scholarly journals Novel Changes in Resident Education during a Pandemic: Strategies and Approaches to Maximize Residency Education and Safety

2020 ◽  
Vol 24 (03) ◽  
pp. e267-e271
Author(s):  
Jared Johnson ◽  
Michael T. Chung ◽  
Michael A. Carron ◽  
Eleanor Y. Chan ◽  
Ho-Sheng Lin ◽  
...  

Abstract Introduction The COVID-19 pandemic has led to a reduction in surgical and clinical volume, which has altered the traditional training experience of the otolaryngology resident. Objective To describe the strategies we utilized to maximize resident education as well as ensure patient and staff safety during the pandemic. Methods We developed a system that emphasized three key elements. First and foremost, patient care remained the core priority. Next, clinical duties were restructured to avoid unnecessary exposure of residents. The third component was ensuring continuation of resident education and maximizing learning experiences. Results To implement these key elements, our residency divided up our five hospitals into three functional groups based on geographical location and clinical volume. Each team works for three days at their assigned location before being replaced by the next three-person team at our two busiest sites. Resident teams are kept completely separate from each other, so that they do not interact with those working at other sites. Conclusions Despite the daily challenges encountered as we navigate through the COVID-19 pandemic, our otolaryngology residency program has been able to establish a suitable balance between maintenance of resident safety and well-being without compromise to patient care.

2009 ◽  
Vol 1 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Peter J. Carek ◽  
Joseph W. Gravel ◽  
Stanley Kozakowski ◽  
Perry A. Pugno ◽  
Gerald Fetter ◽  
...  

Abstract Purpose To examine the opinions of family medicine residency program directors concerning the potential impact of the Institute of Medicine (IOM) resident duty hour recommendations on patient care and resident education. Methods A survey was mailed to 455 family medicine residency program directors. Data were summarized and analyzed using Epi Info statistical software. Significance was set at the P < .01 level. Results A total of 265 surveys were completed (60.9% response rate). A majority of family medicine residency program directors disagreed or strongly disagreed that the recent IOM duty hour recommendations will, in general, result in improved patient safety and resident education. Further, a majority of respondents disagreed or strongly disagreed that the proposed IOM rules would result in residents becoming more compassionate, more effective family physicians. Conclusion A majority of family medicine residency program directors believe that the proposed IOM duty hour recommendations would have a primarily detrimental effect on both patient care and resident education.


Author(s):  
Teresa Gilewski

Optimal care of patients involves the integration of both the scientific and humanistic aspects of medicine. However, the tremendous focus on technology can easily overshadow the personal effect of patient care. The complex relationship between the physician and the patient is a reciprocal one. Not only does the physician influence the experience of the patient, but the patient may leave a significant impression on the physician. Their interactions provide a myriad of opportunities for greater insight into the human condition, but may also contribute toward the struggle of physicians to maintain their own well-being. Enhanced awareness of the significance of these human interactions is at the core of caring for patients.


Author(s):  
Franco V. Trivigno

In Sophocles’s Oedipus at Colonus, the third choral ode presents a dark and pessimistic view of human life, whereby it is best never to have been born and second best to die young. This chapter provides a detailed analysis of the pessimistic position advocated by the chorus, the core of which is an endorsement of the goodness of death. Their conclusion rests on two premises: a quantitative account of the amount of pain a typical human life contains and a narrative account of the life trajectory of a typical human life. After laying out the chorus’s position, the chapter assesses their view and situates it within recent philosophical debates in two areas: on the nature and value of death and on the relationship between well-being and time. In the end, the life of Oedipus, as presented in the tragedy, exemplifies the chorus’s dark perspective.


2015 ◽  
Vol 7 (3) ◽  
pp. 349-363 ◽  
Author(s):  
Lauren Bolster ◽  
Liam Rourke

ABSTRACT Background Despite 25 years of implementation and a sizable amount of research, the impact of resident duty hour restrictions on patients and residents still is unclear. Advocates interpret the research as necessitating immediate change; opponents draw competing conclusions. Objective This study updates a systematic review of the literature on duty hour restrictions conducted 1 year prior to the implementation of the Accreditation Council for Graduate Medical Education's 2011 regulations. Methods The review draws on reports catalogued in MEDLINE and PreMEDLINE from 2010 to 2013. Interventions that dealt with the duty hour restrictions included night float, shortened shifts, and protected time for sleep. Outcomes were patient care, resident well-being, and resident education. Studies were excluded if they were not conducted in patient care settings. Results Twenty-seven studies met the inclusion criteria. Most frequently, the studies concluded that the restrictions had no impact on patient care (50%) or resident wellness (47%), and had a negative impact on resident education (64%). Night float was the most frequent means of implementing duty hour restrictions, yet it yielded the highest proportion of unfavorable findings. Conclusions This updated review, including 27 recent applicable studies, demonstrates that focusing on duty hours alone has not resulted in improvements in patient care or resident well-being. The added duty hour restrictions implemented in 2011 appear to have had an unintended negative impact on resident education. New approaches to the issue of physician fatigue and its relationship to patient care and resident education are needed.


2019 ◽  
Vol 11 (7) ◽  
pp. 2001 ◽  
Author(s):  
Elke Pirgmaier ◽  
Julia Steinberger

In this paper, we put forward a new research agenda for ecological economics, based on three realisations. We then show how these can be connected through research and used to generate insights with the potential for application in broader, systemic change. The first realisation is that the core ambition of ecological economics, that of addressing the scale of human environmental resource use and associated impacts, often remains an aspirational goal, rather than being applied within research. In understanding intertwined environmental and social challenges, systemic approaches (including system dynamics) should be revitalised to address the full scope of what is possible or desirable. The second realisation is that the focus on biophysical and economic quantification and methods has been at the expense of a comprehensive social understanding of environmental impacts and barriers to change—including the role of power, social class, geographical location, historical change, and achieving human well-being. For instance, by fetishising growth as the core problem, attention is diverted away from underlying social drivers—monetary gains as profits, rent, or interest fuelled by capitalist competition and, ultimately, unequal power relations. The third realisation is that ecological economics situates itself with respect to mainstream (neoclassical) economics, but simultaneously adopts some of its mandate and blind spots, even in its more progressive camps. Pragmatic attempts to adopt mainstream concepts and tools often comfort, rather than challenge, the reproduction of the very power relations that stand in the way of sustainability transitions. We consider these three realisations as impediments for developing ecological economics as an emancipatory critical research paradigm and political project. We will not focus on or detail the failings of ecological economics, but state what we believe they are and reformulate them as research priorities. By describing and bringing these three elements together, we are able to outline an ambitious research agenda for ecological economics, one capable of catalysing real social change.


2021 ◽  
Author(s):  
Mahanoor Raza ◽  
Arshalooz Jamila Rahman ◽  
Khadija Humayun ◽  
Shafeen Gulamani ◽  
Muneera Rasheed ◽  
...  

Abstract Background: Resident well-being leads to better patient care practices, but a systematic approach is needed to achieve the wellness agenda. The Theory of Change was used for developing an interventional model for wellness in our study, after identifying the causes of burnout and attrition in a pediatric residency program. Methods: This was a quality improvement project where residents were asked about their main stressors in an anonymous open-ended feedback form. Workload (n=63, 37.5%) was identified as the main source of dissatisfaction. A database of 43 residents who quit in the past ten years was examined to find 40.0% of residents left after the first year of training and the main cause was marriage and/or family concerns (28.9%). Then literature was reviewed to build a wellness intervention's framework. Finally, the Theory of Change was applied focusing on restructuring the residency core, accountability and communication, and stress management. The final theory of the change model included the assumptions that the program needed restructuring because of high attrition, low first pass exam rate, and decreased patient satisfaction. The goal was to increase resident wellness and performance, while keeping patient care at the core. Results: The short-term outcomes were drop in attrition rate from an average of 8.67% to 1.75%, decrease in FCPS exam attempt from 3.3 to almost 1, and an increase in patient satisfaction. Conclusion: Using the Theory of Change, it was possible to address residents’ concerns, increase their retention and improve patient satisfaction by reconstructing the wellness program.


2021 ◽  
pp. 000313482110249
Author(s):  
Steven Tohmasi ◽  
Ariana Naaseh ◽  
Sean Thompson ◽  
Brian R. Smith

Background Recent studies have revealed a high rate of burnout among general surgery (GS) residents. Efforts to design and implement interventions to mitigate fatigue in surgical trainees are critical. Our aim was to assess the educational and wellness impact of outpatient scribe utilization at an academic GS residency program. Methods Electronic surveys were sent to 38 GS residents and 15 faculties who used outpatient scribes for at least 12 months. Questions were scored on a 5-point Likert scale with answers of “Strongly agree” or “Agree” representing affirmative responses. Results Thirty residents and 14 faculty completed the survey, resulting in an 83% overall response rate. Twenty-eight (93%) residents and 12 (86%) faculty believed that scribes decrease the daily workload of trainees. Twenty-seven (90%) residents felt that scribes allow them more time to focus on patient care and improve the quality of their surgical education. Ninety-three percent of residents (n = 28) and faculty (n = 13) believed that scribes enhance resident well-being. Twenty-four (80%) residents reported that scribes help improve adherence to duty hour restrictions. Twenty-five (83%) residents believed that utilizing scribes is an effective fatigue mitigation strategy for surgical training programs. Conclusion Our findings demonstrate that the implementation of an outpatient scribe program at an academic GS residency program may enhance resident education and wellness.


2019 ◽  
Vol 7 (1) ◽  
pp. 9-20
Author(s):  
Inna Yeung

Choice of profession is a social phenomenon that every person has to face in life. Numerous studies convince us that not only the well-being of a person depends on the chosen work, but also his attitude to himself and life in general, therefore, the right and timely professional choice is very important. Research about factors of career self-determination of students of higher education institutions in Ukraine shows that self-determination is an important factor in the socialization of young person, and the factors that determine students' career choices become an actual problem of nowadays. The present study involved full-time and part-time students of Institute of Philology and Mass Communications of Open International University of Human Development "Ukraine" in order to examine the factors of career self-determination of students of higher education institutions (N=189). Diagnostic factors of career self-determination of students studying in the third and fourth year were carried out using the author's questionnaire. Processing of obtained data was carried out using the Excel 2010 program; factorial and comparative analysis were applied. Results of the study showed that initial stage of career self-determination falls down on the third and fourth studying year at the university, when an image of future career and career orientations begin to form. At the same time, the content of career self-determination in this period is contradictory and uncertain, therefore, the implementation of pedagogical support of this process among students is effective.


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