scholarly journals Managing resident workforce and residency training amid COVID-19 pandemic: Scoping review of adaptive approaches

2020 ◽  
Author(s):  
Lemi Tolu ◽  
Garumma Tolu Feyissa ◽  
Wondimu Gudu Jeldu
Keyword(s):  
Residency Training ◽  
Clinical Education ◽  
Data Extraction ◽  
Skills Training ◽  
Residency Education ◽  
Didactic Teaching ◽  
Residency Programs ◽  
Research Activities ◽  
The Impact ◽  
Adaptive Approaches

Abstract Introduction: The impact of Covid-19 on the healthcare system and training is tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training.Objective: to review available adaptive residency training approaches and management of resident work force in different residency programs amid Covid-19 pandemicMethods and materials: We searched for websites of different professional associations and international or national specialty accreditation institutions. We looked for English studies (any form), reviews or editorials, perspectives, short or special communications, and position papers on residency education during the COVID-19 pandemic. Additionally, we searched: MEDLINE, EMBASE, and Google Scholar using keywords. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.Results: We identified 13 documents reporting on residency education during pandemics. Three were articles,5 short or special communications, and the rest editorials and perspectives. We divided the data obtained into six thematic areas: resident staffing, clinical education, surgical education, didactic teaching, research activity, and accreditation process.Conclusions: Residency programs must reorganize the resident's staffing and provide appropriate training to ensure the health and safety of residents during the pandemics. There are feasible adaptive approaches of maintaining residency trainings in the domains of didactic teaching, clinical education and some research activities. Although some innovative virtual surgical skills training methods are implemented in limited surgical residency disciplines, their effectiveness is not well examined. Guidance and flexibility of the accreditation bodies in ensuring competency of residents is one component of the response to the Covid-19 pandemic.

scholarly journals Variability in Obtaining Institutional Review Board Approval for Quality Improvement Activities in Residency Programs

2012 ◽  
Vol 4 (1) ◽  
pp. 106-108 ◽  
Author(s):  
Lisa N. Conforti ◽  
Brian J. Hess ◽  
Kathryn M. Ross ◽  
Lorna A. Lynn ◽  
Eric S. Holmboe
Keyword(s):  
Quality Improvement ◽  
Residency Training ◽  
Quality Of Experience ◽  
Comfort Level ◽  
Institutional Review Board ◽  
Residency Programs ◽  
Institutional Review ◽  
Time Period ◽  
The Impact

Abstract Introduction Quality improvement (QI) activities are an important part of residency training. National studies are needed to inform best practices in QI training and experience for residents. The impact of the Institutional Review Board (IRB) process on such studies is not well described. Methods This observational study looked at time, length, comfort level, and overall quality of experience for 42 residency training programs in obtaining approval or exemption for a nationally based educational QI study. Results For the 42 programs in the study, the time period to IRB approval/exemption was highly variable, ranging from less than 1 week to 56.5 weeks; mean and median time was approximately 18 weeks (SD, 10.8). Greater reported comfort with the IRB process was associated with less time to obtain approval (r  =  −.50; P < .01; 95% CI, −0.70 to −0.23). A more positive overall quality of experience with the IRB process was also associated with less time to obtain IRB approval (r  =  −.60; P < .01; 95% CI, −0.74 to −0.36). Discussion The IRB process for residency programs initiating QI studies shows considerable variance that is not explained by attributes of the projects. New strategies are needed to assist and expedite IRB processes for QI research in educational settings and reduce interinstitutional variability and increase comfort level among educators with the IRB process.

scholarly journals The impact of EAES Fellowship Programme: a five-year review and evaluation

2021 ◽  
Author(s):  
Alice Tsai ◽  
Marek Soltes ◽  
Dusan Lesko ◽  
Michel Adamina ◽  
Pedrag Andrejevic ◽  
...  
Keyword(s):  
Clinical Education ◽  
Positive Impact ◽  
Clinical Skills ◽  
Free Text ◽  
Research Experience ◽  
Research Areas ◽  
Research Activities ◽  
Fellowship Programme ◽  
Operating Theatres ◽  
The Impact

Abstract Background The European Association of Endoscopic Surgery (EAES) fellowship programme was established in 2014, allowing nine surgeons annually to obtain experience and skills in minimally invasive surgery (MIS) from specialist centres across the Europe and United States. It aligns with the strategic focus of EAES Education and Training Committee on enabling Learning Mobility opportunities. To assess the impact of the programme, a survey was conducted aiming to evaluate the experience and impact of the programme and receive feedback for improvements. Methods A survey using a 5-point Likert scale was used to evaluate clinical, education and research experience. The impact on acquisition of new technical skills, change in clinical practice and ongoing collaboration with the host institute was assessed. The fellows selected between 2014 and 2018 were included. Ratings were analysed in percentage; thematic analysis was applied to the free-text feedbacks using qualitative analysis. Results All the fellows had good access to observing in operating theatres and 70.6% were able to assist. 91.2% participated in educational activities and 23.5% were able to contribute through teaching. 44.1% participated in research activities and 41.2% became an author/co-author of a publication from the host. 97.1% of fellows stated that their operative competency had increased, 94.3% gained new surgical skills and 85.7% was able to introduce new techniques in their hospitals. 74.29% agreed that the clinical experience led to a change in their practices. The most commonly suggested improvements were setting realistic target in clinical and research areas, increasing fellowship duration, and maximising theatre assisting opportunities. Nevertheless, 100% of fellows would recommend the fellowship to their peers. Conclusion EAES fellowship programme has shown a positive impact on acquiring and adopting new MIS techniques. To further refine the programme, an individualised approach should be adopted to set achievable learning objectives in clinical skills, education and research.

Impact of Pharmacy Residency Research Training on Residents’ Actual Versus Perceived Ability and Interest to Identify and Solve Practice-Related Problems

2016 ◽  
Vol 29 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Nicole R. Pinelli ◽  
Andrea N. Sikora ◽  
Leigh A. Witherspoon ◽  
Kamakshi V. Rao ◽  
Denise H. Rhoney
Keyword(s):  
Residency Training ◽  
Research Productivity ◽  
Research Training ◽  
Medical Center ◽  
Academic Medical Center ◽  
Pharmacy Practice ◽  
Research Experience ◽  
Perceived Ability ◽  
Research Activities ◽  
The Impact

Purpose: The American Society of Health-System Pharmacists (ASHP) requires that accredited residency programs provide pharmacy residents the opportunity to perform a practice-based project. The objective of this study was to evaluate the impact of pharmacy residency research training on residents’ actual versus perceived ability to solve practice-related problems in their professional careers. Methods: This cross-sectional study surveyed postgraduate year 1 (PGY1) pharmacy practice residents who completed training at a large academic medical center between 2007 and 2013. The survey consisted of 3 areas of assessment, that is, (1) general demographics, (2) perceived research abilities, and (3) self-reported research productivity. Results: A total of 39 residents were eligible; of those, 27 completed the survey (69.2% response rate). Participants reported low perceived ability for conductance of some research activities including study design development, implementation, and publication. No association between perceived research ability and self-reported research productivity was found. Research experience prior to residency training strongly predicted for subsequent publication after completion of PGY1 residency training ( P < .0001). Conclusions: New training mechanisms may be needed to optimize research training that will provide residents with greater emphasis on areas of perceived deficiency.

scholarly journals Impact of COVID-19 on Canadian Radiology Residency Training Programs

2020 ◽  
Vol 71 (4) ◽  
pp. 482-489 ◽  
Author(s):  
Devang Odedra ◽  
Baljot S. Chahal ◽  
Michael N. Patlas
Keyword(s):  
Residency Training ◽  
Training Programs ◽  
The Novel ◽  
Residency Programs ◽  
Video Lectures ◽  
Canadian Association ◽  
Medical Education And Training ◽  
Radiology Residency ◽  
Novel Coronavirus ◽  
The Impact

Purpose: The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19. Methods: A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark. Results: We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations. Conclusion: The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs.

scholarly journals The Impact of COVID-19 pandemic on Obstetrics and Gynecology Residency Programs and perspectives on adaptive ways of training in Ethiopia

2020 ◽  
Author(s):  
Wondimu Gudu ◽  
Mekitie Wondafrash ◽  
Delayehu Bekele ◽  
Balkachew Nigatu ◽  
Malede Birrara ◽  
...  
Keyword(s):  
Data Analysis ◽  
Residency Training ◽  
Quantitative Data ◽  
Clinical Teaching ◽  
Program Directors ◽  
Obstetrics And Gynecology ◽  
Complete Suppression ◽  
Normal Delivery ◽  
Research Activities ◽  
The Impact

Abstract Background: The impact of Covid-19 on healthcare system and trainings has been tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training. Objectives: to assess the effect of Covid-19 pandemic on obstetrics and gynecology residency program and explore residents’ & program directors’ perspectives on alternative academic approaches in Ethiopia.Methods: This is a cross sectional mixed method study which was conducted at 12 institutions engaged in obstetrics and gynecology residency training in Ethiopia from May to June 2020. Quantitative data were collected from 240 residents employing an online platform (Google Forms) and focus group discussion was conducted using the ZOOM video-conferencing platform with eleven chief residents and eight program directors. Quantitative data analysis was performed using Stata 15 statistical software while thematic synthesis approach was used for the qualitative data analysis assisted by ATLAS.ti 7 for windows. Ethical clearance was obtained from IRB of Saint Paul’s Hospital Millennium Medical College. Results: All levels of residents from all residency sites were represented. The level of residents’ engagement in various routine clinical services vary depending on the type of service during COVID-19 pandemic period. Residents’ involvement in routine ANC, high risk clinics are “slightly” reduced while in Gynecology OPDs, the reduction was “severe”. There was no effort made to address the psychological impact of the pandemic on residents. The level of reduction in didactic and clinical teaching (rounds, case presentations, seminars, management sessions ranged from “some” to “complete interruption” for most of the residents at different years of training. Although the reduction in obstetric practical exposure (normal delivery, cesarean delivery) was “slight”, there was “sever” reduction to “complete suppression” (>80%) in major gynecologic surgeries primarily affecting final year residents. Research activities are completely halted in most of the institutions. Generally, adaptive methods to sustain the residency training were implemented in very few of the institutions. Conclusions: There was significant disruption in all domains of the residency training following the report of the first case of COVID-19 in Ethiopia. The preparedness and response of the programs was very poor and there was limited effort in implementing adaptive teaching methods in almost all of the institutions.

An alternative approach to the mandatory year of clinical residency training

1992 ◽  
Vol 82 (11) ◽  
pp. 579-581
Author(s):  
AM Jacobs
Keyword(s):  
Residency Training ◽  
Clinical Education ◽  
Specialty Training ◽  
Medical Field ◽  
Medical Practitioners ◽  
Residency Programs ◽  
Entry Level ◽  
Medical Graduates ◽  
Alternative Approach ◽  
Podiatric Surgery

The author takes the position that a mandatory fifth postgraduate year to serve as a uniform period of clinical education for podiatric medical graduates is unnecessary. A need exists to define primary podiatric medicine as the entry level podiatric medical field of practice. The colleges of podiatric medicine are urged to deemphasize podiatric surgery while placing greater emphasis on primary podiatric care. The author believes that the colleges are responsible for preparing primary podiatric medical practitioners. Residency programs should focus on specialty training in podiatric surgery and podiatric orthopedics.

scholarly journals The impact of artificial intelligence on clinical education: perceptions of postgraduate trainee doctors in London (UK) and recommendations for trainers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maya Banerjee ◽  
Daphne Chiew ◽  
Keval T. Patel ◽  
Ieuan Johns ◽  
Digby Chappell ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Quality Improvement ◽  
Clinical Education ◽  
Clinical Training ◽  
Skills Training ◽  
Clinical Judgement ◽  
Free Text ◽  
Practical Skills ◽  
Training And Education ◽  
The Impact

Abstract Background Artificial intelligence (AI) technologies are increasingly used in clinical practice. Although there is robust evidence that AI innovations can improve patient care, reduce clinicians’ workload and increase efficiency, their impact on medical training and education remains unclear. Methods A survey of trainee doctors’ perceived impact of AI technologies on clinical training and education was conducted at UK NHS postgraduate centers in London between October and December 2020. Impact assessment mirrored domains in training curricula such as ‘clinical judgement’, ‘practical skills’ and ‘research and quality improvement skills’. Significance between Likert-type data was analysed using Fisher’s exact test. Response variations between clinical specialities were analysed using k-modes clustering. Free-text responses were analysed by thematic analysis. Results Two hundred ten doctors responded to the survey (response rate 72%). The majority (58%) perceived an overall positive impact of AI technologies on their training and education. Respondents agreed that AI would reduce clinical workload (62%) and improve research and audit training (68%). Trainees were skeptical that it would improve clinical judgement (46% agree, p = 0.12) and practical skills training (32% agree, p < 0.01). The majority reported insufficient AI training in their current curricula (92%), and supported having more formal AI training (81%). Conclusions Trainee doctors have an overall positive perception of AI technologies’ impact on clinical training. There is optimism that it will improve ‘research and quality improvement’ skills and facilitate ‘curriculum mapping’. There is skepticism that it may reduce educational opportunities to develop ‘clinical judgement’ and ‘practical skills’. Medical educators should be mindful that these domains are protected as AI develops. We recommend that ‘Applied AI’ topics are formalized in curricula and digital technologies leveraged to deliver clinical education.

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 Misuse of medication in adult substance misuse services: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047283
Author(s):  
Rosalind Gittins ◽  
Louise Missen ◽  
Ian Maidment
Keyword(s):  
Systematic Review ◽  
Substance Misuse ◽  
Data Extraction ◽  
Meta Analysis ◽  
Grey Literature ◽  
Opioid Analgesics ◽  
Physical And Mental Health ◽  
Qualitative Synthesis ◽  
Treatment Services ◽  
The Impact

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.

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.

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