scholarly journals Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine Residents

2014 ◽  
Vol 6 (2) ◽  
pp. 310-314 ◽  
Author(s):  
Marina MacNamara ◽  
April Wilhelm ◽  
Geolani Dy ◽  
Sarah Andiman ◽  
Carol Landau ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Focus Groups ◽  
Medical Training ◽  
Quality Care ◽  
Hospital Staff ◽  
Online Information ◽  
Preliminary Assessment ◽  
Internal Medicine Residents ◽  
Adequate Education ◽  
Survey Results

Abstract Background Residents report they lack preparation for caring for an increasingly diverse US population. In response, a variety of curricula have been developed to integrate cultural competency into medical training programs. To date, none of these curricula has specifically addressed members of recently resettled populations. Methods A preliminary assessment was conducted among internal medicine (IM) residents at 1 program (N  =  147). Based on 2 conceptual frameworks and the survey results, a pilot curriculum was developed and integrated into the interns' ambulatory block education within the general IM track (n  =  9). It included (1) online information made available to all hospital staff; (2) 4 interactive didactic sessions; and (3) increased exposure to newly arrived patients. The curriculum was qualitatively evaluated through 2 focus groups. Results The preliminary assessment was completed by 101 of 147 residents (69%), with 61% of respondents indicating they felt that they received less than adequate education in this area. Eight of the 9 interns exposed to the new curriculum participated in the focus groups. Overall, respondents reported they thought patient care had improved for recently resettled populations and across their patient panels after exposure to the curriculum. Conclusions This study demonstrated that an intervention that included didactics and enhanced exposure to a diverse population improved IM interns' perceptions of care for all patients, including recently settled individuals.

scholarly journals Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250769
Author(s):  
Dimitria Doi ◽  
Romulo Ribeiro do Vale ◽  
Jean Michell Correia Monteiro ◽  
Glauco Cabral Marinho Plens ◽  
Mario Ferreira Junior ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Laboratory Tests ◽  
Medical Training ◽  
Outpatient Service ◽  
Ambulatory Setting ◽  
Subjective Perception ◽  
Internal Medicine Residents ◽  
Co Morbidity ◽  
Test Ordering

The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents’ training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents’ subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.

Predictors of Internal Medicine Resident Satisfaction with Teaching by Attendings

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
Cassandra M Guarino ◽  
Chung Pham ◽  
Elaine Quiter ◽  
Jose J Escarce
Keyword(s):  
Internal Medicine ◽  
Clinical Teaching ◽  
Medical Training ◽  
Internal Medicine Resident ◽  
Resident Satisfaction ◽  
Factors Associated ◽  
Medicine Resident ◽  
Internal Medicine Residents ◽  
Number Of Patients ◽  
Negative Factors

This study identifies factors that predict internal medicine resident satisfaction with the quality of teaching by attendings. A key issue facing educators is whether high-quality instruction can be maintained in an environment in which attending physicians have many competing demands placed on their time. A national survey of clinical third-year internal medicine residents in 125 academically affiliated generally medical training programs was conducted. Univariate analyses describe the characteristics of the sample, and multivariate analyses evaluate the factors associated with resident satisfaction with teaching. The response rate was 64.1% (n=1354). Positive factors relating to satisfaction with teaching on inpatient ward rotations included: number of patients seen during rounds, attendings were fulltime, attending did clinical teaching during bedside work rounds, attending gave spontaneous and prepared presentations, and attendings were reached soon when needed. Negative factors included: number of residents in a ward team, number of patients admitted on overnight call, attendings seemed rushed and eager to finish rounds, and attendings were temporarily called away during rounds. Positive factors relating to satisfaction with teaching in continuity clinics included: residents being female and amount of time spent on talking to or examining patients. Negative factors included: amount of time spent on paperwork or routine work, attending changed resident’s decisions, attendings were difficult to reach, and attendings were temporarily called away during teaching. Different clinic settings also affected satisfaction. This study identifies several factors associated with internal medicine residents’ satisfaction with teaching and highlights mutable factors that faculty may consider changing to improve education and satisfaction.

Teaching residents how to break bad news: piloting a resident-led curriculum and feedback task force as a proof-of-concept study

2021 ◽  
pp. bmjstel-2021-000897
Author(s):  
Joseph Sleiman ◽  
David J Savage ◽  
Benjamin Switzer ◽  
Colleen Y Colbert ◽  
Cory Chevalier ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Communication Skills ◽  
Task Force ◽  
Educational Innovation ◽  
Field Testing ◽  
Bad News ◽  
Two Phase ◽  
Academic Medical Centre ◽  
Internal Medicine Residents ◽  
Survey Results

BackgroundBreaking bad news (BBN) is a critically important skill set for residents. Limited formal supervision and unpredictable timing of bad news delivery serve as barriers to the exchange of meaningful feedback.Purpose of studyThe goal of this educational innovation was to improve internal medicine residents’ communication skills during challenging BBN encounters. A formal BBN training programme and innovative on-demand task force were part of this two-phase project.Study designInternal medicine residents at a large academic medical centre participated in an interactive workshop focused on BBN. Workshop survey results served as a needs assessment for the development of a novel resident-led BBN task force. The task force was created to provide observations at the bedside and feedback after BBN encounters. Training of task force members incorporated video triggers and a feedback checklist. Inter-rater reliability was analysed prior to field testing, which provided data on real-world implementation challenges.Results148 residents were trained during the 2-hour communications skills workshop. Based on survey results, 73% (108 of 148) of the residents indicated enhanced confidence in BBN after participation. Field testing of the task force on a hospital ward revealed potential workflow barriers for residents requesting observations and prompted troubleshooting. Solutions were implemented based on field testing results.ConclusionsA trainee-led BBN task force and communication skills workshop is offered as an innovative model for improving residents’ interpersonal and communication skills in BBN. We believe the model is both sustainable and reproducible. Lessons learnt are offered to aid in implementation in other settings.

Truth Disclosure at the End of Life: A Qualitative Study of Internal Medicine Residents in the United Arab Emirates

2021 ◽  
pp. 104990912110638
Author(s):  
Halah Ibrahim ◽  
Thana Harhara
Keyword(s):  
Internal Medicine ◽  
End Of Life ◽  
United Arab Emirates ◽  
Terminal Illness ◽  
Medical Information ◽  
Moral Distress ◽  
Medical Training ◽  
Truth Telling ◽  
Truth Disclosure ◽  
Internal Medicine Residents

Background Respect for patient autonomy has become the guiding biomedical ethical tenet in the West; yet, moral values are contextual and culturally relevant. In the collectivist society of the Middle East, families and physicians have historically believed that concealing truth about a terminal illness is more ethical and compassionate. Recent studies reveal a trend toward truth disclosure. Objective To gain insight into resident experiences with, and barriers to, truth disclosure in terminally ill patients in the United Arab Emirates (UAE). Methods Focus group interviews were conducted with first through fourth year internal medicine residents and recent graduates at two large academic medical centers in the UAE. Qualitative thematic content analysis was used to identify themes related to communication and truth telling in end-of-life care. Results Residents revealed that non-disclosure of medical information in serious illness is a common practice in UAE hospitals. Barriers to truth telling include family objection, deficits in medical training, and inconsistently implemented institutional guidelines. Conclusion Educational and policy interventions are needed to improve physician-patient communication, decrease patient-family-physician tension, and alleviate trainee moral distress.

Genomics in medicine: a novel elective rotation for internal medicine residents

2019 ◽  
Vol 95 (1128) ◽  
pp. 569-572
Author(s):  
Linda N Geng ◽  
Jennefer N Kohler ◽  
Peter Levonian ◽  
Jonathan A Bernstein ◽  
James M Ford ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical Training ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Allied Health Professionals ◽  
Postgraduate Medical Training ◽  
Internal Medicine Residents ◽  
Genomics Education ◽  
Undiagnosed Diseases

It is well recognised that medical training globally and at all levels lacks sufficient incorporation of genetics and genomics education to keep up with the rapid advances and growing application of genomics to clinical care. However, the best strategy to implement these desired changes into postgraduate medical training and engage learners is still unclear. We developed a novel elective rotation in ‘Genomic Medicine and Undiagnosed Diseases’ for categorical Internal Medicine Residents to address this educational gap and serve as an adaptable model for training that can be applied broadly across different specialties and at other institutions. Key curriculum goals achieved include increased understanding about genetic testing modalities and tools available for diagnosis and risk analysis, the role of genetics-trained allied health professionals, and indications and limitations of genetic and genomic testing in both rare and common conditions.

scholarly journals Understanding Resident Learning Preferences Within an Internal Medicine Noon Conference Lecture Series: A Qualitative Study

2014 ◽  
Vol 6 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Adam P. Sawatsky ◽  
Susan L. Zickmund ◽  
Kathryn Berlacher ◽  
Dan Lesky ◽  
Rosanne Granieri
Keyword(s):  
Internal Medicine ◽  
Focus Groups ◽  
Effective Teaching ◽  
Teaching Methods ◽  
Medical Knowledge ◽  
Active Participation ◽  
Learning Preferences ◽  
High Yield ◽  
Internal Medicine Residents ◽  
Yield Learning

Abstract Background The lecture remains the most common approach for didactic offerings in residency programs despite conflicting evidence about the effectiveness of this format. Objective The purpose of this study was to explore the perspectives of internal medicine residents toward conferences held in the lecture format. Methods The investigators invited internal medicine residents (N  =  144) to participate in focus groups discussing their perspectives about noon conference lectures. The investigators used a semistructured guide to ask about motivations for attendance and effectiveness of noon conferences, transcribed the recordings, coded the discussions, and analyzed the results. Results Seven focus groups with a total of 41 residents were held. This identified 4 major domains: (1) motivations for attendance; (2) appropriate content; (3) effective teaching methods; and (4) perspectives on active participation. Residents' motivations were categorized into external factors, including desire for a break and balance to their workload, and intrinsic attributes, including the learning opportunity, topic, and speaker. Appropriate content was described as clinically relevant, practical, and presenting a balance of evidence. Identified effective teaching methods included shorter teaching sessions focused on high-yield learning points structured around cases and questions. While active participation increases residents' perceived level of stress, the benefits of this format include increased attention and learning. Conclusions This study furthers our knowledge of the learning preferences of internal medicine residents within the changing environment of residency education and can be used in conjunction with principles of adult learning to reform how we deliver core medical knowledge.

scholarly journals Internal Medicine Residents’ Perceptions of Nephrology as a Career: A Focus Group Study

Kidney360 ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 1050-1057
Author(s):  
Natalie Beck ◽  
Seth Furgeson ◽  
Michel Chonchol ◽  
Jessica Kendrick
Keyword(s):  
Internal Medicine ◽  
Focus Group ◽  
Medical School ◽  
Focus Groups ◽  
Role Models ◽  
Role Model ◽  
Focus Group Study ◽  
University Of Colorado ◽  
Internal Medicine Residents ◽  
The University

BackgroundInterest in nephrology as a career has declined dramatically over the past several years. Only 62% of nephrology fellowship positions are filled for the upcoming 2020 appointment year. The purpose of this study was to identify perceptions, attitudes, motivators, and barriers to a career in nephrology among internal medicine residents.MethodsWe recruited focus groups of internal medicine residents (N=25) from the University of Colorado, and asked questions aimed at exploring perceptions, attitudes, and barriers to a career in nephrology, and ways to increase interest in nephrology. All focus groups were conducted on the University of Colorado Denver Anschutz Medical Campus. Focus group sessions were recorded and transcribed. Thematic analysis was used to identify key concepts and themes.ResultsResidents described many barriers to a career in nephrology, including lack of exposure, lack of advances in the field, low monetary compensation, high complexity, lack of role models/mentors, and low-prestige/noncompetitive nature of the field. Most residents had no exposure to outpatient nephrology. Lack of new therapeutics was a significant deterrent to nephrology. Nephrology teaching in medical school was described as not clinically relevant and too complicated. Several residents felt they were not smart enough for nephrology. Only three residents had a role model within nephrology. Residents used the word “stigmatized” to describe nephrology, and discussed how low prestige decreased their interest in a field. Participants expressed suggestions to increase interest in nephrology through earlier and more outpatient nephrology exposure, enhanced interactions with nephrologists, and research and advancements in the field.ConclusionsResidents identified several modifiable barriers to a career in nephrology. Changing how nephrology is taught in medical school, enhancing interactions with nephrologists through increased exposure, and highlighting research and advancements in nephrology may change the perception of nephrology and increase the number of residents entering the field.

scholarly journals Urine Microscopy for Internal Medicine Residents: A Needs Assessment & Implementation of Virtual Teaching Sessions

Kidney360 ◽  
2020 ◽  
pp. 10.34067/KID.0006282020
Author(s):  
Jorge Chancay ◽  
Meghana Eswarappa ◽  
Luis Sanchez Russo ◽  
Matthew A Sparks ◽  
Samira S Farouk
Keyword(s):  
Internal Medicine ◽  
Online Survey ◽  
Video Conferencing ◽  
Urine Sediment ◽  
Clinical Interpretation ◽  
School Of Medicine ◽  
Internal Medicine Residents ◽  
Survey Results ◽  
The Impact ◽  
Urine Microscopy

Background: Though urine microscopy is an important step in the initial evaluation of a patient with kidney disease, internal medicine residents have minimal exposure to this technique during their training. The goal of this study was to understand knowledge of and attitudes towards urine microscopy among internal medicine residents, and to implement virtual urine microscopy teaching sessions. Methods: A voluntary, anonymous, online survey was sent to all the categorical internal medicine residents training (n = 131) at the Icahn School of Medicine at Mount Sinai (ISMMS). The survey included thirteen questions to assess attitudes towards, experience with, and clinical interpretation of urine microscopy specimens. In response to the survey results, we implemented virtual urine microscopy teaching sessions using video conferencing software which incorporated real-time urine sediment analysis with nephrology fellows and attending nephrologists. Results: The survey response rate was 45% (59/131). Forty-seven percent (28/59) of respondents reported performing urine microscopy at least once during their training and 75% (44/59) of respondents did not feel comfortable performing urine microscopy. The majority of residents (92%, 54/59) reported they felt urine microscopy was very helpful or somewhat helpful in the evaluation of patients with AKI. Overall, 41% percent of responses to clinical interpretation questions were considered correct. Following survey completion, virtual urine microscopy sessions were held monthly and well received by the participants. Conclusions: Our study found that internal medicine residents perceive urine microscopy as a helpful diagnostic tool, though lack the skills to perform and interpret urine microscopy sediments. Virtual educational sessions using video conferencing software are a technically feasible approach to teaching urine microscopy to internal medicine residents. Future studies include a study of the impact of these sessions on learning of urine microscopy.

scholarly journals P.133 ‘Building Your Neurology Acumen’: a flipped classroom approach to strengthen Internal Medicine residents’ neurological skills

2021 ◽  
Vol 48 (s3) ◽  
pp. S57-S57
Author(s):  
Z Zaeem ◽  
P Smyth ◽  
V Daniels
Keyword(s):  
Internal Medicine ◽  
Mixed Methods ◽  
Curriculum Development ◽  
Focus Groups ◽  
Needs Assessment ◽  
Royal College ◽  
Flipped Classroom ◽  
Mixed Methods Design ◽  
Internal Medicine Residents ◽  
Convenience Sampling

Background: Rotating internal medicine (IM) residents do not feel adequately prepared to approach patients with neurologic issues. The purpose of this project was to conduct a needs assessment to determine the optimal components and delivery of a neurology curriculum for internal medicine residents. Methods: We utilized a mixed-methods design and recruited participants through a combination of purposive and convenience sampling. We conducted interviews with IM residents (n=12) and focus groups with neurology residents (n=7) and neurology staff (n=8). IM residents completed entry- and post-call surveys while on a neurology rotation. Results: Themes according to Kern’s framework for curriculum development: 1. Problem: Discomfort and perception of under-preparedness amongst IM trainees 2. Needs Assessment: What the learners (stakeholders) think they need to know vs. what their teachers want them to know vs external requirements (Royal College) 3. Goals/objectives: What content is relevant for clinical requirements vs assessments? 4. Methods and setting: Didactic vs bedside vs virtual 5. Implementation of the curriculum 6. Evaluation and feedback Conclusions: Our findings illustrate a possible mismatch between internal medicine residents’ needs and neurologist teachers’ expectations in teaching neurology. Addressing learners’ needs could enhance neurology knowledge and sense of preparedness when encountering patients with neurologic issues.

Sign in / Sign up

Export Citation Format

Share Document