scholarly journals Impact of reflective writings on learning of core competencies in medical residents

2021 ◽  
Vol 6 (4) ◽  
pp. 65-79
Author(s):  
Yee Cheun Chan ◽  
Chi Hsien Tan ◽  
Jeroen Donkers
Keyword(s):  
Internal Medicine ◽  
Patient Care ◽  
Deep Level ◽  
Core Competencies ◽  
Reflective Writing ◽  
Internal Medicine Residency ◽  
Structured Interviews ◽  
Residency Programme ◽  
Context Of Learning ◽  
The Impact

Introduction: Reflection is a critical component of learning and improvement. It remains unclear as to how it can be effectively developed. We studied the impact of reflective writing in promoting deep reflection in the context of learning Accreditation Council for Graduate Medical Education (ACGME) competencies among residents in an Internal Medicine Residency programme. Methods: We used a convergent parallel mixed-methods design for this study in 2018. We analysed reflective writings for categories and frequencies of ACGME competencies covered and graded them for levels of reflection. We collected recently graduated residents’ perceptions of the value of reflective writings via individual semi-structured interviews. Results: We interviewed nine (out of 27) (33%) participants and analysed 35 reflective writings. 30 (86%) of the writings showed a deep level (grade A or B) of reflection. Participants reflected on all six ACGME competencies, especially ‘patient care’. Participants were reluctant to write but found benefits of increased understanding, self-awareness and ability to deal with similar future situations, facilitation of self-evaluation and emotional regulation. Supervisors’ guidance and feedback were lacking. Conclusion: We found that a reflective writing programme within an Internal Medicine Residency programme promoted deep reflection. Participants especially used self-reflection to enhance their skills in patient care. We recognised the important role of mentor guidance and feedback in enhancing reflective learning.

The impact of the night float system on internal medicine residency programs

1991 ◽  
Vol 6 (5) ◽  
pp. 445-449 ◽  
Author(s):  
Marie C. Trontell ◽  
Jeffrey L. Carson ◽  
Mark I. Taragin
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Residency ◽  
Residency Programs ◽  
Night Float ◽  
The Impact

scholarly journals Residents’ transformational changes through self-regulated, experiential learning for professionalism

2021 ◽  
Author(s):  
Janet M De Groot ◽  
Aliya Kassam ◽  
Dana Swystun ◽  
Maureen Topps
Keyword(s):  
Experiential Learning ◽  
Patient Care ◽  
Professional Growth ◽  
Teaching Hospitals ◽  
Power Dynamics ◽  
Self Awareness ◽  
Structured Interviews ◽  
Clinical Learning Environment ◽  
Clinical Environments ◽  
The Impact

Purpose: Postgraduate trainees (‘residents”) are required to convey professional behaviours as they navigate complex clinical environments. However, little is known about experiential learning for professionalism. Thus, we asked residents about professionalism challenges within the clinical learning environment: 1) how challenges were identified, 2) what supported successfully addressing challenges and 3) the impact of addressing challenges to further inform resident education. Method: From 2015-2016, twenty-five residents across specialties and multiple university affiliated teaching hospitals participated in appreciative inquiry informed audio-taped semi-structured interviews. Transcripts were categorized deductively for the 2015 CanMEDS Professional Role element addressed (commitment to patients, society, the profession, and physician health).  A pragmatic research paradigm focussed descriptive data analysis on actions and outcomes.  Results: Residents actively identify opportunities for experiential learning of professionalism within the clinical workplace– addressing conflicting priorities with interprofessional clinicians to ensure excellent patient care, providing informal feedback regarding peers’ and other healthcare clinicians’ professionalism lapses and by gaining self-awareness and maintaining wellness. There were no descriptions of commitment to society. Values, relationships, and reflection supported professional behaviours. Many described transformative personal and professional growth as an outcome of addressing professionalism challenges. Conclusions: Residents self-regulated experiential learning for professionalism often results in transformational changes personally and professionally. Elucidation of how residents successfully navigate power dynamics and conflict to provide excellent patient care and feedback for professional regulatory behaviour will support professionalism education. An interprofessional research lens will be valuable to explore how best to incorporate commitment to society within clinical environments. 

scholarly journals Endocrinology in the Time of Coronavirus: A Virtual Endocrinology Elective for Medical Students

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A340-A341
Author(s):  
Meaghan C Moxley ◽  
Elizabeth Lamos ◽  
Rana Malek
Keyword(s):  
Medical Students ◽  
Patient Care ◽  
Student Satisfaction ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Diabetes Care ◽  
Core Competencies ◽  
Determinants Of Health ◽  
The Impact

Abstract Introduction: During the COVID-19 pandemic, the Association of American Medical Colleges recommended that medical students halt in-person learning. Our institution created a competency based virtual endocrinology elective to provide continued clinical experience with a focus on type 2 diabetes (T2DM) and health equity in diabetes care. Methods: A 4-week virtual endocrinology elective alternated between different mini-rotations to maximize exposure to inpatient and outpatient endocrine care, as well as self-directed and faculty/fellow directed educational experiences. Post-elective surveys assessed student satisfaction with elective components and change in comfort levels with T2DM management and social determinants of health (SDH) on diabetes care. Results: Overall, 87% (n=13) of students were “extremely satisfied” with the elective. Increased comfort was seen with management of type 2 DM and the impact of SDH on DM care (DM 88% neutral/uncomfortable to 94% comfortable, SDH 50% neutral/uncomfortable to 94% comfortable). Students were satisfied with the quality of patient care and requested opportunities for more direct involvement. Conclusions: This virtual endocrine elective shows that curricula can be creatively designed to educate students in endocrinology, assess students across core competencies, and demonstrate impacts of telehealth and social determinants of health on endocrine and patient care.

COVID-19: The Impact on Internal Medicine Residency Training (Preprint)

2020 ◽  
Author(s):  
Odalys Estefania Lara Garcia ◽  
Khalid Sawalha ◽  
Oswaldo Aristides Madrid Suarez ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Internal Medicine Residency ◽  
Internal Medicine Residents ◽  
Internal Medicine Residency Training ◽  
The Impact ◽  
The Way

UNSTRUCTURED The SARS-CoV-2 (COVID-19) pandemic outreach has not only affected the care we provide to patients, but also the way our residents are trained, especially internal medicine residents. We review the current challenges and changes that have taken place in the education of internal medicine residents. Proposed solutions are discussed.

The impact of adding 1 month of intensive care unit training in a categorical internal medicine residency program*

2009 ◽  
Vol 37 (4) ◽  
pp. 1223-1228 ◽  
Author(s):  
John J. Mullon ◽  
Ognjen Gajic ◽  
Bhargavi Gali ◽  
Robert D. Ficalora ◽  
Joseph C. Kolars ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Residency Program ◽  
Internal Medicine Residency ◽  
Internal Medicine Residency Program ◽  
The Impact

scholarly journals Internal Medicine Residents’ Views About Care Transitions: Results of an Educational Intervention

2021 ◽  
Vol 8 ◽  
pp. 238212052098859
Author(s):  
Fatima Sheikh ◽  
Evelyn Gathecha ◽  
Alicia I Arbaje ◽  
Colleen Christmas
Keyword(s):  
Internal Medicine ◽  
Qualitative Analysis ◽  
Continuity Of Care ◽  
Transitional Care ◽  
Care Transitions ◽  
Reflective Writing ◽  
Patient Specific ◽  
Transition Of Care ◽  
Internal Medicine Residents ◽  
The Impact

Problem: Suboptimal care transitions can lead to re-hospitalizations. Intervention: We developed a 2-week “Transitions of Care Curriculum” to train first-year internal medicine residents to improve their knowledge and skills to deliver optimal transitional care. Our objective was to use reflective writing essays to evaluate the impact of the curriculum on the residents. Methods: The rotation included: Transition of Care Teaching modules, Transition Audit, Transitional Care Site Visits, and Transition of Care Conference. Residents performed the above elements of care transitions during the curriculum and wrote reflective essays about their experiences. These essays were analyzed to assess for the overall impact of the curriculum on the residents. Qualitative analysis of reflective essays was used to evaluate the impact of the curriculum. Of the 20 residents who completed the rotation, 18 reflective essays were available for qualitative analysis. Results: Five major themes identified in the reflective essays for improvement were: discharge planning, patient-centered care, continuity of care, goals of care discussions, and patient safety. The most discussed theme was continuity of care, with following subthemes: fragmentation of the healthcare system, disjointed care to the patients, patient specific factors contributing to lack of continuity of care, lack of primary care provider role as a coordinator of care, and challenges during discharge process. Residents also identified system-based gaps and suggested solutions to overcome these gaps. Conclusions: This experiential learning and use of reflective writing enhanced the residents’ self-identified awareness of gaps in care transitions and prompted them to generate ideas for systems improvement and personal actions to improve their practice during care transitions.

Abstract P164: Reduction of Heart Failure Readmissions Through an Enhanced Internal Medicine Residency Curriculum

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Mercy P Chandrasekaran ◽  
Janice Barry ◽  
Barbra White ◽  
Paula L Eryazici ◽  
Sorin C Danciu
Keyword(s):  
Internal Medicine ◽  
Heart Failure ◽  
Internal Medicine Residency ◽  
Post Discharge ◽  
Post Intervention ◽  
Statistical Comparison ◽  
Residency Curriculum ◽  
Core Measures ◽  
The Impact

Background: Heart failure (HF) carries a significant economic burden and hospitalizations account for 70% of the total costs of heart failure. Rehospitalizations are particularly costly and potentially avoidable. As part of the National Initiative for Alliance of Independent Academic Medical Centers, we aimed to decrease the HF readmissions by 5% through enhancements in the Internal Medicine Residency Curriculum. Methods: Between 7/10-2/11, we implemented a HF lecture series, multidisciplinary rounds, article and case reviews. Cardiac Rehabilitation, Information Systems, HF Team, Case Managers/Social Work and Nursing staff collaborated to develop better documentation and discharge protocols. To determine the impact of our intervention, the change in 30-day readmission and pre and post questionnaire about HF knowledge/attitudes were statistically analyzed. Results: The pre test questionnaire showed: 1) Residents felt more confident in treating/ counseling patients with HF and were not as confident in identifying precipitants of readmissions or applying core measures. 2) Most residents felt the key factors to preventing readmissions were close post-discharge follow up and patient education. Post intervention questionnaire showed: 1) More residents were confident about the core measures, quality indicators, appropriate documentation of HF. 2) More residents were satisfied with the Internal Medicine Residency Curriculum. The average HF readmission rate reduced from 24.6% to 20.9% between 7/10-11/10 (above goal). January - August 2010 (Before Intervention) September - November 2010 (After Intervention) All HF Admissions 1178 464 All HF Readmissions 292 (24.8 %) 103 (22.2%) Primary HF Admissions 167 63 Primary HF Readmissions 40 (24.0%) 12 (19.0%) Statistical comparison of All HF p=0.483, OR 1.339, 95% CI 0.656-2.727 Statistical comparison of Primary HF p=0.276, OR 1.155 95% CI 0.895-1.491 Conclusions: A 6-month resident-oriented multidisciplinary intervention improved patient care, documentation, and resident understanding of HF syndrome. This led to promising trends towards a significant decrease in 30-day HF readmissions. Further improvement in outcomes should be evident at the completion of 12-month follow-up.

scholarly journals Towards Sustainable Human Resource Development of Convention Project Managers: Job Characteristics and Related Differences in Core Competency

2020 ◽  
Vol 12 (19) ◽  
pp. 7898
Author(s):  
Yeonghye Yoon ◽  
Wenyan Yan ◽  
Eunjin Kim
Keyword(s):  
Human Resource Development ◽  
Core Competencies ◽  
Core Competency ◽  
Job Characteristics ◽  
Project Managers ◽  
Sustainable Growth ◽  
Structured Interviews ◽  
Job Characteristics Model ◽  
The Impact ◽  
Convention Industry

There are currently extensive discussions on the remarkable development of the convention industry and the impact on local economies made by convention visitors, but there is limited research on the human resources expertise which is crucial for sustainable and qualitative development in the field of convention. This study aims to examine differences in core competencies based on the type of job characteristics model of convention project managers. Based on the existing literature, quantitative and qualitative mixed-methods design was used. 12 semi-structured interviews were conducted with professionals to define measurements, especially core competencies. Job characteristics and core competencies were identified with a survey of 392 convention PM. By using a cluster analysis, it investigated the differences in perception of competencies according to the job characteristics model. As a result of the analysis, five job characteristics were verified, and core competencies that were not organized were classified. In addition, it was confirmed through the analysis that there is a difference in perception of core competencies according to job characteristics. Based on the results, this study stresses the importance of the qualitative and sustainable development of the convention industry. Theoretical and practical implications were provided to enhance core competencies according to job characteristics for sustainable growth of convention project managers.

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