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MedEdPublish ◽  
2022 ◽  
Vol 12 ◽  
pp. 1
Author(s):  
Michael Berge ◽  
Michael Soh ◽  
Fahlsing Christopher ◽  
Rene McKinnon ◽  
Berish Wetstein ◽  
...  

Background: This study sought to explore the relationship between semantic competence (or dyscompetence) displayed during “think-alouds” performed by resident and attending physicians and clinical reasoning performance. Methods: Internal medicine resident physicians and practicing internists participated in think-alouds performed after watching videos of typical presentations of common diseases in internal medicine. The think-alouds were evaluated for the presence of semantic competence and dyscompetence and these results were correlated with clinical reasoning performance.  Results: We found that the length of think-aloud was negatively correlated with clinical reasoning performance. Beyond this finding, however, we did not find any other significant correlations between semantic competence or dyscompetence and clinical reasoning performance. Conclusions: While this study did not produce the previously hypothesized findings of correlation between semantic competence and clinical reasoning performance, we discuss the possible implications and areas of future study regarding the relationship between semantic competency and clinical reasoning performance.


2021 ◽  
pp. 000313482110604
Author(s):  
Julia M. Coughlin ◽  
Samantha L. Terranella ◽  
Ethan M. Ritz ◽  
Thomas Q. Xu ◽  
John F. Tierney ◽  
...  

Background To compare opioid prescribing practices of resident physicians across a variety of surgical and nonsurgical specialties; to identify factors which influence prescribing practices; and to examine resident utilization of best practice supplemental resources. Methods An anonymous survey which assessed prescribing practices was completed by residents from one of several different subspecialties, including internal medicine, obstetrics and gynecology, general surgery, neurosurgery, orthopedic surgery, and urology. Fisher’s exact test assessed differences in prescribing practices between specialties. Results Only 35% of residents reported receiving formal training in safe opioid prescribing. Overall, the most frequently reported influences on prescribing practices were the use of standardized order sets for specific procedures, attending preference, and patient’s history of prescribed opioids. Resident physicians significantly underutilize best practice supplemental resources, such as counseling patients on pain expectations prior to prescribing opioid medication; contacting established pain specialists; screening patients for opioid abuse; referring to the Prescription Monitoring Program; and counseling patients on safe disposal of unused pills ( P < .001). Discussion The incorporation of comprehensive prescribing education into resident training and the utilization of standardized order sets can promote safe opioid prescribing.


2021 ◽  
Vol 4 (12) ◽  
pp. e2141511
Author(s):  
Lisa M. Meeks ◽  
Karina Pereira-Lima ◽  
Elena Frank ◽  
Erene Stergiopoulos ◽  
Katherine E.T. Ross ◽  
...  

2021 ◽  
pp. 000313482110650
Author(s):  
Eliza M. Slama ◽  
Laith Batarseh ◽  
Francesca Bryan ◽  
Andrew Roberts ◽  
Faran Bokhari ◽  
...  

The importance of resident wellbeing is increasingly recognized by the ACGME as essential. While prior studies have quantified wellbeing/burnout, few have defined wellbeing from the resident–physician perspective. A REDCap® survey was distributed to residents in various programs, responses were grouped by theme, and data analyzed via chi-square. From 19 institutions, 53/670 responded, from university (34.0%), community (30.2%), and community/university-affiliated (30.2%) programs, mostly surgical (84.9%), followed by medical (9.4%). Wellbeing was defined by mental and spiritual/religious health (33.8%), overall health (23.0%), free time/time management (23.0%), and job/salary satisfaction (18.9%). Proposed changes to traditional training included fewer hours and more schedule flexibility (38.2%), and increased/improved support/feedback (14.7%). Nearly half of the respondents perceived lacking education on career longevity. Wellbeing is paramount to the personal/professional development of residents. Data on resident-defined wellbeing are lacking. The improved understanding of wellbeing defined here can be used to improve residency training programs.


Author(s):  
Tatiana L. Moroz ◽  
Olga A. Ryzhova

A study was carried out to identify differences in training of resident physicians in the specialties: Management and Economics of Pharmacy, Pharmaceutical Technology, Pharmaceutical Chemistry and Pharmacognosy and under the specialist’s program Pharmacy and to explore the possibilities of granting pharmacy workers the right to transit from one specialty to another without compulsory completion of residency. The urgency of this article is associated with a large number of issues that are being faced by pharmacists who transit from one specialty to another.An analysis of the age and occupational structure of pharmacists improving their qualifications (2300 people) was conducted in the Irkutsk region and the Trans-Baikal Territory. The results of the study showed that it seems like a good idea not to associate the transition from one specialty to another with the obligatory completion of residency, but to provide an admission to work as a pharmacist-technologist after initial accreditation, taking into account the specifics of the work of pharmaceutical specialists in pharmacies, the need to ensure the interchangeability of workers and reduce staff turnover without falling off in quality of work.


Author(s):  
Kirsten E.S. Craddock ◽  
Stephanie Grilo ◽  
Teresa A. McCann ◽  
Marina Catallozzi ◽  
Sumeet L. Banker

BACKGROUND The coronavirus disease 2019 pandemic has required modifications to family-centered rounds (FCR), although the specific changes and the effects on patients, families, and providers are not well known. In this study, we explore physician perspectives on changes made to FCR during the initial wave of the coronavirus disease 2019 pandemic and recommendations for the future. METHODS Semistructured individual interviews were conducted with 20 pediatric attending and resident physicians who cared for hospitalized patients between March and May 2020 on pediatric hospital medicine and subspecialty services that typically perform FCR. Transcripts were reviewed by using principles of framework analysis to iteratively develop a codebook. Review of coded segments, with attention to code co-occurrences, was used to clarify themes in the data relating to the research objective and the conceptual framework. RESULTS The rounding format changed for all providers and varied on the basis of clinical service and phase of the pandemic. Themes highlighted specific areas of change: (1) the process of FCR, (2) reaching consensus with families, (3) collaboration with members of the medical team, and (4) resident education, modeling, and supervision. Participants offered recommendations, including standardization of rounds, intentional involvement of nursing staff, and inclusion of families through virtual or small-group bedside rounds. CONCLUSIONS The pandemic led to a variety of modifications to FCR, and these changes had varied effects on communication and education. These findings provide insight into the state of FCR during the pandemic and may frame future recommendations for the development of shared guidelines for circumstances requiring limited bedside rounding.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055184
Author(s):  
María Dolores Braquehais ◽  
Sebastián Vargas-Cáceres ◽  
Gemma Nieva ◽  
Maria Fernanda Mantilla ◽  
Germán Ortega ◽  
...  

ObjectivesLittle is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians.DesignRetrospective observational study.SettingMedical records of the Galatea Care Programme for Sick Physicians.Participants1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018.Primary and secondary outcome measuresNumber of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation.ResultsResidents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001).ConclusionsResidents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.


2021 ◽  
Vol 48 ◽  
pp. 102080
Author(s):  
Sat Bir Khalsa ◽  
Natalie Dyer ◽  
Julia Loewenthal ◽  
Marla Lipsyc-Sharf ◽  
Darshan Mehta ◽  
...  

Cureus ◽  
2021 ◽  
Author(s):  
Emmanuel Tito ◽  
Sarah Black ◽  
Patrick Hilaire ◽  
Joseph Weistroffer ◽  
Cheryl Dickson

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