scholarly journals The Neighborhood Health Exchange: Developing a Community Partnership in Residency

2010 ◽  
Vol 2 (3) ◽  
pp. 456-461 ◽  
Author(s):  
Kimberly M. Tartaglia ◽  
Valerie G. Press ◽  
Benjamin H. Freed ◽  
Timothy Baker ◽  
Joyce W. Tang ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Current System ◽  
Hospital Setting ◽  
Community Outreach ◽  
Community Partnership ◽  
Community Members ◽  
Training Experience ◽  
Ambulatory Training ◽  
Internal Medicine Residents

Abstract Background The current system of residency training focuses on the hospital setting, and resident exposure to the surrounding community is often limited. However, community interaction can play an important role in ambulatory training and in learning systems-based practice, a residency core competency. The goal of the Neighborhood Health Exchange was to develop a community partnership to provide internal medicine residents with an opportunity to interface with community members through a mutually beneficial educational experience. Methods Internal medicine residents received training during their ambulatory block and participated in a voluntary field practicum designed to engage community members in discussions about their health. Community members participated in education sessions led by resident volunteers. Results Resident volunteers completed a survey on their experiences. All residents stated that the opportunity to lead an exchange was very useful to their overall residency training. Eight exchanges were held with a total of 61 community participants, who completed a 3-question survey following the session. This survey asked about the level of material, the helpfulness of the exchanges, and opportunities for improvement. We received 46 completed surveys from community members: 91% stated that the material was presented “at the right level” and 93% stated that the presentations were somewhat or very helpful. Eighty percent gave positive and encouraging comments about the exchange. Conclusion Effective community partnerships involve assessing needs of the stakeholders, anticipating leadership turnover, and adapting the Neighborhood Health Exchange model to different groups. Community outreach can also enhance internal medicine ambulatory training experience, provide residents with patient counseling opportunities, and offer a novel method to enhance resident understanding of systems-based practice, especially within the larger community in which their patients live.

Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions

2021 ◽  
Vol 12 (02) ◽  
pp. 355-361
Author(s):  
Kinjal Gadhiya ◽  
Edgar Zamora ◽  
Salim M. Saiyed ◽  
David Friedlander ◽  
David C. Kaelber
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Medical Center ◽  
Internal Medicine Resident ◽  
Clinical Decision ◽  
University Of Pennsylvania ◽  
Teaching Hospitals ◽  
Medicine Resident ◽  
Internal Medicine Residents ◽  
The University

Abstract Background Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.

scholarly journals Timing and Predictors of Subspecialty Career Choice Among Internal Medicine Residents: A Retrospective Cohort Study

2020 ◽  
Vol 12 (2) ◽  
pp. 212-216
Author(s):  
Jingkun Yang ◽  
Surbhi Singhal ◽  
Yingjie Weng ◽  
Jason P. Bentley ◽  
Neel Chari ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Career Choice ◽  
Residency Training ◽  
Career Choices ◽  
Hospital Medicine ◽  
Care Hospital ◽  
Clinical Exposure ◽  
Internal Medicine Residents ◽  
Primary Care Hospital ◽  
Early Clinical Exposure

ABSTRACT Background Internal medicine residents face numerous career options after residency training. Little is known about when residents make their final career choice. Objective We assessed the timing and predictive factors of final career choices among internal medicine residents at graduation, including demographics, pre-residency career preferences, and rotation scheduling. Methods We conducted a retrospective study of graduates of an academic internal medicine residency program from 2014 to 2017. Main measures included demographics, rotation schedules, and self-reported career choices for residents at 5 time points: recruitment day, immediately after Match Day, end of postgraduate year 1 (PGY-1), end of PGY-2, and at graduation. Results Of the 138 residents eligible for the study, 5 were excluded based on participation in a fast-track program for an Accreditation Council for Graduate Medical Education subspecialty fellowship. Among the remaining 133 residents, 48 (36%) pursued general internal medicine fields and 78 (59%) pursued fellowship training. Career choices from recruitment day, Match Day, and PGY-1 were only weakly predictive of the career choice. Many choices demonstrated low concordance throughout training, and general medicine fields (primary care, hospital medicine) were frequently not decided until after PGY-2. Early clinical exposure to subspecialty rotations did not predict final career choice. Conclusions Early career choices before and during residency training may have low predictability toward final career choices upon graduation in internal medicine. These choices may continue to have low predictability beyond PGY-2 for many specialties. Early clinical exposure may not predict final career choice for subspecialties.

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.

scholarly journals Liberation Medicine: a Community Partnership and Health Advocacy Curriculum for Internal Medicine Residents

2019 ◽  
Vol 35 (10) ◽  
pp. 3102-3104
Author(s):  
Erin Goss ◽  
Shwetha Iyer ◽  
Julia Arnsten ◽  
Linda Wang ◽  
Clyde Lanford Smith
Keyword(s):  
Internal Medicine ◽  
Community Partnership ◽  
Health Advocacy ◽  
Internal Medicine Residents

Perspectives on Cancer Screening Among Latino Community Members and Internal Medicine Residents

2007 ◽  
Vol 1 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Debbie. Salas-Lopez ◽  
Dawne. Mouzon ◽  
Jonnie. Marks ◽  
Neil. Kothari ◽  
Ana. Natale-Pereira
Keyword(s):  
Internal Medicine ◽  
Cancer Screening ◽  
Community Members ◽  
Latino Community ◽  
Internal Medicine Residents

An Integrated Geriatric Training Experience for Internal Medicine Residents

1988 ◽  
Vol 7 (3-4) ◽  
pp. 29-41 ◽  
Author(s):  
Galen L. Barbour ◽  
Mary Jane Tompkins ◽  
Myron G. Eisenberg
Keyword(s):  
Internal Medicine ◽  
Training Experience ◽  
Internal Medicine Residents

scholarly journals Defining Content for a Competency-based (CanMEDS) Postgraduate Curriculum in Ambulatory Care: A Delphi Study

2012 ◽  
Vol 3 (1) ◽  
pp. e21-e32
Author(s):  
René Wong
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Delphi Study ◽  
Delphi Process ◽  
Ambulatory Training ◽  
Societal Needs ◽  
Internal Medicine Residents ◽  
Recent Graduates ◽  
Health Advocate ◽  
Competency Based

Background: Ambulatory training in internal medicine has been noted to be dysfunctional and inadequate. In this study, we developed a set of competency-based outcomes specific to ambulatory care to guide the design, implementation and evaluation of instructional events to ensure that societal needs are addressed. Methods: In 2007 a Delphi technique was used to reach consensus and define the priorities for competency-based training in ambulatory care for internal medicine residents. Four groups of stakeholders in Canada participated: program directors, members of the Canadian Society of Internal Medicine, recent graduates, and residents. Results: Two rounds of the Delphi process were required to reach consensus on a set of sixty competency-based educational objectives in ambulatory care that were classified under the CanMEDS roles. The inclusion of recent graduates in this study resulted in the addition of non-clinical topics that would have otherwise been missed, falling under roles historically viewed as being challenging to teach and evaluate (Manager, Health Advocate). Conclusion: This study is the first time a Delphi-process has been used to define the priorities for ambulatory care training in internal medicine under a competency-based framework. The resulting compendium of competency-based objectives provides a foundation from which educators can design, evaluate and modify existing training experiences.

scholarly journals Advancing Internal Medicine Training: Experience of a Bedside Procedure Service as A Resident Elective

2020 ◽  
Author(s):  
Sheila Swartz ◽  
Adrian Umpierrez De Reguero ◽  
Joseph Puetz ◽  
Lara Voigt ◽  
Nikola Cuzovic ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Ultrasound Guidance ◽  
Improve Patient Safety ◽  
Tertiary Care ◽  
Hospital Medicine ◽  
Complication Rates ◽  
Training Experience ◽  
Internal Medicine Training ◽  
Internal Medicine Residents ◽  
Procedural Complications

Abstract Background: In 2007, the American Board of Internal Medicine eliminated numeric procedure requirements for licensing. The level of exposure to procedures during residency, and subsequent competence of graduating residents, is variable. In 2015, our institution developed a bedside procedure service (BPS) with the intent to teach ultrasound guidance and procedural training to internal medicine residents with direct supervision of technique by Hospital Medicine faculty to optimize learning, increase confidence, and improve patient safety. Objective: In this study, we review the number and complication rates of resident procedures on a dedicated internal medicine bedside procedure service (BPS) as a resident elective.Methods: In this retrospective, observational, single-center study, we reviewed internally collected data from BPS procedures performed from 2015-2019. The BPS offers a variety of procedures done with ultrasound guidance at an adult tertiary care referral center. BPS services are available to all inpatient hospital services. A rotation with the BPS was offered as a stand-alone resident elective for the first time in 2015. Results: 69 residents performed a total of 2700 ultrasound-guided/assisted procedures and 146 diagnostic ultrasound scans from 2015-2019. Residents performed an average of 40 procedures during their elective month. There were 5 resident performed procedural complications with an overall complication rate of 0.19%.Conclusions: Our BPS increased procedural opportunities for residents and allowed for real-time feedback by an experienced faculty member in a one-on-one setting. A dedicated rotation allows the time to focus on becoming proficient in invasive procedures with expert supervision.

scholarly journals An Effective Multimodal Curriculum to Teach Internal Medicine Residents Evidence-Based Breast Health

2014 ◽  
Vol 6 (4) ◽  
pp. 721-725 ◽  
Author(s):  
Jennifer Corbelli ◽  
Rachel Bonnema ◽  
Doris Rubio ◽  
Diane Comer ◽  
Melissa McNeil
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Low Cost ◽  
Clinical Breast Examination ◽  
Knowledge Retention ◽  
Breast Health ◽  
Missed Opportunities ◽  
Knowledge And Skills ◽  
Historical Comparison ◽  
Internal Medicine Residents

Abstract Background Breast health is an area fraught with controversy and missed opportunities to meet women's needs, and the state of internal medicine residency training in this area is inadequate. Objective Our objective was to develop, implement, and evaluate a curriculum to equip internal medicine residents with the knowledge and skills to deliver high-quality, comprehensive breast health care. Methods We developed a 4-hour curriculum for internal medicine interns. It incorporated a team-based learning format and used MammaCare breast model software to teach and evaluate the clinical breast examination. We compared interns' precurriculum and postcurriculum test results to a historical comparison group of postgraduate year (PGY)–2 interns who did not complete the curriculum. We retested interns as PGY-2s to assess knowledge retention. Results A total 41 of 52 interns (79%) completed the curriculum. Their average MammaCare scores improved from 63% to 91%. Scores on a knowledge-based assessment improved from 47% on the pretest to 85% on the posttest (P < .001). Comparison PGY-2s who did not complete the curriculum averaged a score of 52% (P < .001). When retested 9 months after exposure to the curriculum, participants' mean score was 63% (compared to historical comparison PGY-2 group, P < .001). Only 9% of interns who retook the test as PGY-2s reported having received any breast health training subsequent to curriculum completion. Conclusions A targeted half-day, low-cost breast health curriculum significantly improved knowledge and skills in multiple domains, and these improvements were retained in subsequent assessment despite minimal reinforcement in residency training.

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