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.

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.

A national cross-sectional survey of social networking practices of U.S. anesthesiology residency program directors

2012 ◽  
Vol 24 (8) ◽  
pp. 618-624 ◽  
Author(s):  
Andrew L. Barker ◽  
Hania Wehbe-Janek ◽  
Naumit S. Bhandari ◽  
Timothy M. Bittenbinder ◽  
ChanHee Jo ◽  
...  
Keyword(s):  
Social Networking ◽  
Residency Program ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Program Directors

scholarly journals Changing use of the emergency department by the elderly in the United Arab Emirates,1989 and 1999

2002 ◽  
Vol 8 (2-3) ◽  
pp. 409-415
Author(s):  
S. A. Margolis ◽  
R. L. Reed
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
United Arab Emirates ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Male Ratio ◽  
Al Ain ◽  
The Mean ◽  
Over Time

Changes in use by the elderly of the emergency department of a major hospital in Al-Ain in the years 1989 and 1999 were examined. All patients aged 65 years or older who attended the emergency room were included in this cross-sectional survey. Patient numbers rose from 321 in 1989 to 1347 in 1999 with no significant change in the female to male ratio of 0.78 or the mean age of the elderly attendees 72.9 +/- 7.4 years. Attendance rose 5.4 fold while non-urgent attendance rose 14.7 fold, demonstrating rising use but falling illness severity over time.

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.

scholarly journals Educating Emergency Medicine Residents in Emergency Department Administration and Operations: Needs and Current Practice

2014 ◽  
Vol 6 (4) ◽  
pp. 770-773 ◽  
Author(s):  
Taketo Watase ◽  
Lalena M. Yarris ◽  
Rongwei Fu ◽  
Daniel A. Handel
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Medical Education ◽  
Logistic Regression ◽  
Current Practice ◽  
Cross Sectional ◽  
Web Based ◽  
Residency Programs ◽  
Program Characteristics ◽  
Ed Operations

Abstract Background Emergency medicine (EM) residents are expected to develop competence in emergency department (ED) administration and operations. Objectives We assessed current needs and educational practices related to preparing EM residents for their role in ED operations, and explored whether there was an association between program characteristics and the presence of ED operations education in US EM residency programs. Methods We conducted a cross-sectional needs assessment, using a web-based survey sent to all US EM residency programs to assess program characteristics, provision of ED operations-related lectures, availability of an ED administrative fellowship, and presence of a formal ED operations curriculum. Logistic regression was used to determine if any program characteristics were associated with the presence of lectures and a formal operations curriculum. Results Of the 158 Accreditation Council for Graduate Medical Education–accredited EM programs, 117 (74%) responded. Of these, 109 (93%) respondents had at least 1 lecture on ED operational topics. Sixty programs (54%) measured resident productivity. Knowledge of Centers for Medicaid & Medicare Services reimbursement guidelines was significantly positively associated with presence of an ED operations curriculum (OR, 3.52, P  =  .009) and with lectures on patient satisfaction (OR, 3.99, P  =  .006). Measuring resident productivity was positively associated with having lectures on productivity (OR, 2.50, P  =  .02) and with ED throughput (OR, 2.32, P  =  .03). No 2 variables were simultaneously significant in the model. Conclusions Most EM programs had at least 1 lecture on ED operations topics. Roughly half of the programs measured resident productivity and half had a formal ED operations curriculum.

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.

A National Cross-Sectional Survey of Social Networking Practices of U.S. Anesthesiology Residency Program Directors

2013 ◽  
Vol 57 (3) ◽  
pp. 114
Author(s):  
Andrew L. Barker ◽  
Hania Wehbe-Janek ◽  
Naumit S. Bhandari ◽  
Timothy M. Bittenbinder ◽  
ChanHee Jo ◽  
...  
Keyword(s):  
Social Networking ◽  
Residency Program ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Program Directors

scholarly journals Preferences and Practices of U.S. Ophthalmology Residency Program Directors Regarding Post-interview Communication with Residency Applicants

2018 ◽  
Vol 10 (01) ◽  
pp. e43-e47 ◽  
Author(s):  
Allison Chen ◽  
Elaine Tran ◽  
Melissa Clark ◽  
Ingrid Scott ◽  
Paul Greenberg
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Residency Program ◽  
Response Rate ◽  
Program Directors ◽  
Web Based ◽  
Residency Programs ◽  
Graduate Medical ◽  
Residency Program Directors ◽  
Residency Match

Importance Little is known about the perspectives and practices of U.S. ophthalmology residency program directors (PDs) regarding communication between PDs and applicants during the post-interview residency match period. Objective To investigate the preferences and practices of ophthalmology residency PDs regarding post-interview communication between PDs and residency applicants during the residency match period. Design and Setting Web-based anonymous survey. Participants Directors of ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education. Results The response rate was 64% (74/116). The majority (75%; 55/73) of PDs preferred that PDs and residency applicants not communicate during the post-interview period; the main reasons were that such communication was not ethical and not productive. In addition, 62% (46/74) of PDs believed that the Ophthalmology Matching Program should institute a policy of no post-interview communication between applicants and faculty during the residency match period. Conclusion and Relevance The majority of U.S. ophthalmology residency PDs favor instituting a policy of no post-interview communication between applicants and faculty during the residency match period.

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.

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