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Journal of Graduate Medical Education

Adam E Ludvigson, Stephen T Ryan, Christina R Gentile, Gregory J Mills, Graham T VerLee, Moritz H Hansen
Background : Little research exists regarding factors that contribute to resident fatigue during home call. Objective : We objectively tracked the number and type of pages received, as well as residents' sleep time, during home call. We then examined the relationship between paging volume, resident sleep, and resident fatigue. Methods : A total of 4 of 4 urology residents (100%) at a single institution wore a FitBit Charge HR device from July 2015 to July 2016 to track sleep...
October 2018: Journal of Graduate Medical Education
Jennifer A Rama, Carla Falco, Dorene F Balmer
Background : Graduate medical education programs are expected to conduct an annual program evaluation. While general guidelines exist, innovative and feasible approaches to program evaluations may help efforts at program improvement. Appreciative Inquiry is an approach that focuses on successful moments, effective processes, and programs' strengths. Objective : We implemented a novel application of Appreciative Inquiry and its 4 phases (Inquire, Imagine, Innovate, and Implement) and demonstrate how it led to meaningful improvements in a pediatric pulmonology fellowship program...
October 2018: Journal of Graduate Medical Education
Matthew Gorgone, Brian McNichols, Valerie J Lang, William Novak, Alec B O'Connor
Background : Training residents to become competent in common bedside procedures can be challenging. Some hospitals have attending physician-led procedure teams with oversight of all procedures to improve procedural training, but these teams require significant resources to establish and maintain. Objective : We sought to improve resident procedural training by implementing a resident-run procedure team without routine attending involvement. Methods : We created the role of a resident procedure coordinator (RPC)...
October 2018: Journal of Graduate Medical Education
Sandra K Oza, Sandrijn van Schaik, Christy K Boscardin, Read Pierce, Edna Miao, Tai Lockspeiser, Darlene Tad-Y, Eva Aagaard, Anda K Kuo
Background : While leadership training is increasingly incorporated into residency education, existing assessment tools to provide feedback on leadership skills are only applicable in limited contexts. Objective : We developed an instrument, the Leadership Observation and Feedback Tool (LOFT), for assessing clinical leadership. Methods : We used an iterative process to develop the tool, beginning with adapting the Leadership Practices Inventory to create an open-ended survey for identification of clinical leadership behaviors...
October 2018: Journal of Graduate Medical Education
Megan E Miller, Ajanta Patel, Nancy Schindler, Kristen Hirsch, Mei Ming, Stephen Weber, Phyllis Turner, Michael D Howell, Vineet M Arora, Julie L Oyler
Background : The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review recommends that quality improvement/patient safety (QI/PS) experts, program faculty, and trainees collectively develop QI/PS education. Objective : Faculty, hospital leaders, and resident and fellow champions at the University of Chicago designed an interdepartmental curriculum to train postgraduate year 1 (PGY-1) residents on core QI/PS principles, measuring outcomes of knowledge, attitudes, and event reporting...
October 2018: Journal of Graduate Medical Education
Emily K Hadley Strout, Alison R Landrey, Charles D MacLean, Halle G Sobel
Background : Panel management is emphasized as a subcompetency in internal medicine graduate medical education. Despite its importance, there are few published curricula on population medicine in internal medicine residency programs. Objective : We explored resident experiences and clinical outcomes of a 5-month diabetes and obesity ambulatory panel management curriculum. Methods : From August through December 2016, internal medicine residents at the University of Vermont Medical Center reviewed registries of their patients with diabetes, prediabetes, and obesity; completed learning modules; coordinated patient outreach; and updated gaps in care...
October 2018: Journal of Graduate Medical Education
Preston Douglas, Carolyn Goldschmidt, Matthew McCoyd, Michael Schneck
Background : Good medical care relies on communication as much as technical expertise, yet physicians often overestimate the efficacy of their patient communication skills. Teaching communication skills can be cost- and time-intensive, and efforts have rarely focused on challenging situations, such as conveying the news of a patient's brain death to a family member. Objective : We developed a resource-sensitive simulation program to teach residents how to diagnose brain death and how to show empathy in discussing the diagnosis with the patient's family...
October 2018: Journal of Graduate Medical Education
Cristen P Page, Alfred Reid, Christina Drostin, Warren P Newton
Background: Evidence from several specialties suggests that practice patterns developed in residency influence the quality and cost of care long after completion of training. Improving the quality, cost, and patient experience of care (the "Triple Aim") is foundational to future health systems change. Objective: We measured variation in Triple Aim measures among family medicine residency programs in a regional quality improvement collaborative (I3 Population Health Collaborative)...
October 2018: Journal of Graduate Medical Education
Kimberly M Hudson, Gail Feinberg, Laura Hempstead, Christopher Zipp, John R Gimpel, Yi Wang
Background : The primary goal of residency programs is to select and educate qualified candidates to become competent physicians. Program directors often use performance on licensure examinations to evaluate the ability of candidates during the resident application process. The American College of Osteopathic Family Physicians (ACOFP) administers an in-service examination (ISE) to residents annually. There are few prior studies of the relationship between the Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) series and formative assessments of residents in training...
October 2018: Journal of Graduate Medical Education
Karsten A van Loon, Pim W Teunissen, Erik W Driessen, Fedde Scheele
Background : Entrustment of residents has been formalized in many competency-based graduate medical education programs, but its relationship with informal decisions to entrust residents with clinical tasks is unclear. In addition, the effects of formal entrustment on training practice are still unknown. Objective : Our objective was to learn from faculty members in training programs with extensive experience in formal entrustment how formal entrustment relates to informal entrustment decisions...
October 2018: Journal of Graduate Medical Education
Kelly Williamson, Patrick M Lank, Navneet Cheema, Nicholas Hartman, Elise O Lovell
Background : The Maslach Burnout Inventory (MBI) is considered the "gold standard" for measuring burnout, encompassing 3 scales: emotional exhaustion, depersonalization, and personal accomplishment. Other well-being instruments have shown utility in various settings, and correlations between MBI and these instruments could provide evidence of relationships among key variables to guide well-being efforts. Objective : We explored correlations between the MBI and other well-being instruments...
October 2018: Journal of Graduate Medical Education
John Raimo, Sean LaVine, Kelly Spielmann, Meredith Akerman, Karen A Friedman, Kyle Katona, Saima Chaudhry
Background : Residents and practicing physicians displaying signs of stress is common. It is unclear whether stress during residency persists into professional practice or is associated with future burnout. Objective : We assessed the persistence of stress after residency and its correlation with burnout in professional practice. We hypothesized that stress would linger and be correlated with future burnout. Methods : A prospective cohort study was conducted over 10 years using survey instruments with existing validity evidence...
October 2018: Journal of Graduate Medical Education
Heather A Brown, Patrick Mulherin, William C Ferrara, Mark E Humphrey, Alexander Vera, Jeffrey W Hall
Background : Fellowships in global health are increasingly popular and seek to equip physicians with the skills necessary to be effective global health practitioners. Little objective guidance exists on which skills make graduates competitive applicants from the perspective of potential global health employers. Objective : We sought to provide objective evidence for the qualifications that make applicants competitive for global health positions by analyzing the listed qualifications for current job openings in large global health organizations...
October 2018: Journal of Graduate Medical Education
Daniel Palazuelos, Ranu Dhillon, Adrianne Katrina Nelson, Kevin P Savage, Rosabelle Conover, Joel T Katz, Joseph J Rhatigan
Background : The Doris and Howard Hiatt Residency in Global Health Equity and Internal Medicine at Brigham and Women's Hospital provides global health training during residency, but little is known about its effect on participants' selection of a global health career. Objective : We assessed the perceptions of residency graduates from the first 7 classes to better understand the outcomes of this education program, and the challenges faced by participants. Methods : We interviewed 27 of 31 physicians (87%) who graduated from the program between 2003 and 2013 using a convergent mixed-methods design and a structured interview tool that included both open-ended and forced-choice questions...
October 2018: Journal of Graduate Medical Education
Vivek K Murthy, Bridget O'Brien, Gurpreet Dhaliwal
Background : Residents and fellows often seek to emulate master clinician role models; however, the activities these expert clinical faculty pursued early in their careers are not known. Objective : We studied the early career clinical experiences and learning behaviors of peer-defined master academic clinicians. Methods : We performed a retrospective, qualitative interview study of 17 members of the University of California, San Francisco, Department of Medicine Council of Master Clinicians...
October 2018: Journal of Graduate Medical Education
Julie Byerley, Alyssa Tilly
No abstract text is available yet for this article.
October 2018: Journal of Graduate Medical Education
Gail M Sullivan
No abstract text is available yet for this article.
October 2018: Journal of Graduate Medical Education
Omar Viswanath
No abstract text is available yet for this article.
October 2018: Journal of Graduate Medical Education
Christopher P Kovach, Matthew D Ettleson
No abstract text is available yet for this article.
October 2018: Journal of Graduate Medical Education
Christopher Su
No abstract text is available yet for this article.
October 2018: Journal of Graduate Medical Education
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