Journal of graduate medical education最新文献_第3页

Returning to The House of God.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00475.1

Emmet Hirsch

引用次数: 0

"It's Kind of a Rite of Passage": An Exploration Into Residents' Experience of Learning in a Critical Care Setting. "这是一种仪式"：探索住院医生在重症监护环境中的学习体验。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00415.1

Avi J Kopstick, Benjamin W Sanders, Kathryn Felmet, Lalena M Yarris, Serena Phromsivarak Kelly

{"title":"\"It's Kind of a Rite of Passage\": An Exploration Into Residents' Experience of Learning in a Critical Care Setting.","authors":"Avi J Kopstick, Benjamin W Sanders, Kathryn Felmet, Lalena M Yarris, Serena Phromsivarak Kelly","doi":"10.4300/JGME-D-24-00415.1","DOIUrl":"10.4300/JGME-D-24-00415.1","url":null,"abstract":"Background Many trainees complete rotations in intensive care units (ICUs), but little is known about how ICU rotations impact learners. Understanding residents' experiences in ICU rotations is a crucial step toward improving resident education and understanding the consequences, intended and unintended, of critical care learning. Objective We performed a qualitative study to understand how pediatric and emergency medicine residents experience a pediatric ICU (PICU) rotation. Methods For this phenomenological study, we explored residents' experiences with critical care learning by focusing on the high-stakes, emotionally charged PICU environment. Semistructured interviews were conducted with 12 residents after their first PICU rotation from July 2019 through March 2020. Data were analyzed through line-by-line coding, serial discussions, and consensus meetings. Finally, emergent themes and convergent narratives were constructed around the resident PICU experience. Results Residents perceived the PICU as a challenging environment for independent, self-driven, and active learning. They suffered adverse psychological effects, leading some to \"give up\" and many to experience feelings consistent with acute traumatic stress. Despite these challenges, residents described their PICU rotation as a \"rite of passage\" and reported increased comfort with caring for \"sick kids.\" Conclusions Residents describe their PICU rotations as intense experiences that result in increased physician comfort. However, they also endure psychologically traumatic experiences that may hinder them, and the independent practitioners they become, from caring for certain types of patients in the future.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"701-712"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830161","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

TRASH-CAN: An Approach to Promote Planetary Health Education and Research for Health Care Trainees.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00066.1

Gordon M Best, Connor T A Brenna, Owen D Luo, Olivia Cheng-Boivin, Nicole Prince, Mary Hanna, Mathilde Gaudreau Simard, Husein Moloo

{"title":"TRASH-CAN: An Approach to Promote Planetary Health Education and Research for Health Care Trainees.","authors":"Gordon M Best, Connor T A Brenna, Owen D Luo, Olivia Cheng-Boivin, Nicole Prince, Mary Hanna, Mathilde Gaudreau Simard, Husein Moloo","doi":"10.4300/JGME-D-24-00066.1","DOIUrl":"10.4300/JGME-D-24-00066.1","url":null,"abstract":"Background As future health care leaders who work and train in diverse clinical settings, resident physicians are uniquely positioned to advance sustainable health care systems. However, residents are insufficiently educated about health care sustainability and given limited opportunities to engage in planetary health. Objective This article introduces and reports on the early outcomes of the Trainee-Led Research and Audit for Sustainability in Healthcare Canada (TRASH-CAN), a resident-driven initiative launched in 2023 with the aim of reducing Canadian health care's environmental impact. Methods In 2023-2024, we developed a web-based platform that facilitates trainee-led action to support the promotion of sustainability literature, collaboration with national and international institutions, and execution of quality improvement projects to reduce health care waste under the 3 brand pillars of Learning, Leadership, and Delivery. We have promoted TRASH-CAN and its website through conference presentations, social media, mailing lists, and word of mouth. These activities support our goals of engaging trainees, pairing them with mentors, and initiating a variety of quality improvement projects focused on planetary health. Results In its first year of operation, TRASH-CAN has developed a fully functional website hosting intake forms and detailing ongoing projects and opportunities. We have enrolled 15 faculty mentors and 16 residents and medical students, with ongoing projects such as transitioning hospitals to reusable alternatives and optimizing procedural custom operating room equipment packs. Conclusions TRASH-CAN's inaugural year has led to the initiation of 11 sustainability projects and the enrollment of 31 faculty mentors and trainees.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830178","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

Understanding ACGME Standards for Simulation: A Document Analysis of Institutional and Program Requirements.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00127.1

Alexis E Scott, Krystle K Campbell, Jeanne Carey, Larissa Velez, Aditee Ambardekar, Daniel J Scott

{"title":"Understanding ACGME Standards for Simulation: A Document Analysis of Institutional and Program Requirements.","authors":"Alexis E Scott, Krystle K Campbell, Jeanne Carey, Larissa Velez, Aditee Ambardekar, Daniel J Scott","doi":"10.4300/JGME-D-24-00127.1","DOIUrl":"10.4300/JGME-D-24-00127.1","url":null,"abstract":"Background Our institution has established priorities for graduate medical education (GME) simulation which include increasing adoption of, garnering additional financial support for, and creating a core simulation curriculum. Better understanding of the Accreditation Council for Graduate Medical Education (ACGME) simulation requirements will inform our efforts and serve as a guide for other institutions. Objective The purpose of this study was to perform a structured review of ACGME simulation standards using a document analysis to guide GME simulation activities at an institutional level. Methods A document analysis was performed from May 2023 to June 2024 to select and search ACGME Institutional and Program Requirements corresponding to the primary specialties for 21 clinical departments that financially support our simulation center. Content relevant to simulation was identified, and iterative coding with investigator team consensus was performed to assign categories, characterize the requirements, and interpret the findings. Results Twenty-four documents included 120 simulation requirements that were assigned to 12 categories; 70 (58%) requirements were mandatory whereas 50 (42%) were not, and 48 (40%) were simulation-specific, whereas 72 (60%) were simulation-optional. All reviewed specialties had simulation requirements (average 5.4, range 2-12), but the ACGME Institutional Requirements did not. Moderate to strong evidence supported (1) simulation usage by all 21 departments; (2) the need for institutional resource support; and (3) institutional-level patient safety simulation curricula. Conclusions This study identified a large number of simulation requirements, including mandatory patient safety curricula requirements, for all specialties analyzed.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"691-700"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830220","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

Adapting the Planetary Health Report Card for Graduate Medical Training Programs. 为医学研究生培训计划改编 "行星健康报告卡"。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00065.1

Sarah Schear, Karly Hampshire, Taylor Diedrich, Isabel Waters, Aisha Barber

{"title":"Adapting the Planetary Health Report Card for Graduate Medical Training Programs.","authors":"Sarah Schear, Karly Hampshire, Taylor Diedrich, Isabel Waters, Aisha Barber","doi":"10.4300/JGME-D-24-00065.1","DOIUrl":"10.4300/JGME-D-24-00065.1","url":null,"abstract":"Background Leading medical organizations recognize climate change as an urgent threat to public health and social justice. Medical students created the Planetary Health Report Card (PHRC) to evaluate and spur climate action in medical schools. Graduate medical trainees lack a similar tool to evaluate and improve their training programs and institutions. Objective To adapt the PHRC to graduate medical education (GME) contexts and report preliminary validity evidence. Methods In 2023, based on literature review, we adapted the 2022 undergraduate medical PHRC metrics on curriculum and sustainability. We modified keywords in all PHRC domains to apply to GME. We recruited participants with expertise in planetary health, sustainability, and health equity affiliated with GME. Using a modified Delphi Panel method, we surveyed participants on adapted metric validity. We determined percent agreement among participants. Results We recruited 45 eligible participants, of whom 20 (44%) completed a first-round survey. Participants included a senior medical student, residents, fellows, faculty, and program directors from the United States, Canada, and the United Kingdom. Participants had a high level of agreement on metrics in the domains of curriculum, support for trainee-led initiatives, and sustainability. Some metrics in research and community engagement domains fell below the agreement threshold. Conclusions In the first round of a modified Delphi Panel survey, trainees and faculty agreed that metrics adapted from the PHRC are relevant to evaluating GME programs on planetary health, sustainability, and environmental justice.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"104-110"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829517","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

Teaching Climate and Health in Preventive Medicine Residency Programs: A Survey of Program Directors. 预防医学住院医师培训项目中的气候与健康教学：项目主任调查。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00348.1

Marian R Passannante, Shaun Shahani, Michael Gochfeld, Wendy M Purcell, Sajjad A Savul, Pauline Thomas

{"title":"Teaching Climate and Health in Preventive Medicine Residency Programs: A Survey of Program Directors.","authors":"Marian R Passannante, Shaun Shahani, Michael Gochfeld, Wendy M Purcell, Sajjad A Savul, Pauline Thomas","doi":"10.4300/JGME-D-24-00348.1","DOIUrl":"10.4300/JGME-D-24-00348.1","url":null,"abstract":"Background Climate change and related pollution and environmental damage are an urgent focus for public health physicians. Curricular content is increasing in medical schools, but to date, only pediatrics has published guidance for residency education. Objective To survey program directors of Accreditation Council for Graduate Medical Education preventive medicine specialties (public health and preventive medicine [PHPM], occupational and environmental medicine [OEM], and aerospace medicine [AM]) for current teaching on climate and health issues. Methods Links to an online 9-question confidential survey were sent to all program directors through Listservs January through March 2024. Questions were developed with guidance from a climate health expert. Responses were analyzed via summary statistics for continuous data, as well as Fisher's Exact, Kruskal-Wallis, and Wilcoxon pairwise comparison tests for nominal data. Results Thirty-five of 71 programs responded (49.3%), including 21 of 42 PHPM, 12 of 23 OEM, and 2 of 6 AM programs. Two (5.9%) reported having a formal curriculum for climate and health issues, and 2 (5.9%) reported not covering any included topics. Programs differed by topic emphasis with OEM and AM more likely to address fire, smoke, wind, and flooding effects. Lectures and local or state health department rotations were the most frequent teaching strategies. Of complete responders, 23 of 34 (67.6%) expressed interest in joining a workgroup to develop shared curricula. Conclusions This survey of preventive medicine residency programs found that most include climate and health topics, but only 2 have a formal curriculum, and 2 reported no topics included in the survey.","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830171","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

Planetary Health and Sustainable Health Care Education Through Quality Improvement: A Residency Curriculum Integration. 通过质量改进实现行星健康和可持续医疗保健教育：住院实习课程整合。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00064.1

Catherine Chen, Radhika Kadakia

引用次数: 0

An Interprofessional Approach to Prepare Medical Residents and Fellows to Address Climate- and Environment-Related Health Risks. 采用跨专业方法培养医学住院医师和研究员应对与气候和环境有关的健康风险。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00109.1

Tawnya D Peterson, Alexander Domingo, Diane Stadler, Leah Werner, Joseph A Needoba, Sara Walker, Benjamin S Liu, Joanna Hatfield

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Climate Change and Health: Occupational and Environmental Medicine at the Frontlines. 气候变化与健康：气候变化与健康：前线的职业与环境医学》。

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00080.1

Alya Khan, Manijeh Berenji, Marianne Cloeren, Gina Solomon, Rose Goldman

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Diagnostic Stewardship Is Environmental Stewardship.

Journal of graduate medical education Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.4300/JGME-D-24-00118.1

Kristen Bastug, Ellen Townley, Laura Norton

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