scholarly journals Development, implementation, and evaluation of a competency-based didactic and simulation-focused boot camp for incoming urology residents: Report of the first three years

2020 ◽  
Vol 15 (4) ◽  
Author(s):  
Yuding Wang ◽  
Jen Hoogenes ◽  
Roderick Clark ◽  
Nathan C. Wong ◽  
Udi Blankstein ◽  
...  
Keyword(s):  
Boot Camp ◽  
First Year ◽  
Residency Programs ◽  
Canadian Universities ◽  
Confidence Levels ◽  
Objective Structured Clinical Exam ◽  
Initial Program ◽  
Competency Based ◽  
The Mean ◽  
Historical Controls

Introduction: The Royal College of Physicians and Surgeons of Canada’s Competence by Design (CBD) initiative presents curricula challenges to ensure residents gain proficiency while progressing through training. To prepare first-year urology residents (R1s), we developed, implemented, and evaluated a didactic and simulation-focused boot camp to implement the CBD curriculum. We report our experiences and findings of the first three years. Methods: Urology residents from two Canadian universities participated in the two-day boot camp at the beginning of residency. Eleven didactic and six simulation sessions allowed for instruction and deliberate practice with feedback. Pre-and post-course multiple-choice questionnaires (MCQs) and an objective structured clinical exam (OSCE) evaluated knowledge and skills uptake. For initial program evaluation, three R2s served as historical controls in year 1. Results: Nineteen residents completed boot camp. The mean age was 26.4 (±2.8) and 13 were male. Participants markedly improved on the pre- and post-MCQs (year 1: 62% and 91%; year 2: 55% and 89%; year 3: 58% and 86%, respectively). Participants scored marginally higher than the controls on four of the six OSCE stations. OSCE scores remained >88% over the three cohorts. All participants reported higher confidence levels post-boot camp and felt it was excellent preparation for residency. Conclusions: During its first three years, our urology boot camp has demonstrated high feasibility and utility. Knowledge and technical skills uptake were established via MCQ and OSCE results, with participants’ scores near or above those of R2 controls. This boot camp will remain in our CBD curriculum and can provide a framework for other urology residency programs.

scholarly journals LO097: A novel curriculum for assessing competency in resuscitation at the foundations of discipline level of training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S63-S63
Author(s):  
T. Chaplin ◽  
L. McMurray ◽  
A.K. Hall
Keyword(s):  
Assessment Tool ◽  
Professional Activity ◽  
First Year ◽  
Residency Programs ◽  
Modified Delphi ◽  
Simulation Based ◽  
Level Of Consciousness ◽  
Objective Structured Clinical Exam ◽  
Competency Based ◽  
Level Of Training

Introduction / Innovation Concept: Junior residents are often the first physicians who attend to the acutely unwell floor patient, especially at night and on weekends. The ‘Nightmares Course’ at Queen’s University was designed to address an Entrustable Professional Activity (EPA) relevant to several residency programs at the ‘Foundations of Discipline’ level of training: “to manage the acutely unwell floor patient for the first 5-10 minutes until help arrives”. In keeping with competency based medical education principles, this course offers longitudinal and repetitive practice and assessment. We have also designed a summative objective structured clinical exam (OSCE) in order to identify trainees who require additional remedial practice of this EPA. Methods: We developed simulated cases that reflect common but “scary” calls to the floor. We then, using a modified Delphi process with experts in resuscitation, defined relevant milestones applicable to the Foundations of Discipline level of training in order to inform our formative assessment. We also modified the Queen’s Simulated Assessment Tool (QSAT) to adopt CBME terminology and this will be used to provide a summative assessment during a four-scenario OSCE in the spring. Residents with QSAT scores below the competency threshold will be enrolled in a remediation course. Curriculum, Tool, or Material: Weekly sessions were led by staff physicians and were offered to first-year residents from internal medicine, core surgery, obstetrics and gynecology, and anesthesiology over the academic year. Each resident participated in one session every 4-week block. Sessions were organized into themes such as “shortness of breath” or “decreased level of consciousness” and involved three high-fidelity simulated cases with a structured debrief following each case. Formative feedback was given following each case. Conclusion: The Nightmares Course is a novel simulation-based, multidisciplinary curriculum in resuscitation medicine. It includes longitudinal practice and repetitive assessment, as well as summative testing and remediation of an EPA common to several residency programs.

Factors neurosurgery candidates use when choosing a residency program

2014 ◽  
Vol 120 (1) ◽  
pp. 167-172 ◽  
Author(s):  
Lauren H. Marasa ◽  
Thomas A. Pittman
Keyword(s):  
Residency Program ◽  
Response Rate ◽  
Paper Copy ◽  
Boot Camp ◽  
First Year ◽  
Residency Programs ◽  
Electronic Survey ◽  
Faculty Time ◽  
Program Characteristics ◽  
Survey Responses

Object Many factors affect an applicant's decision when selecting a residency program. While some issues are likely important to all applicants, others may be specific to, or weighed differently by, those applying to certain specialties. In an effort to better understand how applicants to neurosurgery programs make decisions about relative rank, the authors created a survey to identify the program characteristics thought most important by applicants. Methods An electronic survey was created and posted to the neurosurgery residency coordinator's forum. Coordinators throughout the country were asked to send the survey link to students who were scheduled to begin as first-year residents in July of 2012. A paper copy of the survey was also distributed at the Society of Neurological Surgeons intern boot camp in Atlanta, Georgia, in July of 2012. Results One hundred ninety-six students obtained a neurosurgical postgraduate year 1 position in the 2011–2012 match; 40 survey responses were received (response rate 20.4%). The factors cited as being most important in selecting a residency were the residents currently in the program, team camaraderie, and the number of operative cases performed. The interview day, specifically the opportunity to talk to the residents, was also thought to be important, as was the knowledge that the applicant would likely be ranked by the program. Conclusions Applicants for neurosurgical training choose a program for reasons similar to those given by applicants to other specialties. Neurosurgery applicants seem marginally more interested in an emphasis on academics and research and slightly less concerned with a program's location, but overall, the differences appear minimal. The interview process is very important, and contact by a representative after the interview also seems significant in applicants' decision making. By recognizing what applicants think is important in choosing a residency, programs can more effectively recruit residents and more efficiently use faculty time and department resources.

An Evaluation of Mood States among First-Year Residents

1989 ◽  
Vol 65 (2) ◽  
pp. 355-366 ◽  
Author(s):  
Robert A. Kirsling ◽  
Mahendr S. Kochar ◽  
Carlyle H. Chan
Keyword(s):  
Depressive Symptomatology ◽  
Negative Mood ◽  
Participation Rate ◽  
Mood States ◽  
First Year ◽  
Residency Programs ◽  
Increased Risk ◽  
The Mean ◽  
Negative Mood States ◽  
University Undergraduates

To examine the need for preventive and treatment interventions, a prevalence study was conducted to ascertain the rate of depressive symptomatology and other negative mood states among 112 first-year residents The participation rate was 54%. Subjects ( N = 61) were administered the Beck Depression Inventory and Profile of Mood States in personal interview sessions. The Profile measures five negative mood states, namely, “tension-anxiety,” “depression-dejection,” “anger-hostility,” “fatigue-inertia,” “confusion-bewilderment,” and one positive state, “vigor-activity.” A 15.5% rate of depression was found, which is lower than a rate of 23 5%, also measured by Beck's inventory, among a sample of university undergraduates and 19 9% among an adult sample from the general population. No differences were observed among residency programs or sex on Beck's scale; however, significantly higher scores were found for women on the “depression-dejection” dimension of the Profile. The mean scores on all negative mood dimensions of the Profile were below the mean for university undergraduate norms. Neither sleep nor hours worked over the past week were associated with increased Beck scores. These results indicate that sleep deprivation and long work hours did not contribute to depression among the subjects who participated in the study. Female interns, however, appear to be at increased risk of depression, and adequate support systems need to be provided.

The Application of American Models to the Experiences and Outcomes of Canadian and International Students Studying in Canada

2005 ◽  
Vol 11 (1) ◽  
pp. 71-97 ◽  
Author(s):  
J. Paul Grayson
Keyword(s):  
Academic Achievement ◽  
International Students ◽  
Pilot Study ◽  
Student Outcomes ◽  
First Year ◽  
Program Satisfaction ◽  
Canadian Universities ◽  
General Utility ◽  
American Students ◽  
The Us

In order to test the general utility of models developed in the US for explaining university outcomes of Canadian and international students, a three year study is currently underway at four Canadian universities. As a first step in this research, a pilot study with two objectives was conducted at York University in Toronto. The first objective is to compare the experiences and outcomes of domestic and international students in their first year of study. The second objective is to test the applicability of a parsimonious general model of student outcomes derived from examinations of American students to Canadian and international students studying in Canada. The specific outcomes examined are academic achievement, credit completion, and program satisfaction in the first year of study.

scholarly journals Direct costs of common osteoporotic fractures (Hip, Vertebral and Forearm) in Iran

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marziyeh Rajabi ◽  
Afshin Ostovar ◽  
Ali Akbari Sari ◽  
Sayed Mahmoud Sajjadi-Jazi ◽  
Noushin Fahimfar ◽  
...  
Keyword(s):  
Direct Cost ◽  
Osteoporotic Fractures ◽  
Direct Costs ◽  
Fracture Incidence ◽  
Inpatient Cost ◽  
First Year ◽  
Forearm Fractures ◽  
Medical Sciences ◽  
The Us ◽  
The Mean

Abstract Background Osteoporotic fractures impose significant costs on society. The objective of this study was to estimate the direct costs of the hip, vertebral, and forearm fractures in the first year after fracture incidence in Iran. Methods We surveyed a sample of 300 patients aged over 50 years with osteoporotic fractures (hip, vertebral, and forearm) admitted to four hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2017 and were alive six months after the fracture. Inpatient cost data were obtained from the hospital patient records. Using a questionnaire, the data regarding outpatient costs were collected through a phone interview with patients at least six months after the fracture incidence. Direct medical and non-medical costs were estimated from a societal perspective. All costs were converted to the US dollar using the average exchange rate in 2017 (1USD = IRR 34,214) Results The mean ± standard deviation (SD) age of the patient was 69.83 ± 11.25 years, and 68% were female. One hundred and seventeen (39%) patients had hip fractures, 56 (18.67%) patients had vertebral fractures, and 127 (42.33%) ones had forearm fractures. The mean direct cost (medical and non-medical) during the year after hip, vertebral and forearm fractures were estimated at USD5,381, USD2,981, and USD1,209, respectively. Conclusion The direct cost of osteoporotic fracture in Iran is high. Our findings might be useful for the economic evaluation of preventive and treatment interventions for osteoporotic fractures as well as estimating the economic burden of osteoporotic fractures in Iran.

scholarly journals Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina Gillezeau ◽  
Wil Lieberman-Cribbin ◽  
Kristin Bevilacqua ◽  
Julio Ramos ◽  
Naomi Alpert ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
First Year ◽  
Convenience Sample ◽  
Student Sample ◽  
Medical Specialties ◽  
Residency Programs ◽  
Deferred Action ◽  
The Status ◽  
Depth Interviews

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

scholarly journals Association between Industry Payments and Scholarly Impact among Academic Ophthalmologists

2019 ◽  
Vol 11 (01) ◽  
pp. e1-e8
Author(s):  
Michael Solotke ◽  
Susan Forster ◽  
Jessica Chow ◽  
Jenesis Duran ◽  
Hasna Karim ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Cross Sectional Study ◽  
Academic Rank ◽  
Cross Sectional ◽  
H Index ◽  
Residency Programs ◽  
Scholarly Impact ◽  
The Mean ◽  
And Gender ◽  
Open Payments

Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact. Design Retrospective cross-sectional study. Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact. Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p < 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p < 0.05). Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.

Coronary Care in a General Hospital

1971 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Gavin Shaw ◽  
Bernard Groden ◽  
Evelyn Hastings
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
General Hospital ◽  
First Year ◽  
Duration Of Stay ◽  
Before And After ◽  
The Mean ◽  
Coronary Care ◽  
Made In

The establishment, staffing and structure and observations made in the first year of the existence of coronary care in an intensive care unit in a general hospital are recorded. Two hundred and twenty eight patients were admitted during the year in whom the diagnosis of myocardial infarction was confirmed. There were 29 deaths in the unit and 14 deaths occurred in the wards of the hospital after discharge from the unit. 49.1 per cent of the patients were admitted within 4 hours of the onset of symptoms and the mean duration of stay in the unit was 86.5 hours. The type of arrhythmia detected in the unit, and the treatment given to the patients both before and after admission to the intensive care unit are described.

Prospective study of multiple sclerosis with early onset

2002 ◽  
Vol 8 (2) ◽  
pp. 115-118 ◽  
Author(s):  
A Ghezzi ◽  
C Pozzilli ◽  
M Liguori ◽  
M G Marrosu ◽  
N Milani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
First Year ◽  
Hormonal Changes ◽  
Disability Status ◽  
Definite Multiple Sclerosis ◽  
Relapsing Remitting ◽  
Clinically Definite Multiple Sclerosis ◽  
The Mean ◽  
And Gender

Fifty-four subjects (36 females and 18 males) affected by clinically definite multiple sclerosis (MS) and with onset of the disease at 15 years of age or before were prospectively studied in five Italian MS centres. Female/male ratio was 4.7 in subjects with age ≥12 years, suggesting a role of hormonal changes in triggering MS onset. The mean follow-up duration was 10.9-5.6 years. The functional systems more frequently involved at onset were the pyramidal and brainstem (both in 28% of cases). The onset was monosymptomatic in 31 subjects (57%). The course was relapsing-remitting in 39 subjects (72%) and relapsing-progressive in 15 (28%). Disability was assessed by the Expanded Disability Status Scale (EDSS): the mean score after 8 years of follow up was 3.5 (-2.5). The score was <4 in 68% of cases, between 4 and 6 in 8% of cases, > 6 in 24% of cases. Disability after 8 years was highly predicted by disability in the first year (p=0.008). There was a tendency to a worse prognosis in relation to the number of relapses in the first 2 years (p=0.08). The outcome was not influenced by the characteristics of symptoms at onset, age and gender.

scholarly journals Pre-selection of apple seedlings for partial powdery mildew (Podosphaera leucotricha Ell. et Ev. /Salm./) resistance

2011 ◽  
Vol 50 (No. 2) ◽  
pp. 65-69 ◽  
Author(s):  
J. Blažek
Keyword(s):  
Powdery Mildew ◽  
First Year ◽  
Podosphaera Leucotricha ◽  
Green House ◽  
Healthy State ◽  
The Mean ◽  
Resistant Genotypes ◽  
Different Levels ◽  
Final Selection ◽  
Selection Of

Incidences of powdery mildew were repeatedly evaluated for two years on 1 420 young seedlings of 20 progenies (of different levels of mildew susceptibility) in a green house, and then for 10 years on 642 seedlings in an orchard. Part of the seedlings in the orchard were pre-selected for the characteristic and others not. Except for the first scoring done in the first year, there was no correlation between mildew incidence on individual seedlings in the green house and their mean performance in the orchard. The seedlings with scores above 6 (resistant or tolerant) at the first stage of evaluation in the green house, however, yielded four times more desirable seedlings after final selection in the orchard than the mean of the total. The progenies that had a better healthy state as a whole yielded more partially resistant genotypes than those with low mean scores. Therefore, the progenies that most rapidly develop infestation on the whole lot should be discarded, whereas those that retain a healthy state longer should be subjected to individual selection according to the previous item.

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