Journal of graduate medical education最新文献

{"title":"Association of the 2017 ACGME US Resident Duty Hour Policy Change With Hospital Quality and Patient Experience.","authors":"Maya L Hunt, Jeanette W Chung, Yue-Yung Hu, Karl Y Bilimoria, Amy L Holmstrom","doi":"10.4300/JGME-D-24-00960.1","DOIUrl":"10.4300/JGME-D-24-00960.1","url":null,"abstract":"<p><p><b>Background</b> In 2017, the Accreditation Council for Graduate Medical Education (ACGME) updated select US residency duty hour requirements to improve continuity of care and resident education. It is unknown if this policy change affected hospital quality of care and patient experience. <b>Objective</b> To evaluate the association of the 2017 duty hour policy change with hospital quality and patient experience in teaching vs nonteaching hospitals. <b>Methods</b> In this observational difference-in-differences (DiD) study, hospital quality (patient outcomes) and patient experience metrics were obtained from Centers for Medicare & Medicaid Services <i>Care Compare</i> data from before (July 1, 2014-June 30, 2016) and after (July 1, 2017-June 30, 2019) the 2017 policy change in teaching and nonteaching hospitals. Primary outcomes include hospital quality (five 30-day readmission indicator rates, five 30-day mortality rates, 8 patient safety indicators), and patient experience (5 measures from Hospital Consumer Assessment of Healthcare Providers and Systems survey). <b>Results</b> A total of 2935 hospitals (250 teaching; 2685 nonteaching) were included. When comparing before and after the 2017 policy change, teaching hospitals had greater reductions in hospital-wide readmission (DiD coefficient -0.26; 95% CI, -0.34 to -0.18; <i>P</i><.001), heart failure readmission (DiD coefficient -0.48; 95% CI, -0.78 to -0.19; <i>P</i><.002), and stroke mortality rates (DiD coefficient -0.56; 95% CI, -0.94 to -0.19; <i>P</i><.01) than did nonteaching hospitals. There were no significant differences between teaching and nonteaching hospitals in other outcomes before vs after policy change. <b>Conclusions</b> After the 2017 duty hour policy change, there was no evidence of worsening of hospital quality or patient experience in teaching hospitals, compared to nonteaching hospitals.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"486-496"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naming Your Spider.","authors":"Heidi Allespach","doi":"10.4300/JGME-D-25-00012.1","DOIUrl":"10.4300/JGME-D-25-00012.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"527-528"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Program Effects as a Source of Construct-Irrelevant Variance in ACGME Milestone Ratings.","authors":"Stanley J Hamstra, Kenji Yamazaki","doi":"10.4300/JGME-D-24-00615.1","DOIUrl":"10.4300/JGME-D-24-00615.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"434-438"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Login That Provided the Password to a Clinician Educator Career.","authors":"Lealani Mae Y Acosta","doi":"10.4300/JGME-D-24-00992.1","DOIUrl":"10.4300/JGME-D-24-00992.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"529-530"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a Hot Dog a Sandwich? Using Lateral Thinking to Teach Philosophy of Science.","authors":"Benjamin Kinnear","doi":"10.4300/JGME-D-24-00929.1","DOIUrl":"10.4300/JGME-D-24-00929.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"420-422"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advice for Authors Considering Submitting to the <i>Journal of Graduate Medical Education</i>.","authors":"Gail M Sullivan","doi":"10.4300/JGME-D-25-00543.1","DOIUrl":"10.4300/JGME-D-25-00543.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"417-419"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The <i>Back to Bedside</i> Leadership Experience.","authors":"Amanda S Xi, Nicholas A Yaghmour, Jeffrey J Dewey","doi":"10.4300/JGME-D-25-00579.1","DOIUrl":"10.4300/JGME-D-25-00579.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"534-536"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Geriatric Competencies in Residents: Validating the 5Ms Dimensions.","authors":"Sarah Montreuil, Éric Marchand, Pascal W M Van Gerven, Alexandre Lafleur","doi":"10.4300/JGME-D-24-00759.1","DOIUrl":"10.4300/JGME-D-24-00759.1","url":null,"abstract":"<p><p><b>Background</b> Despite undergraduate training in geriatric care, gaps persist throughout residency, highlighting limitations of current assessment methods in evaluating medical expertise across geriatric dimensions. <b>Objective</b> We developed a case-based assessment using the geriatric 5Ms framework (Mind, Mobility, Medications, Multicomplexity, Matters Most), aligned with undergraduate objectives and North American internal medicine milestones. We present feasibility data and preliminary validity evidence of using the geriatric 5Ms framework to evaluate residents' geriatric medical expertise. <b>Methods</b> During a 2023 mandatory academic session at a single site, 68 first- to third-year internal medicine residents were randomly assigned to complete assessment and management plans for 3 of 6 geriatric cases within 1 hour. Two blinded educators rated performance on 5Ms dimensions and non-geriatric medical expertise using a 3-level rating scale (0 to 2). We collected feasibility data (logistical integration, participation rates, time to design cases, rate responses) and validity evidence, based on Messick's framework, in part through a post-assessment questionnaire. <b>Results</b> Sixty-five residents completed 3 cases each, and 3 residents completed 2 cases each, resulting in 201 total cases, each integrating all 5Ms dimensions. Scores across the 5Ms dimensions ranged from 0.8 to 1.3, indicating partial assessment and management. All 5Ms dimensions (mean=1.1, SD=0.3) scored significantly lower than non-geriatric medical expertise (mean=1.5; SD=0.3; <i>t</i>(64)=9.58; <i>P</i><.001). Interrater reliability was moderate to strong (ICC=0.67-0.85, <i>P</i><.001). Most residents rated the cases (59 of 67, 88%; mean=4.4; SD=0.7) and the assessment (56 of 67, 84%; mean=4.1; SD=0.7) as representative of clinical practice. <b>Conclusions</b> A case-based assessment using the geriatric 5Ms framework demonstrated feasibility and preliminary validity for evaluating residents' geriatric medical expertise.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"470-478"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Night Shift Work Strategy for Medical Trainees.","authors":"Deandra Kuruppu, Christopher Lau, Joyce Lee-Iannotti, Michelle Zeidler","doi":"10.4300/JGME-D-25-00565.1","DOIUrl":"10.4300/JGME-D-25-00565.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"525-526"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Art, Science, and Study of \"Senioring\": A Narrative Review on the Role of the Supervising Resident.","authors":"Emily A Lang, Pamela Fazzio, Anna K Weiss","doi":"10.4300/JGME-D-24-00739.1","DOIUrl":"10.4300/JGME-D-24-00739.1","url":null,"abstract":"<p><p><b>Background</b> Despite increasing focus on developing senior residents' teaching and supervisory skills, few studies have identified the components of the supervisory resident role. To develop curricula to prepare residents for this role, we must clearly define the supervising role. <b>Objective</b> To summarize the literature regarding the characteristics and behaviors of effective supervising residents and to propose a model of the supervisory resident role. <b>Methods</b> We performed a narrative review, searching PubMed and SCOPUS for literature discussing the supervisory resident role. Titles, abstracts, and articles were screened for inclusion, as were the reference sections of included articles. Using inductive thematic analysis, we coded qualitative statements, survey items, and curriculum goals and organized them into themes based on iterative, reflexive discussion. We used these themes to present a model of the supervisory role. <b>Results</b> Thirty-six works met our inclusion criteria. The articles represented perspectives from faculty members, residents, and medical students and utilized qualitative and quantitative methods. They indicated that the supervising resident is responsible for teaching, managing daily tasks, advocating on behalf of their team members' well-being, and creating a psychologically safe learning environment. Emphasis on each of these components varied by role on the medical team. <b>Conclusions</b> This is one of the first studies to incorporate multiple perspectives to describe the multifaceted role of the supervising resident, and suggests that individuals' positions on the medical team guide their perception of this role. The literature lacks adequate exploration of junior residents', medical students', interdisciplinary team members', and patients' and families' descriptions of this role.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 4","pages":"444-452"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}