scholarly journals Implementing a telemedicine curriculum for internal medicine residents during a pandemic: the Cleveland Clinic experience

2021 ◽  
pp. postgradmedj-2020-139228
Author(s):  
David J. Savage ◽  
Omar Gutierrez ◽  
Bryce Edward Montané ◽  
Achintya Dinesh Singh ◽  
Eric Yudelevich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cleveland Clinic ◽  
Training Programme ◽  
New Paradigm ◽  
Resource Guide ◽  
Internal Medicine Residents ◽  
Virtual Visits ◽  
The Usa ◽  
Residency Programme ◽  
And Training

Telemedicine training was not a substantial element of most residency programmes prior to the COVID-19 pandemic. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Programme (IMRP) is one of the largest programmes in the USA, which made the task of implementing a telemedicine curriculum more complex. Here we describe our experience implementing an effective, expedited telemedicine curriculum for our ambulatory resident clinics. This study was started in April 2020 when we implemented a resident-led curriculum and training programme for providing ambulatory telemedicine care. The curriculum was finalised in less than 5 weeks. It entailed introducing a formal training programme for residents, creating a resource guide for different video communication tools and training preceptors to safely supervise care in this new paradigm. Residents were surveyed before the curriculum to assess prior experience with telemedicine, and then afterward to assess the curriculum’s effectiveness. We also created a mini-CEX assessment for residents to solicit feedback on their performance during virtual appointments. Over 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality. Through collaboration with experienced residents and faculty, we expeditiously deployed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programmes to use.

scholarly journals Implementing a Telemedicine Curriculum for Internal Medicine Residents during a Pandemic: The Cleveland Clinic Experience

2020 ◽  
Author(s):  
David J. Savage ◽  
Omar Gutierrez ◽  
Bryce Montane ◽  
Achintya Dinesh Singh ◽  
Eric Yudelevich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Training Program ◽  
Evaluation System ◽  
Cleveland Clinic ◽  
The United States ◽  
Assessment Instrument ◽  
New Paradigm ◽  
Residency Programs ◽  
Virtual Visits ◽  
And Training

AbstractIntroductionTelemedicine is an important element of healthcare. However, until the COVID-19 pandemic, training in telemedicine was not a substantial element of most residency programs. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Program (IMRP) is one of the largest programs in the United States, which made the task of developing and adopting an effective, expedited telemedicine curriculum challenging. Our goal was to implement a system for teaching telemedicine care skills and supervising the care provided by residents during virtual visits.MethodsThis study was started in April 2020. We developed and implemented a resident-led curriculum and training program for providing telemedicine care in less than five weeks. This entailed creating a formal training program for residents, creating a resource guide for the different video communication tools, and training preceptors to safely supervise care in this new paradigm. We also created an assessment instrument in our education evaluation system that allows residents to receive feedback on their performance during virtual appointments.ResultsOver 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality.DiscussionThrough collaboration with experienced residents and faculty, we expeditiously developed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programs to utilize.

scholarly journals Why residents quit: Prevalence of and reasons for attrition among anaesthesia residents in a single sponsoring institution

2020 ◽  
Vol 29 (2) ◽  
pp. 94-103
Author(s):  
Daphne Moo ◽  
Wei Shyan Siow ◽  
Ee Teng Ong
Keyword(s):  
Residency Training ◽  
Postgraduate Training ◽  
Demographic Data ◽  
Training Programme ◽  
Full Time ◽  
Postgraduate Training Programme ◽  
Residency Programme ◽  
Individualized Training ◽  
The Individual ◽  
And Training

Background: The SingHealth Anaesthesiology Residency Programme (SHARP) is a 5-year postgraduate training programme in Singapore. Since its inauguration in 2011, SHARP has taken in the largest number of anaesthesia residents in Singapore. However, we noticed significant attrition over the years. As attrition is a costly and disruptive affair, both to the individual and the programme, we seek to investigate the prevalence of and reasons for separation, in order to determine ways to minimize attrition. Methods: An online anonymous survey was conducted among all residents who have separated from SHARP. The questionnaire comprised questions regarding demographic data, reasons behind separation, obstacles faced during residency, and potential ways to reduce attrition. Results: From 2011 to 2018, 22 out of 127 residents have separated from the programme, giving an overall attrition prevalence of 17%. Nineteen (86%) of the separated residents responded to our questionnaire. The most common reason for separation was due to difficulties in juggling childcare and training commitments. Of the residents who have separated, more than half of them would consider rejoining the programme if a less than full time (LTFT) option was available. Conclusion: One out of every six residents in the SHARP quits residency training. The reasons behind separation are often varied due to each resident’s unique social circumstances. An individualized training programme with a LTFT option that allows for flexibility may boost retention in the programme.

scholarly journals Reflection on and Exploration of a Standardized Resident Training Programme Based on a Comprehensive Examination of Clinical Skills

2018 ◽  
Vol 3 (2) ◽  
pp. 17
Author(s):  
Jing Yang ◽  
Chun-ting Lu ◽  
Dan Wang ◽  
Bi-yao Su ◽  
Si-min Huang
Keyword(s):  
Internal Medicine ◽  
Clinical Skills ◽  
Case Analysis ◽  
Skills Training ◽  
Training Programme ◽  
Resident Training ◽  
Entrance Examination ◽  
Training Plan ◽  
Clinical Scenarios ◽  
And Training

To identify the optimal clinical skills training programme for internal medicine residents by reflecting upon and analysing the usual training plan and arrangement, and practical tests according to the national standardized resident training policies and requirements. The 3-year-rotation and training plan of the 2013 and 2014 internal medicine resident cohorts, the basic skills and case analysis scores on the basic entrance examination and final graduation examination were reflected, summarized and compared with the ultimate purpose of evaluating standardized resident training. This knowledge was used to perfect a competency-oriented training system that integrated clinical theory, clinical scenarios, clinical skills, bedside teaching, learning, etc. After a 3-year programme of standardized training, the residents’ clinical skills were significantly improved. Statistically significant enhancements (P<0.05) were observed in the case analysis and clinical skills test scores between the basic entrance and graduation examinations of the trainees in both the 2013 and 2014 cohorts. No significant differences (P>0.05) were observed between the trainees in the 2013 and 2014 cohorts in their graduation scores on the clinical skills and case analysis tests, suggesting that both cohorts achieved the same level of mastery and reached the standardized training target, which also reflected the homogeneity of the residency training programme. While this study indicated that the training method was effective, exploring better models in the future is warranted. In conclusion, as a national policy, continuously incorporating reflection and exploration is necessary for designing a reasonable programme for standardized resident training. In this study, analysis of the basic entrance and graduation examinations of comprehensive clinical skills were important for developing an effective standardized resident training programme and training team with satisfactory teaching effects. By this way, implementing and starting new training methods gradually will be improved and especially carried out from 2015 cohorts. Therefore, the residents' clinical competence will be enhanced and also for undergraduates’ and postgraduates’ education as well. At last, the national education criteria for residency will be met.

scholarly journals Development of a curriculum and training program in Woman Veterans Health for Internal Medical Residents

2017 ◽  
Vol 55 (3) ◽  
pp. 167-173
Author(s):  
Manju Ceylony ◽  
Jahan Porhomayon ◽  
Leili Pourafkari ◽  
Nader D. Nader
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Reproductive Health ◽  
Women’S Health ◽  
Women's Health ◽  
Internal Medicine Residents ◽  
Post Test ◽  
Women’S Reproductive Health ◽  
Women's Reproductive Health ◽  
And Training

Abstract Introduction. Internal Medicine residents must develop competency as Primary Care Providers, but a gap exists in their curriculum and training with regard to women’s reproductive health. With increasing need in VA due to new influx of women veterans it poses problems in recruitment of competent physicians trained in Women’s health. Methods. An intensive, one-month women’s reproductive health curriculum with hands on experience for Internal Medicine residents was provided. Curriculum was taught to the residents who rotated at the Women’s Health Clinic for one month. Pre-test and post-test exams were administered. Increase in knowledge of residents in providing gender specific evaluations and management was objectively assessed by changes in post-test scores. Data were analyzed for statistically significant improvement in written tests scores. Results. Total of 47 Internal Medicine residents rotated through Women’s Health Center during the evaluation period. All residents completed both pre-test and post-test exams. The average time to complete the pre-test was 20.5 ± 5.4 min and 19.5 ± 4.8 min for post-test. There was no correlation between the time to complete the pre-test exam and the post-test exam. The total score was significantly improved from 8.5 ± 1.6 to 13.2 ± 1.8 (p < 0.0001). Conclusion. This study shows how to equip physicians in training with information on women’s health that enables them to provide safe and gender appropriate care in primary care settings. This practice will reduce the need for frequent referrals for specialized care and thus provide cost saving for patient and health care on the whole.

Teaching Dermatology to Internal Medicine Residents: Needs Assessment Survey and Possible Directions

2013 ◽  
Vol 17 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Aaron M. Drucker ◽  
Rodrigo B. Cavalcanti ◽  
Brian M. Wong ◽  
Scott R.A. Walsh
Keyword(s):  
Internal Medicine ◽  
Clinical Rotations ◽  
Electronic Survey ◽  
University Of Toronto ◽  
Survey Response Rate ◽  
Internal Medicine Residents ◽  
Assessment Survey ◽  
The University ◽  
Needs Assessment Survey ◽  
And Training

Background: Internal medicine trainees receive limited teaching and training in dermatology and may feel inadequately prepared to assess and manage patients with dermatologic complaints. No study to date has assessed the needs of internal medicine trainees in Canada with regard to dermatology teaching. Objective: To determine internal medicine residents' comfort in assessing and managing dermatologic issues and their educational needs in dermatology. Methods: An electronic survey was conducted of first-, second-, and third-year internal medicine residents at the University of Toronto. Results: Fifty-four of 186 internal medicine trainees responded to our survey (response rate = 29%). Each respondent did not answer every question. Residents were generally uncomfortable or very uncomfortable assessing and managing dermatologic issues in the emergency department (40 of 47, 85%), ward or intensive care unit (39 of 47, 83%), and ambulatory clinic (40 of 47, 85%). Residents thought that various clinical and didactic dermatology exposures would be useful to their training as internists. Case-based teaching and ambulatory clinical rotations were felt to be particularly valuable. Additionally, 38 of 46 (83%) respondents wanted to learn how to perform punch biopsies. Conclusions: An effort should be made to increase the availability of relevant dermatology teaching and clinical exposures for internal medicine residents.

scholarly journals Internal Medicine Residents’ Perceptions of Pharmacist Involvement in Medical Rounds

2021 ◽  
Vol 12 (2) ◽  
pp. 3
Author(s):  
Stephanie M. Tubb ◽  
Erin B. Loesch
Keyword(s):  
Internal Medicine ◽  
Online Survey ◽  
Pharmacy Practice ◽  
Education And Training ◽  
Clinical Pharmacists ◽  
Positive Effects ◽  
Internal Medicine Residents ◽  
Strongly Agree ◽  
Past Experiences ◽  
And Training

Background: Current physicians note the positive effects of clinical pharmacists on rounds, yet minimal evidence exists regarding medical residents’ view of pharmacists in this setting. Knowing their perceptions of clinical pharmacists on acute care rounds will allow pharmacists to optimize their roles and improve their interprofessional interactions. Objective: To assess internal medicine residents’ perceptions of pharmacists on rounds, evaluate which recommendations they prefer to receive, and examine their past experiences with pharmacists on rounds. Methods: Internal medicine residents were invited to complete an online survey containing 7 items regarding past experiences with pharmacists on rounds (5-point Likert-type scale; 1=Strongly Disagree, 5=Strongly Agree), 3 items about preferred recommendations (ranking questions), and 6 items regarding perceptions of pharmacy practice (5-point Likert-type scale; 1=Strongly Disagree, 5=Strongly Agree). Data were analyzed using frequencies. Results: 27 residents participated (33.75% response rate). A majority strongly agreed that they always want a pharmacist to be a part of their rounding team (Mean ± SD = 4.93 ± 0.26). They prefer receiving recommendations from the pharmacist in-person before, during, or after rounds and appreciate recommendations on topics such as anticoagulants, antimicrobial stewardship, and renal dose adjustments. Residents did not express a strong knowledge of pharmacists’ education and training processes (Mean ± SD = 3.77 ± 1.05), which may have led to their lack of agreement that pharmacists are equipped to be mid-level practitioners (Mean ± SD = 3.00 ± 1.30). Conclusions: Internal medicine residents had positive experiences with rounding pharmacists and desire their involvement on rounds. Pharmacists should make recommendations to residents in-person and educate them on their education and training to allow for further advocacy for pharmacist services.

Critical Care Communication Skills Training for Internal Medicine Residents

MedEdPORTAL ◽  
2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Rock ◽  
Nina Gadmer ◽  
Robert Arnold ◽  
David Roberts ◽  
Asha Anandaiah ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Critical Care ◽  
Communication Skills ◽  
Skills Training ◽  
Communication Skills Training ◽  
Internal Medicine Residents

Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

2020 ◽  
Author(s):  
Mohammad Alakchar ◽  
Abdisamad M. Ibrahim ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
Nitin Tandan ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Correlation Coefficient ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resident Attitudes ◽  
Internal Medicine Residents ◽  
Life Threatening ◽  
Degree Of Participation ◽  
Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

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