Development and Implementation of a Solid Tumor Oncologic Emergency Lecture for Internal Medicine and Emergency Medicine Residency Programs

Abstract Background The competency of professionalism encompasses a range of behaviors in multiple domains. Residency programs are struggling to integrate and effectively assess professionalism. We report results from a survey assessing residents’ perceptions of their professional competence and the professionalism of their learning environment. Methods A survey was developed to assess specific behaviors reflecting professionalism based on the conceptualizations of key accrediting bodies. Residents rated their ability to perform the behaviors and reported the frequency with which they observed their fellow residents failing to perform the behaviors. Eighty-five senior residents in emergency medicine, internal medicine, pediatrics, psychiatry, and surgery specialties completed the survey (response rate = 77%). Differences among domains (and among items within domains) were assessed. Correlations between perceived professionalism and the professionalism of the learning environment were described. Results Cronbach alpha for professionalism competence was .93 and for professionalism in the learning environment it was .86. Residents reported feeling most competent in being accountable (mean score = 51.4%; F = 10.3, p<.001) and in demonstrating respect. Some residents reported having trouble being sensitive to patients (n = 5 to 23). Disrespectful behaviors were the most frequently witnessed professionalism lapse in the learning environment (mean = 41.1%; F = 8.1, p<.001). While serious lapses in professionalism were not witnessed with great frequency in the learning environment, instances of over-representing qualifications were reported. Problems in accountability in the learning environment were negatively associated with residents’ perceived competence. Conclusions Residents reported being able to perform professionally most of the time, especially in terms of accountability and respect. However, disrespect was a feature of the learning environment for many residents and several serious lapses were witnessed by a small number of residents. Accountability in the learning environment may be an important indicator of or influence on residents’ professionalism.

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Ophthalmology training and competency levels in caring for patients with ophthalmic complaints among United States internal medicine, emergency medicine, and family medicine residents

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2019.16.25 ◽

2019 ◽

Vol 16 ◽

pp. 25 ◽

Cited By ~ 1

Author(s):

Christopher Daniel Gelston ◽

Jennifer Landrigan Patnaik

Keyword(s):

Internal Medicine ◽

United States ◽

Emergency Medicine ◽

Family Medicine ◽

Educational Training ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Residency Programs ◽

Confidence Levels ◽

Family Medicine Residents

Purpose: To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.Methods: A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”Results: In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.Conclusion: Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.

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Nasce uma nova especialidade : osteopatia

Fisioterapia Brasil ◽

10.33233/fb.v2i3.635 ◽

2016 ◽

Vol 2 (3) ◽

Author(s):

Marco Antônio Guimarães Da Silva

Keyword(s):

Internal Medicine ◽

Emergency Medicine ◽

Preventive Medicine ◽

Rio De Janeiro ◽

Obstetrics And Gynecology ◽

Physical Medicine ◽

National Board ◽

Physical Medicine And Rehabilitation ◽

Allergy And Immunology ◽

Medical Examiners

Por circunstâncias relacionadas à minha titulação, acabei designado pela Universidade Castelo Branco do Rio de Janeiro (UCB) para avaliar uma parceria proposta pela Escola de Osteopatia de Madri (EOM). À época, em 1997, a EOM propunha que a UCB passasse a organizar academicamente os cursos de osteopatia que a referida Escola já vinha ministrando no Brasil, com vistas a, no futuro, torná-lo um curso de pós-graduação. Algumas viagens à Madri para observar a estrutura acadêmica e pedagógica da sede da EOM, condição imposta pela UCB para concretizar a parceria, me levaram a conhecer esta modalidade terapêutica, com resultados efetivamente comprovados através de trabalhos científicos.Realizadas as adaptações que se faziam necessárias, a UCB aprovou, em 2000, o curso de osteopatia, com uma carga horária de 1050 horas para a titulação de especialização acadêmica, nível Lato Sensu. A resolução do COFITO, que estabelece a osteopatia como uma especialidade da fisioterapia, levou-nos a propor ao CEPE da UCB uma complementação de 450 horas, alcançando, assim, as 1.500 horas, distribuídas ao longo de cinco anos, exigidas pela referida resolução do COFITO. A introdução desta técnica terapêutica no Brasil pela corrente Européia e a pronta intervenção do COFITO foram fatores decisivos para nos brindar com mais uma especialidade. Houvera sido a Osteopatia implantada no Brasil por influência da escola americana, talvez os rumos tomados fossem outros. Senão, vejamos. Nos EUA, a osteopatia é normalmente exercida pelo médico, que deve obter sua permissão através do National Board of Osteopatic Medical Examiners, e está dividida em Sociedades Osteopáticas que se distribuem por todas as modalidades médicas; a saber: Allergy and Immunology, Anesthesiology, Dermatology ,Emergency Medicine, Internal Medicine, Neurologists and Psychiatrists, Obstetrics and Gynecology, Occupational and Preventive Medicine, Ophthalmology and Otolaryngology, Orthopedics Pathology, Pediatrics Proctology, Radiology, Physical Medicine and Rehabilitation, Rheumatology Sports Surgery Medicine.Com o objetivo de incentivar as linhas de pesquisas na área da osteopatia, estará sendo criado, durante as III Jornadas Hispano-Lusas de Fisioterapia em Terapia Manual (Sevilha-Espanha, 5 de outubro de 2001), o Centro Internacional de Pesquisas em Osteopatia. O referido Centro, dirigido por um fisioterapeuta brasileiro com Doutorado, terá sua sede na Espanha e manterá núcleos, vinculados a Universidades, na Argentina, no Brasil, na Itália, em Portugal e na Venezuela. Esperamos, desta forma, ao lado do reconhecimento profissional já oferecido pela resolução COFITO, dar mais um passo na consolidação acadêmica da nossa mais nova modalidade terapêutica.

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52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2813 ◽

2007 ◽

Vol 30 (4) ◽

pp. 56

Author(s):

I. Rigby ◽

I. Walker ◽

T. Donnon ◽

D. Howes ◽

J. Lord

Keyword(s):

Internal Medicine ◽

Emergency Medicine ◽

Medical Education ◽

Family Medicine ◽

Training Program ◽

Correlation Coefficient ◽

Training Programs ◽

Self Assessment ◽

Procedural Skills ◽

Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

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Oncologic Emergency Medicine

10.1007/978-3-030-67123-5 ◽

2021 ◽

Keyword(s):

Emergency Medicine ◽

Oncologic Emergency

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A Descriptive Analysis of the Use of Twitter by Emergency Medicine Residency Programs

Journal of Graduate Medical Education ◽

10.4300/jgme-d-16-00716.1 ◽

2018 ◽

Vol 10 (1) ◽

pp. 51-55 ◽

Cited By ~ 5

Author(s):

David Diller ◽

Lalena M. Yarris

Keyword(s):

Emergency Medicine ◽

Medical Education ◽

Descriptive Analysis ◽

Descriptive Statistics ◽

Mixed Methods Study ◽

Instructional Tool ◽

Residency Programs ◽

The Public ◽

Twitter Account ◽

E Mail

ABSTRACT Background Twitter is increasingly recognized as an instructional tool by the emergency medicine (EM) community. In 2012, the Council of Residency Directors in Emergency Medicine (CORD) recommended that EM residency programs' Twitter accounts be managed solely by faculty. To date, little has been published regarding the patterns of Twitter use by EM residency programs. Objective We analyzed current patterns in Twitter use among EM residency programs with accounts and assessed conformance with CORD recommendations. Methods In this mixed methods study, a 6-question, anonymous survey was distributed via e-mail using SurveyMonkey. In addition, a Twitter-based search was conducted, and the public profiles of EM residency programs' Twitter accounts were analyzed. We calculated descriptive statistics and performed a qualitative analysis on the data. Results Of 168 Accreditation Council for Graduate Medical Education–accredited EM programs, 88 programs (52%) responded. Of those programs, 58% (51 of 88) reported having a program-level Twitter account. Residents served as content managers for those accounts in the majority of survey respondents (61%, 28 of 46). Most programs did not publicly disclose the identity or position of their Twitter content manager. We found a wide variety of applications for Twitter, with EM programs most frequently using Twitter for educational and promotional purposes. There is significant variability in the numbers of followers for EM programs' Twitter accounts. Conclusions Applications and usage among EM residency programs are varied, and are frequently not consistent with current CORD recommendations.

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Impact of Pharmaceutical Company Representatives on Internal Medicine Residency Programs

Archives of Internal Medicine ◽

10.1001/archinte.1992.00400170093018 ◽

1992 ◽

Vol 152 (5) ◽

pp. 1009 ◽

Cited By ~ 32

Author(s):

Peter R. Lichstein

Keyword(s):

Internal Medicine ◽

Pharmaceutical Company ◽

Internal Medicine Residency ◽

Residency Programs

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What gets resident physicians stressed and how would they prefer to be supported? A best–worst scaling study

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140719 ◽

2021 ◽

pp. postgradmedj-2021-140719

Author(s):

Andrew Wu ◽

Ritika S Parris ◽

Timothy M Scarella ◽

Carrie D Tibbles ◽

John Torous ◽

...

Keyword(s):

Internal Medicine ◽

Emergency Medicine ◽

Peer Support ◽

Well Being ◽

Specific Information ◽

Choice Modelling ◽

Work Stressors ◽

Cross Sectional ◽

Academic Medical Centre ◽

Best Worst Scaling

IntroductionPhysician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors and implement effective burnout interventions on an institutional level. Assessing resident preferences by specialty for common wellness interventions could also contribute to improved efficacy.MethodsThis cross-sectional study used best–worst scaling (BWS), a type of discrete choice modelling, to explore how 267 residents across nine specialties (anaesthesiology, emergency medicine, internal medicine, neurology, obstetrics and gynaecology, pathology, psychiatry, radiology and surgery) prioritised 16 work-stressors and 4 wellness interventions at a large academic medical centre during the COVID-19 pandemic (December 2020).ResultsTop-ranked stressors were work-life integration and electronic health record documentation. Therapy (63%, selected as ‘would realistically consider intervention’) and coaching (58%) were the most preferred wellness supports in comparison to group-based peer support (20%) and individual peer support (22%). Pathology, psychiatry and OBGYN specialties were most willing to consider all intervention options, with emergency medicine and internal medicine specialties least willing to consider intervention options.ConclusionBWS can identify relative differences in surveyed stressors, allowing for the generation of specialty-specific stressor rankings and preferences for specific wellness interventions that can be used to drive institution-wide changes to improve clinician wellness. BWS surveys are a potential methodology for clinician wellness programmes to gather specific information on preferences to determine best practices for resident wellness.

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