship assessment: Current state of the workforce.

The American Society of Pediatric Hematology Oncology conducted follow-up workforce surveys in 2017 and 2021 as well as a Pediatric Hematology Oncology Fellowship Program Directors Survey in 2020 to provide an updated review of the current workforce. We provide a comprehensive review and analysis of these results with the goal to provide better understanding of the current landscape in pediatric hematology oncology.