Journal of graduate medical education最新文献

{"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":"<p><p><b>Background</b> 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. <b>Objective</b> 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. <b>Methods</b> 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. <b>Results</b> 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. <b>Conclusions</b> TRASH-CAN's inaugural year has led to the initiation of 11 sustainability projects and the enrollment of 31 faculty mentors and trainees.</p>","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}

{"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":"<p><p><b>Background</b> 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. <b>Objective</b> 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. <b>Methods</b> 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. <b>Results</b> 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. <b>Conclusions</b> This study identified a large number of simulation requirements, including mandatory patient safety curricula requirements, for all specialties analyzed.</p>","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}

{"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":"<p><p><b>Background</b> 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. <b>Objective</b> We performed a qualitative study to understand how pediatric and emergency medicine residents experience a pediatric ICU (PICU) rotation. <b>Methods</b> 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. <b>Results</b> 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.\" <b>Conclusions</b> 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.</p>","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}

{"title":"Feasibility and Acceptability of a Virtual Reality Curriculum to Support Firearm Safety Counseling Skills Among Pediatric Residents.","authors":"Francis J Real, Cornelia Griggs, Michelle March, Peter T Masiakos, Andrea Meisman, Gretchen Felopulos, Chana A Sacks, Matthew W Zackoff","doi":"10.4300/JGME-D-24-00022.1","DOIUrl":"10.4300/JGME-D-24-00022.1","url":null,"abstract":"<p><p><b>Background</b> Firearm-related injury is the leading cause of death among US children and adolescents. Residents across specialties report low preparedness to provide firearm safety counseling. Virtual reality (VR) may offer a modality to support residents' skills through deliberate practice in a simulated setting. <b>Objective</b> To describe a novel screen-based VR curriculum on firearm safety counseling and report feasibility and acceptability outcomes, including residents' perceptions. <b>Methods</b> Fifteen senior pediatric residents were recruited from 2 large children's hospitals. The curriculum included 4 simulated scenarios in VR during which residents verbally counseled graphical caregivers who responded in real time, driven by a human facilitator. The curriculum focused on introducing firearm safety, discussing storage devices, and navigating the conversation through motivational interviewing. Following participation, residents completed the Measurement, Effects, Conditions Spatial Presence Questionnaire (MEC-SPQ) to indicate the degree of immersion in the virtual environment. Additional study data were derived from semistructured interviews. We used a constructivist general inductive approach to explore perspectives via coding and pattern identification. <b>Results</b> Quantitatively 14 of 14 residents completing the survey indicated notable attention allocation and spatial presence in the VR environment. During the 15 interviews, residents identified VR as an acceptable modality for deliberate practice of firearm safety counseling skills in a realistic, scaffolded manner. They indicated the rehearsal of specific verbiage as critical to supporting behavior change. Notably, residents reported that the training helped overcome prior barriers to counseling by providing a framework for efficient counseling. <b>Conclusions</b> Among pediatric residents, VR proved a feasible and acceptable modality for training on firearm safety counseling.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"740-746"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830108","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":"Diagnostic Stewardship Is Environmental Stewardship.","authors":"Kristen Bastug, Ellen Townley, Laura Norton","doi":"10.4300/JGME-D-24-00118.1","DOIUrl":"10.4300/JGME-D-24-00118.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"53-57"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829985","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":"Implementing and Assessing Climate Change Education in a Pediatrics Residency Curriculum.","authors":"Mark McShane, Shelley Kumar, Linessa Zuniga","doi":"10.4300/JGME-D-24-00053.1","DOIUrl":"10.4300/JGME-D-24-00053.1","url":null,"abstract":"<p><p><b>Background</b> For physicians to effectively combat the growing health crisis that is climate change, they should begin learning during medical training about its health implications. However, there is little data on residents' knowledge of the climate crisis, and even less data regarding the effectiveness and acceptability of climate change education in graduate medical training programs. <b>Objective</b> To incorporate a new educational session on the health implications of climate change into a residency curriculum and evaluate the acceptability of the session and its effects on residents' knowledge, attitudes, and perceptions of the topic. <b>Methods</b> In July 2021, a 90-minute, interactive, small-group format educational session on the health implications of climate change was incorporated into the first-year curriculum of a pediatric residency program. From July 2021 through June 2023, resident participants completed pre- and post-session surveys that assessed their knowledge, attitudes, and perceptions regarding health implications of climate change. Likert scale data were analyzed using Wilcoxon signed-rank tests. <b>Results</b> Of the 109 residents scheduled to participate, 50 (46%) completed both the pre- and post-session surveys. Session participation increased residents' self-reported knowledge of how climate change impacts health and how physicians can act as climate advocates. Ninety-eight percent of all post-session respondents (58 of 59) agreed that they would recommend the session to other residents. With 3 facilitators, the monthly session required ≤4 hours of preparation and ≤12 hours of direct teaching time per facilitator each academic year. <b>Conclusions</b> A single educational session improved residents' self-reported knowledge of the health implications of climate change and was well-received by participants.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830123","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":"An Interprofessional Approach to Prepare Medical Residents and Fellows to Address Climate- and Environment-Related Health Risks.","authors":"Tawnya D Peterson, Alexander Domingo, Diane Stadler, Leah Werner, Joseph A Needoba, Sara Walker, Benjamin S Liu, Joanna Hatfield","doi":"10.4300/JGME-D-24-00109.1","DOIUrl":"10.4300/JGME-D-24-00109.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829518","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":"Climate Change and Health: Occupational and Environmental Medicine at the Frontlines.","authors":"Alya Khan, Manijeh Berenji, Marianne Cloeren, Gina Solomon, Rose Goldman","doi":"10.4300/JGME-D-24-00080.1","DOIUrl":"10.4300/JGME-D-24-00080.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829666","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":"Becoming Climate-Informed Physicians.","authors":"Elizabeth Messineo, Camilo Pardo, Jessica Lee, Charles E Moon","doi":"10.4300/JGME-D-24-00060.1","DOIUrl":"10.4300/JGME-D-24-00060.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"25-27"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829700","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 \"Climate +1\" Approach to Teach Resident Physicians and Faculty the Effects of Climate Change on Patient Health.","authors":"Kjersti Knox, Anne Getzin, Kari Schmidt Oliver, Victoria Gillet, Karen Hanus, Deborah Simpson","doi":"10.4300/JGME-D-24-00047.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00047.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"152-153"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830225","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}