Journal of graduate medical education最新文献

{"title":"Essential Foundational Education Research Methods Articles for Graduate Medical Educators: A Delphi Study.","authors":"Ethan Feig, Ryanne Mayersak, Christine Luo, Mackenzie R Cook, Lauren Sigman, Jaime Jordan, Jeff Riddell, Leila Zuo, Angela Holly Villamagna, Erin Bonura, Lalena M Yarris","doi":"10.4300/JGME-D-23-00941.1","DOIUrl":"https://doi.org/10.4300/JGME-D-23-00941.1","url":null,"abstract":"<p><p><b>Background</b> Graduate medical educators interested in designing and conducting education research may seek foundational general overview articles on education research methods. <b>Objective</b> We aimed to identify the most useful foundational education research methods articles for medical educators. <b>Methods</b> We identified candidate articles through a 2020 Ovid MEDLINE literature search augmented by the authors' personal files and by cross-checking references of included articles. Articles that were primarily about general education research principles were included; articles were excluded if they were not focused on medical education research methods, were published prior to the year 2000, were written in a non-English language, or had no available abstracts. We conducted a modified Delphi study with 10 participants representing a range of specialties and education research experience to find consensus about the most useful articles. We planned 3 rounds of the Delphi process, the first to eliminate any articles not deemed useful for this audience, and the second and third rounds to include articles that at least 80% of the panel deemed \"most useful\" to education researchers. <b>Results</b> Of 25 relevant articles identified in the literature search: one was excluded in round 1, 7 met the a priori threshold of 80% agreement for inclusion in round 2, and an additional 2 met inclusion in round 3. These 9 foundational education research methods articles relevant to graduate medical educators are described, along with a capsule summary and specific use for education researchers. <b>Conclusions</b> Our modified Delphi study of foundational education research methods articles identified 9 articles deemed useful for graduate medical educators who are seeking methods resources.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"601-606"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476897","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":"Formal Parental Leave Policies and Trainee Well-Being in US Graduate Medical Education: A Systematic Review.","authors":"Michaele Francesco Corbisiero, Jordan J Stellern, Hannah M Kyllo, George Burnet, Kristen DeSanto, Nicole Christian, Shannon N Acker","doi":"10.4300/JGME-D-24-00018.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00018.1","url":null,"abstract":"<p><p><b>Background</b> Variability in parental leave policies across graduate medical education (GME) programs in the United States complicates efforts to support resident wellness and identify best practices for resident well-being. <b>Objective</b> This review aims to assess how formal parental leave policies affect trainees' well-being, professional satisfaction, and performance during training. <b>Methods</b> A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) 2020 guidelines was conducted and registered on PROSPERO in May 2023. Databases searched included MEDLINE, Embase, and Cochrane Central. Studies that evaluated parental leave policies of US-based GME programs and their direct impact on residents and/or fellows were included. Studies were screened for inclusion by 2 independent reviewers, and any conflicts were resolved by a third author. <b>Results</b> Of 1068 articles screened, 43 articles met inclusion criteria. These studies highlighted that leave durations of less than 6 weeks were associated with higher rates of burnout and postpartum depression among trainees. There was no evidence that taking parental leave increased program attrition rate; however, 3 studies reported more than one-third of trainees extended training as a result of taking leave. Trainees who had more than 8 weeks of parental leave reported more successful breastfeeding 6 months out from delivery than those with less than 8 weeks of leave. <b>Conclusions</b> Extended parental leave, notably beyond 6 weeks, improved trainee well-being and professional satisfaction. Based on trainees' perspectives, ideal parental leave policies offer a minimum of 6 to 8 weeks of leave, with a formal and clearly written policy available.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"532-544"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476898","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":"Interventions to Support Resident and Fellow Well-Being During the COVID-19 Pandemic: A Scoping Review.","authors":"Halah Ibrahim, Sawsan Abdel-Razig, Lyuba Konopasek, Jillian Silverberg, Ingrid Philibert","doi":"10.4300/JGME-D-24-00016.1","DOIUrl":"10.4300/JGME-D-24-00016.1","url":null,"abstract":"<p><p><b>Background</b> The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. <b>Objective</b> To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic. <b>Methods</b> The authors conducted a scoping review of the literature published between January 1, 2020, and November 30, 2023, in PubMed, Scopus, Embase, PsycINFO, CINAHL, and ERIC to identify interventions to promote the well-being of trainees during the COVID-19 pandemic. <b>Results</b> Eighteen articles met inclusion criteria, mainly studies conducted in the United States (14 of 18, 77.8%). Most interventions targeted psychological well-being (16 of 18, 88.9%), with only a few studies that included interventions in the physical or social domains. Interventions entailed redeployment, schedule modifications, communication strategies, and expanded mental health support. Most interventions were limited to a few weeks' duration in the first surge phase of the pandemic. Only 11 studies (61%) reported outcome measures, and only 2 (11%) used instruments with validity evidence. Most studies did not report sufficient data to evaluate study quality. <b>Conclusions</b> While longer-term outcome data were often lacking, studies described a range of interventions to support resident well-being. Future research should focus on the effectiveness of well-being interventions and include cohorts from more diverse clinical settings.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"545-556"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476901","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":"A Doctor's Dilemma.","authors":"Dean Gianakos","doi":"10.4300/JGME-D-24-00422.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00422.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"621-622"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476876","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":"Gender Differences in Operative Autonomy Using the Surgical Autonomy Program: A Multicenter Study.","authors":"Elayna P Kirsch, Vishal Venkatraman, Di Deng, Katherine E McDaniel, Alexander D Suarez, Sean M Lew, Josiah Orina, Howard Silberstein, Ira Goldstein, Grahame Gould, Chirag D Gandhi, Chirag Patil, Bradley A Dengler, Rajeev Dharmapurikar, Shivanand P Lad, Michael M Haglund","doi":"10.4300/JGME-D-23-00682.1","DOIUrl":"10.4300/JGME-D-23-00682.1","url":null,"abstract":"<p><p><b>Background</b> The proportion of women surgeons is increasing, but studies show that women in surgical residency are granted less autonomy than men. <b>Objective</b> We utilized the Surgical Autonomy Program (SAP), an educational framework, to evaluate gender differences in self-reported autonomy, attending-reported autonomy, and operative feedback among US neurosurgical residents. <b>Methods</b> The SAP tracks resident progression and guides teaching in neurosurgery. Surgeries are divided into zones of proximal development (opening, exposure, critical portion, and closure). Postoperatively, resident autonomy is rated on a 4-point scale by the resident and the attending for each part of the case, or zone. We utilized data from July 2017 to February 2024 from 8 institutions. Ordinal regression was used to evaluate the odds of self- and attending-evaluated autonomy, accounting for gender, training year, case difficulty, and institution. Differences between attending assessment and self-assessment were calculated across time. Chi-square analyses were used to measure any differences in feedback given to men and women. <b>Results</b> From 128 residents (32 women, 25%), 11894 cases were included. Women were granted less autonomy (OR 0.81; 95% CI 0.74-0.89; <i>P</i><.001) and self-evaluated as having less autonomy (OR 0.73; 95% CI 0.67-0.80; <i>P</i><.001). The odds of women operating at higher autonomy were similar to the odds of operating on a hard case compared to average difficulty (OR 0.77; 95% CI 0.71-0.84; <i>P</i><.001). Men's and women's self-assessment became closer to attending assessment over time, with women improving more quickly for the critical portions of surgeries. Women residents received meaningful postoperative feedback on fewer cases (women: 74.2%, men: 80.5%; X²=31.929; <i>P</i><.001). <b>Conclusions</b> Women operated with lower autonomy by both attending and self-assessment, but the assessment gap between genders decreased over time. Women also received less feedback from their attendings.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"517-524"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476899","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":"A Resident-Led Quality Improvement Initiative to Increase End-of-Life Planning in Primary Care.","authors":"Brooke Wagen, Simisola Kuye, Rajvi Patel, Jaya Vasudevan, Lisi Wang, Robin Reister, Michael Pignone, Christopher Moriates","doi":"10.4300/JGME-D-24-00271.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00271.1","url":null,"abstract":"<p><p><b>Background</b> Despite many benefits of end-of-life (EOL) planning, only 1 in 3 adults has EOL documentation, with low rates in resident primary care clinics as well. <b>Objective</b> To increase clinic completion of life-sustaining treatment (LST) notes and advance directives (AD) for veterans at highest risk for death. <b>Methods</b> The setting was a Veterans Affairs (VA) internal medicine primary care clinic. All clinic residents in the 2021-2022 academic year and all clinic patients identified through a VA risk-stratification tool as highest risk for death were included. Baseline AD and LST completion rates were determined through manual chart review. Our interventions included 2 hours of teaching to increase resident knowledge of EOL planning and a systematic process improvement to complete EOL planning appointments. Outcomes assessed included anonymous resident pre- and post-surveys of self-assessed knowledge and comfort with EOL conversations, as well as rates of LST and AD completion determined through serial chart review. <b>Results</b> In the 2021-2022 academic year, 22 residents (100%) and 54 patients were included. Post-intervention surveys (n=22, 100%) showed improved self-assessed knowledge of EOL concepts and comfort with patient discussions (median Likert increase 3 to 4). The number of residents who completed an EOL planning visit increased from 9 of 22 (41%) to 15 (68%). LST completion increased from 9 of 54 (17%) to 29 (54%), and AD completion increased from 18 of 54 (33%) to 33 (61%). <b>Conclusions</b> A brief teaching intervention to prepare residents for comprehensive EOL visits combined with process improvement to offer EOL planning visits improved self-reported knowledge and comfort and completion of EOL visits.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"596-600"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476877","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":"Clinical Decision Rules: A Starting Place in Medical Education, Not a Destination.","authors":"William A Woods, Barrett H Barnes, Linda A Waggoner-Fountain","doi":"10.4300/JGME-D-24-00144.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00144.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"513-516"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476894","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":"Reddit, Discord, and the Spreadsheet: Misinformation About Residency Programs and How to Combat It.","authors":"Ryan J Keneally, Luis Lemos Lopes","doi":"10.4300/JGME-D-24-00187.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00187.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"506-508"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476852","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":"\"GME Around the World\": Introducing JGME's New Section for International Perspectives in Graduate Medical Education.","authors":"Halah Ibrahim, Marije P Hennus, Harm Peters","doi":"10.4300/JGME-D-24-00706.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00706.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"503-505"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476875","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 Effect of Implicit Bias on the OB/GYN Residency Application Process.","authors":"Thammatat Vorawandthanachai, Calvin Lambert, Nicola Tavella, Cristina M Gonzalez, Francine Hughes","doi":"10.4300/JGME-D-23-00601.1","DOIUrl":"10.4300/JGME-D-23-00601.1","url":null,"abstract":"<p><p><b>Background</b> Medical students from racially minoritized backgrounds receive negative evaluations more frequently, possibly from implicit bias. <b>Objective</b> To determine if a preference for White applicants over Asian and Black applicants exists among resident and attending reviewers of obstetrics and gynecology (OB/GYN) residency applications. <b>Methods</b> In 2021, we sampled academic OB/GYN physicians from 6 academic institutions to randomly receive questionnaire form A or B, each containing 4 contrived Electronic Residency Application Service profiles stratified by United States Medical Licensing Examination scores; institutions attended; and strength of recommendation letters into top-, mid-, and low-tiers. Form A applicants were White top-tier, White mid-tier without resilience, Asian mid-tier with resilience, and White low-tier. Form B applicants were Black top-tier, Asian mid-tier without resilience, White mid-tier with resilience, and White low-tier applicants. Both questionnaires' profiles were identical except for applicants' names and races. The primary outcome was participants' rankings of applicants from most to least desirable. Baseline characteristics of participants were compared with chi-square tests. Rankings were compared using generalized estimating equations to calculate the odds ratio (significance <i>P</i><.05). <b>Results</b> One hundred and ninety-one were invited to participate; 109 participants started the questionnaire, and 103 ranked applicants (response rate 54%). Fifty-three participants completed form A, and 56 completed form B. No significant differences were found in participants' demographics. Participants frequently ranked White applicants significantly more highly than Black applicants (-3.3, 95% CI -3.5, -3.1) and Asian applicants (-3.3, 95% CI -3.5, -3.1). <b>Conclusions</b> Despite identical qualifications, a stronger preference for White applicants over Black or Asian applicants was found.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"557-563"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476856","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}