scholarly journals Characteristics of Highly Rated Internal Medicine Attendings Before and After the 2004 Work-Hour Restrictions

2016 ◽  
Vol 181 (1) ◽  
pp. 76-81
Author(s):  
Renee Mallory ◽  
Jeffrey L. Jackson ◽  
Donald Mondragon ◽  
Christos Hatzigeorgiou ◽  
Kent J. DeZee ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Before And After ◽  
Work Hour

scholarly journals Internal medicine residents’ clinical and didactic experiences after work hour regulation

2006 ◽  
Vol 21 (9) ◽  
pp. 961-965 ◽  
Author(s):  
Leora I. Horwitz ◽  
Harlan M. Krumholz ◽  
Stephen J. Huot ◽  
Michael L. Green
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Residents ◽  
Work Hour

scholarly journals Evaluation of an Online Program To Teach Microbiology to Internal Medicine Residents

2014 ◽  
Vol 53 (1) ◽  
pp. 278-281 ◽  
Author(s):  
Jeannette Guarner ◽  
Eileen M. Burd ◽  
Colleen S. Kraft ◽  
Wendy S. Armstrong ◽  
Kenya Lenorr ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Infectious Disease ◽  
Knowledge Level ◽  
Online Program ◽  
Consultation Service ◽  
Content Type ◽  
Internal Medicine Residents ◽  
Average Improvement ◽  
Before And After ◽  
Case Based

Microbiology rounds are an integral part of infectious disease consultation service. During microbiology rounds, we highlight microbiology principles using vignettes. We created case-based, interactive, microbiology online modules similar to the vignettes presented during microbiology rounds. Since internal medicine residents rotating on our infectious disease elective have limited time to participate in rounds and learn microbiology, our objective was to evaluate the use of the microbiology online modules by internal medicine residents. We asked residents to complete 10 of 25 online modules during their infectious disease elective. We evaluated which modules they chose and the change in their knowledge level. Forty-six internal medicine residents completed assessments given before and after accessing the modules with an average of 11/20 (range, 6 to 19) and 16/20 (range, 9 to 20) correct questions, respectively (average improvement, 5 questions;P= 0.0001). The modules accessed by more than 30 residents included those related toClostridium difficile, anaerobes,Candidaspp.,Streptococcus pneumoniae, influenza,Mycobacterium tuberculosis, andNeisseria meningitidis. We demonstrated improved microbiology knowledge after completion of the online modules. This improvement may not be solely attributed to completing the online modules, as fellows and faculty may have provided additional microbiology education during the rotation.

scholarly journals An ACGME Duty Hour Compliant 3-Person Night Float System for Neurological Surgery Residency Programs

2014 ◽  
Vol 6 (2) ◽  
pp. 315-319 ◽  
Author(s):  
Brian T. Ragel ◽  
Mark Piedra ◽  
Paul Klimo ◽  
Kim J. Burchiel ◽  
Heidi Waldo ◽  
...  
Keyword(s):  
Work Schedule ◽  
Meaningful Difference ◽  
Residency Programs ◽  
Night Float ◽  
System A ◽  
Oregon Health ◽  
Before And After ◽  
Work Hour ◽  
Operative Experience ◽  
Neurological Surgery

Abstract Background In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted the 24+6-hour work schedule and 80-hour workweek, and in 2011, it enhanced work hour and supervision standards. Innovation In response, Oregon Health & Science University's (OHSU) neurological surgery residency instituted a 3-person night float system. Methods We analyzed work hour records and operative experience for 1 year before and after night float implementation in a model that shortened a combined introductory research and basic clinical neurosciences rotation from 12 to 6 months. We analyzed residents' perception of the system using a confidential survey. The ACGME 2011 work hour standards were applied to both time periods. Results After night float implementation, the number of duty hour violations was reduced: 28-hour shift (11 versus 235), 8 hours off between shifts (2 versus 20), 80 hours per week (0 versus 17), and total violations (23 versus 275). Violations increased only for the less than 4 days off per 4-week interval rule (10 versus 3). No meaningful difference was seen in the number of operative cases performed per year at any postgraduate year (PGY) training level: PGY-2 (336 versus 351), PGY-3 (394 versus 354), PGY-4 (803 versus 802), PGY-5 (1075 versus 1040), PGY-7 (947 versus 913), and total (3555 versus 3460). Residents rated the new system favorably. Conclusions To meet 2011 ACGME duty hour standards, the OHSU neurological surgery residency instituted a 3-person night float system. A nearly complete elimination of work hour violations did not affect overall resident operative experience.

scholarly journals Oncology education for Canadian internal medicine residents: the value of participating in a medical oncology elective rotation

2018 ◽  
Vol 25 (3) ◽  
pp. 213
Author(s):  
N.A. Nixon ◽  
H. Lim ◽  
C. Elser ◽  
Y.J. Ko ◽  
R. Lee-Ying ◽  
...  
Keyword(s):  
Internal Medicine ◽  
End Of Life ◽  
Cancer Patients ◽  
Online Survey ◽  
Medical Oncology ◽  
Comfort Level ◽  
Cancer Knowledge ◽  
Self Directed Learning ◽  
Oncology Education ◽  
Before And After

Background Despite the high incidence and burden of cancer in Canadians, medical oncology (mo) rotations are not mandatory in most Canadian internal medicine (im) residency training programs.Methods All im residents scheduled for a mo rotation at 4 Canadian teaching cancer centres between 1 January 2013 and 31 December 2015 were invited to complete an online survey before and after their rotation. The survey was designed to evaluate perceptions of oncology, comfort in managing cancer patients, and basic oncology knowledge.Results The survey was completed by 68 im residents pre-rotation and by 48 (71%) post-rotation. Cancer-related learning was acquired mostly from mo physicians in clinic (35%). Self-directed learning, didactic teaching, and resident or fellow teaching accounted for 31%, 26%, and 10% respectively of learning acquisition. Comfort level in dealing with cancer patients and patients at end of life improved to 4.0/5 from 3.2/5 (p < 0.001) and to 4.0/5 from 3.6/5 (p = 0.003) respectively. Mean knowledge assessment score improved to 83% post-rotation from 76% pre-rotation (p = 0.003), with the greatest increase observed in general knowledge of common malignancies. The 3 topics ranked as most important to learn during a mo rotation were oncologic emergencies, common complications of treatment, and approach to diagnosis of cancer.Conclusions A rotation in mo improves the perceptions of im residents about oncology and their comfort level in dealing with cancer patients and patients at end of life. Overall cancer knowledge is also improved. Given those benefits, im residency programs should encourage most of their residents to complete a mo rotation.

Work hour restrictions and internal medicine residents’ health-related quality of life

2009 ◽  
Vol 31 (2) ◽  
pp. 186-186
Author(s):  
Anne Walling ◽  
Ron D. Hays ◽  
Jason Fish ◽  
Anish P. Mahajan ◽  
Sondra Vazirani ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Quality Of Life ◽  
Health Related Quality ◽  
Internal Medicine Residents ◽  
Related Quality ◽  
Health Related ◽  
Work Hour

scholarly journals 1319. Examining PrEP Knowledge and Prescribing Likelihood Among Medical Residents Before and After PrEP Education

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S403-S403 ◽  
Author(s):  
Elizabeth Christian ◽  
Wendy Craig ◽  
Kinna Thakarar
Keyword(s):  
Internal Medicine ◽  
Educational Intervention ◽  
Care Center ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Medical Residents ◽  
Convenience Sample ◽  
Before And After ◽  
Student’S T ◽  
Motivating Factor

Abstract Background Pre-exposure prophylaxis (PrEP) is effective for HIV prevention, but prescribing rates remain low. We examined the effect of an educational intervention on PrEP knowledge and prescribing likelihood among medical residents. Methods This was a prospective study using a convenience sample of Internal Medicine and Internal Medicine-Pediatrics residents at a tertiary care center in Portland, Maine. Participants attended a resident-led teaching session on PrEP and completed pre- and post-session surveys. PrEP knowledge was measured with five questions (definition, evidence, patient selection criteria, medication choice, and guidelines), and prescribing likelihood was assessed on a Likert scale. Participants identified motivating factors and barriers to prescribing. Survey data were analyzed with McNemar’s test or a paired Student’s t test as appropriate. Results Thirty residents completed the study; of these, 24 (83%) had at least 1 patient that they considered at high risk for HIV, and 14 (46%) reported having &gt;5 such patients. None had ever prescribed PrEP. Average PrEP knowledge score increased after the intervention (pre = 2.33 vs. post = 4.1, P &lt; 0.001). After the intervention, more participants reported that they would be likely to prescribe PrEP (pre = 76% vs. post = 90%, P = 0.014), fewer identified unfamiliarity with PrEP guidelines as a barrier (pre = 73% vs. post = 27%, P &lt; 0.001), and Òother residents are prescribing PrEPÓ became a significant motivating factor (pre = 47% vs. post = 70%, P = 0.04). Preceptor comfort with prescribing PrEP was a consistently important influence on prescribing likelihood (90% vs. 82%, P = 0.22). Conclusion Familiarity with PrEP is relevant to resident practice, and an educational intervention is effective in the short term for addressing inadequate knowledge as a barrier to offering PrEP. Resident practice is influenced by preceptors and peers, suggesting that it may be helpful to include attending physicians in future PrEP education efforts at our institution. Disclosures All authors: No reported disclosures.

scholarly journals A Curriculum to Enhance Resilience in Internal Medicine Interns

2017 ◽  
Vol 9 (5) ◽  
pp. 600-604 ◽  
Author(s):  
Amber-Nicole Bird ◽  
Michelle Martinchek ◽  
Amber T. Pincavage
Keyword(s):  
Internal Medicine ◽  
Small Group ◽  
Chief Resident ◽  
Clinical Events ◽  
Resilience Scale ◽  
Before And After ◽  
Letting Go ◽  
Group Skill ◽  
Additional Support ◽  
Skill Building

ABSTRACT Background  Burnout is a serious concern in graduate medical education. While enhancing resilience in trainees is considered beneficial, there are few studies showing successful interventions. Objective  We developed and implemented a curriculum to teach resilience skills to internal medicine (IM) residents. Methods  Our resilience curriculum focused on 4 small group skill-building workshops: setting realistic goals, managing expectations, letting go after stressful clinical events, and finding gratitude. All sessions were delivered by a chief resident during dedicated teaching time, and combined lectures, group discussions, reflection, and simulated skill-building exercises. Participants were assessed before and after the curriculum using the Connor-Davidson Resilience Scale. Results  Over a period of 2 years, 81 interns participated; 75% (61 of 81) responded prior to participating in the curriculum, and 79% (64 of 81) responded after participation. The majority thought sessions should continue the following year (75%, 48 of 64). Postsession, participants were more comfortable talking about stress and burnout (70%, 44 of 63), were more comfortable talking about medical errors (73%, 46 of 63), and had learned new ways to approach challenges (64%, 41 of 64). Mean resilience scores were lower after the curriculum (72.54 ± 10.18 versus 68.65 ± 10.14, P = .034). Feedback from participants indicated that the sessions fostered a sense of togetherness among peers and provided them with an additional support system. Conclusions  Small group resilience workshops were feasible over 2 years and well received by IM interns, who noted gaining new skills to approach challenges. There was no improvement in resilience scores after the sessions.

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