scholarly journals Evaluating the Evaluators: Implementation of a Multi-Source Evaluation Program for Graduate Medical Education Program Directors

2016 ◽  
Vol 8 (4) ◽  
pp. 592-596 ◽  
Author(s):  
Mary Ellen J. Goldhamer ◽  
Keith Baker ◽  
Amy P. Cohen ◽  
Debra F. Weinstein
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Assessment Tools ◽  
Completion Rates ◽  
Source Evaluation ◽  
Graduate Medical ◽  
Medical Education Program ◽  
Academic Year

ABSTRACT Background Multi-source evaluation has demonstrated value for trainees, but is not generally provided to residency or fellowship program directors (PDs). Objective To develop, implement, and evaluate a PD multi-source evaluation process. Methods Tools were developed for PD evaluation by trainees, department chairs, and graduate medical education (GME) leadership. Evaluation questions were based on PD responsibilities, including Accreditation Council for Graduate Medical Education (ACGME) requirements. A follow-up survey assessed the process. Results Evaluation completion rates were as follows: trainees in academic year 2012–2013, 53% (958 of 1824), and in academic year 2013–2014, 42% (800 of 1898); GME directors in 2013–2014, 100% (95 of 95); and chairs/chiefs in 2013–2014, 92% (109 of 118). Results of a follow-up survey of PDs (66%, 59 of 90) and chairs (74%, 48 of 65) supports the evaluations' value, with 45% of responding PDs (25 of 56) and 50% of responding chairs (21 of 42) characterizing them as “extremely” or “quite” useful. Most indicated this was the first written evaluation they had received (PDs 78%, 46 of 59) or provided (chairs 69%, 33 of 48) regarding the PD role. More than 60% of PD (30 of 49) and chair respondents (24 of 40) indicated trainee feedback was “extremely” or “quite” useful, and nearly 50% of PDs (29 of 59) and 21% of chairs (10 of 48) planned changes based on the results. Trainee response rates improved in 2014–2015 (52%, 971 of 1872) and 2015–2016 (69%, 1276 of 1837). Conclusions In our institution, multi-source evaluation of PDs was sustained over 4 years with acceptable and improving evaluation completion rates. The process and assessment tools are potentially transferrable to other institutions.

scholarly journals Formal Versus Informal Judgments: Faculty Experiences With Entrustment in Graduate Medical Education

2018 ◽  
Vol 10 (5) ◽  
pp. 537-542 ◽  
Author(s):  
Karsten A. van Loon ◽  
Pim W. Teunissen ◽  
Erik W. Driessen ◽  
Fedde Scheele
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Faculty Members ◽  
Extensive Experience ◽  
Faculty Experiences ◽  
Graduate Medical ◽  
Medical Education Program ◽  
Technical Competencies ◽  
Competency Based

ABSTRACT Background  Entrustment of residents has been formalized in many competency-based graduate medical education programs, but its relationship with informal decisions to entrust residents with clinical tasks is unclear. In addition, the effects of formal entrustment on training practice are still unknown. Objective  Our objective was to learn from faculty members in training programs with extensive experience in formal entrustment how formal entrustment relates to informal entrustment decisions. Methods  A questionnaire was e-mailed to all Dutch obstetrics and gynecology program directors to gather information on how faculty entrusts residents with clinical independence. We also interviewed faculty members to explore the relationship between formal entrustment and informal entrustment. Interviews were analyzed with conventional content analysis. Results  Of 92 programs, 54 program directors completed the questionnaire (59% response rate). Results showed that formal entrustment was seen as valuable for generating formative feedback and giving insight into residents' progress in technical competencies. Interviewed faculty members (n = 12) used both formal and informal entrustment to determine the level of resident independence. Faculty reported they tended to favor informal entrustment because it can be reconsidered. In contrast, formal entrustment was reported to feel like a fixed state. Conclusions  In a graduate medical education program where formal entrustment has been used for more than a decade, faculty used a combination of formal and informal entrustment. Informal entrustment is key in deciding if a resident can work independently. Faculty members reported being unsure how to optimally use formal entrustment in practice next to their informal decisions.

scholarly journals Results From a Transitional-Year Program Director Survey: Identifying Crucial Issues and Concerns

2012 ◽  
Vol 4 (1) ◽  
pp. 28-33
Author(s):  
Steven R. Craig ◽  
Hayden L. Smith ◽  
Matthew W. Short
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Administrative Support ◽  
Program Directors ◽  
Program Director ◽  
Community Hospitals ◽  
Graduate Medical ◽  
Program Coordinators ◽  
Critical Issues ◽  
Preparatory Year

Abstract Background Transitional Year (TY) programs meet an important need by preparing residents for specialties that accept individuals after an initial preparatory year. To our knowledge, no surveys to date have been conducted to identify attributes of TY programs and concerns of TY program directors. Purpose The purpose of this study was to review TY program characteristics and identify critical issues and concerns of TY program directors (TYPDs). Methods A web-based, 22-question survey was sent to all 114 TYPDs of programs accredited by the Accreditation Council for Graduate Medical Education between January and April 2011. The survey included open-formatted and closed-formatted questions addressing program and institution demographics, program director time, administrative support, satisfaction, and future plans. Results The survey response rate was 86%. The median age of TY programs was 28 years, with few new programs. More than 80% of TY programs were conducted at community hospitals and university-affiliated community hospitals. Of the responding TYPDs, 17% had served less than 2 years, and 32% had served 10 years or more. Common sponsoring TY programs included internal medicine (88%), general surgery (42%), family medicine (25%), emergency medicine (24%), and pediatrics (18%). Overall, TYPDs were satisfied with their positions. They expressed concerns about inadequate time to complete duties, salary support, and administrative duties assigned to program coordinators. Forty-nine percent of TYPDs reported they planned to leave the position within the next 5 years. Conclusions Our survey provides useful information to assist institutions and the graduate medical education community in meeting the needs of TYPDs and strengthening TY programs.

scholarly journals The ecology of program director leadership: power relationships and characteristics of effective program directors

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bharat Kumar ◽  
Melissa L. Swee ◽  
Manish Suneja
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Program Directors ◽  
Power Relationships ◽  
Main Body ◽  
Power Bases ◽  
Power Structures ◽  
Graduate Medical ◽  
Medical Environment ◽  
Academic Medical

Abstract Background Program directors are often perceived as strong and independent leaders within the academic medical environment. However, they are not as omnipotent as they initially appear. Indeed, PDs are beholden to a variety of different agents, including trainees (current residents, residency applicants, residency alumni), internal influencers (departmental faculty, hospital administration, institutional graduate medical education), and external influencers (the Accreditation Council for Graduate Medical Education (ACGME), medical education community, and society-at-large). Altogether, these agents form a complex ecosystem whose dynamics and relationships shape the effectiveness of program directors. Main body This perspective uses management theory to examine the characteristics of effective PD leadership. We underline the importance of authority, accessibility, adaptability, authenticity, accountability, and autonomy as core features of successful program directors. Additionally, we review how program directors can use the six power bases (legitimacy, referent, informational, expert, reward, and coercive) to achieve positive and constructive change within the complexity of the academic medical ecosystem. Lastly, we describe how local and national institutions can better structure power relationships within the ecosystem so that PD leadership can be most effective. Conclusion Keen leadership skills are required by program directors to face a variety of challenges within their educational environments. Understanding power structures and relationships may aid program directors to exercise leadership judiciously towards fulfilling the educational missions of their departments.

Minimally Invasive Training During Surgical Residency

2011 ◽  
Vol 77 (7) ◽  
pp. 902-906 ◽  
Author(s):  
Gokulakkrishna Subhas ◽  
Vijay K. Mittal
Keyword(s):  
Medical Education ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Graduate Medical Education ◽  
Invasive Surgery ◽  
Program Directors ◽  
Accreditation Council ◽  
Surgery Training ◽  
Graduate Medical ◽  
Laparoscopic Procedures

The field of postgraduate minimally invasive surgery training has undergone substantial growth and change. A survey was sent to all program directors in surgery. Minimally invasive training patterns, facilities, their views, and performance of residents were examined. Ninety-five directors (38%) responded to the questionnaire. Of these, 51 per cent (n = 48) had a program size of three to four residents and 33 per cent (n = 31) had a program size of five to six residents. In 3 per cent of programs (n = 3), residents could not achieve the minimum Accreditation Council for Graduate Medical Education required numbers for advanced laparoscopic cases. Only 47 per cent of programs (n = 45) had dedicated rotations in minimally invasive surgery, ranging from 2 to 11 months. Up to 10 per cent (n = 9) of program directors felt that the current training in minimally invasive surgery was insufficient. Fifty-five per cent (n = 52) felt that laparoscopic adhesiolysis was an advanced laparoscopic procedure, and 33 per cent (n = 31) felt that there should be a separate minimum requirement for each of the commonly performed basic and advanced laparoscopic cases by Accreditation Council for Graduate Medical Education. Fifty-six per cent (n = 53) of programs were performing robotic surgery. Minimally invasive surgery training for surgical residents needs to increase opportunities so that they are able to perform laparoscopic procedures with confidence. There should be specific number requirements in each category of individual basic and advanced laparoscopic procedures.

The Army Graduate Medical Education Program

1976 ◽  
Vol 141 (12) ◽  
pp. 837-843 ◽  
Author(s):  
Frank F. Ledford ◽  
Thomas M. Driskill
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Education Program ◽  
Graduate Medical ◽  
Medical Education Program

scholarly journals Mechanical Ventilation Training During Graduate Medical Education: Perspectives and Review of the Literature

2019 ◽  
Vol 11 (4) ◽  
pp. 389-401 ◽  
Author(s):  
Jonathan M. Keller ◽  
Dru Claar ◽  
Juliana Carvalho Ferreira ◽  
David C. Chu ◽  
Tanzib Hossain ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Education ◽  
Critical Care ◽  
Best Practices ◽  
Graduate Medical Education ◽  
Assessment Tools ◽  
Critical Care Medicine ◽  
Subspecialty Training ◽  
Review Of The Literature ◽  
Graduate Medical

ABSTRACT Background Management of mechanical ventilation (MV) is an important and complex aspect of caring for critically ill patients. Management strategies and technical operation of the ventilator are key skills for physicians in training, as lack of expertise can lead to substantial patient harm. Objective We performed a narrative review of the literature describing MV education in graduate medical education (GME) and identified best practices for training and assessment methods. Methods We searched MEDLINE, PubMed, and Google Scholar for English-language, peer-reviewed articles describing MV education and assessment. We included articles from 2000 through July 2018 pertaining to MV education or training in GME. Results Fifteen articles met inclusion criteria. Studies related to MV training in anesthesiology, emergency medicine, general surgery, and internal medicine residency programs, as well as subspecialty training in critical care medicine, pediatric critical care medicine, and pulmonary and critical care medicine. Nearly half of trainees assessed were dissatisfied with their MV education. Six studies evaluated educational interventions, all employing simulation as an educational strategy, although there was considerable heterogeneity in content. Most outcomes were assessed with multiple-choice knowledge testing; only 2 studies evaluated the care of actual patients after an educational intervention. Conclusions There is a paucity of information describing MV education in GME. The available literature demonstrates that trainees are generally dissatisfied with MV training. Best practices include establishing MV-specific learning objectives and incorporating simulation. Next research steps include developing competency standards and validity evidence for assessment tools that can be utilized across MV educational curricula.

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