scholarly journals Lack of Accredited Clinical Training in Movement Disorders in Europe, Egypt, and Tunisia

2020 ◽  
Vol 10 (4) ◽  
pp. 1833-1843
Author(s):  
Gertrúd Tamás ◽  
Margherita Fabbri ◽  
Cristian Falup-Pecurariu ◽  
Tiago Teodoro ◽  
Mónica M. Kurtis ◽  
...  
Keyword(s):  
Internal Medicine ◽  
General Practice ◽  
North Africa ◽  
Movement Disorders ◽  
Clinical Training ◽  
Training Programs ◽  
Subspecialty Training ◽  
Educational Tools ◽  
Printed Books ◽  
Case Presentations

Background: Little information is available on the official postgraduate and subspecialty training programs in movement disorders (MD) in Europe and North Africa. Objective: To survey the accessible MD clinical training in these regions. Methods: We designed a survey on clinical training in MD in different medical fields, at postgraduate and specialized levels. We assessed the characteristics of the participants and the facilities for MD care in their respective countries. We examined whether there are structured, or even accredited postgraduate, or subspecialty MD training programs in neurology, neurosurgery, internal medicine, geriatrics, neuroradiology, neuropediatrics, and general practice. Participants also shared their suggestions and needs. Results: The survey was completed in 31/49 countries. Structured postgraduate MD programs in neurology exist in 20 countries; structured neurology subspecialty training exists in 14 countries and is being developed in two additional countries. Certified neurology subspecialty training was reported to exist in 7 countries. Recommended reading lists, printed books, and other materials are the most popular educational tools, while courses, lectures, webinars, and case presentations are the most popular learning formats. Mandatory activities and skills to be certified were not defined in 15/31 countries. Most participants expressed their need for a mandatory postgraduate MD program and for certified MD sub-specialization programs in neurology. Conclusion: Certified postgraduate and subspecialty training exists only in a minority of European countries and was not found in the surveyed Egypt and Tunisia. MD training should be improved in many countries.

scholarly journals Expert Consensus on a Canadian Internal Medicine Ultrasound Curriculum

1970 ◽  
Vol 9 (3) ◽  
Author(s):  
Shane Arishenkoff MD ◽  
Marcus Blouw MD ◽  
Sharon Card MD ◽  
John Conly MD ◽  
Colin Gebhardt MD ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Training Programs ◽  
Residency Training Program ◽  
Leadership Role ◽  
Subspecialty Training ◽  
Internal Medicine Training ◽  
General Internal ◽  
Canadian Health ◽  
Canadian Provinces ◽  
Educational Need

Ultrasonography is increasingly used at the bedside. In the absence of an already developed curriculum appropriate for Canadian internal medicine training programs, 13 representatives from internal medicine programs in five Western Canadian provinces met for 2 days to develop and propose a consensus-based internal medicine curriculum for training in the bedside use of ultrasonography in a Canadian health care context.All 13 had had interest or leadership role in those programs. The curriculum’s content was based on three overarching principles agreed upon by the group: (1) content should be selected on the basis of clinical or educational need; (2) content should be feasible (i.e., both cognitive and technical components of the curriculum could be reasonably taught and learned in a competency-based manner while minimizing potential risks to patients); and (3) content should be evidence based. A consensusbased curriculum of 16 proposed topics is to be considered for the core internal medicine residency training program (postgraduate year [PGY] 1 to PGY 3), and 22 topics are to be considered for general internal medicine subspecialty training programs (PGY 4 to PGY 5).

scholarly journals The Current State and Needs of North American Movement Disorders Fellowship Programs

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Ludy C. Shih ◽  
Daniel Tarsy ◽  
Michael S. Okun
Keyword(s):  
Movement Disorders ◽  
North American ◽  
Clinical Training ◽  
Training Programs ◽  
Fellowship Training ◽  
Centers Of Excellence ◽  
Funding Sources ◽  
Current State ◽  
Fellowship Programs ◽  
American Academy Of Neurology

Background. Movement disorders fellowships are an important source of future clinician-specialists and clinician-scientists for the field. Scant published information exists on the number and characteristics of North American movement disorders fellowship training programs.Methods. A 31-item internet-based survey was formulated and distributed to academic movement disorders listed in the American Academy of Neurology (AAN) directory as having a movement disorders fellowship and to all National Parkinson Foundation Centers of Excellence and Care Centers in North America.Results. There was a 77% response rate among academic movement disorders centers. Broad similarities in clinical training were identified. The two most important rated missions of maintaining a movement disorders fellowship were contributions to scholarly activities and to fulfilling a critical need for specialists. Almost a quarter of fellowship programs did not offer a fellowship slot during the most recent academic year. Fellowship directors cited a wide variety of funding sources, but their top concern was lack of available funding for fellowship programs.Conclusions. North American movement disorders fellowship training programs currently offer similar methods of clinical training and education. Lack of funding was the most important obstacle to maintaining fellowship programs and should be made a priority for discussion in the field.

Attracting Internal Medicine Trainees to Rheumatology: Where and When Programs Should Focus Efforts

2009 ◽  
Vol 36 (12) ◽  
pp. 2802-2805 ◽  
Author(s):  
STEVEN J. KATZ ◽  
ELAINE A. YACYSHYN
Keyword(s):  
Internal Medicine ◽  
Infectious Diseases ◽  
Training Program ◽  
Positive Relationship ◽  
Training Programs ◽  
Training Institution ◽  
First Year ◽  
Subspecialty Training ◽  
English Speaking ◽  
Programs Of Study

Objective.To determine where and when efforts should be focused to increase recruitment of rheumatology trainees from internal medicine (IM) programs.Methods.(1) We calculated the percentage of trainees at each of the 13 English-speaking Canadian IM-accredited programs who entered a rheumatology training program in Canada from 2005 to 2007. We then correlated this with the opportunity they would have had to do a rheumatology rotation in each of their 3 postgraduate years of IM training. (2) We calculated the overall percentage of residents who remained at the same training institution after their IM program, 2005–2007, comparing this to 4 similar-size subspecialty training programs.Results.Among IM trainees, 3.5% began rheumatology training in Canada. There was a positive relationship at the postgraduate year 1 (PGY1) level between more rheumatology opportunities and chance of entering rheumatology (r2 = 0.35, p < 0.05), but not at the PGY2 or PGY3 level. Among rheumatology trainees, 78% remained at the training institution where they completed IM training, more than the 70% of gastroenterology trainees, 68% of nephrology trainees, 67% of endocrinology trainees, and 76% of infectious diseases trainees.Conclusion.The opportunity for a rheumatology rotation in the first year of IM training increases the likelihood the trainee may choose rheumatology as a career. Further, most rheumatology trainees continue at the same institution as their IM training, more than other subspecialties. This information may assist recruitment efforts to increase numbers of rheumatology trainees and the overall rheumatology workforce. These data warrant reevaluation of IM programs of study in order to influence trainee career choices and plan better for future workforce requirements in all IM fields.

Guidelines for Combined Internal Medicine-Pediatrics Residency Training Programs

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 190-194
Keyword(s):  
Internal Medicine ◽  
Clinical Training ◽  
Clinical Epidemiology ◽  
Care Delivery ◽  
Residency Review Committee ◽  
Medical Decision ◽  
Adolescent Medicine ◽  
Subspecialty Training ◽  
Review Committee ◽  
Academic Environments

The objectives of a combined residency in internal medicine-pediatrics include the training of general physicians for practice or academic careers addressing the spectrum of illnesses in the newborn, children, adolescents, and adults. Graduates of a combined residency may function as generalists in practice and academic environments or enter subspecialty training. This clinical training can also prepare graduates to undertake research in areas shared by internal medicine and pediatrics, including adolescent medicine, medical genetics, clinical epidemiology, medical decision making, and health care delivery. The strengths of the residencies in internal medicine and pediatrics should complement each other to provide the optimal educational experience. Combined programs include components of independent internal medicine and pediatrics residencies that are accredited respectively by the Residency Review Committee for Internal Medicine and by the Residency Review Committee for Pediatrics, both of which function under the auspices of the Accreditation Council for Graduate Medical Education. Although combined programs will not be independently accredited, the accreditation status of the parent internal medicine and pediatrics programs influences a combined program resident's admission to the certifying examinations of each board. The boards will not accept training in a newly established combined program if the accreditation status of the residency in either discipline is provisional or probationary. If the residency in either discipline is accredited on a probationary basis, residents should not be appointed to the combined program. At least two residents must be enrolled in each year of the 4-year program to ensure peer interaction. GENERAL REQUIREMENTS A combined residency in internal medicine-pediatnics must include at least 4 years of coherent training integral to residencies in the two disciplines that meet the special requirements for adcreditation by the Residency Review Committee of Internal Medicine and Residency Review Committee of Pediatrics, respectively.

5. A needs assessment for a CanMEDS-based curriculum in ambulatory care for internal medicine residents in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 29
Author(s):  
R. Wong ◽  
S. Roff
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Learning Outcomes ◽  
Delphi Technique ◽  
Training Programs ◽  
Internal Medicine Training ◽  
Modified Delphi ◽  
Ambulatory Training ◽  
Ambulatory Medicine ◽  
Care Training

In Canada, graduates of internal medicine training programs should be proficient in ambulatory medicine and practice. Before determining how to improve education in ambulatory care, a list of desired learning outcomes must be identified and used as the foundation for the design, implementation and evaluation of instructional events. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each round of questions. A modified Delphi technique was used to determine the competencies required for an ambulatory care curriculum based on the CanMEDS roles. Four groups deemed to be critical stakeholders in residency education were invited to take part in this study: 1. Medical educators and planners, 2. Members of the Canadian Society of Internal Medicine (CSIM), 3. Recent Royal College certificants in internal medicine, 4. Residents currently in core internal medicine residency programs. Panelists were sent questionnaires asking them to rate learning outcomes based on their importance to residency training in ambulatory care. Four hundred and nineteen participants completed the round 1 questionnaire that was comprised of 75 topics identified through a literature search. Using predefined criteria for degree of importance and consensus, 19 items were included in the compendium and 9 were excluded after one round. Forty-two items for which the panel that did not reach consensus, as well as 3 new items suggested by the panel were included in the questionnaire for round 2. Two hundred and forty participants completed the round 2 questionnaire; consensus was reached for each of the 45 items. After two rounds, 21 items were included in the final compendium as very high priority topics (“must be able to”). An additional 26 items were identified as high priority topics (“should be able to”). The overall ratings by each of the four groups were similar and there were no differences between groups that affected the selection of items for the final compendium. To our knowledge this is the first time a Delphi-process has been used to determine the content of an ambulatory care curriculum in internal medicine in Canada. The compendium could potentially be used as the basis to structure training programs in ambulatory care. Barker LR. Curriculum for Ambulatory Care Training in Medical residency: rationale, attitudes and generic proficiencies. J Gen Intern Med 1990; 5(supp.):S3-S14. Levinsky NG. A survey of changes in the proportions of ambulatory training in internal medicine clerkships and residencies from 1986-87 to 1996-97. Acad Med 1998; 73:1114-1115. Linn LS, Brook RH, Clarke VA, Fink A, Kosecoff J. Evaluation of ambulatory care training by graduates of internal medicine residencies. J Med Educ 1986; 61:293-302.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

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 I’m No Superman: fostering physician resilience through guided group discussion of Scrubs

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur Holtzclaw ◽  
Jack Ellis ◽  
Christopher Colombo
Keyword(s):  
Internal Medicine ◽  
Training Programs ◽  
Low Cost ◽  
Group Discussion ◽  
Well Being ◽  
Internal Medicine Residency ◽  
Resiliency Training ◽  
High Satisfaction ◽  
Burn Out

Abstract Background Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic. Methods We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness. Results The curriculum was successfully conducted for 12 months with each session averaging 18–20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI. Conclusions This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.

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