Academic Program Directors Research Articles

Current status and scope of international electives in neurology training programs: A survey of U.S. and Canadian Academic Program Directors

Current status and scope of international electives in neurology training programs: A survey of U.S. and Canadian Academic Program Directors

The futility of attempting to codify academic achievement standards

Internationally, attempts at developing explicit descriptions of academic achievement standards have been steadily intensifying. The aim has been to capture the essence of the standards in words, symbols or diagrams (collectively referred to as codifications) so that standards can be: set and maintained at appropriate levels; made broadly comparable in different specified contexts; and generally shared and understood better by assessors, academic program directors, students, employers, quality assurance agencies and the public at large. The scale of this practice ranges from rubrics for single assessment tasks to national standards statements used as academic performance benchmarks for graduates from academic programs. A critical analysis shows that the underlying assumptions of this process are fundamentally flawed. Codifications are inherently incapable of meeting the requirements because key terms lack the necessary attributes. A fundamentally different material form of representation is therefore necessary if the original intentions are to be realised.

From Frontline Nurse Managers to Academic Program Directors: Research, Strategies, and Commonalities

Frontline nurse managers, whether in service or academia, are facing very similar stressors related to the ever-expanding job duties that also include providing a positive nurturing work environment for employees. Publications supporting these two administrative positions are referenced in either nursing administration or nursing education journals. Yet much can be shared and learned when both sets of rich research and commentary are merged. This article compares the recent research across these two areas of critical nursing management from a role analysis perspective. Recommendations for encouraging healthy work environments, enhancing personal growth, leadership development, encouraging succession planning, and innovatively partnering toward the future are included.

A Profile of Academic Training Program Directors and Chairs in Radiation Oncology

To identify objective characteristics and benchmarks for program leadership in academic radiation oncology. A study of the 87 Accreditation Council for Graduate Medical Education radiation oncology training program directors (PD) and their chairs was performed. Variables included age, gender, original training department, highest degree, rank, endowed chair assignment, National Institutes of Health (NIH) funding, and Hirsch index (H-index). Data were gathered from online sources such as departmental websites, NIH RePORTER, and Scopus. There were a total of 87 PD. The median age was 48, and 14 (16%) were MD/PhD. A total of 21 (24%) were female, and rank was relatively equally distributed above instructor. Of the 26 professors, at least 7 (27%) were female. At least 24 (28%) were working at the institution from which they had received their training. A total of 6 individuals held endowed chairs. Only 2 PD had active NIH funding in 2012. The median H-index was 12 (range, 0-51) but the index dropped to 9 (range, 0-38) when those who served as both PD and chair were removed from the group. A total of 76 chairs were identified at the time of the study. The median age was 55, and 9 (12%) were MD/PhD. A total of 7 (9%) of the chairs were female, and rank was professor for all with the exception of 1 who was listed as "Head" and was an associate professor. Of the 76 chairs, at least 10 (13%) were working at the institution from which they received their training. There were a total of 21 individuals with endowed chairs. A total of 13 (17%) had NIH funding in 2012. The median H-index was 29 (range, 3-60). These data provide benchmarks for individuals and departments evaluating leadership positions in the field of academic radiation oncology. Such data are useful for evaluating leadership trends over time and comparing academic radiation oncology with other specialties.

Challenges Facing Academic Urology Training Programs: An Impending Crisis

To determine the most pressing issues facing academic urology training centers. The supply of urologists per capita in the United States continues to decrease. Stricter resident requirements, restriction of resident duty hours, and a Graduate Medical Education (GME) funding cap on resident education has led to significant challenges for academic centers. A 32-question survey was sent to Society of University Urologists members. Respondents defined themselves as academic faculty tenure track, program director, academic chair, program director and academic chair, clinical faculty nontenure track, and community faculty member. A total of 143 of 446 members(32%) responded. A lack of funding was indicated as an obstacle to adding new residency positions (65% respondents) and recruiting new faculty (60% respondents). Residency positions not funded by GME (40% respondents) required either clinical or hospital dollars to support these slots. Most respondents (51%) indicated resident research rotations are funded with clinical dollars. Surgical skills laboratories are commonly used (85% respondents) and are supported mostly with hospital or clinical dollars. The majority of respondents (84%) indicated they would expand simulation laboratories if they had better funding. Other than urodynamics and ultrasound, urology residency training programs reported little income from ancillary dollars. There is a significant workforce shortage within urology training programs. Clinical revenue and hospital funding seem to be the main financial support engines to supplement the GME funding shortage, proficiency training, and faculty salary support for teaching. The current system of GME funding for urology residency programs is not sustainable.

Trends in intraoperative neural monitoring for thyroid and parathyroid surgery amongst otolaryngologists and general surgeons

The role of intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery remains a controversial subject for surgeons regardless of surgical training and background. This study aims to compare usage patterns and motivations behind IONM among otolaryngologist-head and neck surgeons (OTO-HNS) and general surgeons (GS) performing thyroid and parathyroid surgery. The study is a multi-institution survey of 103 otolaryngology and affiliated 103 GS programs in the US. 206 surveys were sent to OTO-HNS and GS academic program directors with a response rate of 44.7 %. Of those who performed thyroid surgery, 80.6 % of OTO-HNS and 48.0 % of GS surgeons reported using IONM. 44.3 % of OTO-HNS and 30.8 % of GS respondents used IONM in all thyroid cases. For thyroid surgery, as surgical volume increased, surgeons were more likely to use IONM more frequently. Fourteen percent (14 %) of the OTO-HNS and 41.7 % of the GS respondents used IONM primarily to locate the RLN. Forty percent (40 %) of the OTO-HNS and 8.3 % of the GS used IONM for medicolegal reasons. The majority of OTO-HNS programs use IONM for thyroid and parathyroid surgery, whereas less than half of GS programs regularly use IONM for these surgeries. Thyroid surgeons, with larger thyroid surgery volume, regardless of discipline, tend to use IONM more. The motivations for using IONM differ significantly between OTO-HNS and general surgeons in that more GS use it for locating the RLN, and more OTO-HNS use it for continuous monitoring of the nerve during resection and for medicolegal purposes.

Quality of Education: The Case of Jimma University

The primary objective of this study was to investigate the quality of education, research and service in Jimma University. To attain this objective, a cross sectional survey method was used and the target population of regular students, teachers, department heads, and units of student support services. The findings of the study revealed that Jimma University has used different means to disseminate its mission, vision and values to its staff through various approaches. The University has also made its level best to enhance the quality of education through the implementation of continuous assessment, active learning approach, e-learning, remedial and affirmative action and application of community-based training. However, there was a variation among colleges and Institutes in their performance and hence the academic program and quality assurance director should do its level best to maintain uniformity among these units of the University. Students were also highly complaining the services provided in the university such as cafeteria, dormitory, student clinic and guidance and counseling and it requires the office to develop the capacity of counselors, nurses, lab technicians, pharmacists and cafeteria workers.

Workload demand: a significant factor in the overall well-being of directors of associate degree nursing programs

This descriptive study of workload in relation to the overall well-being of academic program directors was conducted among 242 associate degree nursing program directors in the United States. The Copenhagen Psychosocial Questionnaire II from researchers in Denmark was the instrument used. Participants reported high levels of quantitative and emotional work demands that correlated with high levels of stress, burnout, sleep problems, and decreasing overall physical health. These results support international research findings that have analyzed similar variables in other employment positions. As we face a growing international shortage of nurses, the need for nurse faculty and nurse program directors continues to grow. However, given the state of the nurse program director position, it is not surprising that few qualified faculty prospective applicants are expressing interest in an administrative role. Results are discussed in relation to other recent workload studies, and recommendations follow.

Leadership Behaviour and Effectiveness of Academic Program Directors in Australian Universities

This article focuses on leadership behaviour and effectiveness of university academic program directors who have responsibility for managing a program or course 1 of study. The leadership capabilities were assessed using the Integrated Competing Values Framework as its theoretical foundation. Data from 90 academic program directors and 710 significant others from four Australian universities were analysed. The results lead to the conclusions that these academic program directors were reasonably effective and had the ability to implement and further develop their leadership capabilities, even though they had no formal authority. In their role, these directors mainly focused on ‘getting the job done’ and ‘working with people’. At the same time, they placed less emphasis on monitoring their programs, maintaining networks and introducing changes, thereby putting their programs at risk.

Increasing the Number of Trainees in General Surgery Residencies: Is There Capacity?

General surgeons have decreased as a proportion of the total U.S. surgical workforce. Given the likelihood of increasing shortages of general surgeons, the authors evaluated available expansion capacity of existing general surgery residency programs. In November 2009, the authors e-mailed a Web-based questionnaire to the program directors and coordinators of the 246 U.S. general surgery residency programs that were then certified by the Accreditation Council for Graduate Medical Education. Of the 246 programs the authors contacted, 123 (50%) completed the survey. Community hospital programs and academic programs had similar response rates (52% and 50%, respectively). Of the 115 program directors who responded to the relevant question, 92 (80%) reported sufficient existing case volume capacity to accommodate additional surgery residents. Both community and academic program directors reported modest expansion capacity: an average of 1.7 and 2.0 additional residents per year, respectively. Across all programs, the average additional capacity reported was 1.9 additional residents per year. An expansion of this size would increase the number of general surgery residency positions from 1,137 to 1,515 annually. After accounting for subspecialization, this increase of 378 residents would result in approximately 249 additional general surgeons entering the workforce per year after five years. Expansion capacity within existing approved general surgery residency programs is insufficient to meet the expected demand for general surgeons in the United States. Strategies to alleviate shortages include developing new training programs, cultivating new medical education funding streams, and changing the surgical training paradigm.

The Ohio State University College of Medicine

The Ohio State University College of Medicine

Have personal statements become impersonal? An evaluation of personal statements in anesthesiology residency applications

Study Objective To evaluate personal statements submitted to a major academic anesthesiology program to determine the prevalence of common features and overall subjective quality, and to survey anesthesiology program directors as to how they utilized these statements during the resident selection process. Design Structured analysis of de-identified personal statements and Internet-based survey of program directors. Setting Large academic anesthesiology training program. Subjects 670 applicant personal statements and academic anesthesiology program directors. Measurements Prevalence of 13 specific essay features and 8 quality ratings were calculated for the essays and correlated with other aspects of the residency application, as abstracted from the Electronic Residency Application Service (ERAS) files. A 6-question survey regarding use of personal statements was collected from program directors. Main Results 70 of 131 program directors queried responded to our survey. Interest in physiology and pharmacology, enjoyment of a hands-on specialty, and desire to comfort anxious patients were each mentioned in more than half of the essays. Candidates invited for an interview had essays that received higher quality ratings than essays of those not invited ( P = 0.02 to P < 0.0001). Higher quality ratings were also strongly associated with graduation from a U.S. or Canadian medical school, applicant file screening score, female gender, and younger age. Interrater reliability was good (kappa 0.75-0.99 for structural features, and 0.45-0.65 for quality features). More than 90% of program directors found proper use of English to be a somewhat or very important feature of the essay. Only 41% found the personal statement to be very or somewhat important in selecting candidates for interview invitations. However, over 90% stated that they used the statements during actual interviews with invited applicants. Conclusion The data showed a high prevalence of common features found within personal statements and a general ambivalence amongst those program directors for whom the statements were intended.

Paul is one of the Leading Commentators on ERP Systems and Specifically SAP Solutions

Paul Hawking is one of the leading commentators on ERP systems andspecifically SAP solutions. His knowledge is well respected in both industry andacademia and accordingly is often requiredto assist companies with their ERP strategies. He is a senior lecturer at the Victoria University School of Managementand Information Systems, and SAP academic program director. He has been acommittee member of the SAP Australian User Group for the past six years and isresponsible for knowledge transfer.

Allergy Practice in the Academic Otolaryngology Setting: Results of a Comprehensive Survey

To survey academic otolaryngology centers and obtain information regarding their practice of otolaryngic allergy. A 12-item multiple-choice survey was sent to all academic otolaryngology department chairmen and program directors, as well as all academic liaisons known to the American Academy of Otolaryngic Allergy. Representatives of 71 of 102 (69.6%) accredited otolaryngology programs responded; 52 of 84 respondents reported an active otolaryngic allergy practice at their institution. The testing method most widely employed by those surveyed is intradermal dilutional testing (IDT). The majority of respondents (74.5%) felt that the addition of allergy increased referrals to their department, and a similar majority (72%) were operating at a profit. The most common reasons cited for adding allergy services were to meet educational and residency requirements. The majority of academic otolaryngology programs in the United States currently offer otolaryngic allergy services. The primary reason cited for adding these services is for educational purposes, but there appear to be potential financial benefits as well. C-4.

Ohio State University College of Medicine and Public Health.

Ohio State University College of Medicine and Public Health.

A demographic, service, and financial survey of anesthesia training programs in the United States.

In February 2000, a demographic, service, and finance survey was sent to the directors of anesthesiology training programs in the United States under the auspices of the Society of Academic Anesthesia Chairs/Association of Academic Program Directors. In August of 2000, 2001, and 2002, shorter follow-up surveys were sent to the same program directors requesting the numbers of vacancies in faculty positions and certified registered nurse anesthetists (CRNA) positions. The August 2001 survey also inquired if departments had positive or negative financial margins for the fiscal year ending June 2001. The August 2002 survey included the questions of the 2001 survey and additionally asked if the departments had had an increase or decrease in institutional support and the amount of that current support. The survey results revealed that the average program had 36 anesthetizing locations and 36 faculty. Those faculty spent 69% of their time providing clinical service. Approximately one-half of the departments paid for some of their residents, whereas the other 50% paid for none. Eighty-five percent of the departments employed CRNAs who were funded by the hospital in one third of the departments. In 2000, departments received $34,319/yr in support per faculty full-time equivalent (FTE) from their institutions and had a mean revenue of $407,000/yr/faculty FTE. In 2002, the department's institutional support per FTE increased to $59,680 (a 74% increase since 2000). The departments in academic medical centers paid 20% in overhead expenses, whereas departments in nonacademic medical centers paid 10%. In 2000, 2001, and 2002, the percentage of departments with positive margins was 53%, 53%, and 65%, respectively, whereas the departments with a negative margin decreased from 44% in the year 2000 to 38% in 2001 and 33% in 2002. For the departments with a positive margin, the amount of margin per FTE over this 3-yr period was approximately $50,000, $15,000, and $30,000, respectively. Although the percentage of departments with a negative margin has been decreasing, the negative margin per FTE seems to be increasing from approximately $24,000 to $43,000. The number of departments with open faculty positions has decreased from 91.5% in the year 2000 to 83.5% in 2001 and 78.4% in 2002; in these departments, the number of open faculty positions has also decreased from 3.8 in 2000 to 3.9 in 2001 to 3.4 in 2002. The number of open CRNA positions seems to have been relatively constant with approximately two thirds of the departments requiring an average of approximately four CRNAs each. Overall, academic anesthesiology departments fiscal security seems to have eroded with an increased dependence on institutional support. Departments pay larger overhead rates relative to private practice, and there seems to be a continued, but possibly decreasing, shortage of faculty. A survey was conducted of anesthesia training program directors that demonstrated that their departments' financial conditions have been eroding over the years 2000 to 2002. During this same period of time, departments were receiving an increase in institutional support from $34,319/full-time equivalent (FTE) faculty in the year 2000 to $59,680/FTE in the year 2002. Although there seems to be an approximate 10% shortage in academic faculty, the number of departments with open positions has progressively decreased from 91% to 73% over the past 3 yr. On average, the financial condition of the training departments has deteriorated over the past 3 yr despite a significant increase in institutional support to enable departments to recruit and retain faculty in an era of an apparent national shortage of anesthesiologists.

Factors determining the ultimate fate of a plastic surgery applicant.

Plastic surgery residency program directors are frequently interested in predictors of future career direction in their applicants. Many programs strive to train leaders in academic plastic surgery. To determine what factors may predict the ultimate fate of graduating plastic surgery residents, the authors reviewed the application files of 33 former residents from a single, major plastic surgery training program. The data from 29 residents were available for analysis. Nearly half of the residents graduating from the plastic surgery training program went into private practice. Two factors, the number of years taken off for research before entering the plastic surgery residency and the presence of children, were found to be indicative of a candidate's future career path. Of particular note, there was no difference between academic graduates and nonacademic graduates with regard to their intentions in their letters of recommendation and personal statements. This information is useful to both academic program directors and resident applicants.

Effects of managed care on teaching, research, and clinical practice in academic plastic surgery.

The aim of this study was to determine: 1) if there have been changes in teaching, research, and clinical practice in academic plastic surgery in recent years; and 2) if there have been, are they associated with changes in the managed care environment? Gaining a clearer perspective on how managed care affects academic plastic surgery will enable academicians to define better the problems and opportunities they face mutually and to respond effectively to these issues. This study used a cross-sectional study design. Reference time periods were the premanaged care era (1990-1991) versus the current time (1997-1998). Data were collected by questionnaires sent to 94 academic program directors in plastic surgery. The main independent variable of managed care was measured as the difference in the percent of income from health maintenance organizations generated by each program in 1990 to 1991 versus 1997 to 1998. The dependent variables of teaching, research, and clinical practice were measured by the percentage of time spent in each category, the number of work hours per week, the number of staff personnel, the location of teaching, the number of grants and publications, and the percentage of reconstructive and cosmetic cases in 1990 to 1991 versus 1997 to 1998. Univariate analysis, paired Student's t-test, Fisher's exact test, Pearson's correlation, Spearman's correlation, and linear regression were used to establish significance (alpha = 0.05) of the effects of managed care on dependent variables. Sixty-six questionnaires were completed and returned (70% response rate). There were significant changes in the managed care environment, clinical practice (operating room and clinics), and research in academic plastic surgery from 1990 to 1997. The percentage of income generated from managed care increased from 9.8% (of total revenue) in 1990 to 23.6% in 1997 (an increase of 13.8%; p < 0.0001). Academic plastic surgeons were found to spend significantly more time in clinical practice (3% more of total time spent; 5.3 hours more per week in 1997; p < 0.016). This change correlated significantly with the increase in managed care (p < 0.015). In addition, the percentage of cosmetic cases increased from 18.0% in 1990 to 28.3% in 1997 (p < 0.001), and that of reconstructive surgery was reduced proportionately (p < 0.001). Also, a significant decrease in the time spent for research was observed (mean reduction, 2.8 hours less per week; p < 0.001). Although the trend was to a lower number, there were no significant changes in the amount of time spent in teaching (p > 0.08) and in administrative duty (p > 0.06), or in the number of personnel employed in the teaching programs (p > 0.05). In summary, these findings suggest that: 1) a greater percentage of revenue was generated from managed care in 1997 than in 1990, indicating a growing fiscal influence by managed care on academic plastic surgery; 2) furthermore, this change is associated with academic plastic surgeons devoting more time to clinical practice and less time to research endeavors; and 3) although managed care policies do affect teaching adversely, this effect has not yet reached significance for the period examined during this study.

Current status of residency programs: Survey of program directors

This survey was compiled to provide current data on the structure and content of radiology residency programs and the role of the residency program director. A survey, created in electronic form and on paper, was distributed to all United States academic, private, and military radiology residency program directors. Of the 202 survey forms distributed, 168 (83%) were completed and returned. Eighty percent of respondents support national curriculum guidelines, but most do not favor national curriculum requirements. About half (53%) of programs spend 6 months in "view box" nuclear medicine; others provide some experience by lectures and on-call time. Most programs (60%) relieve residents of some call during the senior year. Some programs (28%) allow seniors time away from clinical duties to study for the oral board exam, and 17% permit time away to study for the written boards. Seventy-eight percent of programs have had a "problem resident," and 47% have asked a resident to leave the program. Directors' most frequently expressed concern was threat of diminished residency numbers due to decreased funding.

Predictors of physical therapy faculty job turnover.

The purpose of this study was to determine what factors are predictive of job turnover of faculty in physical therapy education programs. Four hundred six physical therapy faculty and 92 academic program directors participated in the study. Data were collected from two questionnaires mailed to the participants. Fifteen predictors of turnover were tested, using correlational and multiple regression analyses for data on faculty and education programs. Findings showed that 10% of the faculty resigned within a 1-year period. Low, but significant, correlations were found between higher turnover and fewer years of employment, behavioral intentions to leave, lower salary, higher job stress, and baccalaureate programs. Multiple regression analysis revealed that education programs with faculty having fewer years of employment and the availability of many job alternatives demonstrated significantly higher turnover. Measures to reduce turnover, including faculty recruitment and retention plans, job redesign strategies, and faculty development programs for new faculty, are recommended.