scholarly journals Family practice graduate medical education and hospitalsʼ patient care costs in New Jersey

1994 ◽  
Vol 69 (9) ◽  
pp. 747-53 ◽  
Author(s):  
A F Tallia ◽  
D E Swee ◽  
R O Winter ◽  
L K Lichtig ◽  
F M Knabe ◽  
...  
Keyword(s):  
Medical Education ◽  
New Jersey ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Family Practice ◽  
Graduate Medical ◽  
Care Costs

scholarly journals Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

2009 ◽  
Vol 1 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Susan G. Mautone
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Near Misses ◽  
Scheduling System ◽  
Duty Hours ◽  
Graduate Medical ◽  
Vehicle Accidents

Abstract Background Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Methods Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Results Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour “nap” break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P  =  .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Conclusions Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new “normal” for our program.

scholarly journals Educational Experiences Residents Perceive As Most Helpful for the Acquisition of the ACGME Competencies

2012 ◽  
Vol 4 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Lourdes R. Guerrero ◽  
Susan Baillie ◽  
Paul Wimmers ◽  
Neil Parker
Keyword(s):  
Medical Education ◽  
Los Angeles ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Role Models ◽  
Monitoring And Evaluation ◽  
Learning Activities ◽  
Web Based ◽  
Residency Programs ◽  
Graduate Medical

Abstract Background The Accreditation Council for Graduate Medical Education (ACGME) requires physicians in training to be educated in 6 competencies considered important for independent medical practice. There is little information about the experiences that residents feel contribute most to the acquisition of the competencies. Objective To understand how residents perceive their learning of the ACGME competencies and to determine which educational activities were most helpful in acquiring these competencies. Method A web-based survey created by the graduate medical education office for institutional program monitoring and evaluation was sent to all residents in ACGME-accredited programs at the David Geffen School of Medicine, University of California-Los Angeles, from 2007 to 2010. Residents responded to questions about the adequacy of their learning for each of the 6 competencies and which learning activities were most helpful in competency acquisition. Results We analyzed 1378 responses collected from postgraduate year-1 (PGY-1) to PGY-3 residents in 12 different residency programs, surveyed between 2007 and 2010. The overall response rate varied by year (66%–82%). Most residents (80%–97%) stated that their learning of the 6 ACGME competencies was “adequate.” Patient care activities and observation of attending physicians and peers were listed as the 2 most helpful learning activities for acquiring the 6 competencies. Conclusion Our findings reinforce the importance of learning from role models during patient care activities and the heterogeneity of learning activities needed for acquiring all 6 competencies.

scholarly journals Responsiveness to societal needs in postgraduate medical education: the role of accreditation

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Ingrid Philibert ◽  
Danielle Blouin
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Postgraduate Medical Education ◽  
Social Accountability ◽  
Working Environment ◽  
World Health ◽  
Physician Workforce ◽  
Social Responsiveness ◽  
Graduate Medical

Abstract Background Social accountability in medical education has been defined as an obligation to direct education, research, and service activities toward the most important health concerns of communities, regions, and nations. Drawing from the results of a summit of international experts on postgraduate medical education and accreditation, we highlight the importance of local contexts in meeting societal aims and present different approaches to ensuring societal input into medical education systems around the globe. Main text We describe four priorities for social responsiveness that postgraduate medical education needs to address in local and regional contexts: (1) optimizing the size, specialty mix, and geographic distribution of the physician workforce; (2) ensuring graduates’ competence in meeting societal goals for health care, population health, and sustainability; (3) promoting a diverse physician workforce and equitable access to graduate medical education; and (4) ensuring a safe and supportive learning environment that promotes the professional development of physicians along with safe and effective patient care in settings where trainees participate in care. We relate these priorities to the values proposed by the World Health Organization for social accountability: relevance, quality, cost-effectiveness, and equity; discuss accreditation as a lever for change; and describe existing and evolving efforts to make postgraduate medical education socially responsive. Conclusion Achieving social responsiveness in a competency-based postgraduate medical education system requires accrediting organizations to ensure that learning emphasizes relevant competencies in postgraduate curricula and educational experiences, and that graduates possess desired attributes. At the same time, institutions sponsoring graduate medical education need to provide safe and effective patient care, along with a supportive learning and working environment.

scholarly journals Remediation in the Context of the Competencies: A Survey of Pediatrics Residency Program Directors

2013 ◽  
Vol 5 (1) ◽  
pp. 60-63 ◽  
Author(s):  
Meredith P. Riebschleger ◽  
Hilary M. Haftel
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Residency Program ◽  
Online Survey ◽  
Medical Knowledge ◽  
Program Directors ◽  
Graduate Medical ◽  
Competency Based ◽  
Residency Program Directors

Abstract Background The 6 competencies defined by the Accreditation Council for Graduate Medical Education provide the framework of assessment for trainees in the US graduate medical education system, but few studies have investigated their impact on remediation. Methods We obtained data via an anonymous online survey of pediatrics residency program directors. For the purposes of the survey, remediation was defined as “any form of additional training, supervision, or assistance above that required for a typical resident.” Respondents were asked to quantify 3 groups of residents: (1) residents requiring remediation; (2) residents whose training was extended for remediation purposes; and (3) residents whose training was terminated owing to issues related to remediation. For each group, the proportion of residents with deficiencies in each of the 6 competencies was calculated. Results In all 3 groups, deficiencies in medical knowledge and patient care were most common; deficiencies in professionalism and communication were moderately common; and deficiencies in systems-based practice and practice-based learning and improvement were least common. Residents whose training was terminated were more likely to have deficiencies in multiple competencies. Conclusion Although medical knowledge and patient care are reported most frequently, deficiencies in any of the 6 competencies can lead to the need for remediation in pediatrics residents. Residents who are terminated are more likely to have deficits in multiple competencies. It will be critical to develop and refine tools to measure achievement in all 6 competencies as the graduate medical education community may be moving further toward individualized training schedules and competency-based, rather than time-based, training.

Responsibility for Patient Care in Graduate Medical Education

2015 ◽  
Vol 169 (11) ◽  
pp. 987 ◽  
Author(s):  
Katie A. Greenzang ◽  
Jennifer C. Kesselheim
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Graduate Medical
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