Applicant Perspectives on Virtual Otolaryngology Residency Interviews

Objective: Residency interviews serve as an opportunity for prospective applicants to evaluate programs and to determine their potential fit within them. The 2019 SARS-CoV2 pandemic mandated programs conduct interviews virtually for the first time. The purpose of this study was to assess applicant perspectives on the virtual interview. Methods: A Qualtrics survey assessing applicant characteristics and attitudes toward the virtual interview was designed and disseminated to otorhinolaryngology applicants from 3 large academic institutions in the 2020 to 2021 application cycle. Results: A total of 33% of survey applicants responded. Most applicants were satisfied with the virtual interview process. Applicants reported relatively poor quality of interactions with residents and an inability to assess the “feel” of a geographic area. Most applicants received at least 11 interviews with over a third of applicants receiving >16 interviews. Only 5% of applicants completed >20 interviews. Most applicants believed interviews should be capped between 15 and 20 interviews. Most applicants reported saving >$5000, with over a quarter of applicants saving >$8000, and roughly one-third of applicants saving at least 2 weeks of time with virtual versus in-person interviews. Conclusions: While virtual interviews have limitations, applicants are generally satisfied with the experience. Advantages include cost and time savings for both applicants and programs, as well as easy use of technology. Continuation of the virtual interview format could be considered in future application cycles; geographical limitations may be overcome with in-person second looks, and increased emphasis should be placed on resident interactions during and prior to interview day.

HYBRID DISCOURSE AND THE EMERGENCE OF CONTEXT IN BBC’S QUESTION TIME

This paper explores how hybrid discourse, instantiated in talk and interaction, can be shaped not only by a situational context (TV panel show) and cultural context (TV’s increasing democratisation of laity), but also by human volition in pursuit of recognizable to others and allowed within the confi nes of the setting. It does this by examining the emergence of context in light of a non-mainstream hybrid and refl exive activity. Specifically, it examines a non-normative interview format that has arisen in contemporary broadcasting through the analysis of three transcribed segments which were taken from two key episodes of the BBC’s fl agship political program: Question Time. Using a range of analytical concepts from symbolic interactionism, pragmatics, and conversational analysis, such as frames and footings, activity types, discourse types, and turn-taking, the analysis shows how institutional (political) and non-institutional (normative) practices can come together in the pursuit of individual goals and contemporary media’s goal for increasingly partisan journalism and confrontainment. Overall, the paper highlights the importance of a multidimensional approach to context, whereby meaning both emerges from and is constitutive of the forms and functions of an activity’s discourse, whilst further highlighting the role of hybridity in contemporary discourse.

From Users to Choosers: the Change in Employee Technology Expectations

<p>This research looks at the motivation for using non-sanctioned technologies within a business context; that is, using Information Technology (IT) systems other than those provided (or approved) by the IT department. In this research, the non-sanctioned IT systems of primary interest are the internet based applications, but also includes personally owned hardware devices such as laptops, tablets and smartphones. This qualitative study used the key informant approach to gain an understanding of the subject using a semi-structured interview format. The results show that employees in knowledge based roles are choosing their own technology tools when they believe that they give them better functionality or flexibility over those offered and approved by the traditional IT department. Graduates and other millennial employees are found to be using non-sanctioned systems more frequently than older workers; millennials are also far more likely to use whatever application or device they want, regardless of the source or what corporate IT policies stated. The use of these non-sanctioned technologies should be a source concern to IT management because many of these can circumvent the organisations security and data management governance policies, giving the potential for data loss or unwanted exposure, regulatory compliance failure or have undesirable legal implications. The results also suggest that IT departments do not have the resources to keep up with the rate of change in technology. At the same time, the users of their services are able to obtain technology solutions from a range of other sources. This may mean a change in the role of the IT department as it loses its position as the technology gatekeeper.</p>

From Users to Choosers: the Change in Employee Technology Expectations

<p>This research looks at the motivation for using non-sanctioned technologies within a business context; that is, using Information Technology (IT) systems other than those provided (or approved) by the IT department. In this research, the non-sanctioned IT systems of primary interest are the internet based applications, but also includes personally owned hardware devices such as laptops, tablets and smartphones. This qualitative study used the key informant approach to gain an understanding of the subject using a semi-structured interview format. The results show that employees in knowledge based roles are choosing their own technology tools when they believe that they give them better functionality or flexibility over those offered and approved by the traditional IT department. Graduates and other millennial employees are found to be using non-sanctioned systems more frequently than older workers; millennials are also far more likely to use whatever application or device they want, regardless of the source or what corporate IT policies stated. The use of these non-sanctioned technologies should be a source concern to IT management because many of these can circumvent the organisations security and data management governance policies, giving the potential for data loss or unwanted exposure, regulatory compliance failure or have undesirable legal implications. The results also suggest that IT departments do not have the resources to keep up with the rate of change in technology. At the same time, the users of their services are able to obtain technology solutions from a range of other sources. This may mean a change in the role of the IT department as it loses its position as the technology gatekeeper.</p>

Practitioners’ views on shared decision-making implementation: A qualitative study

Introduction Shared decision-making (SDM) refers to the collaboration between patients and their healthcare providers to make clinical decisions based on evidence and patient preferences, often supported by patient decision aids (PDAs). This study explored practitioner experiences of SDM in a context where SDM has been successfully implemented. Specifically, we focused on practitioners’ perceptions of SDM as a paradigm, factors influencing implementation success, and outcomes. Methods We used a qualitative approach to examine the experiences and perceptions of 10 Danish practitioners at a cancer hospital experienced in SDM implementation. A semi-structured interview format was used and interviews were audio-recorded and transcribed. Data was analyzed through thematic analysis. Results Prior to SDM implementation, participants had a range of attitudes from skeptical to receptive. Those with more direct long-term contact with patients (such as nurses) were more positive about the need for SDM. We identified four main factors that influenced SDM implementation success: raising awareness of SDM behaviors among clinicians through concrete measurements, supporting the formation of new habits through reinforcement mechanisms, increasing the flexibility of PDA delivery, and strong leadership. According to our participants, these factors were instrumental in overcoming initial skepticism and solidifying new SDM behaviors. Improvements to the clinical process were reported. Sustaining and transferring the knowledge gained to other contexts will require adapting measurement tools. Conclusions Applying SDM in clinical practice represents a major shift in mindset for clinicians. Designing SDM initiatives with an understanding of the underlying behavioral mechanisms may increase the probability of successful and sustained implementation.

Shifting the Surgical Residency Match to a 100% Virtual Interview Format During the COVID-19 Pandemic, How has It Affected Placement Into Surgical Training Programs?

Introduction The AAMC transitioned to virtual interview formats for the 2020-2021 residency match. This study aims to examine the impact of the 100% virtual interview format for the 2020-2021 residency match on both application and match changes for multiple surgical specialties, including neurosurgery (NS), orthopedic surgery (OS), plastic surgery (PS), general surgery (GS), thoracic surgery (TS), and vascular surgery (VS). Methods Cross-sectional study comparing application and match changes between the in-person 2019-2020 and virtual 2020-2021 residency match cycles for different surgical specialties. Results There was an overall increase in the number of applicants for 5 of the surgery specialties but not VS, and an overall increase in the number of applications per residency program across all specialties. The average number of applications per applicant also increased, except in TS. There were no major match changes except in TS, which saw an increase in number of spots filled by MDs to nearly 100% from 84.2% in the previous cycle. Conclusion The switch to the 100% virtual 2020-2021 residency match interview format was associated with an overall increase in the number of applications per program and number of applications per applicant across multiple surgical specialties. There was a decrease in the number of applicants to VS and an increase in the number of applications per applicant. The switch to a virtual interview format in 2020-2021 was also associated with an increase in TS spots filled by MDs to almost 98%, increasing the already concerning TS match disparity for DO and IMG applicants.

CHALLENGES FACED BY VASCULAR SURGEONS IN ACCEPTANCE OF THEIR SPECIALTY BY MEDICAL COMMUNITY OF PAKISTAN

Objective: To determine the challenges being faced by vascular surgeons in acceptability of their specialty by the medical community of Pakistan. Study Design: Qualitative case study. Place and Duration of Study: Various training institutes & teaching hospitals all over the Pakistan, from Sep 2019 to Feb 2020. Methodology: Semi structured interview format comprising of a series of open ended and broad questions to get maximum relevant information, were sent to 13 surgeons (vascular and part time vascular surgeons) practicing vascular surgery at least for the last five years in various training institutes and teaching hospitals of Pakistan. Interviews were audio recorded on telephone and in persons. The data was transcribed, cleansing was done, and analyzed through inductive and thematic content analysis. Results: Handful of qualified vascular surgeons, inadequate vascular training program, part time vascular surgery and unawareness/misconceptions/myths about vascular diseases, were the major challenges being faced by the vascular community for their separate identity. Conclusion: The vascular community is facing great challenges of shortage of qualified vascular surgeons and technicians, inadequate training centers, part time vascular surgery and misconceptions/myths/unawareness about vascular diseases.

Evaluating Caregiver Risk: The Dementia Caregiver Interview Guide

Objectives: Family and other informal caregivers of individuals with dementia can be at increased risk for a significant decline in wellbeing or their ability to continue to provide care. There is extensive literature on the multifactorial elements contributing to risk, but frontline practitioners may be uncertain how to apply their knowledge of risk to an assessment of individual caregivers during clinical encounters. We developed a new one-page guided interview tool (the Dementia Caregiver Interview Guide, or DCIG) to guide practitioners to: (1) systematically assess known factors associated with high caregiver risk in a clinical interview format and (2) concisely document their judgement regarding risk of decompensation arising from caregiver stress. This semi-structured interview format collects detailed information while promoting a collaborative communication process. This study evaluated the validity of risk-assessment using the DCIG. Methods: A convenience sample of 50 caregivers was recruited during routine intake at the Reitman Centre at Sinai Health in Toronto, Canada. Risk was assessed using both the DCIG and the Caregiver Risk Screen (CRS). Total scores on the two tools were compared to establish concurrent and discriminant validity for the DCIG. Results: The DCIG correlated positively with the CRS (Spearman’s rho = 0.737; p < 0.001) and identified caregivers at risk at a moderate level of agreement with the CRS (Cohen’s Kappa = 0.559). Conclusions: The DCIG allows clinicians to efficiently identify caregivers’ level of risk for functional and emotional decline or decompensation in a client-centered, naturalistic manner.