scholarly journals Craniomaxillofacial Trauma Experience in Otolaryngology Residency: A National Survey of Program Directors

2019 ◽  
Vol 12 (2) ◽  
pp. 134-140
Author(s):  
Melissa S. Oh ◽  
Anita B. Sethna ◽  
Oswaldo A. Henriquez
Keyword(s):  
Pediatric Trauma ◽  
Program Directors ◽  
The United States ◽  
Cross Sectional Survey ◽  
Case Volume ◽  
Cross Sectional ◽  
Residency Programs ◽  
Level 1 ◽  
Didactic Lecture ◽  
Lecture Time

This article aimed to assess the depth and volume of craniomaxillofacial (CMF) trauma exposure and education in otolaryngology residency training in the United States. This is a cross-sectional survey. A 15-question web-based survey was distributed to program directors of 106 Accreditation Council for Graduate Medical Education (ACGME)-approved otolaryngology residency programs to inquire about program size and demographics, trauma coverage, case volume, and education. Responses were collected anonymously. A total of 77 responses were received, representing 73% of residency programs. Seventy-five programs (97%) reported that their residents rotated at a level 1 trauma center, and 72 (94%) covered CMF trauma. Sixty-one programs (79%) included pediatric CMF trauma. The majority of programs (76%) allocated less than 10% of residency-dedicated didactic lecture time to CMF trauma. Residents in all programs typically logged at least 11 to 20 cases before graduation with 24% of programs averaging more than 50 cases per resident. Ninety percent of respondents described the training as “somewhat” to “very adequate.” CMF coverage by the otolaryngology department, number of cases, and dedicated didactic lecture time to CMF trauma were significant factors on the perception of adequate training. The majority of program directors felt that the training in CMF trauma was adequate. Reasons for this may include that most residents rotate at level 1 trauma centers, have exposure to pediatric trauma, encounter an adequate volume of cases, and have dedicated didactic time to CMF education.

The Role of the Away Rotation in Otolaryngology Residency

2017 ◽  
Vol 156 (6) ◽  
pp. 1104-1107 ◽  
Author(s):  
Jennifer A. Villwock ◽  
Chelsea S. Hamill ◽  
Jesse T. Ryan ◽  
Brian D. Nicholas
Keyword(s):  
Program Directors ◽  
P Value ◽  
Cross Sectional Survey ◽  
Case Volume ◽  
Cross Sectional ◽  
Web Based ◽  
Clinical Exposure ◽  
Residency Programs ◽  
Near Future

Objective To determine the availability and purpose of away rotations during otolaryngology residency. Study Design Cross-sectional survey. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors, of which 38 programs responded. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. A P value of <.05 was considered statistically significant. Results Thirty-nine percent (n = 38) of queried programs responded. Mandatory away rotations and elective away rotations were both present in 6 of 38 programs (16%). Neither number of faculty ( P = .119) nor residents ( P = .88) was predictive of away rotation. Away rotations were typically >151 miles from the home institution and typically used to address deficiencies in clinical exposure (67%) or case volume (50%). Participants of mandatory away rotations were universally provided housing, with other consideration such as stipend (33%), relocation allowance (33%), or food allowance (16%) sometimes offered. In contrast to mandatory rotations, half of elective rotations were to obtain a unique international mission trip experience. Nearly one-third of surveyed program directors (29%) would consider adding an away rotation to their curriculum in the next 3 years. Conclusions Mandatory and elective away rotations play a role in a small, but not insignificant, number of training programs. The rationale for these rotations is variable. Given that nearly one-third of program directors would consider adding an away rotation in the near future, further research into components of a meaningful away rotation and how to optimize the away rotation experience is warranted.

Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs

2020 ◽  
Vol 12 (02) ◽  
pp. e171-e174
Author(s):  
Donna H. Kim ◽  
Dongseok Choi ◽  
Thomas S. Hwang
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Emergency Room ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct Supervision ◽  
Residency Programs ◽  
Residency Program Directors ◽  
Competency Assessments

Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.

Extremes in Otolaryngology Resident Surgical Case Numbers: An Update

2017 ◽  
Vol 156 (6) ◽  
pp. 1060-1066 ◽  
Author(s):  
Tiffany P. Baugh ◽  
Christine B. Franzese
Keyword(s):  
National Database ◽  
Cross Sectional Survey ◽  
Case Volume ◽  
Cross Sectional ◽  
Residency Programs ◽  
Key Indicator ◽  
Resident Surgeon ◽  
The Mean ◽  
Minimum Numbers

Objectives The purpose of this study is to examine the effect of minimum case numbers on otolaryngology resident case log data and understand differences in minimum, mean, and maximum among certain procedures as a follow-up to a prior study. Study Design Cross-sectional survey using a national database. Setting Academic otolaryngology residency programs. Subjects and Methods Review of otolaryngology resident national data reports from the Accreditation Council for Graduate Medical Education (ACGME) resident case log system performed from 2004 to 2015. Minimum, mean, standard deviation, and maximum values for total number of supervisor and resident surgeon cases and for specific surgical procedures were compared. Results The mean total number of resident surgeon cases for residents graduating from 2011 to 2015 ranged from 1833.3 ± 484 in 2011 to 2072.3 ± 548 in 2014. The minimum total number of cases ranged from 826 in 2014 to 1004 in 2015. The maximum total number of cases increased from 3545 in 2011 to 4580 in 2015. Multiple key indicator procedures had less than the required minimum reported in 2015. Conclusion Despite the ACGME instituting required minimum numbers for key indicator procedures, residents have graduated without meeting these minimums. Furthermore, there continues to be large variations in the minimum, mean, and maximum numbers for many procedures. Variation among resident case numbers is likely multifactorial. Ensuring proper instruction on coding and case role as well as emphasizing frequent logging by residents will ensure programs have the most accurate data to evaluate their case volume.

scholarly journals Variation in Use of Damage Control Laparotomy for Trauma By Trauma Centers in the United States, Canada, and Australasia

2021 ◽  
Author(s):  
Derek J. Roberts ◽  
Peter D. Faris ◽  
Chad G. Ball ◽  
Andrew W. Kirkpatrick ◽  
Ernest E. Moore ◽  
...  
Keyword(s):  
United States ◽  
Damage Control ◽  
High Volume ◽  
The United States ◽  
Trauma Centers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frequency Of Use ◽  
Volume Level ◽  
Level 1

Abstract Background: It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy.Methods: A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy.Results: Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States=156 (78.4%), Canada=26 (13.1%), and Australasia=17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p=0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada=7.49; 95% confidence interval (CI)=1.39-40.27], level-1 verification status (OR=6.02; 95% CI=2.01-18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score >15) patients (OR per-100 patients=1.62; 95% CI=1.20-2.18) and patients with penetrating injuries (OR per-5% increase=1.27; 95% CI=1.01-1.58) in the last year.Conclusions: The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

scholarly journals Surgical Aptitude Testing among Ophthalmology Residency Applicants: Current Utilization and Residency Program Directors' Perspectives

2019 ◽  
Vol 11 (02) ◽  
pp. e10-e17
Author(s):  
Amy Lu ◽  
Samuel Beckstead ◽  
Michael Wilkinson ◽  
Ingrid U. Scott
Keyword(s):  
Program Directors ◽  
Application Process ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Aptitude Testing ◽  
Testing Strategies ◽  
Current Utilization ◽  
Residency Application ◽  
Residency Program Directors

Purpose To investigate the proportion of United States ophthalmology residency programs that utilize surgical aptitude testing during the applicant interview, and the perspectives of program directors (PDs) regarding surgical aptitude testing of applicants. Design This is a cross-sectional survey. Methods An anonymous survey constructed on REDCap was emailed to the PD of each ophthalmology residency accredited by the Accreditation Council for Graduate Medical Education. Main outcome measures are proportion of programs which include surgical aptitude testing during the applicant interview, and proportion of PDs who (1) believe the current residency application process adequately assesses applicants' surgical aptitude; (2) believe surgical aptitude testing results predict surgical success; and (3) favor inclusion of surgical aptitude testing for applicant evaluation. Results Of 115 PDs, 63 completed the survey (54.8%). One (1.6%) reported current use of surgical aptitude testing during the interview and 6 (9.5%) used such testing previously. Fifty-five (87.3%) respondents do not believe the residency application process adequately assesses surgical aptitude. Most respondents (40/63, 63.5%) do not support using results from currently available surgical aptitude testing strategies performed during the interview to rank applicants; 47 (74.6%) do not believe results of such testing predict ultimate surgical potential. However, 35 (55.6%) would use surgical aptitude data for applicant screening if valid testing could be performed before the interview. Conclusion While most PDs do not believe the current ophthalmology residency application process adequately assesses surgical aptitude, screening for surgical aptitude during the application process is seldom employed, largely due to a perceived lack of valid testing strategies available.

scholarly journals Teaching High-Value Care in Pediatrics: A National Survey of Current Practices and Guide for Future Curriculum Development

2017 ◽  
Vol 9 (6) ◽  
pp. 741-747 ◽  
Author(s):  
Michael J. Tchou ◽  
Alice Walz ◽  
Elizabeth Burgener ◽  
Alan Schroeder ◽  
Rebecca Blankenburg
Keyword(s):  
Medical Training ◽  
Health Care Expenditures ◽  
Program Directors ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Formal Curriculum ◽  
Residency Programs ◽  
Discussion Format ◽  
Case Based

ABSTRACT Background  Health care expenditures in the United States are increasing at an unsustainable pace. There have been calls to incorporate education on resource stewardship into medical training, yet the perceived need for and current use of high-value care (HVC) curricula in pediatrics residency programs is unknown. Objective  We described the current national landscape of HVC curricula in pediatrics residencies, including characterization of current programs, barriers to the practice of HVC, and clarification of preferred curricula types. Methods  Using a cross-sectional study design, we conducted a national, anonymous, web-based survey of pediatrics residency program directors and pediatrics chief residents in fall 2014. Results  We received responses from 85 of 199 (43%) pediatrics program directors and 74 of 199 (37%) pediatrics chief residents. Only 10% (8 of 80) of program directors and 12% (8 of 65) of chief residents reported having a formal curriculum on HVC. Respondents identified the largest barriers to HVC as a lack of cost transparency (program directors) and attending physicians having the final say in treatment decisions (chief residents). The majority of respondents (83%, 121 of 146) agreed their program needs a HVC curriculum, and 90% (131 of 145) reported they would use a curriculum if it was available. Respondents significantly preferred a case-based conference discussion format over other approaches. Conclusions  Most pediatrics residency programs responding to a survey lacked formal HVC curricula. There is a desire nationally for HVC education in pediatrics, particularly in a case-based discussion format.

Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors

2017 ◽  
Vol 156 (6) ◽  
pp. 1072-1077 ◽  
Author(s):  
Sarah M. Dermody ◽  
William Gao ◽  
Johnathan D. McGinn ◽  
Sonya Malekzadeh
Keyword(s):  
United States ◽  
Medical Education ◽  
National Survey ◽  
Program Directors ◽  
The United States ◽  
Cross Sectional ◽  
Residency Programs ◽  
Surgical Case ◽  
Anonymous Questionnaire ◽  
Case Logs

Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

scholarly journals COVID-19’s Impact on the 2020-2021 Resident Match: A Survey of Otolaryngology Program Directors

2020 ◽  
pp. 000348942096704
Author(s):  
David A. Kasle ◽  
Sina J. Torabi ◽  
Said Izreig ◽  
Rahmatullah W. Rahmati ◽  
R. Peter Manes
Keyword(s):  
Program Directors ◽  
Large Majority ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Research Involvement ◽  
Historical Importance ◽  
The Impact ◽  
Question Survey

Objective: To determine the impact coronavirus disease of 2019 (COVID-19) will have on the 2020-2021 otolaryngology (OTO-HNS) resident application cycle. Methods: A cross-sectional survey targeting OTO-HNS program directors (PD) was created and disseminated via email to PDs on May 28th 2020. Descriptive analyses of the 19-question survey was performed, and free text responses for certain suitable questions were thematically categorized into groups determined to be relevant during analysis. Results: Twenty-nine of 123 solicited PDs (23.6%) completed the survey. Nineteen (65.5%) respondents indicated they would not host away rotations (AR) in 2020, and 9 (31.0%) reported that they would consider away rotators without home programs. Regarding the historical importance of AR, 21 (72.4%) PDs stated they were either “extremely” or “very” important in evaluating candidates. Sixteen (55.2%) PDs stated that virtual interviews would impact their ability to properly gauge candidates and 12 (41.4%) were unsure. Eight PDs (27.6%) stated their evaluation of candidates will likely change, with a shift toward an increased reliance on letters of recommendation, research involvement, and clerkship grades. The large majority of PDs—25 (86.2%)—were not worried that the COVID-19 pandemic would affect the abilities of new interns beginning in 2021. Conclusion: Virtual interviews and engagement activities will mostly supplant sub-Is and AR for the 2020-2021 OTO-HNS application cycle. Surveyed PDs largely believe these will be insufficient in providing a comprehensive assessment of candidates, and will similarly limit applicants’ ability to gauge residency programs. Criteria utilized to evaluate students is expected to change.

scholarly journals Variation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Derek J. Roberts ◽  
Peter D. Faris ◽  
Chad G. Ball ◽  
Andrew W. Kirkpatrick ◽  
Ernest E. Moore ◽  
...  
Keyword(s):  
United States ◽  
Damage Control ◽  
High Volume ◽  
The United States ◽  
Trauma Centers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frequency Of Use ◽  
Volume Level ◽  
Level 1

Abstract Background It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy. Methods A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy. Results Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States = 156 (78.4%), Canada = 26 (13.1%), and Australasia = 17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p = 0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada = 7.49; 95% confidence interval (CI) 1.39–40.27], level-1 verification status (OR = 6.02; 95% CI 2.01–18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score > 15) patients (OR per-100 patients = 1.62; 95% CI 1.20–2.18) and patients with penetrating injuries (OR per-5% increase = 1.27; 95% CI 1.01–1.58) in the last year. Conclusions The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

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