scholarly journals Needs assessment for a curriculum for difficult conversations -a survey from 5 Chinese accredited neurology residency training programs

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lixin Zhou ◽  
Bo Wu ◽  
Liyong Wu ◽  
Xin Cheng ◽  
Bo Hu ◽  
...  
Keyword(s):  
Residency Training ◽  
Online Survey ◽  
Training Programs ◽  
Unmet Need ◽  
Skills Training ◽  
Current Status ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Difficult Conversations ◽  
Previous Training

Abstract Background Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredited neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n = 168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence (P = 0.003) and were under lower pressure (P = 0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredited Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote a standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

scholarly journals Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs

2020 ◽  
Author(s):  
Lixin Zhou ◽  
Bo Wu ◽  
Liyong Wu ◽  
Xin Cheng ◽  
Bo Hu ◽  
...  
Keyword(s):  
Residency Training ◽  
Online Survey ◽  
Training Programs ◽  
Unmet Need ◽  
Skills Training ◽  
Current Status ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Difficult Conversations ◽  
Previous Training

Abstract Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredit neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredit Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

scholarly journals Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs

2020 ◽  
Author(s):  
Lixin Zhou ◽  
Bo Wu ◽  
Liyong Wu ◽  
Xin Cheng ◽  
Bo Hu ◽  
...  
Keyword(s):  
Residency Training ◽  
Online Survey ◽  
Training Programs ◽  
Unmet Need ◽  
Skills Training ◽  
Current Status ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Difficult Conversations ◽  
Previous Training

Abstract Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredited neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field.Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredited Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote a standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

scholarly journals Needs assessment for a curriculum for difficult conversations in a neurology residency training program in China

2019 ◽  
Author(s):  
Lixin Zhou ◽  
Bo Wu ◽  
Liyong Wu ◽  
Xin Cheng ◽  
Bo Hu ◽  
...  
Keyword(s):  
Residency Training ◽  
Online Survey ◽  
Unmet Need ◽  
Skills Training ◽  
Current Status ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Training Time ◽  
Difficult Conversations ◽  
Previous Training

Abstract Background Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in which neurology programs in China teach residents about difficult conversations and determine whether there is a perceived need for a formalized educational curriculum in this field.Method An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.Results A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence(P=0.003)and were under lower pressure(P=0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.Conclusion This survey provides a contemporary assessment of the current status of education on the topic of difficult conversations in neurology residency training. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Targeted communication curriculum in difficult conversation should be further developed and implemented for the neurological residents in China.

68. The resident experience in a large urban teaching setting: Results of the 2005-2006 resident exit survey, University of Torontos

2007 ◽  
Vol 30 (4) ◽  
pp. 66
Author(s):  
N. Tenn-Lyn ◽  
S. Verma ◽  
R. Zulla
Keyword(s):  
Quality Control ◽  
Residency Training ◽  
Royal College ◽  
Online Survey ◽  
Career Guidance ◽  
Training Programs ◽  
Program Planning ◽  
Educational Experience ◽  
Care Experience

We developed and implemented an annual online survey to administer to residents exiting residency training in order to (1) assess the quality of the residency experience and (2) identify areas of strength and areas requiring improvement. Long-term goals include program planning, policy-making and maintenance of quality control. Survey content was developed from an environmental scan, pre-existing survey instruments, examination of training criteria established by the CFPC and the CanMEDS criteria established by the RCPSC. The survey included evaluation benchmarks and satisfaction ratings of program director and faculty, preparation for certification and practice, quality of life, quality of education, and work environment. The response rate was 28%. Seventy-five percent of respondents were exiting from Royal College training programs. Results of descriptive statistics determined that the overall educational experience was rated highly, with 98.9% of respondents satisfied or very satisfied with their overall patient care experience. Ninety-six percent of respondents were satisfied or very satisfied with the overall quality of teaching. Preparation for practice was identified as needing improvement, with 26% and 34% of respondents giving an unsatisfactory rating to career guidance and assistance with finding employment, respectively. Although 80% of respondents reported receiving ongoing feedback and 84% discussed their evaluations with their supervisors, only 38% of evaluations were completed by the end of the rotation. The results indicate that residents are generally satisfied with their experiences during residency training, especially with their overall educational experience. Areas of improvement include preparation for practice and timeliness of evaluations. Further iterations of this survey are needed to refine the instrument, identify data trends and maintain quality control in residency training programs. Frank JR (ed.). The CanMEDS competency framework: better standards, better physicians, better care. Ottawa: The Royal College of Physicians and Surgeons of Canada, 2005. Merritt, Hawkins and Associates. Summary Report: 2003 Survey of final-year medical residents. http://www.merritthawkins.com/pdf/MHA2003residentsurv.pdf. Accessed May 1, 2006. Regnier K, Kopelow M, Lane D, Alden A. Accreditation for learning and change: Quality and improvement as the outcome. The Journal of Continuing Education in the Health Professions 2005; 25:174-182.

A Canadian Perspective of simulation-based skill attainment in Internal Medicine Residency (Preprint)

2018 ◽  
Author(s):  
Tamer Abdel Moaein ◽  
Chirsty Tompkins ◽  
Natalie Bandrauk ◽  
Heidi Coombs-Thorne
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Training Programs ◽  
Skill Training ◽  
Skills Training ◽  
Skill Learning ◽  
Comfort Level ◽  
Procedural Skills ◽  
Internal Medicine Training ◽  
Simulation Based

BACKGROUND Clinical simulation is defined as “a technique to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion”. In medicine, its advantages include repeatability, a nonthreatening environment, absence of the need to intervene for patient safety issues during critical events, thus minimizing ethical concerns and promotion of self-reflection with facilitation of feedback [1] Apparently, simulation based education is a standard tool for introducing procedural skills in residency training [3]. However, while performance is clearly enhanced in the simulated setting, there is little information available on the translation of these skills to the actual patient care environment (transferability) and the retention rates of skills acquired in simulation-based training [1]. There has been significant interest in using simulation for both learning and assessment [2]. As Canadian internal medicine training programs are moving towards assessing entrustable professional activities (EPA), simulation will become imperative for training, assessment and identifying opportunities for improvement [4, 5]. Hence, it is crucial to assess the current state of skill learning, acquisition and retention in Canadian IM residency training programs. Also, identifying any challenges to consolidating these skills. We hope the results of this survey would provide material that would help in implementing an effective and targeted simulation-based skill training (skill mastery). OBJECTIVE 1. Appraise the status and impact of existing simulation training on procedural skill performance 2. Identify factors that might interfere with skill acquisition, consolidation and transferability METHODS An electronic bilingual web-based survey; Fluid survey platform utilized, was designed (Appendix 1). It consists of a mix of closed-ended, open-ended and check list questions to examine the attitudes, perceptions, experiences and feedback of internal medicine (IM) residents. The survey has been piloted locally with a sample of five residents. After making any necessary corrections, it will be distributed via e-mail to the program directors of all Canadian IM residency training programs, then to all residents registered in each program. Two follow up reminder e-mails will be sent to all participating institutions. Participation will be voluntarily and to keep anonymity, there will be no direct contact with residents and survey data will be summarized in an aggregate form. SPSS Software will be used for data analysis, and results will be shared with all participating institutions. The survey results will be used for display and presentation purposes during medical conferences and forums and might be submitted for publication. All data will be stored within the office of internal medicine program at Memorial University for a period of five years. Approval of Local Research Ethics board (HREB) at Memorial University has been obtained. RESULTS Pilot Results Residents confirmed having simulation-based training for many of the core clinical skills, although some gaps persist There was some concern regarding the number of sim sessions, lack of clinical opportunities, competition by other services and lack of bed side supervision Some residents used internet video to fill their training gaps and/or increase their skill comfort level before performing clinical procedure Resident feedback included desire for more corrective feedback, and more sim sessions per skill (Average 2-4 sessions) CONCLUSIONS This study is anticipated to provide data on current practices for skill development in Canadian IM residency training programs. Information gathered will be used to foster a discourse between training programs including discussion of barriers, sharing of solutions and proposing recommendations for optimal use of simulation in the continuum of procedural skills training.

scholarly journals The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Alshdaifat ◽  
Amer Sindiani ◽  
Wasim Khasawneh ◽  
Omar Abu-Azzam ◽  
Aref Qarqash ◽  
...  
Keyword(s):  
Mental Health ◽  
Residency Training ◽  
Training Programs ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Residents ◽  
Tertiary Center ◽  
The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

scholarly journals Education Research: Difficult conversations in neurology

Neurology ◽  
2018 ◽  
Vol 90 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Monica E. Lemmon ◽  
Charlene Gamaldo ◽  
Rachel Marie E. Salas ◽  
Ankita Saxena ◽  
Tiana E. Cruz ◽  
...  
Keyword(s):  
Focus Groups ◽  
Communication Skills ◽  
Poor Prognosis ◽  
Skills Training ◽  
Communication Skills Training ◽  
Cross Sectional ◽  
Difficult Conversations ◽  
Perceived Preparedness ◽  
Terminal Diagnosis ◽  
Prognostic Uncertainty

ObjectiveTo characterize features of medical student exposure to difficult conversations during a neurology core clerkship.MethodsThis was a cross-sectional concurrent nested mixed methods study, and all students rotating through a required neurology clerkship between 2014 and 2015 were enrolled. Data collection included an electronic communication tracker, baseline and end-of-clerkship surveys, and 4 facilitated focus groups. Students were asked to log exposure to patient–clinician conversations about (1) new disability, (2) poor prognosis, (3) prognostic uncertainty (4), terminal diagnosis, and (5) end-of-life care.ResultsA total of 159 students were enrolled and 276 conversations were tracked. Most (70%) students observed at least 1 difficult conversation, and conversations about poor prognosis, new disability, and prognostic uncertainty were most commonly logged. At clerkship end, most students (87%) desired additional bedside training in communication skills. Exposure to one of the predefined conversation types did not improve student perceived preparedness to lead difficult conversations in the future. In focus groups, students noted that the educational value of observation of a difficult conversation could be optimized with preconversation planning and postconversation debriefing.ConclusionsDifficult conversations are common in neurology, and represent a valuable opportunity to provide communication skills training on the wards. Future curricula should consider ways to leverage these existing opportunities to enhance communication skills training.

scholarly journals Why Do Data Users Say Health Care Data Are Difficult to Use? A Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Ho Heon Kim ◽  
Bora Kim ◽  
Segyeong Joo ◽  
Soo-Yong Shin ◽  
Hyo Soung Cha ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Online Survey ◽  
Data Use ◽  
Survey Study ◽  
Current Status ◽  
Sensitive Information ◽  
Cross Sectional ◽  
Health Care Data ◽  
Public Data

BACKGROUND There has been significant effort in attempting to use health care data. However, laws that protect patients’ privacy have restricted data use because health care data contain sensitive information. Thus, discussions on privacy laws now focus on the active use of health care data beyond protection. However, current literature does not clarify the obstacles that make data usage and deidentification processes difficult or elaborate on users’ needs for data linking from practical perspectives. OBJECTIVE The objective of this study is to investigate (1) the current status of data use in each medical area, (2) institutional efforts and difficulties in deidentification processes, and (3) users’ data linking needs. METHODS We conducted a cross-sectional online survey. To recruit people who have used health care data, we publicized the promotion campaign and sent official documents to an academic society encouraging participation in the online survey. RESULTS In total, 128 participants responded to the online survey; 10 participants were excluded for either inconsistent responses or lack of demand for health care data. Finally, 118 participants’ responses were analyzed. The majority of participants worked in general hospitals or universities (62/118, 52.5% and 51/118, 43.2%, respectively, multiple-choice answers). More than half of participants responded that they have a need for clinical data (82/118, 69.5%) and public data (76/118, 64.4%). Furthermore, 85.6% (101/118) of respondents conducted deidentification measures when using data, and they considered rigid social culture as an obstacle for deidentification (28/101, 27.7%). In addition, they required data linking (98/118, 83.1%), and they noted deregulation and data standardization to allow access to health care data linking (33/98, 33.7% and 38/98, 38.8%, respectively). There were no significant differences in the proportion of responded data needs and linking in groups that used health care data for either public purposes or commercial purposes. CONCLUSIONS This study provides a cross-sectional view from a practical, user-oriented perspective on the kinds of data users want to utilize, efforts and difficulties in deidentification processes, and the needs for data linking. Most users want to use clinical and public data, and most participants conduct deidentification processes and express a desire to conduct data linking. Our study confirmed that they noted regulation as a primary obstacle whether their purpose is commercial or public. A legal system based on both data utilization and data protection needs is required.

The Effects of Situational Obstacles and Social Support on Suicide- Prevention Gatekeeper Behaviors

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 264-271 ◽  
Author(s):  
J. Taylor Moore ◽  
Konstantin P. Cigularov ◽  
Peter Y. Chen ◽  
Jeremy M. Martinez ◽  
Jarrod Hindman
Keyword(s):  
Social Support ◽  
Suicide Prevention ◽  
Online Survey ◽  
Training Programs ◽  
Gatekeeper Training ◽  
Cross Sectional ◽  
Referral Practices ◽  
Prevention Behavior ◽  
The Relationship

Background: Although the effectiveness of suicide-prevention gatekeeper-training programs in improving knowledge, attitudes, and referral practices has been documented, their effects do not seem to be lasting. Aims: This study investigated situational obstacles at work that prevent suicide-prevention gatekeepers from engaging in suicide-prevention behavior and the role of social support in modifying the relationship between situational obstacles and suicide-prevention behaviors. Methods: 193 gatekeepers completed an online survey to rate the obstacles they had experienced at work since completing a gatekeeper-training program and the support received from coworkers, supervisors, and the organization. Participants also reported the frequency of suicide-prevention behaviors performed. Results: The results indicated that both situational obstacles and social support predicted the number of suicide-prevention behaviors performed, as expected. There was also a trend that support from supervisors and the organization may alleviate the adverse effect of situational obstacles on suicide-prevention behavior. Limitations: The cross-sectional nature of the study does not allow for directional, causal conclusions to be drawn. Conclusions: By understanding the roles of situational obstacles faced by trained gatekeepers at their work and the support they receive from supervisors and organizations, appropriate strategies can be identified and applied to facilitate gatekeeper performance.

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