Program Directors Research Articles

Determinants of immediate uptake of Post-Partum Intrauterine Device among women delivered in hospitals in West Wolegga Zone, Ethiopia

BackgroundThe use of immediate postpartum intrauterine contraceptive devices during the postpartum period supports women’s need for spacing births and prevents them from unplanned pregnancies. However, in developing countries, utilization of immediate postpartum contraceptives is low. This increases the risk of maternal morbidity, maternal mortality, preterm birth, child mortality, low birth weight, and small gestational age in subsequent pregnancy with interpregnancy interval.ObjectiveTo assess immediate postpartum intrauterine contraceptive device utilization and the associated factors among women who gave birth in Hospitals in West Wolegga Zone in 2020.Methods and materialsAn institutional-based cross-sectional study was conducted in public hospitals in the West Wolegga Zone from 1 April 2020 to 30 April 2020 among 290 postpartum women. The sample size was proportionally allocated to six hospitals by considering their monthly delivery. Study subjects were taken by systematic sampling technique (Kth=N/n =1025/290=3.53), thus every 4th woman who gave birth in the hospital was recruited in each hospital until the total sample size for this study was obtained.Bivariable and multivariable logistic regression was used to assess the association of independent variables with immediate postpartum intrauterine device utilization. A significance level of 0.05 was used to assess the statistical significance of the study’s associations.ResultsIn this study, the magnitude of the Immediate postpartum intrauterine contraceptive device utilization was 19.3%.factors like Early initiation of antenatal care [AOR=4.46 95% CI:1.84-10.78], Planning of future pregnancy [AOR=3.7(95% CI: 1.43-9.54)], Ever heard of the immediate postpartum intrauterine contraceptive device [AOR=2.67(95% CI: 1.08-6.58)] and Counseling about postpartum intrauterine contraceptive device [AOR=5.15(95% interval: 2.00-13.28] were associated with immediate postpartum intrauterine device utilizations.ConclusionThe use of immediate postpartum intrauterine contraceptive devices is low compared to other studies conducted in Ethiopia. Age, early antenatal care initiation, pregnancy planning, hearing of the immediate postpartum intrauterine device immediately inserted after delivery, and counselling on the immediate postpartum intrauterine device were significantly associated with mothers’ use of immediate postpartum intrauterine devices. Health Program directors should develop strategies to increase the use of immediate postpartum intrauterine contraceptive devices.

Program Director and Nephrology Fellow Perception of Home Hemodialysis Education in the United States

Background: Public policy focuses on increasing the prevalence of home dialysis. Home hemodialysis (HHD) education and comfort with the procedure are significant barriers to increasing prevalence. This study examines nephrology fellowship didactic curriculum, training program infrastructure and barriers identified by both program directors and trainees Methods: The anonymous, on-line survey was developed to assess HHD curriculum in US nephrology fellowship programs. During academic year 2023-24, all US nephrology program directors (n=150) were surveyed and asked to forward survey link to their fellows, and to indicate the number to whom they forwarded the link. Results: Fifty-five (55/150; 37%) US nephrology program directors responded to the survey; 80% completed it. Thirty-seven (37/55, 67%) forwarded the link to their fellows. Fellow response rate was 53/237 (22%); 50/53 completed it (94%). 75% of the program directors reported either having an HHD curriculum or were developing one. Program directors reported that didactic lectures (87%) were the most frequently available curriculum component, whereas fellows report education on counselling (72%) was most frequent. 60% of fellows and 86% of program directors reported fellow attendance at HHD longitudinal/continuity clinic (routinely or as part of a block rotation). Both PDs and fellows identified insufficient patients as a key barrier to implementing HHD curriculum. Fellows who attended outpatient HHD clinic felt more confident and prepared in HHD-related competencies. Conclusions: The HHD curriculum exists as didactic lectures, attendance at outside HHD courses, and ESKD-shared decision-making at training programs. Most programs also have continuity clinics. Our findings highlight the presence of curriculum although inconsistent. Fellows who worked in clinic were more likely to be confident and more prepared to manage HHD patients. Additionally, fellows with longitudinal clinic felt better prepared than those attending block rotations. Training programs should consider incorporating HHD longitudinal clinical rotations, although this may require creativity to achieve.

Entrustable professional activities (EPAs) in postgraduate periodontics programs in Saudi Arabia: A modified Delphi study

AbstractPurposeThe purpose of this study was to obtain a validated consensus among expert periodontists in Saudi Arabia regarding end‐of‐periodontics‐residency‐training entrustable professional activities (EPAs) using a modified Delphi method.MethodsThe study consisted of two phases. A preliminary phase in which experts met and proposed an initial list of EPAs following an extensive literature review. The second phase consisted of two rounds of the modified Delphi method in which expert periodontists in Saudi Arabia determined the content validity of each EPA. This was determined with a 5‐point scale ranging from 1 (not important/relevant) to 5 (very important/relevant), and the mean score for each EPA was calculated. EPAs with a mean value of ≤ 4 or agreement rate among experts of less than 80% were excluded.ResultsAn initial list of 40 EPAs was proposed. A total of 30 expert periodontists participated in the first round, and 24 participated in the second round of the modified Delphi method ratings. Most of the participants were program directors and represented different programs and cities in Saudi Arabia. Five EPAs were removed, and a final list of EPAs was produced based on the defined criteria. The Cronbach's alpha was 0.920, indicating high reliability.ConclusionsA final list of 35 end‐of‐periodontics‐training EPAs was produced. The findings of this study can serve as a valuable resource for curriculum development, assessments, and evaluation of periodontics training programs in Saudi Arabia.

Characterizing and Evaluating the Structures of Combined Pediatrics and Medical Genetics and Genomics Residency Programs.

There is limited information on rationale for the current training structure within combined Pediatrics-Medical Genetics and Genomics Residency (MGG) residency programs. This study addresses the benefits and drawbacks of different training structures. Program Directors (PDs) and Associate PDs of combined Pediatrics-MGG residency programs were surveyed to evaluate perceived benefits of different structures and the relative importance of particular pediatric rotations for combined training. Programs varied in terms of how many times a typical resident transitioned between Pediatrics and MGG during training (range 4 to > 9). PDs varied in their opinions of which training structure would be most ideal for training a future Clinical Geneticist within a combined Pediatrics-MGG program. However, the majority of PDs indicated that consecutive training (completing two years of Pediatrics, followed by MGG) would support particular aims of training including continuity of patient care and research productivity. The top six out of twenty pediatric rotations that were ranked as most important in order of importance were neonatal intensive care, development and behavior pediatrics, term newborn, pediatric intensive care, neurology, and inpatient pediatric wards. Particular structures may facilitate distinct aims within training; however, there was not widespread consensus on which program structure would be best. Specific pediatric rotations were highlighted as very important, which could influence future curriculum development.

Abstract 4134935: Impact of COVID-19 on Cardiology Fellows and Faculty in the United States: Two Years Later

Introduction: Recent data demonstrated that the COVID-19 pandemic adversely affected cardiovascular fellows in training (cFIT) and faculty in terms of educational disruption and search for job prospects, respectively. However, less is known about the pandemic's effect on cFIT and faculty in terms of general well-being, shifts in personal and professional priorities, quantitative measures of stress levels, and research productivity. Methods: A national survey targeting cFIT and faculty was developed to assess the effect of the pandemic two years later on these parameters. Fifty-four participants, including 21 cFIT and 33 faculty, responded to the survey. The survey was distributed between October 2021 and May 2022 to program directors of ACGME-accredited general cardiology fellowship programs in the United States. Results: 30% of cFITs perceived impaired clinical training during the pandemic; 36% of fellows experienced a decline in their clinical skills in the cardiac catheterization lab, while 27% experienced a decrease in their echocardiographic skills. Additionally, a significant percentage of cFIT reported negative interference in their competencies in nuclear cardiology (27%) and electrophysiology (12%). Most participants (76%), including faculty and fellows, reported several health issues such as sleep problems, low energy, changes in appetite, difficulty concentrating, and restlessness due to the pandemic. 43% of the faculty and 61% of cFIT reported high rates of impaired short-term productivity (Figure). Conclusion: In this national survey, we found that two years after the onset of the COVID-19 pandemic, cardiology fellows and faculty continued to experience significant concerns for decreased hands-on training and diminished research productivity. While faculty were not distressed regarding decreased clinical competencies, concerns about short-term and long-term research productivity persisted. Faculty and fellows all experienced increased stress levels and impaired productivity. Although limited by a small sample size, which can introduce bias, these results signal the importance of performing a follow-up study on the impact of COVID-19 on wellness as well as the impact on career.

Assuring and Improving Learning Outcomes

Universities have a responsibility to measure and assure graduate learning outcomes ("Higher Education Standards Framework (Threshold Standards)," 2021; TEQSA, 2017). However, while assuring learning outcomes is a priority across the sector, many universities fail to collect meaningful data on student achievement of these outcomes (Martin & Mahat, 2017). Some institutions are investigating technologically enhanced processes to improve the efficiency and accuracy of learning-achievement data (Burrack & Musselwhite Thompson, 2021; El Marsafawy, 2022). Over the past four years, the University of Technology Sydney (UTS) Business School has made substantial enhancements to assurance of learning (AoL) practices, leveraging learning management system (LMS) functionality and data visualisation software to create a streamlined process, which better facilitates the continuous improvement of programs. This work is of particular interest to academic and professional staff involved in collecting and reporting on student achievement data, in program continuous improvement and evaluation, or in leveraging technology-enhanced learning analytics. The UTS Business School’s AACSB accreditation necessitates the collection, tracking, and reporting of student achievement of program-level learning outcomes (AACSB, 2020). Each program identifies subjects to "develop" and "assure" learning outcomes, with student achievement measured within specific assessment tasks and collated for program-level analysis. This process can be administratively complex, and historically involved multiple manually collated spreadsheets. This represented a substantial time cost for the faculty and often resulted in unreliable data. It was, for example, common practice to report overall subject marks rather than the specific learning outcome to determine achievement level, resulting in assessment practices that diverged from the recommended standards of constructive alignment (Biggs, 2014). In 2021, faculty T&L and central learning technologies teams commenced a pilot using LMS tools and the interactive data visualization tool PowerBI to streamline data collection, collation, and visualisation. Canvas Outcomes set up at the faculty level allows for centralised achievement-data collection, which, when linked to student and program information in PowerBI, can be used to obtain program-level insights. Beyond administrative efficiency, the project was also designed to improve and foreground the constructive alignment (Biggs, 2014) of measured learning outcomes. The revised process requires the embedding of learning-outcome-aligned assessment criteria within rubrics, resulting in improved constructive alignment and data transparency. The initial pilot was evaluated using Human Centred Design (IDEO.org, 2015) methods, which concluded the new system was an improvement on previous processes. Since the pilot, the faculty has completed a full rollout to over 60 subjects and 20 programs. Once this foundational AoL process was in place, program and subject-level continuous-improvement projects could be built upon it. Previous reporting methods had limited usefulness to Program Directors and were no longer fit for purpose due to changes in AACSB requirements. Reporting processes were therefore adjusted to focus on continuous improvement of key program metrics. In the new process, Program Directors and teaching teams review program data to identify curriculum or student-experience improvements that will enhance student achievement of learning outcomes. For example, a master's program identified that a high percentage of students were falling below expectations in two outcomes. Investigating the causes identified a need for substantial changes, with new subjects taking assurance responsibilities, and revisions to the program's overall assessment strategy. Recent data shows significant improvements in the target outcomes. This presentation will outline these updated technology-enhanced AoL processes demonstrating how the collected data can be used to improve university programs and the student learning experience.

Understanding faculty perspectives on health equity curriculum implementation in graduate medical education: a qualitative study

BackgroundDespite increased awareness of persistent healthcare disparities, integrating health equity education into medical residency curricula needs urgent expansion. The Accreditation Council for Graduate Medical Education (ACGME) mandates addressing healthcare disparities and social determinants of health, but implementation remains insufficient due to pervasive barriers.ObjectiveTo explore residency faculty perspectives at one institution surrounding implementing a health equity curriculum within their programs.MethodsBetween November 2022 and April 2023, qualitative interviews and focus groups were conducted with residency faculty participants (n = 13) from a large academic medical institution. Participants were recruited via an internal email list directory of program directors. Semi-structured sessions explored faculty perspectives on health equity curriculum implementation. Data analysis utilized template analysis and thematic coding.ResultsFaculty perceived barriers included limited time for teaching health equity, challenges in prioritizing health equity content within the curriculum, lack of formal training and expertise, discomfort in leading discussions, and institutional barriers such as resource allocation and lack of buy-in.ConclusionsFindings underscored the need for institutionally supported faculty development and protected learning time for health equity education. Despite participant recruitment and representation limitations, the study provides valuable insights for addressing curricular challenges. This study highlights critical areas for improving health equity curriculum implementation in graduate medical education. Addressing these faculty barriers can enhance resident competency in identifying and addressing healthcare disparities.Trial registrationThe study received approval from the Thomas Jefferson Institutional Review Board (IRB #22E.762).

Meeting the accreditation standard through implementation of a multiprogram residency advisory committee and ongoing quality improvement.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To describe the process utilized by a large multiprogram residency site to expand preceptor engagement and establish ongoing quality improvement efforts in order to meet the program's needs in response to evolving ASHP accreditation standards. A multiprogram residency advisory committee (RAC) primarily composed of residency program leadership was formed to focus on aspects of program management and accreditation compliance that were not being addressed at the monthly all-preceptor meeting. The ASHP standard and a recent residency accreditation survey guided the RAC agenda, which led to the creation of a combined manual for the institution's 5 residency programs and a preceptor manual. Preceptor engagement was improved through the establishment of local preceptor requirements, inclusion of preceptor representatives on the RAC, expansion of subcommittee opportunities, addition of a preceptor midpoint retreat, and optimization of the end-of-year preceptor retreat. Communication with residents and identification of continual improvement opportunities were improved through roundtables with residents, residency program directors, and the RAC chair; a monthly meeting with the rotating chief resident and RAC chair; and face-to-face exit interviews with the department's chief of pharmacy. The RAC chair has been a key figure in coordinating program change to meet the ASHP standard as well as leading planning for subsequent ASHP surveys. Through the establishment of a multiprogram RAC and a RAC chair, our program has been able to engage a large preceptor group that is dedicated to continual improvement and provides the ability to dynamically respond to ASHP's progressing guidance for pharmacy residency programs.

What puzzles L2 learners about German grammar? Using practitioner research to explore threshold concepts in language curricula

Taking the perspective of a language program director (LPD), this practitioner research (PR) study describes how analysis of learners’ reflections written for an advanced undergraduate German course in the United States helped an LPD see how students had experienced learning grammar in lower-level instruction. The study analyses a semester-long project based on the PR framework of exploratory practice (EP), in which students ( n = 30) pursued individual questions (‘puzzles’) about German grammar that would be most meaningful to them in their language learning journey. Initial analysis of the students’ questions revealed a general preference among learners to investigate grammar topics previously covered in the lower-division curriculum. In-depth case studies, focused on two learners’ experiences with EP, show how the project allowed students to investigate their grammar puzzles using resources across the entire curriculum, including dialoguing with teachers and students in other courses. The study looks to threshold concept theory to theorize students’ learning experiences vis-à-vis L2 grammar (specifically inflectional morphology, i.e. case markings) and argues that the flexibility of the EP framework and its core tenets of working towards understanding and involving others supported the LPD in seeing how learners understood and felt about German grammar and grammar instruction across the larger curriculum.

Perceived Factors That Enable Resident Entry to the Specialty of Radiation Oncology.

The field of radiation oncology (RO) has experienced large fluctuations in the number of applicants to residency programs. It is essential to understand the modifiable factors which influence entry. The objective of this project is to identify factors (i.e., "enablers") that motivate prospective medical students to apply to RO. A survey was developed to characterize RO enablers and barriers as perceived by current RO residents. An existing conceptual framework of why medical students choose primary care was used as the foundation of the survey and was modified for relevance towards RO. The final mixed-methods survey was administered to Canadian RO residents (2015-2019 match years) via Program Directors and the Canadian Association of Radiation Oncologists resident member database. Medical students are most likely to select a career in RO during or after a clerkship experience. Extrinsic factors strongly motivating interest in RO were (% rating as very important or extremely important on a 5-point scale) as follows: positive feedback from radiation oncologists (86%) and RO residents (66%), clinical rotations in RO (84%) and mentorship (77%). Intrinsic factors include perceived fulfillment (95.2%), commitment to patient care (85.3%), and intellectual challenge (67.7%). Qualitative data highlighted the importance of mentorship, the "hand-heart" connection, career variability/flexibility, career satisfaction/lifestyle, and personal connections with cancer/cancer care in motivating students to pursue RO. Increased preclinical exposure such as mentorship may encourage students to seek clerkship opportunities in RO. These findings inform strategies to recruit medical students to a career in RO.

Leveraging the Electronic Health Record to Measure Resident Clinical Experiences and Identify Training Gaps: Development and Usability Study.

Competence-based medical education requires robust data to link competence with clinical experiences. The SARS-CoV-2 (COVID-19) pandemic abruptly altered the standard trajectory of clinical exposure in medical training programs. Residency program directors were tasked with identifying and addressing the resultant gaps in each trainee's experiences using existing tools. This study aims to demonstrate a feasible and efficient method to capture electronic health record (EHR) data that measure the volume and variety of pediatric resident clinical experiences from a continuity clinic; generate individual-, class-, and graduate-level benchmark data; and create a visualization for learners to quickly identify gaps in clinical experiences. This pilot was conducted in a large, urban pediatric residency program from 2016 to 2022. Through consensus, 5 pediatric faculty identified diagnostic groups that pediatric residents should see to be competent in outpatient pediatrics. Information technology consultants used International Classification of Diseases, Tenth Revision (ICD-10) codes corresponding with each diagnostic group to extract EHR patient encounter data as an indicator of exposure to the specific diagnosis. The frequency (volume) and diagnosis types (variety) seen by active residents (classes of 2020-2022) were compared with class and graduated resident (classes of 2016-2019) averages. These data were converted to percentages and translated to a radar chart visualization for residents to quickly compare their current clinical experiences with peers and graduates. Residents were surveyed on the use of these data and the visualization to identify training gaps. Patient encounter data about clinical experiences for 102 residents (N=52 graduates) were extracted. Active residents (n=50) received data reports with radar graphs biannually: 3 for the classes of 2020 and 2021 and 2 for the class of 2022. Radar charts distinctly demonstrated gaps in diagnoses exposure compared with classmates and graduates. Residents found the visualization useful in setting clinical and learning goals. This pilot describes an innovative method of capturing and presenting data about resident clinical experiences, compared with peer and graduate benchmarks, to identify learning gaps that may result from disruptions or modifications in medical training. This methodology can be aggregated across specialties and institutions and potentially inform competence-based medical education.

Perspectives from program directors on the selection process for Saudi periodontics residency programs: a cross-sectional study.

Applying to periodontics programs in Saudi Arabia holds significant importance for both applicants and periodontics program directors. As of today, there has been no investigation into how periodontics program directors (PDs) identify and select potential candidates for their programs. The aim of this study is to assess the factors taken into consideration during the selection process for periodontics programs by PDs in Saudi Arabia. In this cross-sectional study, an electronic survey was sent out to Periodontics PDs of the Saudi Commission for Health Specialties (SCFHS) in Saudi Arabia. Variables of interest included the Grade Point Average (GPA), Saudi Dental License Exam (SDLE), research, interview, service and electives, letter of recommendation, and other miscellaneous factors. A degree of importance scale was used to measure the significance of each factor for PDs. This study surveyed 16 PDs with a response rate of 72.7%. The majority of PDs were from the Central and Western Regions. Approximately 56% of the PDs were affiliated with universities. The study identified, from the perspective of PDs, that the most important factors were the reputation and performance of the applicant during clinics or interactions with staff, followed by general research experience. Additionally, interview performance was rated equally with SDLE score and GPA, as well as factors such as undertaking periodontics elective rotations during internship and working in the same department. Regardless of the region or number of years of experience, all PDs considered the most significant factor to be the reputation and performance of the applicant during clinics or interactions with staff. This study sheds light on the factors perceived by program directors in Saudi Arabia that influence the selection process for applicants to periodontics programs. By understanding these factors, dental graduate students can better customize their applications and experiences to meet the expectations of admission committees.

Securing the Future: Financial Ties of Thoracic Surgery Program Directors to Industry

Thoracic surgery program directors (PDs) are key mentors for the next generation of cardiothoracic surgeons and surgeon-scientists. This study evaluates the industry payments to PDs compared to other practicing thoracic surgeons to assess potential conflicts of interest and their influence. PDs were identified using the Electronic residency application system (ERAS) and their National provider identifiers (NPIs). Industry payments from 2015 to 2021 were extracted from the OpenPayments (cms.gov) database. We analyzed the number and types of payments, including consulting fees, speaking engagements, and research-related contributions. Payments were compared by PD characteristics such as gender, specialty, and academic metrics using the Chi-square test and Kruskal-Wallis test. All 77 identified PDs (66 males and 11 females) received industry payments, totaling $14,094,422 across 8,028 transactions. The median payment was $16716, with maximum reaching $2,661,001. Male PDs and those in cardiac specialties received significantly higher payments. Research funding for PDs was predominantly awarded to males (100%). Significant disparities were observed in industry payments to PDs compared to non-PDs, especially in food and beverage, and educational activities. PDs initially received more than double the research payments compared to non-PDs in the early years. This disparity reduced significantly by 2021, reflecting a move towards more equitable research funding. The substantial payment to PDs reflects their significant role in thoracic surgery, yet raises concerns regarding potential influence on trainees. These findings underscore the need for increased transparency and measures to address disparities in industry support, particularly concerning gender and specialty.

Residency program directors’ views on ideal applicant: a national survey

PurposeThe aim of this study is to investigate and highlight the most important factors influencing the candidate’s selection for residency matching by program directors of surgical and non-surgical specialties in Saudi Arabia.MethodThis cross-sectional study was conducted in the Central, Eastern, Western, Northern, and Southern regions of Saudi Arabia from February 1, 2023, to August 31, 2023. A total of sixty-one program directors completed a questionnaire, which was adapted and validated from a previous study with permission and tailored to meet the objectives of this research.ResultsThe mean age of the study population was 40.2 years, with surgical specialty program directors being older at 41.7 years and nonsurgical specialty program directors being younger at 39.6 years. In both cases, the highest importance was given to ‘Applicant’s attitude and professionalism’, followed in surgical specialties by ‘Doing clinical rotations in the PD institution’ and ‘Performance in clinical rotation during internship’ in non-surgical specialties. with a mean score of 4.13 and 4.95, respectively. The importance of ‘The impression/opinion of current residents’ has had a certain importance in both specialties. While the number of research projects was prioritized more by surgical PDs (38.6%) compared to non-surgical PDs (29.4%).ConclusionThis study highlights the critical role of professionalism and a positive attitude in clinical rotations and interviews for program acceptance in Saudi Arabia. The significance of letters of recommendation and research focus varies between surgical and non-surgical program directors. Program directors should adopt effective recruitment strategies that incorporate practical implications during internships.

Variations in Trauma Education Practices Across Emergency Medicine Residencies: Insights from a National Survey of Program Directors.

Care of the acutely injured trauma patient is integral to the practice of emergency medicine. It is currently unknown how most emergency medicine residencies structure their residents' trauma experience and little guidance for competency assessment is provided by the Residency Review Committee. Our study aimed to determine current emergency medicine residency practices in trauma resuscitation. We conducted a cross-sectional survey of members of the Council of Residency Directors in Emergency Medicine (CORD) listserv in April 2023. Frequency with percentage of item responses is reported and differences across trauma levels assessed via Fisher's exact test (α = 0.05). Fifty-seven program directors responded to the survey (21.9%), the majority of whom operate at Level I facilities. Significantly more Level II/ III centers send residents to other sites for trauma experience compared to Level I (p = 0.000). Residents participate in all key procedures (eg, airway management, central venous access) when managing traumas except thoracotomy where participation was notably lower and statistically different across levels (p = 0.000). Lastly, program directors were very confident their residents can lead traumas independently and few acknowledged citations for deficiency in trauma training. Trauma training and confirmation of competency is critical among EM residents who may serve as the sole lead in rural emergency departments. This study demonstrates that there is considerable variability in how residency programs structure trauma education, particularly with regards to the exposure to invasive procedures and the opportunity to lead trauma resuscitations. As the American Board of Emergency Medicine has introduced requirements for program directors to attest specifically to the competence of residents to lead trauma resuscitations, standardized and validated tools should be adopted to support this attestation and ensure competence regardless of the program hospital's trauma level.

William M. Reynolds (1951-2024).

Memorializes William M. Reynolds (1951-2024). "Bill" served as director of the graduate program in school psychology at the University of Wisconsin-Madison and held appointments as principal investigator at the Waisman Center on Mental Retardation and Human Development and as discipline chief of Psychology of the University Affiliated Program at the Waisman Center. He developed the Reynolds Adolescent Depression Scale and the Reynolds Childhood Depression Scale, which are widely used both clinically and in research. Bill held a professorship at the University of British Columbia (1991-2000), serving as director of the School Psychology graduate program. In 2000, Dr. Reynolds returned to California as professor of Psychology at Cal Poly Humboldt. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and Extent of Industry Funding to Program Directors Across Pediatric Surgical Specialties

IntroductionIndustry funding in surgical education offers benefits but presents conflicts of interest. This study defines the prevalence and extent of industry funding to fellowship program directors (FPDs) across pediatric surgical specialties. Materials and methodsThis was a retrospective cross-sectional analysis of FPDs in pediatric surgical specialties. Data were amalgamated from the Centers for Medicare and Medicaid Services and the Accreditation Council for Graduate Medical Education. Characteristics of FPDs were obtained from academic websites and medical licensing boards. Personal industry payments from 2016 to 2022 were analyzed, and temporal trends were elucidated. Comparisons were made by year, surgical specialty, and control groups with nonparametric tests. ResultsA total of 241 FPDs were identified, with 206 (85%) receiving industry payments over the study period. The specialties with the highest prevalence of industry funding to FPDs were pediatric orthopedic surgery (100%), pediatric urology (96%), and pediatric surgery (85%). Total industry payments aggregated to $7.3 million dollars with the majority awarded to pediatric orthopedic surgery (91%). Most industry payments were for royalties or licensing (57%) and consulting fees (31%). Median total industry payments per FPD differed between subspecialties (P < 0.001) and was highest in pediatric orthopedic surgery ($7009, interquartile range [IQR], $1771-$50,239) and lowest in pediatric otolaryngology ($116, IQR, $75-$1626). Male FPDs had higher median total industry payments than female FPDs ($1643, IQR, $172-$8731 versus $193, IQR, $84-$712, P < 0.001). ConclusionsIndustry payments to FPDs in pediatric surgical specialties are highly prevalent, but the magnitude varies by specialty. Future work is needed to establish mechanisms that promote equitable partnerships between academia and industry for pediatric surgery training.

2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry

Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry (ACLP) has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade. We convened a workgroup of 8 ACLP members holding leadership positions in residency and fellowship education on local and national levels. The project was approved by the ACLP Executive Council and conducted via a three-stage iterative process. Consensus was reached on 34 recommendations across four domains, including structural issues, faculty supervsion, formal curriculum and evaluations, and elective experiences. Residents must spend sufficient time on CLP rotations to achieve relevant milestones. Given that consultants are expected to offer unique insight, the ideal placement of core CLP rotations comes at a time in residency where residents are able to provide expert opinion and lead teams. Faculty expertise in CLP and availability to provide direct supervision and oversight to trainees is essential. A separate and formal CLP didactic curriculum should exist, and elective opportunities should be offered to supplement training. These recommendations are intended to guide residency program directors towards optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship. Establishing a strong CLP foundation for all residents is essential for ensuring competency in providing psychiatric care for medically complex patients and collaborating with our colleagues in other specialties, as well as fostering trainee interest in pursuing a career in CLP.

Evidence-Based Medicine Culture, Curriculum, and Program Outcomes: A CERA Study.

Limited faculty development is a barrier to advancing evidence-based medicine (EBM) education. This study sought to describe program director perception of EBM culture in family medicine residency training and to assess the association among structured faculty roles, EBM curricula, and specific resident outcomes including publications in EBM. Members of the Society of Teachers of Family Medicine EBM collaborative drafted survey questions based on a literature review. The questions were electronically distributed in May 2023 to all US family medicine residency program directors who had not previously opted out by the Council of Academic Family Medicine Educational Research Alliance within its study of family medicine program directors. We analyzed results using descriptive and comparative statistics. The overall response rate was 44.7% (309/691). We found that 260/281 (92%) of program directors reported an EBM curriculum of some kind, and 253/281 (90%) of program directors agreed/strongly agreed that EBM was accepted by residents. Of the respondents, 72/281 (25.6%) reported that no specific faculty member was responsible for their EBM curriculum. Most program directors reported that less than 50% of residents will leave their programs with the ability to detect an error in original research (23.8%; 67/281), detect an important omission in an UpToDate article (16%; 45/281), or author a narrative review for American Family Physician (10%; 28/281). Program directors reported strong acceptance of EBM among residents and a high prevalence of a formal curriculum. However, many lacked a specific faculty lead, and few reported that residents had strong EBM skills. This study identified gaps in residency training to support future EBM-skilled family physicians as well as concerns about pathways for the development of future EBM faculty.

Family Medicine Resident Remediation Compared Across Two CERA Studies.

From 2020 to 2022, multiple medical schools transitioned from teaching patient care directly to online electives. Family medicine program directors reported on these learners' abilities to meet the Accreditation Council of Graduate Medical Education (ACGME) core competencies during residency. The authors hypothesized an increased need for medical knowledge remediation in the 2023 Council of Academic Family Medicine Educational Research Alliance (CERA) study. Using the 2017 and 2023 CERA studies, the authors evaluated which factors were associated with residents requiring remediation, residents completing remediation, the duration of remediation, and the most remediated core competency. Compared to 2017, the percentage of residents who successfully remediated in the 2023 study increased (P=.006), while remediation duration stayed unchanged at 6 to 12 months. The top ACGME core competency needing remediation remained professionalism in both studies (2017: 38.1%; 2023: 45.1%; P=.10) with medical knowledge being second most common (2017: 30.2%; 2023: 25.2%; P=.20). We found no associations between non-U.S. medical graduate percentage, core faculty remediation training, professionalism training, or didactic hours and the number of residents undergoing remediation, the percentage of residents remediating successfully, or the most common competency remediated. Program director gender, degree, race, years of experience, underrepresented in medicine status, and remediation training were not associated with any resident remediation variables studied. Professionalism remains the top core competency requiring remediation. We found no associations between resident, program, training, or program director factors and the core competency requiring remediation, the number of residents needing remediation, or the percentage of residents who completed remediation.