Journal of graduate medical education最新文献_第2页

Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources. 将气候变化教育纳入住院实习：关注社区风险和资源。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00061.1

Charles Moon, Sandra Braganza, Eleanor Bathory

{"title":"Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources.","authors":"Charles Moon, Sandra Braganza, Eleanor Bathory","doi":"10.4300/JGME-D-24-00061.1","DOIUrl":"10.4300/JGME-D-24-00061.1","url":null,"abstract":"Background: Graduate medical education (GME) focused on climate change (CC) health effects is essential. However, few CC education evaluations exist to guide residency programs looking to implement CC content.Objective: To evaluate the effect of an education session on residents' self-reported knowledge of CC health effects and confidence utilizing local CC anticipatory guidance and community resources with patients.Methods: A CC session was integrated into the pediatric, family medicine, and social medicine curricula at an urban academic medical center in 2023. A convenience sample of residents participated in 1 of 4 nonrandomized case-based or lecture-based sessions. Pre- and post-session 5-question Likert-scale surveys were used for assessment and analyzed using paired t tests.Results: Sixty-eight of 108 eligible residents completed the surveys (28 case-based, 40 lecture-based, 63% response rate). Residents' understanding and confidence to engage with patients on CC health effects after the educational session improved (Q1 mean difference 1.3, t 67=9.85, 95% CI 1.04-1.57, P<.001; Q2 1.5, t 67=9.98, 95% CI 1.20-1.82, P<.001; Q3 1.8, t 67=12.84, 95% QI 1.54-2.11, P<.001; Q4 2.1, t 67=16.25, 95% CI 1.84-2.36, P<.001; Q5 2.1, t 67=16.28, 95% CI 1.86-2.38, P<.001).Conclusions: Resident self-reported understanding of the health effects of CC and confidence utilizing local CC anticipatory guidance and resources with patients increased after a CC education session.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830129","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}

引用次数: 0

International Planetary Health Education in Undergraduate and Graduate Medical Curricula: A Scoping Review. 医学本科生和研究生课程中的国际行星健康教育：范围审查。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00027.1

Rajajee Selvam, Niève Séguin, Lisa Zhang, Ariane Lacaille-Ranger, Lindsey Sikora, Isabelle Raiche, Daniel I McIsaac, Husein Moloo

{"title":"International Planetary Health Education in Undergraduate and Graduate Medical Curricula: A Scoping Review.","authors":"Rajajee Selvam, Niève Séguin, Lisa Zhang, Ariane Lacaille-Ranger, Lindsey Sikora, Isabelle Raiche, Daniel I McIsaac, Husein Moloo","doi":"10.4300/JGME-D-24-00027.1","DOIUrl":"10.4300/JGME-D-24-00027.1","url":null,"abstract":"Background Climate change is a public health emergency, yet planetary health education is absent for many medical and health professions trainees. Objective To perform a scoping review exploring the inclusion of planetary health in undergraduate and graduate medical education. Methods A search strategy was developed with a health sciences librarian and run on 6 databases from their inception to February 2022: MEDLINE, Embase, APA PsycInfo, CINAHL, Global Health, and Scopus. The Arksey and O'Malley framework was employed to broadly select publications that described the implementation of planetary health in undergraduate and postgraduate medical education. Commentaries were included if they outlined a potential curriculum. Extracted data was grouped thematically using an iterative approach based on competencies described, key considerations, and anticipated barriers. Results After screening 2407 articles, 42 were included. Thirty articles involved medical education at undergraduate or postgraduate levels, while 10 discussed multidisciplinary education including veterinary medicine, public health, and nursing. Two articles discussed planetary heath education for staff physicians. Reported competencies included eco-medical literacy, environmental inequity, and planetary health advocacy. Key considerations for curricular development included longitudinal implementation, interprofessional collaboration, and experiential learning through quality improvement projects. Barriers to implementation included time constraints and the lack of knowledgeable educators and administrative support for curricular change. Conclusions This scoping review outlines key recommendations and barriers to help facilitate the implementation of planetary health education in medical training.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"58-68"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830131","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}

引用次数: 0

Strategies for Successfully Changing Specialty During Training. 在培训期间成功转换专业的策略。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00394.1

Elizabeth M Thackeray, Mark J Harris

引用次数: 0

A Perspective on Promotion in Place and Competency-Based, Time-Variable Graduate Medical Education. 透视就地晋升和基于能力、时间可变的毕业医学教育。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00380.1

Steven H Rose, Timothy R Long

引用次数: 0

Non-Teaching Service Patients Versus Patients Without Teaching Value.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00200.1

Parul Sud, Halina Kusz, Molly E Gabriel-Champine

引用次数: 0

Sustainability in Action: A Financial Incentive for Trainees Embracing Environmentally Friendly Quality Improvement Projects. 可持续发展在行动：对接受环境友好型质量改进项目的受训人员的经济激励。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00059.1

Esther H Chen, Elena Fuentes-Afflick

{"title":"Sustainability in Action: A Financial Incentive for Trainees Embracing Environmentally Friendly Quality Improvement Projects.","authors":"Esther H Chen, Elena Fuentes-Afflick","doi":"10.4300/JGME-D-24-00059.1","DOIUrl":"10.4300/JGME-D-24-00059.1","url":null,"abstract":"Background Engaging and motivating busy trainees to work on reducing the climate impact of their clinical practice is challenging. To our knowledge, there are no published studies of graduate medical education (GME)-wide, institutional efforts to engage residents in implementing climate sustainability improvement projects. Objective We piloted a novel, institution-wide, pay-for-performance (P4P) sustainability quality improvement (SusQI) program in 2023-2024 that enabled residents from all GME programs to implement SusQI projects with practice-changing improvement goals for a financial incentive. Methods Project leaders were provided an opportunity to implement a project by identifying a SusQI problem and collaborating with stakeholders toward meeting environmentally friendly monthly improvement goals for an incentive payment. Eligible residents who reached their monthly goal for 6 months of the academic year would receive $400. Results Of the 4 SusQI projects approved for the P4P program, 3 remained active after 6 months. One project stalled because of institutional barriers. Two hundred and ten residents participated. Environmental impacts included an increase in low anesthetic gas flow use in operating room cases (mean [SD] 25% to 53% [0.1]), increase of radiology workroom waste sorting into recycling and composting bins (mean [SD] 20% to 58% [0.1]), and increase in emergency department instruments recycled (mean [SD] 9% to 24% [0.2]). Two hundred and ten residents are set to receive $84,000 at the end of the year for meeting their SusQI goals. Conclusions We were able to integrate sustainability into QI programs by implementing an institution-wide pay-for-performance SusQI program that encouraged residents to develop and implement environmentally friendly practice projects.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"135-139"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830168","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}

引用次数: 0

Implementing a Clinical Decision Support Tool to Reduce Operating Room Anesthetic Fresh Gas Flow: A Resident-Led, Sustainability-Focused Quality Improvement Initiative. 实施临床决策支持工具以减少手术室麻醉新鲜气体流量：一项由住院医师主导、以可持续发展为重点的质量改进计划。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00074.1

Julia Collins, Marcus Karim, Bebhinn Akcay, Nandini Palaniappa, Jenson Wong

{"title":"Implementing a Clinical Decision Support Tool to Reduce Operating Room Anesthetic Fresh Gas Flow: A Resident-Led, Sustainability-Focused Quality Improvement Initiative.","authors":"Julia Collins, Marcus Karim, Bebhinn Akcay, Nandini Palaniappa, Jenson Wong","doi":"10.4300/JGME-D-24-00074.1","DOIUrl":"10.4300/JGME-D-24-00074.1","url":null,"abstract":"Background Lowering fresh gas flow (FGF) can help decrease the carbon footprint of the operating room as FGF levels act as an indirect measure of anesthetic gas waste. Objective The aim of this quality improvement project was to reduce clinician FGF during general anesthesia with clinical decision support (CDS) tools within the electronic health record (EHR) at a single institution. Methods A non-interruptive alert to reduce FGF was coded into the anesthesia intraoperative EHR workspace to alert whenever the 10-minute average FGF exceeded 1 L/min. It was targeted at anesthesia residents, attendings, and certified registered nurse anesthetists at a single US large academic level 1 trauma center. The number of general anesthesia cases with a target FGF of ≤2 L/min and the amount of sevoflurane (L/hr) was tracked on an individual and institutional basis. Results Following CDS implementation from July 2023 through July 2024, 2677 of 4573 (58.5%) had a mean FGF ≤2 L/min, demonstrating a 116.7% increase from our institution's baseline of 27.0% (1200 of 4446 cases) from July 2022 to June 2023, corresponding to a sevoflurane usage reduction of 36.7%. Conclusions Implementing a non-interruptive alert in the EHR altered institution-level behaviors to reduce environmentally harmful anesthetic gas emissions.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830121","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}

引用次数: 0

Music and Medicine in Concert.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00560.1

Nara Miriam Michaelson

引用次数: 0

A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years. 气候变化与人类健康医学教育研究生奖学金：前 5 年的经验和成果。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00110.1

Caleb Dresser, Tess Wiskel, Catharina Giudice, Kimberly Humphrey, Latoya Storr, Satchit Balsari

{"title":"A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years.","authors":"Caleb Dresser, Tess Wiskel, Catharina Giudice, Kimberly Humphrey, Latoya Storr, Satchit Balsari","doi":"10.4300/JGME-D-24-00110.1","DOIUrl":"10.4300/JGME-D-24-00110.1","url":null,"abstract":"Background Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. Objective To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation. Methods A GME training program was developed and implemented at an emergency medicine department in a US teaching hospital in collaboration with affiliated academic centers. Participants consisted of emergency physicians from the United States and abroad. Program duration and format were adjusted to meet individual career goals. Outcomes assessed include program completion, postgraduation professional roles, and academic outputs and public engagement before and after fellowship matriculation (2019-2023), compared via paired t tests. Results Five fellows have matriculated; 2 have graduated, while 3 remain in training. Costs and in-kind support include salaries, faculty time, research support, travel to conferences, and tuition for a public health degree. Fellows averaged 0.26 outputs per month before matriculation (95% CI 0.01-0.51) and 2.13 outputs per month following matriculation (95% CI 0.77-3.50); this difference was significant via 2-tailed t test (alpha=.05, P=.01). Subanalyses of academic output and public engagement reveal similar increases. Following matriculation, 186 of 191 (97.4%) of outputs were related to climate change. Conclusions For the 5 fellows that have enrolled in this GME climate change fellowship, academic and public engagement output rates increased following fellowship matriculation.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"129-134"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830229","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}

引用次数: 0

Resident Physicians Can Promote Environmental Health and Climate-Informed Health Care.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00175.1

Jacob Rha, Camille Ezran, Katherine T Liu, Lesley B Gordon

引用次数: 0