Journal of graduate medical education最新文献

{"title":"Choose the Right Tool for the Task: Leveraging Developmental Interactions in Medicine.","authors":"Jeremy Branzetti, Holly Caretta-Weyer, Nicole Deiorio","doi":"10.4300/JGME-D-24-00648.1","DOIUrl":"10.4300/JGME-D-24-00648.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143866","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":"Hand Over Hand.","authors":"Anna Dovre","doi":"10.4300/JGME-D-25-00031.1","DOIUrl":"10.4300/JGME-D-25-00031.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"239-240"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143887","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":"New US State Laws Conflict With ACGME Common Program Requirements.","authors":"Sarah Smith, Saman Yaghoubian, Matthew Wecksell","doi":"10.4300/JGME-D-24-00647.1","DOIUrl":"10.4300/JGME-D-24-00647.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"159-161"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143896","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: Reply to \"Clinical Decision Rules: A Starting Place in Medical Education, Not a Destination\".","authors":"Nathan Baggett","doi":"10.4300/JGME-D-24-00993.1","DOIUrl":"10.4300/JGME-D-24-00993.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"247"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143917","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":"Where Does the Week Go? Parsing Trends in Program Director Workload.","authors":"Margaret Turlington, John Newland, Matthew Cahn, Brady Campbell, Stephen M Kavic","doi":"10.4300/JGME-D-24-00473.1","DOIUrl":"10.4300/JGME-D-24-00473.1","url":null,"abstract":"<p><p><b>Background</b> Program directors (PDs) play an important role in resident career development, and resident retention may be influenced by PD turnover and workload. <b>Objective</b> To examine PD tenure, work hours, and resident attrition. <b>Methods</b> A retrospective study of data from the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book from 2012 to 2021. Descriptive statistics were used to examine PD characteristics. Regression analyses were used to examine trends in PD tenure and work hours as well as the relationship between work hours, PD turnover, and resident attrition rate for anesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, general surgery, plastic surgery, orthopaedic surgery, otolaryngology, thoracic surgery, urology, and vascular surgery programs. <b>Results</b> Average PD tenure has decreased between 2012 and 2021 for most specialties, with an overall average decrease from 7.0 years to 6.6 years. Total weekly hours spent by PDs on job-related activities in all specialties decreased over time, from 51.3 hours to 44.2 hours. The proportion of weekly hours spent on teaching has decreased slightly, with a corresponding increase in time spent on clinical supervision and administrative duties. PDs in procedural specialties spend more time on clinical supervision, while PDs in non-procedural specialties devote more time to administration. Logistic regression showed a significant association between weekly hours spent by PDs on clinical supervision and resident attrition rate. <b>Conclusions</b> Length of PD tenure and total number of weekly hours devoted to residency-related activities has decreased across specialties. Proportions of time spent on teaching, clinical supervision, and administrative work vary.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"204-210"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143923","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 Multipronged Effort to Incorporate Professionalism Into Campuswide Programming Through a Center for Professionalism.","authors":"Kyler M Godwin, Asma Ali, Larry Laufman, Ellen M Friedman","doi":"10.4300/JGME-D-24-00663.1","DOIUrl":"10.4300/JGME-D-24-00663.1","url":null,"abstract":"<p><p><b>Background</b> Professionalism, a core competency for graduate medical education accreditation, has a clear educational mandate. However, the pathway to successful incorporation of professionalism within organizational culture has not been established. Integration of professionalism within the learning environment requires intentional design and formal education. <b>Objective</b> To describe the integration of professionalism in the learning environment through formal education and programming and report feasibility and acceptability data. <b>Methods</b> The Center for Professionalism (Center) was developed in 2013 to align with the learning and clinical environments of our academic medical center. Primary drivers of a culture of professionalism were identified through input from key partners, responses to institutional and national surveys, peer-reviewed literature, and institutional core values. Educational content was incorporated through a variety of interactive andragogical approaches, including large-group sessions, departmental trainings, retreats, and workshops. Education is delivered to everyone in the institution, including trainees, students, staff, and faculty, and evaluated for satisfaction, feasibility, and acceptability. <b>Results</b> Approximately 2000 individuals have provided feedback to the Center. Aggregated feedback from Center activities indicates most participants (70%-98%) would recommend participation in Center programming to colleagues. Participants' perception of their ability to address professionalism-related topics, such as comfort in addressing workplace incivility, increased. Fifty-six percent (n=64) of participants felt uncomfortable/very uncomfortable addressing workplace incivility before the workshop; 74% (n=84) felt comfortable/very comfortable addressing workplace incivility after. <b>Conclusions</b> Implementation and integration of a center for professionalism across a health science center is feasible, acceptable, and helps to fulfill accreditation mandates through education and support.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"229-234"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143822","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 Analysis of Obstetrics and Gynecology Medical Student Performance Evaluation Clerkship Narratives: Insights From the PRIME+ Framework.","authors":"Michelle L Shui, Weronika Armstrong, Marie Altendahl, Anthony Shanks, Shireen M Sims, Rini B Ratan, Said S Saab","doi":"10.4300/JGME-D-24-00660.1","DOIUrl":"10.4300/JGME-D-24-00660.1","url":null,"abstract":"<p><p><b>Background</b> Despite existing guidelines for writing clerkship summative assessment narratives, their quality, structure, and utility remain variable. Categorizing Medical Student Performance Evaluation (MSPE) narratives using a framework can reveal patterns and gaps in content, offering actionable insights. <b>Objective</b> This study aimed to (1) categorize MSPE narrative comments using the PRIME+ framework (professionalism, reporting, interpreting, managing, and educating, and areas for improvement [+]), and (2) examine differences in length and content by gender, race, origin of medical school, and final clerkship grade. <b>Methods</b> Seven hundred twenty applications to our obstetrics and gynecology (OB/GYN) residency program in 2023 were reviewed, focusing on the OB/GYN core clerkship narrative. Narratives were categorized using the PRIME+ framework, and differences in length and content were assessed by gender, race, origin of medical school, and final grade. Differences between groups were evaluated with nonparametric tests. <b>Results</b> Six hundred fifty-three narratives from 231 medical schools were included. Fifty-one unique grading systems were reported. PRIME+ domains were represented as follows: professionalism (94.8%, 619 of 653), reporter (71.1%, 464 of 653), interpreter (37.5%, 245 of 653), manager (69.1%, 451 of 653), educator (69.7%, 455 of 653), and areas for improvement (3.7%, 24 of 653). For each domain, <13% of narratives included ≥1 specific example. Median word count differed between US-based (155 words; 95% CI, 148-162) and international (61 words; 95% CI, 51-75) applicants (<i>P</i>=.001). Students earning \"honors\" had longer narratives (median words 149; 95% CI, 131-164 vs 117; 95% CI, 97-134; <i>P</i>=.001) with more specific examples (1.2 examples; 95% CI, 0.97-1.4 vs 0.88; 95% CI, 0.53-1.2; <i>P</i>=.024) and advanced PRIME+ domains, specifically educator (<i>P</i>=.016). The number of specific examples differed by race (<i>P</i>=.02) but not gender. <b>Conclusions</b> MSPE narratives for the OB/GYN clerkship demonstrate variability in content and length.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"189-195"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143839","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: In response to \"A Perspective on Promotion in Place and Competency-Based, Time-Variable Graduate Medical Education\"-Reply.","authors":"Steven H Rose, Timothy R Long","doi":"10.4300/JGME-D-25-00173.1","DOIUrl":"10.4300/JGME-D-25-00173.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"244-245"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143908","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":"Digital Storytelling: Navigating Individual and Emerging Professional Selves Through Medical Memes.","authors":"Yi-Chien Yang, Tim Mickleborough, Ching-Jung Ho, Chia-Jui Su, Ming-Jung Ho","doi":"10.4300/JGME-D-24-00722.1","DOIUrl":"10.4300/JGME-D-24-00722.1","url":null,"abstract":"<p><p><b>Background</b> Socialization is a critical process for professional identity formation (PIF), but little is known about how this occurs through online engagement. <b>Objective</b> To explore how Taiwanese medical trainees form professional identities on social media through engagement with medical memes. <b>Methods</b> Using a conceptual framework that examined the dual focus of PIF as a negotiation between personal and professional selves, a descriptive qualitative analysis of medical memes was implemented. In total, 369 memes from a resident's popular Facebook fan page were analyzed using content analysis. Textual and visual elements of memes were analyzed to understand how trainees expressed their individuality, how they conformed to professional norms, and the tensions they experienced. Eighteen codes emerged and were categorized into levels of individual, relational, organizational, and societal. Comments were also analyzed to understand respondents' engagement with memes and support of the PIF process. <b>Results</b> Findings show insights into how medical trainees navigate the dual focus of PIF on multiple levels: the individual and the collective (relational, organizational, and societal). Trainees' engagement with memes highlighted the identity dissonance they experienced as they negotiated losing parts of their individual selves while learning how to conform to organizational norms. Memes allow trainees to reflect on how they experience misalignments between what they expect from the learning environment and workplace realities. <b>Conclusions</b> Online socialization through engagement with medical memes supports the development of PIF; however, it also provides space for trainees to express resistance, share negative experiences, and gain peer solidarity during difficult professional transitions.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"150-158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143874","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":"Factors Affecting Family Medicine Residents' Decision to Provide Obstetric Care: A Concept Mapping Study.","authors":"Cynthia L Salter, Rowena Pingul-Ravano, Claire Lama, Ryan Bills","doi":"10.4300/JGME-D-24-00541.1","DOIUrl":"10.4300/JGME-D-24-00541.1","url":null,"abstract":"<p><p><b>Background</b> Approximately 25% of family physicians provided obstetric (OB) delivery care in 2000, but today that proportion has declined to <7%, affecting availability of delivery care in rural areas. Prior research shows that training experiences influence residents' decision to include OB care in their post-training practice. <b>Objective</b> To explore factors affecting family medicine (FM) residents' decision to provide OB delivery services in future practice and to use this information to strengthen residency OB training. <b>Methods</b> This cross-sectional study used concept mapping, a participatory mixed-methods approach that produces a visual representation of key concepts. It included FM residents and recent graduates participating in 2022-2023 at 3 Mid-Atlantic programs that share a tertiary-level university-affiliated hospital as training site for OB deliveries. <b>Results</b> Eighteen of 60 eligible subjects (30%) completed the generation/brainstorming and structuring data collection steps online, and 36 (60%) completed an interpretation session. Eight clusters of factors emerged: (1) motivation to practice OB care/patient relationship; (2) supportive training and modeled practice; (3) competing interests and necessity of additional training; (4) location and needs of community; (5) burnout cluster; (6) challenges of long-term competency and skills; (7) lack of enough learning opportunities and support; (8) lack of respect and inclusion. Participants rated training factors as both highly important and highly changeable, including \"fragmented teaching,\" \"feeling inadequate or inadequately prepared,\" and \"ease or difficulty getting the required number of deliveries.\" Based on these findings, participating residency programs have adjusted training structure, adding a faculty liaison who provides all OB rotation orientation. <b>Conclusions</b> This study identified factors affecting FM residents' decision-making around providing OB care in their future practice, including supportiveness of training environment and adequacy of learning opportunities.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"17 2","pages":"172-181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143883","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}