Care Residency Programs Research Articles

Respiratory Residency: Establishing Excellence for the Newly Licensed Respiratory Therapist.

Workforce issues have highlighted the fact that newly graduated respiratory therapists (RTs) need more support during their transition to practice; however, there are few data on best practices for RT residency programs. The aim of this project was to evaluate the feasibility and effectiveness of a residency program for licensed RTs with < 1 y of experience post graduation. The approach to improve new graduate transition to practice included a streamlined clinical-based orientation, didactic learning, evidence-based practice plan, and incorporated simulation. Data were collected in a secure electronic database at a multi-campus health care system utilizing anonymous questionnaires. The participants responded to questions about demographic information, overall confidence, clinical skills, and knowledge base topic confidence. Participant responses reported an increase in their overall factor score measures for role confidence, clinical skills, and knowledge-based topics. The collected responses showed an increase in a wide range of clinical skills and other soft skills. These results indicate that a respiratory care residency program adds value to the training, overall well-being, and retention of the newly graduated RT.

51108 Skin of Color Education in Primary Care Residency Programs: A Nationwide Survey of Program Directors

51108 Skin of Color Education in Primary Care Residency Programs: A Nationwide Survey of Program Directors

A Scoping Review of Obstetrics and Gynecology Curricula in Primary Care Residency Programs.

While Women's Health (WH) is a priority for primary care, (Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), and combined Medicine/Pediatrics (Med/Peds)), residency curricula remain heterogeneous with deficits in graduates' WH expertise and skills. The overall objective of this study was to assess the quality of WH curricula at primary care residency programs in the United States (US), with a focus on topics in obstetrics and gynecology (OBGYN). PubMed®, ERIC, The Cochrane Library, MedEdPORTAL, and professional organization websites were systematically searched in 2019 and updated in 2021. Included studies described OBGYN educational curricula in US primary care residency programs. Following abstract screening and full-text review, data from eligible studies was abstracted and quality assessed using the Medical Education Research Study Quality Instrument (MERSQI). A total of 109 studies met the inclusion criteria. Over a quarter of studies were interdepartmental or interdisciplinary. The most common single-department studies were IM (38%) and FM (26%). Twenty (25%) studies addressed comprehensive OBGYN curricula; the most common individual topics were cervical and breast cancer screening (31%) and contraception (16%). Most studies utilized multiple instructional modalities, most commonly didactics (54%), clinical experiences (41%), and/or simulation (21%). Most studies included self-reported outcomes by residents (70%), with few (11%) reporting higher-level assessments (i.e., patient, or clinical outcomes). Most studies were single-group pre- and post-test (42%) with few randomized controlled trials (4%). The mean MERSQI score for studies with sufficient data (90%) was 9.8 (range 3 to 15.5). OBGYN educational curricula for primary care trainees in the US was varied with gaps in represented residents, content, assessments, and study quality.

Factors Influencing Primary Care Career Choice: A Multi-Institutional Cross-sectional Survey of Internal Medicine Primary Care Residency Graduates.

Although primary care is associated with population health benefits, the supply of primary care physicians continues to decline. Internal medicine (IM) primary care residency programs have produced graduates that pursue primary care; however, it is uncertain what characteristics and training factors most affect primary care career choice. To assess factors that influenced IM primary care residents to pursue a career in primary care versus a non-primary care career. Multi-institutional cross-sectional study. IM primary care residency graduates from seven residency programs from 2014 to 2019. Descriptive analyses of respondent characteristics, residency training experiences, and graduate outcomes were performed. Bivariate logistic regression analyses were used to assess associations between primary care career choice with both graduate characteristics and training experiences. There were 256/314 (82%) residents completing the survey. Sixty-six percent of respondents (n = 169) practiced primary care or primary care with a specialized focus such as geriatrics, HIV primary care, or women's health. Respondents who pursued a primary care career were more likely to report the following as positive influences on their career choice: resident continuity clinic experience, nature of the PCP-patient relationship, ability to care for a broad spectrum of patient pathology, breadth of knowledge and skills, relationship with primary care mentors during residency training, relationship with fellow primary care residents during training, and lifestyle/work hours (all p < 0.05). Respondents who did not pursue a primary care career were more likely to agree that the following factors detracted them from a primary care career: excessive administrative burden, demanding clinical work, and concern about burnout in a primary care career (all p < 0.05). Efforts to optimize the outpatient continuity clinic experience for residents, cultivate a supportive learning community of primary care mentors and residents, and decrease administrative burden in primary care may promote primary care career choice.

Validation of entrustable professional activities for use in neonatal care residency programs

ObjectiveDefine and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs. MethodsAn exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions. ResultsSeven EPAs were drafted by the coordinators´ committee (n = 5) and used in the content validation process with a group (n = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity. ConclusionSeven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.

Enhancing a Family Medicine Obstetric Care Residency Program in Oklahoma.

Enhancing a Family Medicine Obstetric Care Residency Program in Oklahoma.

Picking Apart a Program Evaluation Committee: A Multiple Case Study Characterizing Primary Care Residency Program Evaluation Committee Structure, Program Improvement, and Outcomes.

As of 2014, the Accreditation Council for Graduate Medical Education (ACGME) mandates initiating a Program Evaluation Committee (PEC) to guide ongoing program improvement.However, little guidance nor published reports exist about how individual PECs have undertaken this mandate. To explore how four primary care residency PECs configure their committees, review program goals and undertake program evaluation and improvement. We conducted a multiple case study between December 2022 and April 2023 of four purposively selected primary care residencies (e.g., family medicine, pediatrics, internal medicine). Data sources included semi-structured interviews with four PEC members per program and diverse program artifacts. Using a constructivist approach, we utilized qualitative coding to analyze participant interviews and content analysis for program artifacts. We then used coded transcripts and artifacts to construct logic models for each program guided by a systems theory lens. Results: Programs adapt their PEC structure, execution, and outcomes to meet short- and long-term needs based on organizational and program-unique factors such as size and local practices. They relied on multiple data sources and sought diverse stakeholder participationto complete program evaluation and improvement. Identified deficiencies were often categorized as internal versus external to delineate PEC responsibility, boundaries, and feasibility of interventions. The broad guidance provided by the ACGME for PEC configuration allows programs to adapt the committee based on individual needs. However, further instruction on program evaluation and organizational change principles would augment existing PEC efforts.

Identifying factors that influence the selection of a postgraduate year 2 ambulatory care residency program

AbstractIntroductionStudies have been conducted to evaluate motivating factors for pharmacy students in pursuing a postgraduate year 1 (PGY1) residency program. Currently, no literature assesses the factors driving the selection of a specific PGY2 ambulatory care (AC) pharmacy program.ObjectivesThe primary objective of this study was to identify factors driving the selection of a specific PGY2 AC pharmacy residency program. Secondary objectives were to describe whether these driving factors have changed throughout the residency year, the impact of remote work in the selection of a PGY2 AC program, and the impact of resident well‐being in the selection of a PGY2 AC program.MethodsA questionnaire was electronically distributed to 199 American Society of Health‐System Pharmacists residency program directors (RPDs) of PGY2 AC programs in March 2023. The RPDs were asked to forward the questionnaire and reminder emails to their current PGY2 AC residents. The questionnaire included a combination of categorical, Likert‐type, open‐ended, and demographic questions. Descriptive statistics were used to analyze the results.ResultsIn total, 72 PGY2 AC residents responded, providing a response rate of 27%. The mean age was 26 (±1.30) years, 69% identified as female, and 57% practiced in an urban setting. The top three factors that influenced the selection prior to the ASHP Match were culture of the program, perceived positive resident morale, and mentorship provided by RPD and preceptors. These factors remained the most influential after being in residency for approximately 8–9 months. The ability to work from home or remotely, complete a teaching certificate program, and conduct telehealth visits were the least influential factors.ConclusionAn understanding of the factors that were most influential in the selection of a PGY2 AC program provides a unique resource to RPDs, allowing them to better position their program for future candidates.

A Longitudinal Pediatric Primary Care Residency Tailored to Meet Workforce Need: A 10-Year Evaluation.

Background We started a primary care residency program intended to prepare graduates for primary care and increase entry into primary care, using time-limited funds from the Health Resources and Services Administration (HRSA). Objective To compare the graduates of the primary care residency program to their categorical peers, and whether they remained in the state, began primary care careers, and whether they identified as underrepresented in medicine. Methods This is a retrospective study of a cohort of 39 residents who graduated from the University of North Carolina primary care residency program from 2014-2023. In 2016, HRSA grant funding expired and the program continued with ongoing financial support from the 2 institutions. Graduate demographics and career choices were compared to categorical residents (159 total) for graduate years 2014 to 2023. Results The primary care pediatrics residency has graduated 39 residents to date. Job placement data was obtained for all 39 graduates. Graduates of the program have 5.5-fold greater odds (95% CI, 2.5-12.5) of working in primary care roles following graduation than peer categorical residents. Most graduates (33 of 39, 85%) have taken jobs in general pediatrics (including primary care, urgent care, adolescent medicine, or hospital medicine). The program has recruited a large proportion of its residents (12 of 39, 31%) from groups historically underrepresented in medicine. Conclusions We developed an innovative primary care pediatric residency in collaboration with a community partner, spurred by HRSA funds, that has trained a diverse group of new primary care pediatricians.

Preparing Physicians to Treat Addiction: Inclusion of Dedicated Addiction Training During Internal Medicine Residency.

Physicians in internal medicine lack comfort and skills required to diagnose and treat substance use disorder (SUD). Formal training in substance use treatment within primary care training has traditionally been inconsistent and sparse. The purpose of this study is to assess the impact of a longitudinal experiential addiction curriculum on the attitudes and experiences of graduates from a primary care/internal medicine residency program that included formal addiction didactics, rotations in an outpatient addiction clinic embedded within the resident primary care clinic, and exposure to addiction medicine faculty across treatment settings. A survey was emailed to all graduates from a single academic primary care residency program who graduated between 2016 and 2018 (n = 53). The survey assessed pharmacotherapy for SUD prescribing patterns, comfort with SUD pharmacotherapy, overall comfort treating SUD, experience correcting stigmatizing language, and providing guidance to colleagues on the care of patients with SUD. A subset of respondents (n = 14) were interviewed regarding their experience with the residency program's addiction medicine curriculum and its impact on their current clinical practice. Sixty percent (n = 28) of graduates responded to the survey. All respondents felt comfortable using medications to treat SUD. Eighty-four percent perceived themselves as more comfortable using pharmacotherapy to treat SUD than their colleagues. Qualitative interviews revealed that this addiction medicine training shaped participants' attitudes toward patients with SUD and imparted them with the skills to address stigmatizing language. Participants described how they have become ambassadors of addiction medicine in their workplace and a resource to colleagues with less comfort in the management of SUD. Graduates of a primary care/internal medicine residency with a dedicated addiction medicine curriculum are comfortable prescribing pharmacotherapy for SUD, taking an active role in reducing SUD-related stigma, and serving as a resource for colleagues.

Building Interest in the Primary Care Specialty Through Enhanced Global Health Experience.

Background An overwhelming majority of matriculating medical students in the USA are keen to deliver quality health care to all people, including the socioeconomically disadvantaged populations in remote, resource-scarce regions nationally and worldwide. Here, we describe a protocol developed to evaluate the interest of our medical students in global health activities. We also examined the relationship between students' interest in global health and readiness to pursue a future career in the primary care specialty. Materials and methods We designed a survey in Qualtrics online software and reached all first-year and third-year medical students between 2019 and 2022 enrolled at the Alabama College of Osteopathic Medicine (ACOM).The survey utilized ordinal scale items to explore the medical students' interest in primary care residency programs, their interest in global health and international travel, and their perceptions of how a range of factors might motivate their desire to participate in global health activities. The study was approved by ACOM's Institutional Review Board (IRB). In order to compare findings from this study withdata from other medical schools, we developed constructs using the national aggregate data, in percentages, from matriculants and graduates of Doctor of Osteopathic Medicine (DO) degree-granting medical schools according to gender, published by the American Association of Colleges of Osteopathic Medicine (AACOM). Statistical analysis of national aggregate data was performed using the unpaired t-test. Results Both female and maleparticipants had lived or traveled abroad before starting medical school.Female (98%, n=249) and male (95%, n=140) participants in the first-year cohorts considered helping the underserved population as important or very important as it is related to a career in medicine. Females in the third-year cohorts (97%, n=71) also ranked this statement as important or very important compared to male cohorts (89%, n=31). Ahigher proportion of females (43%, n=108) compared to males (35%, n=52) in first-year cohorts agreed or strongly agreed that they would likely pursue a residency in primary care.More females (59%, n=43)than males (46%, n=16)in the third-year cohorts agreed or strongly agreed with the same statement. Analysis of the aggregatenational data (2009-2022) revealed that the percentage (actual count not available) of female students who plannedto practice in underserved/shortage areawas higher both at the time of matriculation (M=51%, SD=4%) and before graduation (M=40%, SD=4%) compared to males (matriculation: M=40%, SD=5%; graduation: M=33%, SD=4%) presenting a significant difference (matriculation t(24)=6.7, p<0.0001; graduation t(24)=5.4, p<0.0001). Furthermore, a higher percentage of females at the time of matriculation (M=25%, SD=5%) and graduation (M=40%, SD=6%) plannedto practice in the primary care specialtiescompared to males (matriculation: M=17%, SD=4%; graduation: M=29%, SD=6%) presenting a significant difference (matriculation: t(24)=4.6, p = 0.0001; graduation: t(24)=4.8, p<0.0001). Conclusions Interest in global health activities may be associated with interest in pursuing a future career in the primary care specialty. In this study, more female medical students expressed interestin participating in global healthexperiences, serving the underserved population domesticallyand abroad, andexpressing interest in primary care than males.

Profile of speech therapy in oncology and palliative care residency program at an oncology referral hospital

Introduction: Hospital environments are among the different professional contexts in which speech therapists can work. Patients with cancer or at their final stage of life are eligible for speech therapy intervention. Based on this premise, a program called Residência Multiprofissional em Saúde was created focusing on Oncology-Palliative Care.Objective: This study aimed to analyze the assistance provided by speech therapists in the scope of a multiprofessional residency program at an oncology referral hospital.Methods: The documentary research was based on a retrospective qualitative-quantitative approach. A sample of 344 m dical records were analyzed using a form containing open and closed questions as part of the study.Results: All data were organized in spreadsheets and submitted to statistical treatment using the chisquared test and the G-test. Only 67 patients were evaluated by speech therapists, and among these only 16 underwent rehabilitation. Functional evaluation of swallowing was the most frequent evaluation method found in the analyzed medical records (9.30%), tactile-thermal-stimulation was the most used therapeutic method in speech therapy (2.03%), and most patients had no clinical evolution with speech therapy (1.74%).Discussion: It is possible to observe a variation in the types of evaluation performed, which makes the evaluation an even more subjective process, increasing the risks of diagnostic confusion. Health services managed based on quality management advocate standardized care, with the implementation of protocols, forms, indicators and care flows; features that have not yet been implemented or developed in current palliative practice.Conclusion: Results suggest that there is a fragmentation in the structure of the Speech Therapy Service, which is directed especially towards swallowing disorders, thus evidencing the need for a systematization of speech therapy assistance provided to PC patients.

THU006 Exploring Primary Care Resident Perspectives On Diabetes Education In Training

Abstract Disclosure: N. Francis: None. S. Cardillo: None. D.R. Nandiwada: None. Background: The training residents gain in Family Medicine (FM) and Internal Medicine (IM) residency programs provide a critical foundation for their knowledge in diabetes (DM) management. It is one of the most common diagnoses physicians-in-training will encounter in their residency training programs and in clinical settings. However, a 2012 study compared diabetes care in resident clinics versus private physicians and found significant decrease in patient satisfaction (56.5% vs. 71.3%) in resident clinics. A 2020 study surveying primary care (PC) residency program directors showed that most FM and IM residency training programs focus on the core diabetes care and management topics with much less focus on emerging topics, such as 2nd generation insulin analogs and digital health technologies. The purpose of our survey was to better assess current resident perceptions and attitudes towards their DM education and their perceived comfort level in comprehensive DM counseling, evaluation, and management. Methods: A 12 item survey was designed using the Qualtrics program. The survey link was sent via email to IM- PC and FM residents at a major academic medical center. Data was collected from September 13th, 2022 to present. The survey included a combination of multiple choice, Likert scale and ranking questions. Results: 14 residents responded to the survey to date with the majority (71%) belonging to the IM-PC group and the remainder (29%) family medicine. Residents felt most comfortable managing diabetes related complications and counseling on foot and eye care and hypoglycemia. Respondents reported being most uncomfortable in prescribing non-insulin medication (50%) and initiating an insulin regimen (43%) and less comfortable counseling patients on continuous glucose monitoring systems (83%) and insulin administration (66%). While majority of residents (72%) found their DM curriculum clinically relevant, 85% of residents reported there was not enough time allotted. Respondents felt a more longitudinal lecture series, with increased access to treatment frameworks and on-site feedback on their DM counseling and care would best supplement their DM curriculum. Conclusion: This survey data explores specific areas that residents have identified as being least comfortable and also expresses what they identified as the most preferable ways to modify and design an educational intervention. This information allows for tailored curricular intervention highlighting diabetes technologies, insulin and non-insulin prescribing practice in a longitudinal lecture style format that provides access to DM treatment frameworks and incorporates direct on-site feedback to the residents. This provides evidence for the development of a novel clinically integrated DM curriculum. Presentation: Thursday, June 15, 2023

A Model for Residency Training: The Small Animal Emergency and Critical Care Residency Program at Purdue University.

Training residents in any specialty is a balancing act between ensuring high-quality education, making certain the resident meets the requirements set forth by the specialty college to achieve credentials and be eligible to take the board certification examination, and fulfilling clinical duties at that institution. For programs such as this one, residents are integral members of the clinical team, working primary emergency receiving shifts in order to allow the service to function; this leads to a need to identify and protect learning time for the residents. Those involved in the Purdue Small Animal Emergency and Critical Care residency program believe that in the chaos that is emergency and critical care, a firm timeline with attainable checkpoints is crucial to resident success. Such a timeline follows goal-setting theory and provides structure and guidance to candidates to navigate their 3-year program and ensure that they complete all requirements during the residency period. Candidates completing the Purdue program successfully finish their credentials, including at least one first author publication, and have at least one scientific presentation to improve their curriculum vitae. This article serves to present the structure and timelines used by the Purdue Small Animal Emergency and Critical Care program to organize its residency program as an example of a successful program.

Learning from complex elderly care: a qualitative study on motivating residents in family medicine

BackgroundMore and more patients need complex care, especially the elderly. For various reasons, this is becoming increasingly difficult. The onus is essentially on family physicians to provide this care and family medicine residency programs should therefore prepare their residents for this task. We know from self-determination theory (SDT) that motivation plays a key role in learning and that in order to boost motivation, fulfillment of 3 basic psychological needs - for autonomy, competence, and relatedness – is crucial. As residents often lack motivation, residency programs face the important challenge to motivate them to learn about and engage in complex elderly care. How to do so, however, is not yet sufficiently understood.MethodsWe conducted a qualitative multi-institutional case study across four universities in Belgium and the Netherlands. In the period between June, 2015, and May, 2019, we triangulated information from semi-structured interviews, document analysis, and observations of educational moments. Guided by SDT concepts, the analysis was performed iteratively by a multidisciplinary team, using ATLAS.ti, version 8. In this process, we gained more insights into residents’ motivation to learn complex elderly care.ResultsWe scrutinized 1,369 document pages and 4 films, observed 34 educational moments, and held 41 semi-structured interviews. Although we found all the 3 basic psychological needs postulated by SDT, each seemed to have its own challenges. First, a tension between the need to guide residents and to encourage their independent learning complicated fulfillment of the need for autonomy. Second, the unpredictability of complex care led to reduced feelings of competence. Yet, guidelines and models could help residents to capture and apprehend its complexity. And third, family medicine practice, patients, and educational practice, by either satisfying or thwarting the need for relatedness, were identified as key mediators of motivation. By setting the right example and encouraging residents to discuss authentic dilemmas and switch their health care approach from cure to care, educators can boost their motivation.ConclusionOur study has demonstrated that the degree of perceived autonomy, guidance by the education program, use of authentic dilemmas, as well as involvement of group facilitators can aid the process of motivation.Trial registrationNVMO, ERB number 482.

Publication rates and characteristics of PGY2 psychiatric pharmacy resident research projects.

To describe the publication rates and characteristics of PGY2 psychiatric pharmacy residency projects presented as a poster presentation at the annual meetings of the College of Psychiatric and Neurologic Pharmacists (CPNP) from 2002 to 2018. (As of 2022 the organization is under the name, American Association of Psychiatric Pharmacists.). CPNP abstracts from even years were strategically searched in PubMed, Ovid MEDLINE, and Google Scholar. If a publication was identified, additional data were collected for characterization, including study information, journal information, author information, institutional affiliation, publication year, and time to publication. A total of 348 abstracts were evaluated. Publication in a journal was achieved for 60 projects (17.2%), with publication rates decreasing from 2012 to 2018. The mean time to publication was 17.3 months after completion of the residency, with most projects published at 8 months. More than half (51.7%) of these projects were published in a psychiatric pharmacy journal affiliated with CPNP. Study designs were predominantly retrospective, observational, cohort studies with a focus on evaluation of a drug therapy outcome. The PGY2 resident was the first author in 90% of the publications. Forty percent included other health care professionals outside of pharmacy as a coauthor. PGY2 residencies affiliated with academic institutions had overall higher publications rates. Publication rates for PGY2 psychiatric pharmacy residency projects are low and are decreasing over time despite an increasing number of PGY2 psychiatric pharmacy residency programs. This publication rate is lower than that reported in the literature for PGY2 critical care residency programs. The downward trend of publication rates for PGY2 psychiatric pharmacy residency projects is concerning.

Minding the Gap: Assessment of Radiation Oncology Knowledge in Primary Care Residents

<h3>Purpose/Objective(s)</h3> The purpose of this study is to assess the knowledge base of primary care residents in the state of Oklahoma regarding radiation oncology. <h3>Materials/Methods</h3> For this study, primary care resident physicians were defined as those training in Family Medicine or Internal Medicine. Primary Care residency programs within the state of Oklahoma were identified through the Accreditation Council for Graduate Medical Education (ACGME) website. Residency programs were in both urban and rural communities. Program directors were contacted to set up a didactic session. A 1-hour lecture covering introductory topics in radiation oncology as well as case-based learning topics pertaining to radiation oncology in the primary care setting was delivered. Residents were given a pre- and post-lecture survey. Ten residency programs, with a total of 281 residents, extended an invitation for didactics. Given the ongoing COVID-19 pandemic, some programs requested that the lecture be delivered virtually. <h3>Results</h3> A total of 122 residents completed the pre-lecture survey; 51.6% were female, 41.7% were interns, 39.2% were second year residents, and 17.5% were third year residents. A total of 50.8% of respondents attended medical school in Oklahoma and 30.3% attended an allopathic medical school. Over half of trainees stated that they had no exposure to didactics covering radiation oncology during the pre-clinical years of medical school (66.1%). A similar number of residents (65.5%) stated that there were no structured radiation oncology rotations in medical school during clinical years. An overwhelming majority of residents felt that the pre-clinical curriculum did not adequately cover radiation oncology (95.9%). Residents reported that most training facilities had radiation oncology services at their disposal (73.3%); however, only 60.3% of residents had previously interacted with a radiation oncologist. When asked about their level of confidence in consulting a radiation oncologist, 63.6% of residents stated that they did not feel confident while 24% felt neutral, 12.4% felt somewhat confident, but none of the residents surveyed felt confident. Following the lecture, 63.3% of responding residents felt confident or somewhat confident consulting radiation oncology, while only 8.8% felt not confident. Additionally, 98.5% of respondents felt this lecture was beneficial to their resident education. <h3>Conclusion</h3> The majority of respondents felt medical school curriculum does not adequately cover radiation oncology. Nobody in the pre-lecture survey felt confident consulting a radiation oncologist. Most trainees felt this lecture was beneficial to their training. This study highlights a gap in medical knowledge and identifies areas of collaboration between radiation oncologists and primary care physicians regarding patient co-management.

Virtual interviews for admission to health care residency programs during the COVID-19 pandemic.

The COVID-19 pandemic forced residency programs to adapt their selection processes. Our objective was to describe the experience of virtual interviews conducted to select residents through applicants' perception. An electronic questionnaire was sent to health care residency applicants after their interviews conducted in 2020. Two-hundred and twenty-one questionnaires were collected and the average distance to the facility was 163 km. Also, 67.9% of the applicants used a personal computer, 98.2% felt that they were treated appropriately, 77.8% were able to state their ideas, and 12.2% reported technical difficulties. In addition, 32.6% said that they would prefer virtual interviews for future selection processes and 17.6%, that it would be irrelevant. Virtual interviews allowed the resident selection process to be completed; one third of applicants would prefer virtual interviews in the future and there were no apparent technological limitations.

Factors Influencing Graduating Medical Students in Puerto Rico to Pursue a Primary Care Residency in the Continental United States.

Primary care physician shortage represents a challenge for many countries and territories, including Puerto Rico (PR), where a significant proportion of the graduating medical students preferred the continental United States (C-US) to complete their training and even as the definitive setting for their practice. We surveyed medical students who graduated from medical schools in PR and have been accepted in a residency program to evaluate the influence of a set of demographics, academic, and personal factors in their decision to pursue a primary care residency program in the C-US. A 19-item questionnaire was distributed by institutional email to those medical students who graduated from one of the four Liaison Committee on Medical Education fully accredited medical schools in PR in 2019. We summarized our data by frequency and percentages. We performed data analysis with statistical significance considered for P values &lt;.05. The questionnaire had a response rate of 51% (138/273), where 49% (67/138) were accepted in a primary care residency. Sixty percent (40/67) matched in a primary care program in the C-US. Among the evaluated factors, a prior degree in C-US (65%) and first-degree relatives living in the C-US (70%) were associated with students who matched in the mainland. First-degree relatives living in PR (96%) were associated with students who remained on the island for training. The results provide insight into the influence that personal factors have on the decision of medical students in PR to pursue primary care training in the C-US.

Point-of-care ultrasound training for residents in anaesthesia and critical care: results of a national survey comparing residents and training program directors’ perspectives

BackgroundPoint-of-care ultrasound (POCUS) has become an essential tool for anaesthesia and critical care physicians and dedicated training is mandatory. This survey describes the current state of Italian residency training programs through the comparison of residents’ and directors’ perspective.MethodsObservational prospective cross-sectional study: 12-question national e-survey sent to Italian directors of anaesthesia and critical care residency programs (N = 40) and residents (N = 3000). Questions focused on POCUS teaching (vascular access, transthoracic echocardiography, focused assessment for trauma, transcranial Doppler, regional anaesthesia, lung and diaphragm ultrasound), organization (dedicated hours, teaching tools, mentors), perceived adequacy/importance of the training and limiting factors.ResultsFive hundred seventy-one residents and 22 directors completed the survey. Bedside teaching (59.4–93.2%) and classroom lessons (29.7–54.4%) were the most frequent teaching tools. Directors reported higher participation in research projects (p < 0.05 for all techniques but focused assessment for trauma) and simulation (p < 0.05 for all techniques but transthoracic echocardiography). Use of online teaching was limited (< 10%); however, 87.4% of residents used additional web-based tools. Consultants were the most frequent mentors, with different perspectives between residents (72.0%) and directors (95.5%; p = 0.013). Residents reported self-training more frequently (48.5 vs. 9.1%; p < 0.001). Evaluation was mainly performed at the bedside; a certification was not available in most cases (< 10%). Most residents perceived POCUS techniques as extremely important. Residents underestimated the relevance given by directors to ultrasound skills in their evaluation and the minimal number of exams required to achieve basic competency. Overall, the training was considered adequate for vascular access only (62.2%). Directors mainly agreed on the need of ultrasound teaching improvement in all fields. Main limitations were the absence of a standardized curriculum for residents and limited mentors’ time/expertise for directors.ConclusionPOCUS education is present in Italian anaesthesia and critical care residency programs, although with potential for improvement. Significant discrepancies between residents’ and directors’ perspectives were identified.