Journal of graduate medical education最新文献

{"title":"ERRATUM.","authors":"","doi":"10.4300/JGME-D-24-00936.1","DOIUrl":"10.4300/JGME-D-24-00936.1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.4300/JGME-D-23-00862.1.].</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6","pages":"753"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830103","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":"Estimation of Air Travel-Related Greenhouse Gas Emissions for the In-Person Anesthesiology Oral Board Examination.","authors":"Alan Clegg, Sierra Mastrantonio, John F Pearson","doi":"10.4300/JGME-D-23-00804.1","DOIUrl":"10.4300/JGME-D-23-00804.1","url":null,"abstract":"<p><p><b>Background</b> With an increased focus on climate change in graduate medical education (GME), the environmental implications of travel for board certification examinations remain poorly described. The return to the mandatory in-person applied examination (AE) for board eligible anesthesiologists presents potentially sizeable greenhouse gas (GHG) emissions when compared to the virtual format administered during the COVID-19 pandemic. <b>Objective</b> To estimate the GHG emissions from air travel to the in-person AE and discuss its implications for various specialties as they return to in-person examinations. <b>Methods</b> An estimate of the GHG emissions was conducted using data from the 2023 NRMP Main Residency Match: Match Rates by Specialty and State report, utilizing residency training site as a proxy for anesthesiologists' home. An alternative estimate was made using the anesthesiologists' predicted state distribution postgraduation. We estimated annual GHG emissions, expressed as metric tons of carbon dioxide equivalent (MTCO2e), produced from graduating residents flying to The American Board of Anesthesiology testing center in Raleigh, North Carolina, USA. We collected emissions using the International Civil Aviation Organization emissions calculator. <b>Results</b> Annual emissions of examinee travel from their respective residency training state was estimated to be 517.37 MTCO2e. The alternative estimate using anesthesiologists' predicted postgraduation state was 568.05 MTCO2e. This estimate of CO2e roughly equates to the average annual emissions produced by 112 passenger vehicles. <b>Conclusions</b> The AE in-person format results in an estimated 517 to 568 MTCO2e.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"149-151"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829988","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":"Lessons Learned From Caring for Those in Harm's Way: Translating \"Operational Readiness\" to Civilian Medical Education.","authors":"Dolores Mullikin, Michael Soh","doi":"10.4300/JGME-D-24-00051.1","DOIUrl":"10.4300/JGME-D-24-00051.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"11-14"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830136","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 Curriculum in a Network of US Family Medicine Residency Programs.","authors":"Jennifer S Robohm, Grace Shih, Robert Stenger","doi":"10.4300/JGME-D-23-00850.1","DOIUrl":"10.4300/JGME-D-23-00850.1","url":null,"abstract":"<p><p><b>Background</b> Physicians require climate-related training, but not enough is known about actual or desired training at the graduate medical education level. <b>Objective</b> To quantify the climate curriculum provided within a network of family medicine residency programs in the Northwestern United States, to assess barriers to adoption of climate curricula, and to identify preferred climate-related content, delivery methods, and program actions. <b>Methods</b> In fall 2021, residents and faculty in a family medicine residency network responded to a 25-item, anonymous, online survey about climate-related training within their programs. Likert scales were used to assess the extent of current and desired climate curricula in respondent programs, and a paired samples <i>t</i> test was used to compare them. Drop-down menus and frequencies were used to identify top barriers to integration of a climate curriculum, and preferred curricular content, delivery methods, and program actions. <b>Results</b> Responses were received from 19.3% (246 of 1275) of potential respondents. Nearly ninety percent (215 of 240) reported little or no climate content in their programs. Respondents desired significantly more climate-related training (t[237]=18.17; <i>P</i><.001; Cohen's d=1.18) but identified several barriers, including insufficient time/competing curricular priorities (80.7%, 192 of 238), concern about the political/controversial nature of the topic (27.3%, 65 of 238), and perceived irrelevance (10.9%, 26 of 238). More respondents selected integration of climate content throughout relevant didactics (62.2%, 145 of 233) than other delivery methods. Over 42% of respondents selected each of the climate-related topics and program actions suggested. <b>Conclusions</b> Despite a number of barriers, most family medicine faculty and residents desire significantly more climate-related content in their training curricula.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 6 Suppl","pages":"78-85"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829620","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":"The Impact of Diagnosis-Specific Plan Templates on Admission Note Writing Time: A Quality Improvement Initiative.","authors":"Zachary Rumlow, Yahya Almodallal, M Bridget Zimmerman, Rebecca Miner, Rachel Asbury, Lindsey A Knake, Anna Schmitz","doi":"10.4300/JGME-D-24-00087.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00087.1","url":null,"abstract":"<p><p><b>Background</b> There are limited objective studies regarding the effectiveness of strategies to alleviate the documentation burden on resident physicians. <b>Objective</b> To develop and implement diagnosis-specific templates for the plan of care section of inpatient admission notes, aiming to reduce documentation time. <b>Methods</b> Twelve templates for the plan of care section of admission notes were written by the study authors, reviewed by attending physicians, and shared with the residents through the electronic health record (EHR) on September 23, 2022. EHR audit log data were collected to examine admission note writing times, supplemented by resident feedback on acceptability via an anonymous survey. Feasibility measures included time investment, experience with the EHR, and resident training. <b>Results</b> Between July 1, 2021 and June 30, 2023, 62 pediatric residents contributed 9840 admission notes. The templates were used in 557 admission notes. The mean total time spent on an admission note decreased from 97.9 minutes pre-intervention to 71.0 minutes post-intervention with the use of a template; an adjusted reduction of 23% (95% CI 16%-30%; <i>P</i><.001). The mean attending time spent editing an admission note was unchanged. The survey results underscored wide acceptability of the templates among the residents. Feasibility data showed that the project required minimal time investment from the health care informatics team and minimal resident training. <b>Conclusions</b> Using templates in the care plan section of admission notes reduces the time residents spend writing admission notes.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"581-587"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476857","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":"Weekend Sabbatical.","authors":"Eleanor R Menzin","doi":"10.4300/JGME-D-24-00266.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00266.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"619-620"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476858","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":"Coming Up for Air.","authors":"Nara Miriam Michaelson","doi":"10.4300/JGME-D-24-00298.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00298.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"623-624"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476895","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":"Providing Delayed, In-Person Collected Feedback From Residents to Teaching Faculty: Lessons Learned.","authors":"Kathleen M Finn, Michael G Healy, Emil R Petrusa, Leila H Borowsky, Arabella S Begin","doi":"10.4300/JGME-D-24-00029.1","DOIUrl":"https://doi.org/10.4300/JGME-D-24-00029.1","url":null,"abstract":"<p><p><b>Background</b> Teaching faculty request timely feedback from residents to improve their skills. Yet even with anonymous processes, this upward feedback can be difficult to obtain as residents raise concerns about identification and repercussions. <b>Objective</b> To examine faculty perception of the quality and content of feedback from residents after increasing anonymity and sacrificing timeliness. <b>Methods</b> Between 2011 and 2017, an associate program director at a large internal medicine residency program met briefly with each resident individually to obtain feedback about their teaching faculty shortly after their rotation. To improve anonymity, residents were promised their feedback would not be released until they graduated. In 2019, all feedback was collated and released at one time to faculty. We administered 3 timed, voluntary, anonymous, 36-item closed-ended surveys to faculty asking about the content and value, and to self-identify whether the feedback was praise, constructive, or criticism. <b>Results</b> Exactly 189 faculty participated with 140 completing all 3 surveys (74.1% response rate). Faculty reported this feedback content to be of higher quality (81.0%, 81 of 100) and quantity (82.4%, 84 of 102) in contrast to prior feedback. More than 85.4% (88 of 103) of faculty agreed this feedback was more specific. Faculty identified less praise (median 35.0% vs median 50.0%, <i>P</i><.001) and more negative constructive feedback (median 20.0% vs median 5.0%, <i>P</i><.001) compared to prior feedback. More than 82% (116 of 140) of faculty reported it would change their behavior, but 3 months after receiving the feedback, only 63.6% (89 or 140) felt the same way (<i>P</i><.001). Faculty were divided on the necessity of a time delay, with 41.4% (58 of 140) believing it reduced the feedback's value. Despite the delay, 32.1% (45 of 140) felt they could identify residents. <b>Conclusions</b> Offering a substantial delay in feedback delivery increased anonymity and enabled residents to furnish more nuanced and constructive comments; however, faculty opinions diverged on whether this postponement was valuable.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"564-571"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476851","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":"Initial Experiences With a 2-Stage Residency Interview Process.","authors":"Maisa Nimer, Rachael Lefevre, Audra Clark, Deborah Farr, Sneha Bhat, Kareem AbdelFattah","doi":"10.4300/JGME-D-23-00902.1","DOIUrl":"https://doi.org/10.4300/JGME-D-23-00902.1","url":null,"abstract":"<p><p><b>Background</b> A drawback to interviews having largely become virtual is candidates' difficulty sensing a program's fit. Programs have offered nonevaluative second looks to address this. There is concern that in-person contact with candidates would still indirectly contribute to a candidate's evaluation. <b>Objective</b> We describe implementing an alternative interview structure to incorporate the benefits of virtual and in-person interviews, and describe preliminary feasibility and acceptability data. <b>Methods</b> Our general surgery program selection process for the 2022-2023 application cycle included a first phase of holistic review and a second phase of interviews. The second phase had a first round of virtual interviews, then a second round of in-person interviews (with a virtual option). Only scores from the second interview were used in ranking. Prior to the Match, applicants and faculty were surveyed about the process. <b>Results</b> All 1175 applications to the program were reviewed. Of those, 190 (16.2%) were invited to interview virtually; 188 of 190 (98.9%) completed the virtual interview. Eighty-two of 188 (43.6%) were invited for a second interview; 69 of 82 (84.1%) chose to interview in-person, and 13 of 82 (15.9%) interviewed virtually. Sixty-eight of 188 (36.2%) applicants responded to the survey. Sixty-three of 68 (92.6%) agreed the 2-stage interview process was fair, and 51 of 68 (75%) felt that nonevaluative second looks were not truly nonevaluative. Fifteen faculty spent 3 hours over 6 weeks in holistic review. Twenty-four faculty completed 6 days of interviews, each spending 2.5 to 3 hours per day. Twelve of 24 faculty (50%) responded to their survey, with all 12 stating they would participate again. <b>Conclusions</b> A process of first-round virtual and second-round in-person interviews was feasible and perceived by applicants to be fair and beneficial.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"588-595"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476900","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":"Diversity, Equity, and Inclusion Efforts in Graduate Medical Education: Identifying Opportunities for Collaborative Learning.","authors":"Adena E Rosenblatt, Margaret C Lo, Lauren S Fane, Daniel L Dent, Karen E George","doi":"10.4300/JGME-D-23-00867.1","DOIUrl":"https://doi.org/10.4300/JGME-D-23-00867.1","url":null,"abstract":"<p><p><b>Background</b> Physician-patient racial and cultural concordance is essential to address health care disparities. Yet, limited literature on diversity, equity, and inclusion (DEI) outcomes in graduate medical education (GME) suggests the need for high-yield DEI resources. <b>Objectives</b> To describe and identify DEI efforts by US residency program director (PD) associations and areas for collaboration among the GME community. <b>Methods</b> Through bimonthly teleconferences and 5 iterative revisions from June to September 2022, the DEI workgroup of the US Organization of PD Associations developed a 17-question needs assessment survey to investigate DEI activities across residency PD associations, which was delivered twice electronically from September to November 2022 to 30 specialty PD association representatives. <b>Results</b> Survey response rate was 73% (22 of 30). Specialties track resident demographics more than PD demographics (11 of 22, 50% vs 7 of 22, 32%). Tracked demographics vary and include race, gender, and sexual orientation. Most PD associations have DEI committees (16 of 22, 73%) implementing various initiatives, the most common of which was providing resources to ensure diverse representation (11 of 16, 69%). Most specialties provide residency recruitment resources (14 of 22, 64%) and funding for visiting rotations or mentorship for underrepresented trainees (12 of 22, 54%). Resources for pipeline programs (7 of 22, 32%) and retention of diverse residents (7 of 22, 32%) were less common. Faculty development training focused more on teaching DEI to residents (14 of 22, 64%) than on teaching health disparities (7 of 22, 32%). <b>Conclusions</b> Our study demonstrates substantial DEI interventions among specialty PD associations. Yet, educational gaps exist in specific DEI content, faculty development, and curricular dissemination.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"16 5","pages":"525-529"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476896","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}