Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: systematic review

Abstract Objective China is home to one-fifth of the world's population. In the setting of a growing and aging population as well as the designation of palliative care access as a human right in 2013, the implementation of palliative care in China gains special importance. Palliative care education is an important precondition to ensure a nationwide access to palliative care. This systematic review details the status of under- and postgraduate palliative care education in China, examining both the students’ and physicians’ perception, knowledge, and skills in palliative care, and the available educational interventions and programs. Method Four databases were searched in September 2018, using considered search terms. Titles, abstracts, and, if necessary, full texts were scanned to identify publications matching the inclusion criteria. Results Nine publications were included. They revealed six findings: palliative care education is lacking in both under- and postgraduate medical education, only a few programs exist. Palliative care as a concept is well known, detailed knowledge, and practical skills are less developed. Chinese physicians consider palliative care an important field to be developed in cancer care, yet the majority of healthcare professionals are not willing to work in palliative care services. Communication should be a main emphasis in palliative care education, especially in undergraduate training. Finally, there is no highly qualified research on under- or postgraduate palliative care education in Mainland China. Significance of results These findings suggest that palliative care education in China is in demand and should be systematically integrated into medical education. Further research on the topic is urgently needed.

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Are residents learners or workers? A historical perspective in Japan

The Asia Pacific Scholar ◽

10.29060/taps.2021-6-1/pv2339 ◽

2021 ◽

Vol 6 (1) ◽

pp. 122-124

Author(s):

Hirohisa Fujikawa ◽

Daisuke Son ◽

Masato Eto

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Postgraduate Medical Education ◽

Working Hours ◽

The United States ◽

Accreditation Council ◽

Graduate Medical ◽

Resident Wellness ◽

Aged Society ◽

Near Future

Many countries enforce limits on the number of hours that medical residents work. For example, in the United States, regulations about duty hours were instituted by the Accreditation Council of Graduate Medical Education as early as in 2003, reinforcing those limits in 2011 and again in 2017 (Accreditation Council for Graduate Medical Education, 2017). These reforms triggered discussion in medical education literature about their wide-ranging effects on resident education, resident wellness, and patient care (Bolster & Rourke, 2015). In Japan, restrictions on working hours will be implemented for physicians in April 2024 (Shibuya & Unno, 2019). Because of its rapidly shifting demographics to being a super-aged society with a low birth rate, Japan is now facing issues with residents’ learning and working that other countries will need to confront in the near future as their populations shift as well (as of late 2020). Here we report on the history and current situation of postgraduate medical education in Japan, which are highly relevant to re-evaluating postgraduate training in other countries.

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The journal club in postgraduate medical education: A systematic review

Medical Teacher ◽

10.3109/01421590109177943 ◽

2001 ◽

Vol 23 (5) ◽

pp. 455-461 ◽

Cited By ~ 23

Author(s):

Jon Ebbert ◽

Victor Montori ◽

Henry Schultz

Keyword(s):

Systematic Review ◽

Medical Education ◽

Journal Club ◽

Postgraduate Medical Education

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Training medical students and residents in the use of electronic health records: a systematic review of the literature

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocz178 ◽

2019 ◽

Vol 27 (1) ◽

pp. 175-180 ◽

Cited By ~ 7

Author(s):

Akshay Rajaram ◽

Zachary Hickey ◽

Nimesh Patel ◽

Joseph Newbigging ◽

Brent Wolfrom

Keyword(s):

Systematic Review ◽

Medical Education ◽

Medical Students ◽

Electronic Health Records ◽

Postgraduate Medical Education ◽

Health Improvement ◽

Review Of The Literature ◽

High Quality ◽

Health Records ◽

Electronic Health

Abstract Objective Our objectives were to identify educational interventions designed to equip medical students or residents with knowledge or skills related to various uses of electronic health records (EHRs), summarize and synthesize the results of formal evaluations of these initiatives, and compare the aims of these initiatives with the prescribed EHR-specific competencies for undergraduate and postgraduate medical education. Materials and Methods We conducted a systematic review of the literature following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines. We searched for English-language, peer-reviewed studies across 6 databases using a combination of Medical Subject Headings and keywords. We summarized the quantitative and qualitative results of included studies and rated studies according to the Best Evidence in Medical Education system. Results Our search yielded 619 citations, of which 11 studies were included. Seven studies involved medical students, 3 studies involved residents, and 1 study involved both groups. All interventions used a practical component involving entering information into a simulated or prototypical EHR. None of the interventions involved extracting, aggregating, or visualizing clinical data for panels of patients or specific populations. Discussion This review reveals few high-quality initiatives focused on training learners to engage with EHRs for both individual patient care and population health improvement. In comparing these interventions with the broad set of electronic records competencies expected of matriculating physicians, critical gaps in undergraduate and postgraduate medical education remain. Conclusions With the increasing adoption of EHRs and rise of competency-based medical education, educators should address the gaps in the training of future physicians to better prepare them to provide high quality care for their patients and communities.

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Addressing the physician burnout epidemic with resilience curricula in medical education: a systematic review

BMC Medical Education ◽

10.1186/s12909-021-02495-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chanhee Seo ◽

Mario Corrado ◽

Karine Fournier ◽

Tayler Bailey ◽

Kay-Anne Haykal

Keyword(s):

Systematic Review ◽

Medical Education ◽

Postgraduate Medical Education ◽

Training Model ◽

Risk Of Bias ◽

Significant Heterogeneity ◽

Modest Improvement ◽

Resilience Training ◽

Comprehensive Search ◽

Meta Analyses

Abstract Background A variety of stressors throughout medical education have contributed to a burnout epidemic at both the undergraduate medical education (UGME) and postgraduate medical education (PGME) levels. In response, UGME and PGME programs have recently begun to explore resilience-based interventions. As these interventions are in their infancy, little is known about their efficacy in promoting trainee resilience. This systematic review aims to synthesize the available research evidence on the efficacy of resilience curricula in UGME and PGME. Methods We performed a comprehensive search of the literature using MEDLINE, EMBASE, PsycINFO, Educational Resources Information Centre (ERIC), and Education Source from their inception to June 2020. Studies reporting the effect of resilience curricula in UGME and PGME settings were included. A qualitative analysis of the available studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I Tool. Results Twenty-one studies met the inclusion criteria. Thirteen were single-arm studies, 6 quasi-experiments, and 2 RCTs. Thirty-eight percent (8/21; n = 598) were implemented in UGME, while 62 % (13/21, n = 778) were in PGME. There was significant heterogeneity in the duration, delivery, and curricular topics and only two studies implemented the same training model. Similarly, there was considerable variation in curricula outcome measures, with the majority reporting modest improvement in resilience, while three studies reported worsening of resilience upon completion of training. Overall assessment of risk of bias was moderate and only few curricula were previously validated by other research groups. Conclusions Findings suggest that resilience curricula may be of benefit to medical trainees. Resilience training is an emerging area of medical education that merits further investigation. Additional research is needed to construct optimal methods to foster resilience in medical education.

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Guidance for providing effective feedback in clinical supervision in postgraduate medical education: a systematic review

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139566 ◽

2021 ◽

pp. postgradmedj-2020-139566

Author(s):

Jessica Weallans ◽

Caroline Roberts ◽

Sarah Hamilton ◽

Stephen Parker

Keyword(s):

Systematic Review ◽

Medical Education ◽

Clinical Supervision ◽

Qualitative Content Analysis ◽

Postgraduate Medical Education ◽

Empirical Studies ◽

Composite Model ◽

Inclusion Criteria ◽

Effective Feedback ◽

The Common

The primary aim was to systematically review the empirical evidence relating to models and guidance for providing effective feedback in clinical supervision occurring in postgraduate medical education contexts. A secondary aim was to identify the common and differentiating components of models and guidance for providing effective feedback in this context. A systematic review was conducted. Fifty-one records met the inclusion criteria, including 12 empirical studies. Empirical records meeting inclusion criteria were critically appraised. Qualitative content analysis was applied to the guidance on effective and ineffective feedback provision to identify key principles. A composite model was created synthesising the guidance identified for providing effective feedback. The evidence supporting specific models and guidance in postgraduate medical education was limited. However, there is evidence to support all of the commonly identified principles. In addition, a consensus about the principles of effective feedback in clinical supervision in postgraduate medical education was found.

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