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Factors that detract from making meaningful connections with patients and finding meaning and joy in medical practice have found their way into resident education. Burnout and moral injury are increasingly reported by residents across specialties. [1, 2] A curriculum in Narrative Medicine was established at a community hospital family medicine residency as an antidote to these influences. Evaluative survey data and qualitative semi structured interviews reveal that the program created healing spaces for residents. This essay describes the program features and the evidence provided by the residents endorsing the healing impact of the program.

PurposeResidency programs must ensure resident competence for independent practice. The coronavirus disease-19 (COVID-19) pandemic disrupted health care delivery, impacting pediatric residencies. This study examines the impact on pediatric resident education.MethodsThe authors conducted a mixed methods national survey of pediatric residency program directors (PDs) from May 2020 to July 2020. Data analysis included descriptive statistics, chi-square, and Wilcoxon rank sum tests. Multivariable modeling identified factors associated with resident preparation for more senior roles. Thematic analysis was performed on open-ended questions about PD COVID-19 pandemic recommendations to peers, Accreditation Council for Graduate Medical Education and American Board of Pediatrics.ResultsResponse rate was 55% (110/199). PDs reported the COVID-19 pandemic negatively affected inpatient (n=86, 78.2%), and outpatient education (n=104, 94.5%), procedural competence (n=64; 58.2%), and resident preparation for more senior roles (n=50, 45.5%). In bivariate analyses, increasingly negative impacts on inpatient and outpatient education were associated with an increasingly negative impact on resident preparation for more senior roles (P=.03, P=.008), these relationships held true in multivariable analysis. Qualitative analysis identified 4 themes from PD recommendations: 1) Clear communication from governing bodies and other leaders; 2) Flexibility within programs and from governing bodies; 3) Clinical exposure is key for competency development; 4) Online platforms are important for education, communication, and support.ConclusionsThe COVID-19 pandemic negatively impacted inpatient and outpatient education. When these were more negatively impacted, resident preparation for more senior roles was worse, highlighting the importance of competency based medical education to tailor experiences ensuring each resident is competent for independent practice.

Objective The objective of our paper is to review all of the relevant literature in ophthalmology microsurgical education and identify which teaching methodologies were most effective. Methods A systematic review and meta-analysis of the literature was conducted. Electronic databases, including Ovid MEDLINE, Cochrane CENTRAL, and EMBASE, were searched with preset terms. The search was through December 11, 2019. Eligibility criteria included studies with sufficient data for analyzing associations between surgical teaching techniques and success rates in surgical skills and the organization of the intervention as a microsurgical skills course, curriculum, or program. The articles were independently reviewed by two authors. Each included study was evaluated for quality using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach and risk of bias using the Cochrane Collaboration's tool for assessing bias. Data Extraction and Synthesis Data extraction was performed by two reviewers and disagreements were checked by a third reviewer. A random-effects analysis was used to pool the outcomes of studies. Main Outcomes and Measures Outcomes included time for completion of surgical task, level of preparedness, competency score, and number of surgeries with complications. Results A total of 439 studies were reviewed and 13 studies (n = 8,790 surgical cases; n = 115 trainees) were included in the meta-analysis. Excluded articles studied cataract simulation training as the primary intervention or were not related to ophthalmology. All pooled results demonstrated a positive association with surgical outcomes; however, video-based education (standardized mean difference [SMD] = 2.49 [95% confidence interval (CI): 0.36–4.63]; four effects [four studies]; n = 69; I 2 = 90%) and stepwise teaching method (odds ratio [OR = 3.84 [95% CI: 2.66–5.55]; six effects [six studies]; n = 6,968; I 2 = 39%) interventions were the most favorable. Conclusion and Relevance The following five interventions evaluated in this paper were found to be effective methods of improving performance outcomes in ophthalmic microsurgery: (1) didactic lectures, (2) video-based education, (3) surgical wet-laboratory, (4) stepwise method, and (5) direct supervision and feedback. Our meta-analysis concludes that video-based education and stepwise teaching interventions are the most effective methods for a microsurgical ophthalmology training curriculum. Combining the strengths of the interventions analyzed in this study should be considered when implementing and adjusting ophthalmic surgical skills curriculums.

This is a systematic review examines evidence about integrated care, co-located care, and collaborative care education and training among general psychiatry residents in the Unites States.

The prevalence of complex patients is on the rise. However, little attention has been paid to the process of providing care to complex patients and how this might be taught to residents. The aim of this scoping review is to map the extent and type of evidence for collaborative and integrated care as a means of caring effectively for complex patients, and as training required to equip physicians to care for complex patients.

Objective To determine the presence and activity of ophthalmology departments associated with residency programs on social media platforms and the use of these social media platforms by residency applicants. Design Cross-sectional online assessment of ophthalmology training program departments' presence and activity on Facebook, Twitter, and Instagram. Participants A total of 120 accredited ophthalmology residency training programs and 498 ophthalmology residency applicants. Methods Each department was evaluated by (1) searching for social media links on the department's Web site, (2) searching for the department on Facebook, Twitter, and Instagram, and (3) searching on Google. A simultaneous survey was conducted to assess social media platform use of 2019 to 2020 ophthalmology residency application cycle candidates. Main Outcomes The presence of ophthalmology departments on Facebook, Twitter, and Instagram, as well as the total number of followers and posts during January 2020. Results Of 120 programs evaluated, 45 programs (37.5%) had a Facebook page, 29 (24.3%) were on Twitter, and 22 (18.3%) had an Instagram page. Among top 20 Doximity-ranked ophthalmology programs, 80% had at least one social media page on Facebook, Twitter, or Instagram compared with 33% among the remainder of programs (chi-square test = 15.2, p Conclusion Departments of top 20 ophthalmology residency had both a greater presence and following on social media compared with other departments. While Facebook was the most used platform by ophthalmology departments, applicants most commonly used Instagram. As applicants come to use these social media resources more frequently, ophthalmology residency programs may increasingly benefit from maintaining an active social media page.

Background To evaluate fertility knowledge among current Obstetrics and Gynecology (OB-GYN) residents using a recently published validated instrument, the Fertility and Infertility Treatment Knowledge Score (FIT-KS). Methods OB-GYN residents in the United States were recruited through an email to all residency coordinators nationwide. They were asked to voluntarily respond to a short questionnaire including demographic information and the FIT-KS instrument, through an online survey platform. Of approximately 5000 OB-GYN residents in the country, 177 responded. Results The sample was 91% female, with 69% between the ages of 26 and 30. Participants evenly represented all 4 years of training. Mean FIT-KS score was 21.2 (73% correct; range 17–26). No statistically significant differences were noted across the level of training. Several knowledge gaps were noted. Residents could define the common assisted reproductive technologies; however overestimated their success rates per cycle. Conclusions Substantial gaps exist in fertility knowledge among OB-GYN residents, with understanding of male fertility and success rates of Assisted Reproductive Technologies (ART) being particularly limited. Knowledge of fertility does not change throughout residency training, demonstrating consistent gaps in fertility knowledge. Knowledge during post graduate year (PGY)-1 year is consistent with mean scores found in prior research in Internal Medicine residents (65%), as well as a cohort of female medical students and obstetrics and gynecology residents and fellows (64.9%) (Fertil Steril 108:711-7, 2017; Fertil Steril 110:e239, 2018).

Residents commonly feel that a lack of time is a significant barrier in keeping up-to-date with both medical knowledge and literature. In this study, we addressed that barrier by placing an iPad-based live fact feed in the resident workroom of our emergency department, therefore allowing for passive learning while on shift. We hypothesized that residents with access to the live feed would score higher on monthly post-curriculum block exams. We ended up finding that the residents actually prefer a more active approach to learning and that many more people in the emergency department other than the residents benefitted from the fact board.

Reflection, where clinical experiences are analyzed to gain greater understanding and meaning, is an important step in workplace learning. Residency programs must teach their residents the skills needed for deep reflection. Medical educators may find it difficult to construct a curriculum which includes the key elements needed to enable learners to attain these skills. When we first implemented reflection into our residency curriculum, we soon realized that our curriculum only taught residents how to engage in superficial reflection. Our curriculum lacked some key elements. To help guide the transformation of our curriculum, we combed the literature for best practices. The CONTeMPLATE mnemonic was born out of this process. It is a tool to help medical educators consider and implement key elements required to enable deep reflection. The purpose of this article is to show medical educators how they can use the CONTeMPLATE mnemonic to incorporate reflective practice into their own curriculum.

Chronic pain involves a complex mechanism that afflicts 50 million adults in the United States and incurs societal costs upwards of $560 billion annually. The consequences of this epidemic have resulted in an epidemic of its own, with the opioid crisis becoming a top priority in healthcare. Historically, the sub-optimal practices of overprescribing opioids and inadequate monitoring of iatrogenic addiction have contributed to this problem. If progress is to be made in this area, it is imperative that we examine how future physicians are being trained to manage pain. We examined internal medicine resident knowledge regarding pain as well as their satisfaction with medical school preparation in this regard using two surveys: The Knowledge and Attitudes Survey Regarding Pain (KASRP) and The Medical School Pain Curriculum Survey (MSPCS). Residents scored an overall 60.7% on the knowledge assessment survey, and less than 50% of respondents agreed that their medical school curriculum had prepared them sufficiently. This suggests that improvements can be made in medical school curricula regarding pain management education to better train physicians on how to manage pain, particularly in an era that demands expertise in this area.

The “ED Stories” project is a novel method for promoting individual wellness and interpersonal relationships on a virtual platform in an emergency medicine residency program. We engaged multiple individuals across all levels of medical training on a virtual platform to facilitate discussion regarding difficult situations, patient interactions, and tips on how to succeed in challenge circumstances in the future. The platform was outlined as a “safe space,” free of judgment and criticism. We engaged 54 participants with a culmination of 131 interactions; there were 14 original posts with a total of 22 comments. We believe that this virtual platform allowed for safe discussion of difficult concepts related to our jobs and served as an outlet to promote physician wellness and reduce burnout in the future.

Feedback is defined as a regulatory mechanism where the effect of an action is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibility or it conflicts with their self-assessment. Therefore, attention has turned to sociocultural factors that influence feedback-seeking, acceptance, and incorporation into performance. Understanding and application of specific aspects of psychosocial theories could help in designing initiatives that enhance the effect of feedback on learning and growth. In the end, the quality and impact of feedback should be measured by its influence on recipient behavior change, professional growth, and quality of patient care and not the skills of the feedback provider. Our objective is to compare and contrast older and newer definitions of feedback, explore existing feedback models, and highlight principles of relevant psychosocial theories applicable to feedback initiatives. Finally, we aim to apply principles from patient safety initiatives to emphasize a safe and just culture within which feedback conversations occur so that weaknesses are as readily acknowledged and addressed as strengths.

Colombia is a densely populated country with a small number of pediatric rheumatology specialists, including 14 specialists for a population of 1,927,000 children in 2014. The objective of the study was to improve the skills required for early identification, timely referral, and management of musculoskeletal diseases, especially juvenile idiopathic arthritis (JIA), in a group of pediatricians and pediatric residents in a remote region of Colombia. Supported by grant programs developed by the International League of Associations for Rheumatology (ILAR), a combined educational strategy (blended learning) was implemented based on two classroom educational activities and four online modules. The students’ acquired knowledge and perception of the strategy were evaluated. Scores were reported as median values and interquartile ranges (IQR), and the differences between scores were estimated using the Wilcoxon test for equal medians. Forty-one students were enrolled, 37 completed the online modules, and 33 attended the final in-person session. The results of the written tests demonstrated an improved ability to solve clinical problems compared with the results of the tests before the course (the median initial vs. final test scores 3 (IQR = 1) vs. 5 (IQR = 0), p = 0.000). The students reported high levels of satisfaction related to compliance with the proposed objectives, the relevance of the contents and activities performed, and the impact on everyday practice. These types of strategies are useful as tools for continuing medical education. However, the results pertain only to short-term learning. It is necessary to evaluate their impact on “lifelong learning.”. © 2016, International League of Associations for Rheumatology (ILAR).

Objective Simulation-based learning strategies have demonstrated improved procedural competency, teamwork skills, and acute patient management skills in learners. “Boot camp” curricula have shown immediate and delayed performance in surgical and medical residents. We created a 5-day intensive, simulation and active learning-based curriculum for internal medicine interns to address perceived gaps in cognitive, affective and psychomotor domains. Intern confidence and self-perceived competence was assessed via survey before and after the curriculum, along with qualitative data. Results A total of 33 interns completed the curriculum in 2014, 32 in 2015. Interns had a significant increase in confidence and self-perceived competence in procedural, cognitive and affective domains (all p values

Introduction: With the globalization of higher education through online training, opportunities exist for collaboration between institutions to promote ongoing advancement of healthcare professionals in resource-limited countries. The success of these programs is dependent on the ability of the program to meet the educational needs of the student and assist with implementation of the new information into practice. A post graduate residency program for physical therapists was introduced to Kenya to promote the development of the profession of physical therapy. This study sought to explore barriers that affected participation in the residency program, and how participants perceived the residency program fostered the use of new skills in the clinical environment, as well as the limitations they faced in applying the skills gained through the residency program in a clinical setting. Methods and Materials: The participants in this study were in the third and fourth cohorts of the residency program (n = 27). One-on-one interviews were performed with the residents following completion of the program. A qualitative phenomenology research design was used to describe the manner in which the residency was experienced within the context of the environment in which the experience took place. Descriptions and narratives were obtained from the residents to provide a window into their lived experience. Results: Four themes were discovered: (1) The ongoing challenge to balance often conflicting responsibilities: family, work and education, (2) A need to educate patients and colleagues on newly acquired skills to gain acceptance, (3) Success in the program requires reliance on support networks, and (4) Increased confidence gained in delivery of patient care. Discussion: Although the residents faced obstacles for completing the residency and integrating newly acquired knowledge and skills into clinical practice, they were able to formulate strategies to meet these challenges. Understanding the barriers and facilitators that affect participants in international collaborative efforts may ultimately assist residency and other educational programs in designing new models of education, which will advance the physical therapy profession globally.

Introduction Participation in quality improvement (QI) projects is required of pediatric residents, and evidence-based medicine has highlighted the importance of providing residents with experiential practice in this realm. Embedding QI projects within a continuity clinic provides residents an opportunity for meaningful involvement in QI efforts. Methods A QI curriculum was implemented within a pediatric residency program that included an introductory lecture on QI principles and participation in resident-led, team-based QI projects at an outpatient clinic. Residents designed, implemented, and analyzed projects beginning in their intern year. Projects operated on an accelerated, 6-month time frame, allowing residents to complete multiple projects over the course of their residency. Resident QI knowledge was assessed before and after an introductory lecture with the Quality Improvement Knowledge Application Tool (QIKAT). Resident feedback was solicited 1 year following curriculum implementation via anonymous online surveys. Results Residents completed four QI projects that produced meaningful improvements in clinic processes and patient care. QIKAT scores significantly increased after the introductory lecture. Residents reported that the curriculum afforded them increased confidence to implement plan-do-study-act cycles and improve patient care in their future practices. Qualitative feedback highlighted the team-based structure, participation in multiple projects, and visible direct impacts on patient care as strengths of the curriculum. Increased involvement of clinic staff, scheduling concerns, and improved communication were areas for improvement. Discussion Our model for integrating resident-led QI projects into an ambulatory clinic rotation is feasible and has been well received by residents and impactful on clinic processes and care.

WOS: 000428204000007, PubMed ID: 29553464, Background: Professionalism education is one of the major elements of surgical residency education. Aims: To evaluate the studies on core professionalism education programs in surgical professionalism education. Study Design: Systematic review. Methods: This systematic literature review was performed to analyze core professionalism programs for surgical residency education published in English with at least three of the following features: program developmental model/instructional design method, aims and competencies, methods of teaching, methods of assessment, and program evaluation model or method. A total of 27083 articles were retrieved using EBSCOHOST, PubMed, Science Direct, Web of Science, and manual search. Results: Eight articles met the selection criteria. The instructional design method was presented in only one article, which described the Analysis, Design, Development, Implementation, and Evaluation model. Six articles were based on the Accreditation Council for Graduate Medical Education criterion, although there was significant variability in content. The most common teaching method was role modeling with scenario-and case-based learning. A wide range of assessment methods for evaluating professionalism education were reported. The Kirkpatrick model was reported in one article as a method for program evaluation. Conclusion: It is suggested that for a core surgical professionalism education program, developmental/instructional design model, aims and competencies, content, teaching methods, assessment methods, and program evaluation methods/models should be well defined, and the content should be comparable.

Background The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. Methods The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others. Also, the hospital provides a large emergency medical services program providing basic and advanced life support and critical care transport, which is capable of performing rapid sequence intubation. Each EM residency class, except for the first 2 months of the inaugural class, used New Innovations to log procedures. New Innovations is an online database for tracking residency requirements, such as procedures and hours. For the first 3 months, procedures were logged by hand on a log sheet. In addition, our department has a wireless electronic system (Qpath) for recording and logging ultrasound images. These logs were reviewed retrospectively without any patient identifiers. Actual procedures and simulation procedures were combined for analysis as they were only logged separately halfway through the study period. Procedures were summed and the average procedure rate per resident per year was calculated. Results In total, 66 full resident years were analyzed. Overall, ultrasound was the most commonly performed procedure, with each resident performing 125 ultrasounds per year. Removing “resuscitations,” the second most common was endotracheal intubation, performed 28.91 times per year, and third most was laceration repair, which was performed 17.39 times per year. Our lowest performed procedure was thoracentesis, which was performed on average 0.11 times per resident per year. Conclusions Residents performed a variety of procedures each year. Ultrasound examinations were the most frequent procedure performed. The number of ultrasound procedures performed may reflect the changing training landscape and influence future Accreditation Council of Graduate Medical Education requirements.

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program. We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included. This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.

Introduction: Quality Improvement projects are an important part of residency education in the United States and are required for accreditation by the Accreditation Council for Graduate Medical Education. Participation in standard chart-based quality improvement had failed to generate excitement among residents in our program. The objective of our innovation was to inspire interest in quality improvement among our residents. Methods: Our residency program instituted a book discussion group. Attendance and participation of attendees was recorded, and residents were sent a follow-up survey one month after the activity to gauge their impressions. Results: Out of 16 residents in the program, 12 attended the discussion group, and all attendees participated in the discussion. The follow-up survey revealed that 10/11 (91%) of respondents had read at least part of the book and 11/11 (100%) wanted to have another book discussion group in the upcoming year. Conclusion: We believe that the use of a book discussion group can be a novel, inspiring strategy to teach quality improvement in a residency program.

Background Interest in global health during postgraduate residency training is increasing across medical specialties, and multiple disciplines have categorized global health training opportunities in their arena. No such cataloging exists for anesthesiology residency programs. The aim of this study was to assess and characterize global health opportunities and the attitudes of program directors (PDs) in U.S. anesthesiology residency programs towards this training. Methods A cross-sectional 20-question survey on global health opportunities was distributed to 128 ACGME accredited anesthesiology residency program directors via email between October 2015 and January 2016. Descriptive statistics and exploratory inferential analyses were applied. Maximal nonresponse selection bias was estimated. Results The overall response rate was 44%. Of those who responded, 61% reported that their residency program had a global health elective, with a maximal bias estimate of 6.5%. 45% of program directors with no global health elective reported wanting to offer one. 77% of electives have articulated educational goals, but there is substantial heterogeneity in curricula offered. Program director attitudes regarding the value of global health programs differed significantly between those with and without existing programs. Conclusions The proportion of U.S. anesthesiology residency programs offering global health electives is similar to that in other medical specialties. There is inconsistency in program structure, goals, curriculum, and funding. Attitudes of program directors differ between programs with and without electives, which may reflect bidirectional influence to be investigated further. Further studies are needed to codify curricula, assess effectiveness, and validate methodologies. Electronic supplementary material The online version of this article (10.1186/s12909-017-1056-3) contains supplementary material, which is available to authorized users.

Introduction Since 2008, the McMaster University Royal College Emergency Medicine residency training program has run practice Short Answer Question (SAQ) examinations to help residents test their knowledge and gain practice in answering exam-style questions. However, marking this type of SAQ exam is time-consuming. Methods To help address this problem, we require that senior residents help mark at least one exam per year alongside faculty members. Examinees’ identities are kept anonymous by assigning a random number to each resident, which is only decoded after marking. Aggregation of marks is done by faculty only. The senior residents and faculty members all share sequential marking of each question. Each question is reviewed, and exemplar “best practice” answers are discussed. As novel/unusual answers appear, instantaneous fact-checking (via textbooks, or the internet) and discussions occur allowing for real-time modification to the answer keys as needed. Results A total of 22 out of 37 residents (post graduate year 1 to post graduate year 5 (PGY1 to PGY5)) participated in a recent program evaluation focus group. This evaluation showed that residents feel quite positive about this process. With the anonymization process, residents do not object to their colleagues seeing and marking their answers. Senior residents have found this process informative and have felt that this process helps them gain insight into better “examsmanship.” Conclusions Involving residents in marking short-answer exams is acceptable and perceived as useful experience for improving exam-taking skills. More studies of similar innovations would be required to determine to what extent this may be the case.

Initiatives like “American Medical Association (AMA)-Reimagining Residency” and “Accreditation Council for Graduate Medical Education (ACGME)-Next Accreditation System” are examples of a paradigm shift toward learner-centered pedagogy in resident education. Such interventions require an understanding of the basics of the learning process itself. This study aimed to identify preferred learning styles in pathology with the intent to use specialty-specific pattern data, if any, to improve pathology training modalities. Kolb’s learning tool questionnaire was sent to pathology-inclined medical students, pathology residents, fellows, and faculty in 5 academic programs. Data from 84 respondents (6 students, 37 residents, 12 fellows, 29 attendings) were analyzed. There was remarkable similarity in learning styles of fellows and faculty, revealing a dominance of observational learning styles (“assimilating” and “diverging”) that was consistent with pathology being a visual field. In contrast, residents showed dominance of “learn by doing” styles (“converging” and “accommodating”). Residents’ stratification by training year showed a scattered distribution with an upward trend toward “learn by doing” behavior. While the difference in styles between residents and faculty/fellows may be due to a generational gap, transition from medical school, or acquisition of technical skills required for grossing specimens, this is an opportunity for adopting blended learning models and active learning processes to cater to residents’ different styles and to allow for flexibility to use all styles as and when needed. Based on these findings, we hypothesize that partnering juniors and seniors with similar styles has a potential for successful mentorship and exploration of other psychometrics is recommended for further understanding and improvement of pathology training.

INTRODUCTION Since the creation of HCAHPS Patient Satisfaction (PS) scores, Patient Experience (PE) has become a metric that can profoundly affect the fiscal balance of hospital systems, reputation of entire departments and welfare of individual physicians. While government and hospital mandates demonstrate the prominence of PE as a quality measure, no such mandate exists for its education. The objective of this study was to determine the education and evaluation landscape for PE in categorical Emergency Medicine (EM) residencies. METHODS This was a prospective survey analysis of the Council of Emergency Medicine Residency Directors (CORD) membership. Program directors (PDs), assistant PDs and core faculty who are part of the CORD listserv were sent an email link to a brief, anonymous electronic survey. Respondents were asked their position in the residency, the name of their department, and questions regarding the presence and types of PS evaluative data and PE education they provide. RESULTS 146 responses were obtained from 139 individual residencies, representing 72% of all categorical EM residencies. This survey found that only 27% of responding residencies provide PS data to their residents. Of those programs, 61% offer simulation scores, 39% provide third party attending data on cases with resident participation, 37% provide third party acquired data specifically about residents and 37% provide internally acquired quantitative data. Only 35% of residencies reported having any organized PE curricula. Of the programs that provide an organized PE curriculum, most offer multiple modalities. 96% provide didactic lectures, 49% small group sessions, 47% simulation sessions and 27% specifically use standardized patient encounters in their simulation sessions. CONCLUSION The majority of categorical EM residencies do not provide either PS data or any organized PE curriculum. Those that do utilize a heterogeneous set of data collection modalities and educational techniques. AOA and ACGME residencies show no significant differences in their resident PS data provision or formal curricula. Further work is needed improve education given the high stakes of PS scores in the EM physician’s career.

Use of integrative medicine (IM) is prevalent in children, yet availability of training opportunities is limited. The Pediatric Integrative Medicine in Residency (PIMR) program was designed to address this training gap. The PIMR program is a 100-hour online educational curriculum, modeled on the successful Integrative Medicine in Residency program in family medicine. Preliminary data on site characteristics, resident experience with and interest in IM, and residents’ self-assessments of perceived knowledge and skills in IM are presented. The embedded multimodal evaluation is described. Less than one-third of residents had IM coursework in medical school or personal experience with IM. Yet most (66%) were interested in learning IM, and 71% were interested in applying IM after graduation. Less than half of the residents endorsed pre-existing IM knowledge/skills. Average score on IM medical knowledge exam was 51%. Sites endorsed 1–8 of 11 site characteristics, with most (80%) indicating they had an IM practitioner onsite and IM trained faculty. Preliminary results indicate that the PIMR online curriculum targets identified knowledge gaps. Residents had minimal prior IM exposure, yet expressed strong interest in IM education. PIMR training site surveys identified both strengths and areas needing further development to support successful PIMR program implementation.

La investigación, en especial la dirigida a brindar información para lograr cambios positivos en las decisiones sanitarias nacionales, es de fundamental importancia, ejemplo de ello es que en la actualidad existen estudios aplicados como base de políticas públicas (1). Además, la investigación crea profundos cambios en las personas que la ejecutan, como la generación de criterio, la formación de hábito y cultura de investigación, el aumento de la participación en actividades académicas, entre otros (2). ...

Aim: To identify the psychosocial conditions of physicians who received the first phase of the transition period adaptation training for family medicine practice in Bursa, and develop an efficient and reliable scale to take measurements during subsequent training processes. Materials and methods: A pilot test was given, using survey methodology, to physicians (442 people) who attended the first phase of the transition period adaptation training for family medicine practice in province of Bursa, Turkey, in 2008. The survey questions were designed to assess 3 factors: A- Adaptation to the program, B- Occupational self-confidence, and C- Non-exhaustion. Each factor was represented by 10 to 11 questions. A 5-point Likert-type scale was used for assessment (I-Strongly agree, II- Agree, III-Neither agree nor disagree, IV- Disagree, V-Strongly disagree.). Questions involving age, gender, length of professional experience, opinions about the training, knowledge and opinions of the family practice system, as well as views about the future work practice of each participant were asked. The contents of the 31-question survey to be used for the Pilot Test, along with its validity in terms of scope and content investigated, taking the views of 3 specialist doctors. Then, the survey was given to 442 doctors who participated in adaptation training, both before and after the training program. The results were analysed using the SPSS (Statistical Package for the Social Sciences) program. Reliability analysis was performed for all the factors in all 31 questions. Having removed the questions lowering the reliability in each factor, the remaining 17 questions were classified in 3 factors, by applying Factor Analysis (Quatrimax Method). Results: Two hundred seventy-one male (61.3%) and 171 female (38.7%) physicians participated in the survey. Mean age and length of professional experience was higher in males than females. While the majority of the participants (72%) thought the training they received was just an activity that would improve their adaptation, a small percentage (7.9%) thought that it would increase their professional competence. Statistically speaking, mean occupational self-confidence factor scores were higher in post-training tests compared to the mean scores before training (P < 0.001). Conclusion: Findings show that the first phase of the transition period adaptation training for family medicine provides a positive beginning and psychosocial improvement for these family medicine practitioners. Amaç: Bu çalışmanın amacı, Bursa’da aile hekimliği uygulaması geçiş dönemi birinci aşama uyum eğitimi alan hekimlerin eğitimle ilgili psikososyal durumlarını belirlemek ve bundan sonraki eğitim süreçlerinde ölçüm yapabilecek geçerlilik ve güvenirliği belirlenmiş bir ölçek geliştirmekti. Yöntem ve gereç: Türkiye, Bursa ilinde, 2008 yılında, aile hekimliği uygulaması birinci aşama uyum eğitimine alınan hekimlere (442 kişi) anket yöntemi ile pilot test uygulandı. Anket soruları üç ana faktör üzerinde oluşturuldu; A-Programa Uyum, B-Mesleki Özgüven, C-Tükenmemişlik. Her bir faktör, 10-11 adet soru ile temsil edildi. Değerlendirme için 5 şıklı Likert tipi ölçek kullanıldı (I-Kesinlikle katılıyorum, II-Katılıyorum, III-Kararsızım, IV-Katılmıyorum, V-Kesinlikle katılmıyorum). Her katılımcının yaş, cins, meslek yılı, eğitime bakışı, aile hekimliği hakkındaki bilgisi, aile hekimliği sistemi hakkındaki kanaati ve mesleki yönden geleceğe bakışlarını belirleyen sorular da sorgulandı. Pilot Test için kullanılacak 31 soruluk anket formunun içerik ve kapsam yönünden geçerliliği 3 uzman doktorun görüşü alınarak araştırıldı. Daha sonra, anket uyum eğitimi alacak olan 442 doktora eğitim öncesi ve sonrası uygulandı. Sonuçlar SPSS istatistik programında değerlendirildi. 31 Sorunun tümünde, bütün faktörler için güvenilirlik analizi uygulandı. 31 tutum sorusu içerisinde güvenirliği düşüren sorular anketten çıkarıldıktan sonra geriye kalan 17 soruya Faktör Analizi (Quatrimax Yöntemi) uygulanarak, 3 faktör altında sınıfl andırıldı. Bulgular: Ankete 271 erkek (% 61,3) ve 171 kadın (% 38,7) hekim katıldı. Yaş ve meslek yılı ortalamaları erkeklerde kadınlardan daha yüksek idi. Katılımcıların çoğunluğu (% 72), aldıkları eğitimin sadece uyumlarını artıracak olan bir etkinlik olduğunu düşünürken, az bir bölümü (% 7,9) mesleki yeterlilik sağlayacağını düşünmekte idi. Mesleki Özgüven faktörünün eğitimden sonraki ortalamaları eğitimden önceki ortalamalarından istatistiksel olarak daha yüksekti (P < 0,001). Sonuç: Bulgular aile hekimliği uygulaması geçiş dönemi birinci aşama uyum eğitimlerinin, aile hekimlerine olumlu bir başlangıç ve psikososyal iyileşme sağladığını göstermektedir

Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development