Internal Medicine–Paediatrics residents’ application of life design principles to career decisions

2021 ◽  
pp. postgradmedj-2021-140094
Author(s):  
Lynae Conyers ◽  
Sean Tackett ◽  
Scott Wright
Keyword(s):  
Internal Medicine ◽  
Design Thinking ◽  
Career Planning ◽  
Career Path ◽  
Career Decisions ◽  
Design Strategies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Career Plans ◽  
Life Design

BackgroundResidency is an important time for career planning. Little is known about how trainees make career decisions during this formative period.ObjectiveThe objective of this study was to understand whether ‘design thinking’ activities help to inform Internal Medicine–Paediatrics (Med-Peds) residents’ career decisions.MethodsWe performed a cross-sectional survey of a national sample of fourth-year Med-Peds residents in May–July 2019 covering intended career, helpfulness of ‘life design’ strategies used to inform career decision and confidence with intended career plans. Bivariate analyses were performed to evaluate associations between used strategies and confidence with career plans.ResultsA total of 86/145 (59%) of residents responded to the survey. The most helpful activities for clarifying career decisions were immersive exposure to the career during residency, and reflecting on compatibility of careers with their views of life and work. Finding the right mentor was associated with higher confidence in one’s intended career path (p<0.05). There were no significant differences with confidence in intended career plan by gender or career path. Career decisions made during the first 2 years of residency were associated with higher confidence than those made prior to or in the second half of residency (p=0.01 and p=0.004).ConclusionThis national survey of graduating Med-Peds residents reveals that proactive life design strategies were helpful in bringing clarity to their decision and were associated with higher confidence in intended career plans. These data should be of interest to residency training programmes in their efforts to support trainees with their career decisions.

scholarly journals Hidden bedside rationing in the Netherlands: a cross-sectional survey among physicians in internal medicine

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ursula W. de Ruijter ◽  
Hester F. Lingsma ◽  
Willem A. Bax ◽  
Johan Legemaate
Keyword(s):  
Internal Medicine ◽  
The Netherlands ◽  
Patient Choice ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Physician Characteristics ◽  
Distribution Of Resources ◽  
Healthcare Rationing ◽  
Do So

Abstract Background Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice. Methods Cross-sectional online questionnaire on knowledge of -, experience with -, and opinion on rationing among physicians in internal medicine within the Dutch healthcare system. Multivariable ordinal logistic regression was used to explore relations between hidden bedside rationing and physician characteristics. Results The survey was distributed among 1139 physicians across 11 hospitals with a response rate of 18% (n = 203). Most participants (n = 129; 64%) had experience prescribing a cheaper course of treatment while a more effective but more expensive alternative was available, suggesting bedside rationing. Subsequently, 32 (24%) participants never disclosed this decision to their patient, qualifying it as hidden. The majority of participants (n = 153; 75%) rarely discussed treatment cost. Employment at an academic hospital was independently associated with more bedside rationing (OR = 17 95%CI 6.1–48). Furthermore, residents were more likely to disclose rationing to their patients than internists (OR = 3.2, 95%CI 2.1–4.7), while salaried physicians were less likely to do so than physicians in private practice (OR = 0.5, 95%CI 0.4–0.8). Conclusion Hidden bedside rationing occurs in the Netherlands: patient choice is on occasion limited with costs as rationale and this is not always disclosed. To what extent distribution of healthcare should include bedside rationing in the Netherlands, or any other country, remains up for debate.

A Survey of Arizona Pharmacists to Identify Opportunities to Enhance Pharmacists’ Competitiveness in a Tightening Labor Market

2021 ◽  
pp. 089719002110007
Author(s):  
Caitlin K. Cameron ◽  
Ahmad A. Alamer ◽  
Eliane Fossati ◽  
Gamal Raslan ◽  
Tiffany Nguyen ◽  
...  
Keyword(s):  
Labor Market ◽  
Conflict Resolution ◽  
Personal Development ◽  
Career Planning ◽  
Survey Design ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge Domains ◽  
Inpatient Settings ◽  
Employment Needs

Background: The pharmacy profession has experienced dramatic shifts in scopes of practice, services offered, and employment opportunities over the last couple decades. At the same time, the number of students graduating from pharmacy school each year has steadily increased. The combined effect of these factors is a tightening labor market. Identification of potential knowledge and skill deficits in the applicant pool will create opportunity for pharmacists to tailor their personal development and educators to design content to address contemporary needs. Objective: To determine if the current pharmacist pool meets employment needs in Arizona with respect to specific skills and knowledge. Methods: In a cross-sectional survey design, Arizona licensed pharmacists were asked to provide their perspective of the knowledge and skills of candidates for pharmacist positions within 8 skill & knowledge domains. Descriptive statistics were used for respondents’ characteristics. A multivariate logistic regression was used for association between respondent characteristics and responses. Free responses were assessed using a qualitative thematic analysis. Results: Among 685 respondents, 88% were employed, 48% had precepting experience, and 44% were involved with hiring. The majority were from chain community pharmacies (33%) and inpatient settings (22%). Management and conflict resolution skills were reported as lacking by 35% and 28% of respondents respectively; 24% reported insufficient compounding knowledge. Conclusion: Our findings suggest knowledge deficits in management, conflict resolution, and compounding. This information can be used for career planning and for educational program development or curricular enhancements. Similar studies in other regions will provide data on national needs.

scholarly journals Delivering on the Promise: Exploring Training Characteristics and Graduate Career Pursuits of Primary Care Internal Medicine Residency Programs and Tracks

2019 ◽  
Vol 11 (4) ◽  
pp. 447-453
Author(s):  
Robin Klein ◽  
Samantha Alonso ◽  
Caitlin Anderson ◽  
Akanksha Vaidya ◽  
Nour Chams ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Clinical Experiences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Training Time ◽  
Residency Programs ◽  
Primary Care Internal Medicine ◽  
Ambulatory Training ◽  
Curricular Content

ABSTRACT Background Specialized primary care internal medicine (PC IM) residency programs and tracks aim to provide dedicated PC training. How programs deliver this is unclear. Objective We explored how PC IM programs and tracks provide ambulatory training. Methods We conducted a cross-sectional survey from 2012 to 2013 of PC IM program and track leaders via a search of national databases and program websites. We reported PC IM curricular content, clinical experiences, and graduate career pursuits, and assessed correlation between career pursuits and curricular content and clinical experiences. Results Forty-five of 70 (64%) identified PC IM programs and tracks completed the survey. PC IM programs provide a breadth of curricular content and clinical experiences, including a mean 22.8 weeks ambulatory training and a mean 69.4 continuity clinics per year. Of PC IM graduates within 5 years, 55.8% pursue PC or general internal medicine (GIM) careers and 23.1% pursue traditional subspecialty fellowship training. Curricular content and clinical experiences correlate weakly with career choices. PC IM graduates pursuing PC or GIM careers correlated with ambulatory rotation in women's health (correlation coefficient [rho] = 0.36, P = .034) and mental health (rho = 0.38, P = .023) and curricular content in teaching and medical education (rho = 0.35, P = .035). PC IM graduates pursuing subspecialty fellowship negatively correlated with curricular content in leadership and teams (rho = -0.48, P = .003) and ambulatory training time (rho = -0.38, P = .024). Conclusions PC IM programs and tracks largely deliver on the promise to provide PC training and education and produce graduates engaged in PC and GIM.

Menopause Management Knowledge in Postgraduate Family Medicine, Internal Medicine, and Obstetrics and Gynecology Residents: A Cross-Sectional Survey

2019 ◽  
Vol 94 (2) ◽  
pp. 242-253 ◽  
Author(s):  
Juliana M. Kling ◽  
Kathy L. MacLaughlin ◽  
Peter F. Schnatz ◽  
Carolyn J. Crandall ◽  
Lisa J. Skinner ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Obstetrics And Gynecology ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Management Knowledge

scholarly journals Internal medicine residents identify gaps in medical education on outpatient referrals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Masha J. Slavin ◽  
Mangala Rajan ◽  
Lisa M. Kern
Keyword(s):  
Internal Medicine ◽  
New York ◽  
Medical Education ◽  
Clinical Information ◽  
Ambulatory Setting ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Internal Medicine Residents ◽  
Strongly Agree ◽  
Residents Attitudes

Abstract Background Relevant clinical information is often missing when a patient sees a specialist after being referred by another physician in the ambulatory setting. This can result in missed or delayed diagnoses, delayed treatment, unnecessary testing, and drug interactions. Residents’ attitudes toward providing clinical information at the time of referral and their perspectives toward training on referral skills are not clear. We sought to assess internal medicine residents’ attitudes toward and experiences with outpatient referrals. Methods We conducted a cross-sectional survey in October–December 2018 of all internal medicine interns and residents affiliated with a large, urban internal medicine residency program in New York, NY. We used a novel survey instrument that included 13 questions about attitudes toward and experiences with outpatient referrals. We used descriptive statistics to characterize the results. Results Overall, 122 of 132 residents participated (92% response rate). Respondents were approximately equally distributed across post-graduate years 1–3. Although 83% of residents reported that it is “always” important to provide the clinical reason for a referral, only 11% stated that they “always” provide a sufficient amount of clinical information for the consulting provider when making a referral. Only 9% of residents “strongly agree” that residency provides sufficient training in knowing when to refer patients, and only 8% “strongly agree” that residency provides sufficient training in what information to provide the consulting physician. Conclusions These results suggest a substantial discrepancy between the amount of information residents believe they should provide at the time of a referral and the amount they actually provide. Many residents report not receiving adequate training during residency on when to refer patients and what clinical information to provide at the time of referral. Improvements to medical education regarding outpatient referrals are urgently needed.

scholarly journals Expectations Regarding Dental Practice: A Cross-Sectional Survey of European Dental Students

2020 ◽  
Vol 17 (19) ◽  
pp. 7296
Author(s):  
Thomas Gerhard Wolf ◽  
Ralf Friedrich Wagner ◽  
Oliver Zeyer ◽  
Duygu Ilhan ◽  
Tin Crnić ◽  
...  
Keyword(s):  
Private Equity ◽  
Online Survey ◽  
Career Planning ◽  
Positive Influence ◽  
Dental Students ◽  
Insurance Companies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Future Career ◽  
Significant Difference

Obtaining information on expectations among dental students regarding their career planning was the main purpose of this observational online survey. The questionnaire was designed with 18 items in five different languages: English, French, German, Italian and Spanish. Data were collected on nationality, age, sex, country of residence, university attended, semester, expected year of graduation and expectations about future career. More than 3000 participants (n = 3851, 2863 females 74.34% and 988 males 25.66% with a sex ratio of 0.35) participated in the survey. Almost one-third (31.29%) of the participants plan to start their own practice at least three years after vocational training, a quarter (25.76%) after three, and only 12.59% after one year. A positive influence of the family in the decision to start a practice was observed in 50.07% of the sample with a statistically significant difference regarding sex (p < 0.01). Almost one-third of the participants did not wish to work in an institution run by private equity or insurance companies, while 21.79% would work in that environment (p < 0.01). European dental students desire mainly to become self-employed and start their own practice. New professional practices also offer them options for their future career that they have not yet decided on or thought about.

scholarly journals Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

PLoS ONE ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. e0172167 ◽  
Author(s):  
Michael N. Daniels ◽  
Sharon Maynard ◽  
Ivan Porter ◽  
Hope Kincaid ◽  
Deepika Jain ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Career Interest ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Internal Medicine Residents

scholarly journals Ophthalmology training and competency levels in caring for patients with ophthalmic complaints among United States internal medicine, emergency medicine, and family medicine residents

2019 ◽  
Vol 16 ◽  
pp. 25 ◽  
Author(s):  
Christopher Daniel Gelston ◽  
Jennifer Landrigan Patnaik
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Emergency Medicine ◽  
Family Medicine ◽  
Educational Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Confidence Levels ◽  
Family Medicine Residents

Purpose: To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.Methods: A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”Results: In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.Conclusion: Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.

scholarly journals Professional Commitment and Career Maturity of Full-Time Nursing Postgraduates in China: A Cross-Sectional Study

2020 ◽  
Author(s):  
kejimu sunzi ◽  
cheng lei ◽  
jun pan ◽  
mei ju
Keyword(s):  
Response Rate ◽  
Career Planning ◽  
Survey Design ◽  
Career Maturity ◽  
Cross Sectional Study ◽  
Professional Commitment ◽  
Full Time ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Status

Abstract Background: Nursing is becoming ever more demanding, and is regarded as a stressful occupation because of manpower shortages and various other challenges associated with nursing practice.This article describes the students’ professional commitment and career maturity, and students establish their career objectives during the early stages of their graduate study. Methods: A cross sectional，survey design was conducted at universities in China. A sample of 184 students was selected using the professional commitment scale and career maturity scale to investigate the status quo of professional commitment and career maturity of full-time nursing postgraduates. Data was collected using self-designed demographic characteristics of the student, professional commitment scale, career maturity scale in 2019.Data was analyzed using correlation coefficient test(α < 0.05 ).Results: Participants returned 184 surveys (response rate, 100%) . Career maturity (105.12±11.13), Specialty commitment(90.0 ±12.09),Career maturity was positively correlated with Professional Commitment (r=0.20).Conclusions: The career maturity and professional commitments of full-time nursing postgraduates were of an average level. Career planning courses could be useful to strengthen the vocational education of the post-graduate students.

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