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Residency learning

Emily E Whitgob, Rebecca L Blankenburg, Alyssa L Bogetz
PURPOSE: Trainee mistreatment remains an important and serious medical education issue. Mistreatment toward trainees by the medical team has been described; mistreatment by patients and families has not. Motivated by discrimination towards a resident by a family in their emergency department, the authors sought to identify strategies for trainees and physicians to respond effectively to mistreatment by patients and families. METHOD: A purposeful sample of pediatric faculty educational leaders was recruited from April-June 2014 at Stanford University...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
DeWitt C Baldwin, Steven R Daugherty
Relatively little is known about how, from whom, and under what conditions residents say they most effectively learn. We examined the relationships between residents' self-reported ratings of 11 different sources of learning and a number of empirical variables, using a national, random sample of postgraduate year (PGY) 1 and PGY-2 residents in the 1998-1999 training year. Residents were surveyed by mail. Completed surveys were received from 64.2% of 5616 residents contacted. The most often reported sources of learning were other residents and attending physicians...
October 2016: Journal of Graduate Medical Education
Amber R Atwater, Mariah Rudd, Audrey Brown, John S Wiener, Robert Benjamin, W Robert Lee, Jullia A Rosdahl
BACKGROUND : There is limited information on the impact of widespread adoption of the electronic health record (EHR) on graduate medical education (GME). OBJECTIVE : To identify areas of consensus by education experts, where the use of EHR impacts GME, with the goal of developing strategies and tools to enhance GME teaching and learning in the EHR environment. METHODS : Information was solicited from experienced US physician educators who use EPIC EHR following 3 steps: 2 rounds of online surveys using the Delphi technique, followed by telephone interviews...
October 2016: Journal of Graduate Medical Education
Cristen P Page, Alfred Reid, Catherine L Coe, Martha Carlough, Daryl Rosenbaum, Janalynn Beste, Blake Fagan, Erika Steinbacher, Geoffrey Jones, Warren P Newton
BACKGROUND : Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. OBJECTIVE : We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool...
October 2016: Journal of Graduate Medical Education
Greg Ogrinc, Emily S Cohen, Robertus van Aalst, Beth Harwood, Ellyn Ercolano, Karyn D Baum, Adam J Pattison, Anne C Jones, Louise Davies, Al West
BACKGROUND : Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. OBJECTIVE : We sought to determine the clinical and educational impact of an integrated QI curriculum. METHODS : This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum...
October 2016: Journal of Graduate Medical Education
Raphael Rabinowitz, Jeanne Farnan, Oliver Hulland, Lisa Kearns, Michele Long, Bradley Monash, Priti Bhansali, H Barrett Fromme
BACKGROUND : Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. OBJECTIVE : To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. METHODS : In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals...
October 2016: Journal of Graduate Medical Education
Rachel Stork Poeppelman, Cara A Liebert, Daniel Brandt Vegas, Carl A Germann, Anna Volerman
BACKGROUND : Team-based learning (TBL) promotes problem solving and teamwork, and has been applied as an instructional method in undergraduate medical education with purported benefits. Although TBL curricula have been implemented for residents, no published systematic reviews or guidelines exist for the development and use of TBL in graduate medical education (GME). OBJECTIVE : To review TBL curricula in GME, identify gaps in the literature, and synthesize a framework to guide the development of TBL curricula at the GME level...
October 2016: Journal of Graduate Medical Education
Qing Hong, Jieping Feng, Haijuan Liu, Xiaomin Li, Lirong Gong, Zhen Yang, Weiming Yang, Xiongfa Liang, Rujiang Zheng, Zhicai Cui, Weiliang Wang, Daixiong Chen
Sparganosis is an important parasitic disease in Guangzhou and is mainly acquired by consumption of frog meat or contact with fresh frogs infected by larval stages (spargana) of the tapeworm species Spirometra mansoni (S. mansoni). In this study we assessed the prevalence of intestinal S. mansoni infections (with adult parasites) in dogs and cats on one hand and of extraintestinal S. mansoni infections (with spargana) in frogs on the other. In Addition, a questinnaire survey among residents in Guangzhou City was carried out in order to evaluate the awareness of autochthonous people about the medical and epidemiological relevance of Spirometra and sparganosis...
October 21, 2016: International Journal of Infectious Diseases: IJID
Thanh Tam Tran, Joel Adams-Bedford, Vasoontara Yiengprugsawan, Sam-Ang Seubsman, Adrian Sleigh
INTRODUCTION: Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress. METHODS: Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6...
2016: PloS One
Christian Wybranski, Ilya Adamchic, Friedrich-Wilhelm Röhl, Jens Ricke, Frank Fischbach, Katharina Fischbach
OBJECTIVE: To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique. METHODS: An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA...
October 22, 2016: Skeletal Radiology
Ruohollah Seddigh, Esmat Abdollahpour, Somayeh Azarnik, Behnam Shariati, Amir-Abbas Keshavarz-Akhlaghi
Objectives: To explore the experiences of general practitioners who continue to sit a highly-competitive residency entrance examination, despite repeated failure. Methods: This qualitative, exploratory study employed semi-structured, in-depth interviews with 35 candidates of a residency entrance exam who had failed the examination at least twice and were preparing to sit it again. Interview questions addressed the challenges they faced and how they managed these challenges...
October 22, 2016: International Journal of Medical Education
Anju Saraswat, John Bach, William D Watson, John O Elliott, Edward P Dominguez
BACKGROUND: Current surgical education relies on simulated educational experiences or didactic sessions to teach low-frequency clinical events such as abdominal compartment syndrome (ACS). The purpose of this pilot study was to evaluate if simulation would improve performance and knowledge retention of ACS better than a didactic lecture. METHODS: Nineteen general surgery residents were block randomized by postgraduate year level to a didactic or a simulation session...
August 4, 2016: American Journal of Surgery
Masaaki Iwata, Hisahito Ishida, Koichi Kaneko, Yukihiko Shirayama
An accumulating body of evidence has demonstrated that inflammation is associated with the pathology of depression. We recently found that psychological stress induces inflammation in the hippocampus of the rat brain through the inflammasome, a component of the innate immune system. Microglia, the resident macrophages in the brain, play a central role in the innate immune system and express inflammasomes; thus, we hypothesized that hippocampal microglia would be key mediators in the development of depression via stress-induced inflammation...
October 18, 2016: Pharmacology, Biochemistry, and Behavior
Rebecca Leddy, Madelene Lewis, Susan Ackerman, Jeanne Hill, Paul Thacker, Maria Matheus, Sameer Tipnis, Leonie Gordon
Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided...
October 18, 2016: Academic Radiology
Eddie Y Liu, Bo Li, Cindy M L Hutnik
Wet lab and surgical simulation can reduce the learning curve of difficult surgical techniques, accelerate the rate for trainees to achieve surgical competency, and improve patient safety. To provide the most up-to-date information and hands-on experiences with novel ophthalmic surgical techniques and instruments, the Department of Ophthalmology at Western University has created a wet lab-based, multilevel microsurgery skills transfer course through collaboration with various industry partners. Several elements in the course goal and design differentiate this type of surgical course from typical wet labs: the format is multileveled surgical training, with a beginner level targeting undergraduate medical students, an intermediate level for ophthalmology residents, and an advanced level for trained ophthalmologist...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Mohammed Al-Temimi, Michael Kidon, Samir Johna
CONTEXT: Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. OBJECTIVE: Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. DESIGN: Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs...
October 14, 2016: Permanente Journal
Aaron L Grant, Claire Temple-Oberle
OBJECTIVE: The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. DESIGN: A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale...
October 17, 2016: Journal of Surgical Education
Shruti Gupta, Jehan Alladina, Kevin Heaton, Eli Miloslavsky
BACKGROUND: Subspecialty fellows can serve as a tremendous educational resource to residents; however, there are multiple barriers to an effective resident-fellow teaching interaction in the setting of inpatient consultation. We designed and evaluated a resident-directed intervention to enhance communication and teaching during consultation on the general medicine wards. METHODS: Five medical teams were randomized to receive the intervention over a 3 month period (3 control, 2 intervention teams)...
October 20, 2016: BMC Medical Education
Macarena C García, Anton B Dodek, Tom Kowalski, John Fallon, Scott H Lee, Michael F Iademarco, John Auerbach, Michele K Bohm
Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1). In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids (2). In Massachusetts, unintentional opioid-related overdose deaths, including deaths involving heroin, increased 45% from 2012 to 2013.* In 2014, the rate of these deaths reached 20.0 per 100,000, nearly 2.5 times higher than the U.S. rate overall (3,4)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Volker Wenzel, Nikolaus Gravenstein
PURPOSE OF REVIEW: Mentoring is fundamentally valuable and important to students considering a path into our specialty, as well as to colleagues already in it and with ambition to advance. General principles and personal experiences are collected and described to help inform future mentors and to reinforce the value of having a mentor and the satisfaction (and work) that is associated with such a role. RECENT FINDINGS: Detecting a latent talent among medical students or residents may be challenging but is worth the effort to develop personal careers and the specialty itself...
October 18, 2016: Current Opinion in Anaesthesiology
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