VA Problem-Solving Training During COVID-19 for Clinicians of Patients With Complex Comorbidities

To address the shortage of mental health providers in geriatrics, VA has implemented clinician training in a VA Problem Solving Training (PST) protocol adapted to the needs of mostly older patients with complex comorbidities. This presentation will summarize PST implementation adaptations during COVID-19, and compare Veteran treatment outcomes before (2019) and during COVID-19 (2020). Sixty-one clinicians attended a workshop and small-group consultation for two training cases. Consultants provided ongoing feedback to program leadership about pandemic-related implementation challenges. Program adaptations during COVID-19 addressed challenges related to delivering treatment by telephone, video, or in-person and recruitment barriers. Veterans in both cohorts (N = 122) had significant reductions in mental health symptoms from baseline to posttreatment in paired t-test comparisons (ps < .01). Flexibilities afforded to clinicians in the training during the pandemic did not diminish the effectiveness of the intervention, thus supporting continued implementation of the training program with added flexibility.

Exploring Factors Contributing to the Implementation of Ontario’s Healthy Kids Community Challenge: Surveys and Key Stakeholder Interviews with Program Providers

(1) Background: To explore factors contributing to the Healthy Kids Community Challenge (HKCC) program implementation; (2) Methods: Data were collected through a quantitative survey (n = 124) and in-depth telephone interviews (n = 16) with program providers. Interviews were recorded and transcribed for thematic analysis using NVivo; (3) Results: Provincial funding and in-kind support from community partners were key. Initiatives were feasible to implement, and key messages were well-received by communities. Specific practices and process were commonly discussed, and strong local program leadership was crucial to implementation; (4) Conclusions: Results have implications for planning and implementing future multi-component, community-based health promotion programs that include similar partnerships.

Gender Evaluation and Numeric Distribution in Emergency Medicine Residencies (GENDER): A follow-up survey of current EM residents (Preprint)

BACKGROUND Females comprise over half of medical school matriculants but only one-third of emergency medicine (EM) residents. Various factors may contribute to why fewer females choose the field of emergency medicine, such as existing presence of females in the specialty. OBJECTIVE This study is a follow-up to previous work, and a survey was used to assess current residents’ attitudes and perceptions on various factors including those relating to gender on creating rank lists as medical students and in perceived effects on residency education. METHODS An online survey consisting of Likert scale questions of a variety of factors influencing a student’s decision to create a rank list and in perceived effects on residency education was sent to current EM residents in 2020. RESULTS Residents from 17 programs participated in the survey with an 18% response rate. The most important factors in creating a rank list were the personality of residents in the program, location, and facility type. For factors specifically related to gender, respondents who answered affirmatively to whether gender composition of residents affected selection of a program in making a rank list were more likely to also answer affirmatively to subsequent questions related to gender of program leadership (p<0.001) and gender composition of attending physicians (p<0.001). Personality of residents was also the most important factor perceived to affect residency education. For factors influencing rank list and residency education, female respondents placed higher importance on subcategories related to gender (i.e., gender composition of residents, of program leadership, and of attending physicians) to a significant degree compared to their male counterparts. CONCLUSIONS While factors such as location and resident personality show the most importance in influencing residency selection, when stratifying based on respondent gender, females tend to indicate factors relating to gender have more influence on rank list and residency education compared to males. CLINICALTRIAL N/A

Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.

Does the Medical Student Performance Evaluation Change the Decision to Invite Residency Applicants?

Introduction: Although emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers. While prior studies have demonstrated that MSPE content is variable and selectively positive, no prior work has evaluated the impact of the MSPE on the likelihood to invite (LTI) applicants for a residency interview. This study aimed to evaluate how information in the MSPE impacted LTI, with the hypothesis that changes in LTI would be relatively rare based on MSPE review alone. Methods: We conducted a prospective, observational study analyzing applications to three EM residency programs during the 2019-2020 match cycle. Reviewers assessed applications and rated the LTI on a five-point Likert scale where LTI was defined as follows: 1 = definitely no; 2 = probably no; 3 = unsure; 4 = probably yes; and 5 = definitely yes. The LTI was recorded before and after MSPE review. A change in LTI was considered meaningful when it changed the overall trajectory of the applicant’s likelihood to receive an invitation to interview. Results: We reviewed a total of 877 applications with the LTI changing ≥1 point on the Likert scale 160 (18.2%) times. The LTI was meaningfully impacted in a minority of applications – 48 total (5.5 %, p< 0.01) – with only 1 (0.11%) application changing from 1 or 2 (definitely/probably no) to 4 or 5 (probably/definitely yes) and 34 (3.8%) changing from 3 (unsure) to 4 or 5 (probably/definitely yes). Thirteen (1.5%) applications changed from 4 or 5 (probably/definitely yes) to 3 (unsure or probably/definitely no). Conclusion: Review of the MSPE resulted in a meaningful change in LTI in only 5.5% of applications. Given the time required for program leadership to review all parts of the variably formatted MSPEs, this finding supports a more efficient application review, where the PD’s focus is on succinct and objective aspects of the application, such as the Standardized Letter of Evaluation.

Create an Information Exchange Platform for the Mandarin Library: The Management Strategy of E-paper of SLIS Program Leadership Team

In contrast with certain well developed areas in the world, the operating conditions of the senior high school libraries in the Chinese world still has much to improve. One of the feasible ways to strengthen cooperation is via digital networks, namely the e-papers, by incorporating both information and opinions marketplace. To enhance the cooperation functions among communities, resolve the insufficient professional knowledge among community operators issue, and improve overall service quality, the SLIS Program Leadership Team has issued an e-paper. Also, from the viewpoint of knowledge management, it has set up a homepage based community knowledge database for the e-paper. Furthermore, with a mutually-shared mind by initially providing it to the entire Chinese community for reference, with more and more library community members participate, consequently the goal is forming, that is, Make Chinese World the Exchange Platform. Finally, this report will cover four sections as: the e-paper’s media functions, problems faced in Taiwan, solutions and strategies based on the experience of Lo-tung Senior School, and suggestions for further studies.

Sharing the Mic in Domestic Violence Program Leadership: Expanding on Dr. Perlmutter’s Call for Social Work Administration

Domestic violence (DV) work in the United States emerged as a grassroots collectivist movement and grew into more formalized programming within nonprofit social service organizations. In this commentary, co-authored by DV program leaders along with DV scholars and social work educators, we apply and extend the work of Dr. Felice Perlmutter as we reflect on the role of professionalized social work in DV program leadership. Narratives of DV program leaders highlight models of anti-oppressive, feminist and empowerment-focused leadership emerging from diverse sources of experience and education. We promote an anti-oppressive stance of “sharing the mic” to include diversity of voices and ways of learning and leading. We assert that formal social work education and training provides valuable preparation, as do lived experiences, survivor voices, and community membership. A theory of effective leadership emerges that promotes mutual

PELATIHAN MANAJEMEN KEPEMIMPINAN (LEADERSHIP) DALAM BERORGANISASI

Leadership is an inherent ability in a person who leads and depends on various factors, both internal and external factors. Currently the problem of leadership is an urgent problem so that the phenomenon of a leadership crisis that occurs as a result of a crisis of confidence has emerged. One solution that can be put forward is to create capable individuals to become leaders. The method used in carrying out this activity is to conduct training for student council in building leadership in an organization. The Leadership Management Training Program (Leadership) in Organizations that has been implemented is a training where members of the Organization, especially the Intra School Student Organization (OSIS) at SMPN 18 Bekasi City can acquire and learn attitudes, abilities, expertise, specific behavioral knowledge related to organization and management leadership. This training is a series of activities designed to increase the skills, knowledge, experience, or changes in the attitudes of members of the Organization