bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Medical Students' Experiences With Residents as Teachers on Clerkship Assessment
Authors: Huynh Anhtuan , Savitski Jennifer , Kirven Melissa , Godwin Jennifer , Gil Karen M 
Published: July 2013

Abstract

Background
We assessed the impact of resident teaching in medical students' overall assessment of an obstetrics and gynecology clerkship.

Methods
Between September 2007 and March 2010, third-year medical students completed a questionnaire at the end of their clerkship. Questions covered the number of topics they recalled learning about from residents, perceptions of the quality of education received from residents, perceptions of the experience with the residents as teachers, and overall rating of the obstetrics and gynecology clerkship.

Results
Questionnaires were completed by all medical students (N  =  74), with 63 students returning complete surveys. There was a small correlation between the number of topics students recalled learning about from residents and ratings of quality of education (r  =  0.249, P  =  .03), a small correlation between the number of topics students recalled learning about from residents and level of satisfaction with the clerkship (r  =  0.262, P  =  .04), and a larger correlation between assessment of the overall experience with residents as teachers and ratings of quality of education received from residents (r  =  0.687, P &lt; .001). Overall experience with residents as teachers and perceived quality of education from residents were both associated with satisfaction with the clerkship (r  =  0.756, P &lt; .001 and r  =  0.603, P &lt; .001, respectively). A regression model with these variables accounted for 58% of the variability in students' ratings of the clerkship (F  =  27.103, P &lt; .001, R  =  .761, R2  =  .579). The only significant independent variable was assessment of the overall experience with residents as teachers (t  =  5.350, P &lt; .001).

Conclusion
Quality of interactions between residents and medical students is a key factor in medical students' assessment of their clerkship.
Specialist Training in Obstetrics and Gynecology in Singapore: Transition to Structured Residency Program
Authors: Tagore Shephali , Min Bernard Chern Su , Goh Shen Li , Tan Lay Kok , Kwek Kenneth , Tan Kok Hian 
Published: July 2013

Abstract

Background
The article describes the experience of planning and implementing the transition of the residency program in obstetrics and gynecology at Singhealth, Singapore, from a model largely based on British training principles to a new model in accordance with the ACGME-International (ACGME-I) standards.

Intervention
Initial steps in transitioning to the new model entailed (1) identifying faculty with an interest in education to lead the various initiatives and programs and to ensure appropriate educational role models, (2) securing adequate funding, (3) holding focus groups with physicians to identify opportunities for improvement in the new system, and (4) developing a schedule for the phased implementation of key features of the structured system.

Results
The program started in July 2011, with 14 residents for a 4-year course of training. The curriculum consisted of 5 modules: (1) general obstetrics and gynecology and ambulatory care, (2) maternal fetal medicine, (3) urogynecology and minimally invasive surgery, (4) reproductive medicine, and (5) gynecology oncology. Faculty was assigned responsibility for teaching and assessing the 6 competencies, and appropriate training was provided through specially designed, professional-development programs.

Conclusions
Challenges in the implementation of the new training program included the need to replace clinical service previously provided by trainees, a lack of fit between the traditional qualifying exam and the new model for training, and the need to adapt teaching strategies to new competencies not explicitly taught in the prior program, particularly practice-based learning and improvement and systems-based practice. The strength of the new obstetrics and gynecology residency lies in having a structured, competency-based, closely supervised approach to training with standardized evaluations, timely feedback, and a committed faculty.
Restructuring Graduate Medical Education to Meet the Health Care Needs of Emirati Citizens
Authors: Abdel-Razig Sawsan , Alameri Hatem 
Published: July 2013

Abstract
Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.
Successfully Matching Into Surgical Specialties: An Analysis of National Resident Matching Program Data
Authors: Rinard Jeremy R. , Garol Ben D. , Shenoy Ashvin B. , Mahabir Raman C. 
Published: July 2013

Abstract

Objective
We explored the impact that attributes of US medical school seniors have on their success in matching to a surgical residency, in order to analyze trends for National Resident Matching Program (NRMP) match outcomes in surgical specialties between 2007 and 2009.

Methods
Using Electronic Residency Application Service data and NRMP outcomes, we analyzed medical students' attributes and their effect in successfully matching students into residency positions in surgery, otolaryngology, orthopedic surgery, plastic surgery, and obstetrics and gynecology. Attributes analyzed included self-reported United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Alpha Omega Alpha (AOA) Honor Medical Society membership, research experience, additional graduate degree status, and graduation from a top 40 National Institutes of Health (NIH)–funded medical school. Odds ratios were calculated for each criterion, and 95% confidence intervals were used to determine significance.

Results
Between 2007 and 2009, the number of surgical specialty residency positions increased by 86, and the number of applicants increased by 34. Membership in AOA, USMLE Step 1 and Step 2 scores, research experience, and graduation from a top 40 NIH-funded medical school frequently had a significant impact on residents successfully matching into many specialties, while additional graduate degrees had no effect on matching into surgical specialties (range 0.64 to 1.2).

Conclusions
Although the statistical significance varied across specialties, higher USMLE Step 1 and Step 2 scores, AOA membership, research experience, and graduation from a top 40 NIH-funded medical school generally had a positive impact on match success to surgical residency for US allopathic seniors. Test preparation and seeking research experience during undergraduate medical education may be effective approaches for increasing the likelihood of success for US seniors matching into a surgical specialty.
An “Education for Life” Requirement to Promote Lifelong Learning in an Internal Medicine Residency Program
Authors: Panda Mukta , Desbiens Norman A. 
Published: July 2013

Abstract

Background
Lifelong learning is an integral component of practice-based learning and improvement. Physicians need to be lifelong learners to provide timely, efficient, and state-of-the-art patient care in an environment where knowledge, technology, and social requirements are rapidly changing.

Objectives
To assess graduates' self-reported perception of the usefulness of a residency program requirement to submit a narrative report describing their planned educational modalities for their future continued medical learning (“Education for Life” requirement), and to compare the modalities residents intended to use with their reported educational activities.

Materials and Methods
Data was compiled from the Education for Life reports submitted by internal medicine residents at the University of Tennessee College of Medicine Chattanooga from 1998 to 2000, and from a survey sent to the same 27 graduates 2 to 4 years later from 2000 to 2004.

Results
Twenty-four surveys (89%) were returned. Of the responding graduates, 58% (14/24) found the Education for Life requirement useful for their future continued medical learning. Graduates intended to keep up with a mean of 3.4 educational modalities, and they reported keeping up with 4.2. In a multivariable analysis, the number of modalities graduates used was significantly associated with the number they had planned to use before graduation (P  =  .04) but not with their career choice of subspecialization.

Conclusion
The majority of residents found the Education for Life requirement useful for their future continued medical learning. Graduates, regardless of specialty, reported using more modalities for continuing their medical education than they thought they would as residents. Considering lifelong learning early in training and then requiring residents to identify ways to practice lifelong learning as a requirement for graduation may be dispositive.
Utilization and Barriers to Mental Health Services Among Depressed Medical Interns: A Prospective Multisite Study
Authors: Guille Constance , Speller Heather , Laff Rachel , Epperson C. Neill , Sen Srijan 
Published: July 2013

Abstract

Background
Compared with graduate students and young adults in the general population, depression is more prevalent among training physicians, yet physicians are often reluctant to seek mental health treatment. The purpose of this study is to identify perceived barriers to mental health treatment among depressed training physicians.

Methods
Subjects for this study were drawn from intern classes during the 2007–2008 and 2008–2009 academic years from 6 and 13 participating community and university hospitals, respectively. At 3-month intervals throughout the intern year, participants completed the Patient Health Questionnaire regarding current depressive symptoms and questions regarding current mental health treatment. We explored potential barriers to mental health treatment at the end of the intern year and determined the proportion of subjects screening positive for depression and seeking treatment through analysis of subject responses. Stepwise binary logistic regression was conducted to compare baseline characteristics among depressed interns who sought mental health treatment and those that did not.

Results
Of the 42.5% (278 of 654) of interns who screened positive for depression, 22.7% (63 of 278) reported receiving treatment during the intern year. The most frequently cited barriers to seeking treatment were time (91.5%), preference to manage problems on their own (75.1%), lack of convenient access (61.8%), and concerns about confidentiality (57.3%). Interns who had previously sought treatment for depression were more likely to seek treatment during internship.

Conclusions
Despite high rates of depression, few interns appear to seek mental health treatment due to time constraints, lack of convenient access, concerns about confidentiality, and a preference to manage problems on their own. By identifying barriers to mental health treatment we can begin to remove obstacles to the delivery of evidence-based treatments and implement prevention, screening, and early detection programs to improve the mental health of physicians in training.
Improving Quality and Patient Satisfaction in a Pediatric Resident Continuity Clinic Through Advanced Access Scheduling
Authors: Tuli Sanjeev Y. , Thompson Lindsay A. , Ryan Kathleen A. , Srinivas Ganga L. , Fillipps Donald J. , Young Christopher M. , Tuli Sonal S. 
Published: July 2013

Abstract

Objective
To evaluate the impact of advanced access scheduling in a pediatric residency clinic on resident and patient satisfaction, medical education, practice quality, and efficiency.

Methods
Residents were assigned to either the advanced access template (10 appointments available to patients and 2 physician overbooks) or the prior template (5 available and 8 overbooks). Outcomes included resident and patient satisfaction, appointment availability, and continuity of care and clinic costs.

Results
Patient satisfaction improved in 7 areas (P &lt; .001). Residents in either template did not report an impact on medical education experiences. Significant increases were realized with appointment availability and the number of patients seen. Continuity also increased as the overflow/acute visits decreased (P &lt; .001). Overall costs per visit decreased 22%. Because of the significant improvements in access, continuity, and efficiency, all residents were switched to the advanced access template after completion of the study.

Conclusions
Improvement in access to the primary physician has a significant impact on patient satisfaction with health care delivery. This model optimizes the limited time that residents have in continuity clinic, and it has implications for health care delivery quality improvement.
Teaching and Assessing Systems-Based Practice: A Pilot Course in Health Care Policy, Finance, and Law for Radiation Oncology Residents
Authors: Mitchell James D. , Parhar Preeti , Narayana Ashwatha 
Published: July 2013

Abstract

Background
Under the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project, residency programs are required to provide data on educational outcomes and evidence for how this information is used to improve resident education.

Objective
To teach and assess systems-based practice through a course in health care policy, finance, and law for radiation oncology residents, and to determine its efficacy.

Methods and Materials
We designed a pilot course in health care policy, finance, and law related to radiation oncology. Invited experts gave lectures on policy issues important to radiation oncology and half of the participants attended the American Society for Therapeutic Radiation and Oncology (ASTRO) Advocacy Day. Participants completed pre- and postcourse tests to assess their knowledge of health policy.

Results
Six radiation oncology residents participated, with 5 (84%) completing all components. For the 5 residents completing all assessments, the mean precourse score was 64% and the mean postcourse score was 84% (P  =  .05). Improvement was noted in all 3 sections of health policy, finance, and medical law. At the end of the course, 5 of 6 residents were motivated to learn about health policy, and 4 of 6 agreed it was important for physicians to be involved in policy matters.

Conclusions
Teaching radiation oncology residents systems-based practice through a course on health policy, finance, and law is feasible and was well received. Such a course can help teaching programs comply with the ACGME Outcome Project and would also be applicable to trainees in other specialties.
Implementation and Experience of the First Chief Residency Program in Singapore
Authors: Soo Yap Eng , Wei-Ping Goh , Kee Adrian C. L. , Cheun Chan Yee 
Published: July 2013

Abstract

Background
Like their counterparts in many other nations, physicians in Singapore are tasked with providing care, conducting research, and teaching and providing leadership to junior doctors. In this paper, we describe our experience implementing the first chief residency program in Singapore.

Initiative
A pilot of a chief residency program was initiated in the Department of Medicine at National University Hospital in July 2008, with 1 chief resident (CR) and 2 associate CR positions. The pilot used the US model for CR training as the initial framework. CRs would assist in the orientation and integration of new residents, teach residents, promote camaraderie among residents, help resolve issues, function as a liaison to senior staff, and would be developed as potential health care leaders and physician role models.

Results
The CRs performed a host of administrative duties and initiated several improvements in the residency, including better practices for leave scheduling, call roster planning, and a night float system. CRs attended monthly meetings with division heads and participated in departmental strategic planning as well as professional development and leadership courses. The CR position was well regarded by the other residents, and this resulted in increased interest in identifying and addressing opportunities for improvement. The introduction of a chief residency also made the department a more attractive posting for residents and contributed to a significant increase in the number of applicants for residency rotations.

Conclusions
A chief residency program can benefit residents' morale and a CR's development as a leader, and it can facilitate linkage between junior and senior hospital management that promotes active involvement in problem solving and clinical and education improvement. Support from hospital administrators and senior clinicians is essential, and mentoring and succession planning are important to ensure the program's continued success.
Can Medical School Performance Predict Residency Performance? Resident Selection and Predictors of Successful Performance in Obstetrics and Gynecology
Authors: Stohl Hindi E. , Hueppchen Nancy A. , Bienstock Jessica L. 
Published: July 2013

Abstract

Background
During the evaluation process, Residency Admissions Committees typically gather data on objective and subjective measures of a medical student's performance through the Electronic Residency Application Service, including medical school grades, standardized test scores, research achievements, nonacademic accomplishments, letters of recommendation, the dean's letter, and personal statements. Using these data to identify which medical students are likely to become successful residents in an academic residency program in obstetrics and gynecology is difficult and to date, not well studied.

Objective
To determine whether objective information in medical students' applications can help predict resident success.

Method
We performed a retrospective cohort study of all residents who matched into the Johns Hopkins University residency program in obstetrics and gynecology between 1994 and 2004 and entered the program through the National Resident Matching Program as a postgraduate year-1 resident. Residents were independently evaluated by faculty and ranked in 4 groups according to perceived level of success. Applications from residents in the highest and lowest group were abstracted. Groups were compared using the Fisher exact test and the Student t test.

Results
Seventy-five residents met inclusion criteria and 29 residents were ranked in the highest and lowest quartiles (15 in highest, 14 in lowest). Univariate analysis identified no variables as consistent predictors of resident success.

Conclusion
In a program designed to train academic obstetrician-gynecologists, objective data from medical students' applications did not correlate with successful resident performance in our obstetrics-gynecology residency program. We need to continue our search for evaluation criteria that can accurately and reliably select the medical students that are best fit for our specialty.
Acute Coronary Syndrome and Cardiac Arrest: Using Simulation to Assess Resident Performance and Program Outcomes
Authors: Opar Susan P. , Short Matthew W. , Jorgensen Jennifer E. , Blankenship Robert B. , Roth Bernard J. 
Published: July 2013

Abstract

Background
Simulation training has emerged as an effective method of educating residents in cardiac emergencies. Few studies have used emergency simulation scenarios as an outcome measure to identify training deficiencies within residency programs.

Purpose
The purpose of this study was to evaluate postgraduate year-1 (PGY-1) residents on their ability to manage an acute coronary syndrome and cardiac arrest scenario before and after internship in order to provide outcome data to improve program performance.

Methods
A total of 58 PGY-1 residents from 10 medical specialties were evaluated using a human patient simulator before and after internship. They were given 12 minutes to manage a patient with acute coronary syndrome and ventricular fibrillation due to hyperkalemia. An objective checklist following basic and advanced cardiac life support guidelines was used to assess performance.

Results
A total of 58 interns (age, 25 to 44 years [mean, 29.1]; 38 [65.6%] men; 41 [70.7%] allopathic medical school graduates) participated in both the incoming and outgoing examination. Overall chest pain scores increased from a mean of 60.0% to 76.1% (P &lt; .01). Medical knowledge performance improved from 51.1% to 76.1% (P &lt; .01). Systems-based practice performance improved from 40.9% to 71.0% (P &lt; .01). However, patient care performance declined from 93.4% to 80.2% (P &lt; .01).

Conclusions
A simulated acute coronary syndrome and cardiac arrest scenario can evaluate incoming PGY-1 competency performance and test for interval improvement. This assessment tool can measure resident competency performance and evaluate program effectiveness.