Journal of graduate medical education最新文献

{"title":"Finding Healing Together.","authors":"Lillian Seo","doi":"10.4300/JGME-D-24-00564.1","DOIUrl":"10.4300/JGME-D-24-00564.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"649-650"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830112","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 Residency Elective in Sustainable Health Care.","authors":"Madison Miracle, Bhargavi Chekuri, Katharine Weber","doi":"10.4300/JGME-D-24-00120.1","DOIUrl":"10.4300/JGME-D-24-00120.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"157-158"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828682","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":"To the Editor: Electronically Implementing COMLEX-USA Level 2 to USMLE Step 2 Conversion Tools.","authors":"Dhimitri A Nikolla, Brandon M Dedrick, Emily Frack, Aman Ahuja, Richard Rowland","doi":"10.4300/JGME-D-24-00669.1","DOIUrl":"10.4300/JGME-D-24-00669.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"760-761"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830147","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 Rapid-Response Curricular Approach to Teaching Politically Charged Topics.","authors":"Janet B Henrich, Katherine A Gielissen, Cynthia F McNamara, Shefali Pathy, Allister F Hirschman, Joseph X Canarie, Mukta Dhond, Ilana Richman, Tracy L Rabin, Luz Vasquez, John Encandela","doi":"10.4300/JGME-D-24-00140.1","DOIUrl":"10.4300/JGME-D-24-00140.1","url":null,"abstract":"<p><p><b>Background</b> Residency education in the United States faces challenges from evolving external influence on evidence-based reproductive and gender-affirming health care (R/GAHC). Curricula must incorporate information and resources to assist residents in navigating changes. <b>Objective</b> To illustrate a process for expeditiously adapting curriculum in response to changing laws affecting R/GAHC. <b>Methods</b> A 6-step model was used to tailor an R/GAHC module within an existing curriculum. Steps included identifying the medical education problem; conducting needs assessments with residents and educators; and designing, implementing, and evaluating the curriculum. The module was piloted in 2022 with internal medicine residents in 3 training programs at one institution during 4-hour small-group academic half-days. We evaluated the module's feasibility with time and cost analysis and residents' self-reported readiness to provide R/GAHC through essential tasks and knowledge. We evaluated acceptability by assessing whether residents and educators engaged in and completed the curriculum, and evidence of administrative support. <b>Results</b> A needs assessment clarified the educational problem as an urgent need to educate residents on the implications of legal changes affecting R/GAHC. Curriculum planning occurred over 2 months and implementation over 3 months. Of 175 eligible residents, 164 (94%) were trained. Evaluation showed that the curriculum was well received by residents, whose post-training self-assessment showed readiness to provide R/GAHC. Faculty time to plan and implement the module was substantial (estimated 207 person hours), yet participation was consistent, and administrative commitment constant. <b>Conclusions</b> We demonstrated a generalizable approach for expeditiously tailoring curricula to prepare residents to navigate changing laws affecting health care provision.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"723-729"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830173","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 the Future Green? Assessing Environmental Health Confidence in Internal Medicine Residents.","authors":"Jessica Y Chambers, Jillian Rippon, Daniel Ahle, Xavier Le, Beth Miller, Alejandro Moreno","doi":"10.4300/JGME-D-24-00081.1","DOIUrl":"10.4300/JGME-D-24-00081.1","url":null,"abstract":"<p><p><b>Background</b> Despite global awareness of the impacts of climate change on human health, assessment of resident physicians' confidence in environmental health is limited. Lack of confidence in explaining environmental health topics can affect both patient education and advocacy efforts. <b>Objective</b> To determine how confident resident physicians are in their environmental health training and their ability to explain climate health topics. <b>Methods</b> An online survey was distributed to internal medicine residents at a large university-affiliated program in 2023. Self-perceived confidence levels in explaining various environmental health topics to a peer were measured using a Likert scale (from 1=not confident at all, to 5=completely confident) and a subsequent rank-order analysis of the response means. <b>Results</b> The response rate was 56% (62 out of 110 residents). A mean confidence score of 2.22 was reported on all topics, with hazardous waste (m=1.73), endocrine disruptors (m=1.76), water quality (m=1.9), toxicology (m=2.02), and environmental justice (m=2.04) representing lowest scores. Highest mean scores were reported in food security (m=2.71) and emerging infectious disease (m=2.92). Twenty-seven of 62 (44%) residents reported no confidence at all in their ability to discuss environmental justice concepts, with 17 of 62 (27%) reporting slight confidence in doing so. <b>Conclusions</b> Physician trainees report low confidence levels regarding their ability to explain multiple environmental topics to their peers. Forty-four of 62 (71%) residents report either no or slight confidence in their ability to explain environmental justice to a colleague.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830134","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":"Reducing Waste at the Bedside: A Resident-Led Project to Decrease Waste and Cost From Diagnostic Paracentesis.","authors":"Sara Gottesman, Barbara Mensah, Priyanka Jagannathan, Charles Hyman, Deepak Agrawal","doi":"10.4300/JGME-D-24-00034.1","DOIUrl":"10.4300/JGME-D-24-00034.1","url":null,"abstract":"<p><p><b>Background</b> Physicians have a responsibility to reduce the environmental harms from health care waste. Residents contribute to waste during bedside procedures. <b>Objective</b> To calculate waste and estimated cost reduction with the introduction of a novel resident-designed paracentesis kit at a single academic center in Texas in 2023. <b>Methods</b> We calculated waste through observation of bedside diagnostic paracentesis performed by internal medical residents, tracking which components were discarded without use from the hospital-provided kit. Residents designed a novel kit containing only procedural essentials. We calculated possible waste reduction when using the novel kit, as well as potential cost savings by comparing the average cost of the current hospital kit across multiple medical equipment retailers to the summed cost of the components of the novel kit. <b>Results</b> Sixteen items were discarded without use from the commercially available kit, out of 29 total items. The estimated cost saving per diagnostic paracentesis was $95. <b>Conclusions</b> This resident-led development of a diagnostic paracentesis kit was successful in decreasing both waste and cost, while involving residents in improving the environmental impact of their practices.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830160","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 Qualitative Study of Workplace Gossip in the Residency Learning Environment.","authors":"Michael Chaikof, Janet Bodley, Michele Farrugia, Evan Tannenbaum, Bobbie Ann Adair White","doi":"10.4300/JGME-D-24-00153.1","DOIUrl":"10.4300/JGME-D-24-00153.1","url":null,"abstract":"<p><p><b>Background</b> Gossip is a ubiquitous sociocultural phenomenon serving many functions in human interactions, including in workplace and academic settings. Gossip can have profound positive and negative impacts; however, its impact on medical residents and their learning environment is unknown. <b>Objective</b> To understand the function and impact of workplace gossip-from and about colleagues and supervisors-on medical residents' experiences in their learning environment. <b>Methods</b> This exploratory study used principles of constructivist grounded theory. Data were collected from residents in the obstetrics and gynecology and psychiatry programs at a large academic institution via semistructured interviews in 2021. Seven residents were interviewed. Transcripts were analyzed using inductive coding, and themes were identified. <b>Results</b> Thematic analysis revealed perceived positive and negative impacts of gossip. Perceived positive impacts included affirmation and roadmapping. Perceived negative impacts included anxiety/fear and the role of gossip in reinforcing the educational hierarchy. Other themes, which are perceived to have both positive and negative impacts, included the role of gossip in learning and in group status. The identity of the gossiper, audience, and subject of gossip also impacted its effects. Gossip between residents about faculty members was perceived as roadmapping, or an affirming role, whereas gossip involving faculty members created anxiety and reinforced negative aspects of the hierarchy. <b>Conclusions</b> Workplace gossip serves both positive and negative roles within the medical learning environment. It can function as informal debriefing and can also threaten psychological safety. Its impact on residents is affected by the identities of the gossiper, subject, and audience.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"684-690"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830169","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":"Prescribing Change: The Dire Need to Address Climate and Health in Graduate Medical Education.","authors":"Matthew G Tuck, Colleen Y Colbert, Rebecca Philipsborn, Thomas Cooney","doi":"10.4300/JGME-D-24-00927.1","DOIUrl":"10.4300/JGME-D-24-00927.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830155","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":"Investigating the Roles and Impact of Clinical Competency Committees in Graduate Medical Education: A Narrative Review.","authors":"Andem Ekpenyong, Eric S Holmboe, Marjan Govaerts, Sylvia Heeneman","doi":"10.4300/JGME-D-24-00017.1","DOIUrl":"10.4300/JGME-D-24-00017.1","url":null,"abstract":"<p><p><b>Background</b> Although Clinical Competency Committees (CCCs) were implemented to facilitate the goals of competency-based medical education, implementation has been variable, and we do not know if and how these committees affected programs and assessment in graduate medical education (GME). <b>Objective</b> To explore the roles CCCs fulfill in GME and their effect on trainees, faculty, and programs. <b>Methods</b> We conducted a narrative review of CCC primary research with the following inclusion criteria: all articles must be research in nature, focused on GME and specifically studying CCCs, and published in English language journals from January 2013 to November 2022. <b>Results</b> The main results are as follows: (1) The primary role of the CCC (decision-making on trainee progress) is mostly described in \"snapshots\" (ie, focusing on a single aspect of this role at a single point in time); (2) CCCs are taking on secondary roles, some of which were anticipated (eg, remediation, feedback) whereas others were \"unanticipated\" (eg, use of CCC data to validate trainee self-assessment, predict trainee performance in other settings such as certifying examinations, investigate gender bias in assessment); and (3) Articles briefly mentioned short-term outcomes of CCCs at the level of the trainees, faculty, and programs. However, most studies described interventions to aid CCC work and did not specifically aim at investigating short-term (eg, curriculum changes) or long-term outcomes (eg, improved patient outcomes). <b>Conclusions</b> CCCs fulfill a range of roles in assessment beyond their intended purpose. A more systematic approach is needed to investigate the outcomes of CCC implementation on GME.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"662-683"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830184","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 Curricula in US Graduate Medical Education: A Scoping Review.","authors":"Adrian Cois, Sara Kirkpatrick, Rachelle Herrin","doi":"10.4300/JGME-D-24-00086.1","DOIUrl":"10.4300/JGME-D-24-00086.1","url":null,"abstract":"<p><p><b>Background</b> Climate change threatens humanity's health and well-being. While climate change topics have been increasingly incorporated into undergraduate medical education, it is unclear to what extent they have been incorporated into graduate medical education (GME) curricula in the United States. <b>Objective</b> To examine how climate change has been incorporated into GME curricula in the United States. <b>Methods</b> We conducted a scoping review of published literature from January 2013 through November 2023. PubMed and Scopus were searched, with articles assessed by 3 reviewers in a blinded fashion. Resources were included if they described how climate change is incorporated into GME curricula in the United States, and if they discussed topics such as disaster medicine, mass casualty events, environmental medicine, public health, health policy, wilderness medicine, quality improvement, and sustainability. Articles were analyzed using descriptive numerical analysis and qualitative assessment to identify article characteristics and themes. <b>Results</b> The inclusion criteria generated 17 articles that examined climate change incorporation into GME curricula and curriculum interventions covering topics used for inclusion. The most common type of article (5 of 17, 29%) employed surveys of program directors on the inclusion of climate-related topics. <b>Conclusions</b> Published accounts of climate-related topics in US GME program curricula are few. More content is found in topics related to emergency medicine. Curricula frameworks have been proposed for pediatric and internal medicine residency programs, but we know little about their efficacy. Future scholarship should fill these gaps to educate learners to improve health care sustainability and resiliency.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"69-77"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829673","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}