Early Graduate Research Articles

Curricular changes and interim posts during Covid-19: graduates’ perspectives

BackgroundDuring the COVID-19 pandemic UK medical schools facilitated the early graduation of their final-year medical students to ‘Foundation interim Year 1 (FiY1) doctors’ through amendments made to curricula and final assessment. Such changes gave opportunity for evaluation. This study therefore aimed to explore 1) graduate perspective on the implementation of FiY1 and 2) how changes to course structures have affected self-reported preparedness for work.MethodsQuestionnaire surveys using Likert scale and free-text responses (n = 45), and semi-structured interviews (n = 7) were conducted with FiY1s from two UK medical schools contrasting in the amendments made to course structures. Data were analysed using quantitative methods and thematic analysis; 44% (n = 20) of respondents believed that governing health bodies had not communicated sufficiently prior to starting work.ResultsGraduates who had sat modified practical and written examinations reported ‘legitimacy’ and feeling more prepared compared to having not sat examinations (practical 100%, n = 17; written 88.3%, n = 15). Graduates from both schools agreed that carrying out assistantships as originally scheduled would have made them feel more prepared (91.1%, n = 41).ConclusionsThe implementation of FiY1 was largely well received by graduates yet assistantship programmes may fulfil a similar role in normal times. Medical schools and governing bodies must ensure effective communication channels exist with students in order to better prepare them for their first posts, especially in times of crisis. Additionally, final examinations contribute to feelings of preparedness for work and instil a sense of legitimacy, a finding which is relevant to working within the current programmatic assessment structure.

School quality matters: A multilevel analysis of school effects on the early reading achievement of Black girls

Early reading achievement is essential for all children’s development and future success. However, U.S. schools continue to under prepare Black children in early literacy, as evidenced by disparate outcomes observed for this population of learners. The under preparation of Black students is problematic, given the strong negative correlation between early reading proficiency and high school graduation. Preschool learning opportunities are a means to curb this trend, but these instructional opportunities vary in quality and effectiveness. Variations in quality may significantly impact Black girls. Little specific attention has been given to the early reading of Black girls.’ Therefore, this article’s purpose is to assess the effects of schools on the early reading achievement of Black girls. This study used multilevel modeling to gauge the effects of schools on Black girls’ early reading achievement. Our estimates provide correlational inferences concerning the associations between school characteristics and the early reading achievement of Black girls. The reading achievement of a representative sample of Black girls ( N = 886) and their corresponding schools was used to assess school effects. The schools’ socioeconomic status (SES) and school locations were the primary school characteristics of interest. Results indicate that schools account for approximately 18% of the variation in Black girls’ early reading achievement. Thus, schools play a meaningful role in the early reading achievement of Black girls. School-level SES was negatively correlated with Black girls’ early reading achievement, but this effect was mediated by school location. In conclusion, schools’ observed effects on early Black girl achievement were moderate and influenced by school location. Implications for supporting the early reading achievement of Black girls are provided for educational stakeholders.

Workforce: Physician associate graduates in England: a cross-sectional survey of work careers

Physician associates (PAs) are a new healthcare professional group in the UK. While PAs have been known as a stable but flexible workforce in the USA for over 50 years, little is known about their career paths in the UK's NHS. A cross sectional online survey (January 2020 - May 2020) of graduates from the longest running UK PA course investigated stability and factors influencing job retention or movement. One-hundred and sixty-two (71%) graduates provided a full response. Descriptive analysis was by early graduates (2006-2013), mid-graduates (2014-2017) and recent graduates (2018-2020). Early and mid-graduates held their first jobs for a mean of 3 years. For early graduates, the longest held job was 11 years, with a mode of 7 years. Enjoyment of the work, learning opportunities and working with supportive consultants were the most highly rated factors in PA job retention.

Competency-Based Medical Education: Considering Its Past, Present, and a Post-COVID-19 Era.

Advancement toward competency-based medical education (CBME) has been hindered by inertia and a myriad of implementation challenges, including those associated with assessment of competency, accreditation/regulation, and logistical considerations. The COVID-19 pandemic disrupted medical education at every level. Time-in-training sometimes was shortened or significantly altered and there were reductions in the number and variety of clinical exposures. These and other unanticipated changes to existing models highlighted the need to advance the core principles of CBME. This manuscript describes the impact of COVID-19 on the ongoing transition to CBME, including the effects on training, curricular, and assessment processes for medical school and graduate medical education programs. The authors outline consequences of the COVID-19 disruption on learner training and assessment of competency, such as conversion to virtual learning modalities in medical school, redeployment of residents within health systems, and early graduation of trainees based on achievement of competency. Finally, the authors reflect on what the COVID-19 pandemic taught them about realization of CBME as the medical education community looks forward to a postpandemic future.

Rethinking Research Mentoring: A Tutorial on How and Why to Implement a PhD Student–Mediated Mentorship Model

Purpose:In this tutorial, we describe the initiation and implementation of a recently developed PhD Student–Mediated Mentorship Model (PS-MMM) used within our lab. In a PS-MMM, PhD students mentor graduate and undergraduate students under the direction of a faculty advisor. The model aims to address the PhD shortage by (a) teaching PhD students to be research mentors to facilitate their success in the early career years and (b) encouraging clinical graduate students to transition into and be successful in research doctoral training. As a third objective, we aim to address the research–practice gap by increasing the research experiences available to undergraduate and clinical graduate students through implementation of a PS-MMM. We provide a step-by-step outline and case examples for initiating and scaling up a PS-MMM.Conclusions:Implementation of a PS-MMM has led to consistent, positive benefits for mentees and mentors within our lab. The observed benefits, feasibility, and flexibility of our PS-MMM support more widespread use of PS-MMMs within other communication sciences and disorders programs.

Accuracy Enhancement of Prediction Method using SMOTE for Early Prediction Student's Graduation in XYZ University

According to the Minister of Education and Culture of the Republic of Indonesia's regulations from 2014, one of the essential elements in implementing higher education is the student's study duration. Higher education institutions will use early graduation prediction as a guide when developing policy. According to XYZ University data, the student study period is Grade Point Average (GPA), Gender, and Age are all aspects to consider. Using a dataset of 8491 data, the Prediction of Early Graduation of Students based on XYZ University data was examined by this study, particularly in the information systems and informatics study program. The aim is to find significant features and compare three prediction models: Artificial Neural Networks (ANN), K-Nearest Neighbor (K-NN) method, and Support Vector Machines (SVM). The Challenge in the development of a prediction model is imbalanced data. The Synthetic Minority Oversampling Technique (SMOTE) handles the class imbalance problem. Next, the machine learning models are trained and then compared. Prediction results increase. The best test accuracy value is on ANN with a data Imbalance of 62.5% to 70.5% after using SMOTE, compared to the accuracy test on the K-NN method with SMOTE 69.3%, while the SVM method increased to 69.8%. The most significant increase in recall value to 71.3% occurred in the ANN.

Perceptions and reflections of early graduates of the first emergency medicine residency program in Ethiopia: A qualitative study.

IntroductionA bi-institutional partnership between physicians at Addis Ababa University, Ethiopia and the University of Toronto, Canada led the development and implementation of a novel emergency medicine (EM) postgraduate training program at Addis Ababa University (AAU). Subsequently, the first three cohorts of trainees were invited to participate in the evaluation of the curricular components devised and delivered by Toronto EM physicians as part of the Toronto Addis Ababa Academic Collaboration in EM (TAAAC-EM). We sought to characterise the strengths and weaknesses of the curriculum to improve it for future trainee cohorts.MethodsThis curriculum assessment used semi-structured, in-depth individual interviews to evaluate components of the TAAAC-EM program curriculum. Interviews were conducted with a purposive sampling of graduates from the first three cohorts of the TAAAC-EM program.ResultsTwelve participants were interviewed. The following themes were identified; The TAAAC-EM program built a novel EM culture at AAU and shifted teaching from didactic to learner-centered strategies where teachers serve as role models; The curriculum content of the EM resident program, including didactic and practical sessions, was well received by the graduates interviewed; Challenges identified included lack of continuity in training, and difficulties transitioning to practice in a locally nascent field; Participants evaluated the TAAAC-EM program model as very positive overall, and supported replicating the model by expanding within Ethiopia and beyond.ConclusionsThe challenges identified in the program, including lack of continuity of clinical teaching and meeting the local educational resource needs of new graduates, helped inform program adaptations and improvements. TAAAC-EM, currently in its eleventh year, is now focused on transitioning full teaching responsibilities to local faculty and continuing to support a positive EM teaching culture. We believe that this thriving partnership can serve as a model for future north-south and south-south collaborations in postgraduate medical education.

A Delicate Aggression: Savagery and Survival in the Iowa Writers’ Workshop by David O. Dowling.

<i>A Delicate Aggression: Savagery and Survival in the Iowa Writers’ Workshop</i> by David O. Dowling.

Dr. Richard C. Nelson: Teacher, Researcher, Motivator, Leader, and Incredible Human.

As one of the early graduate students of the Penn State Biomechanics Laboratory (1970-1974), I had the pleasure of being involved in the lab developed under the direction of Dr. Richard Nelson. His vision of applying engineering principles to human movement, particularly through the vehicle of sport analysis, inspired many to commit to a career of biomechanical exploration of the many aspects of human movement. By bringing many international scholars to the lab, he exposed his students to innovative and unique approaches to research. By developing technical applications, he made biomechanical inquiry more scientific and applicable. By caring for and mentoring a new generation of scientists and providing them the direction and tools they would need to establish their own labs and careers, he helped us become teachers, researchers, consultants, and mentors for a new generation of students. His love of life inspired us all to further the groundbreaking work he had begun and continued throughout his amazing career. His contributions to the field of biomechanics through his visionary establishment of societies, journals, collegial relationships, and consulting skills have served our community well. It was an honor and a privilege to know and learn from him.

The early graduates from Tongji Medical University(1912-1955)

The early history of Tongji Medical University can be demonstrated from the graduate certification and the photos of graduates from the Tongji Deutsch Medical School in 1912 to the Wuhan Medical College in 1955. It was found that the names, the chancellors and the affiliations of the university kept changing based on the changing of the names, stamps and signatures of the chancellors on the graduate certificates. It was also found that the apparent morale among graduates appeared to be different during different historical stages in graduate photos. Both graduate certificates and graduate photos show the educational achievements by the Tongji Medical University.

Confronting the nameless-faceless: a duoethnography of navigating turnover and early career socialization

PurposeThe purpose of this duoethnography was to share our narratives as a left-behind early career faculty (ECF) and graduate student with minoritized identities and reflect on academic socialization processes. Specifically, when many scholars are raising alarms about the retention and success of faculty with minoritized identities, it is crucial to recognize the dimensions of socialization within the organizational context of academia.Design/methodology/approachThe authors sought an approach that would facilitate the interrogation of the overlap and divergence of the authors’ perspectives. Duoethnography research design was chosen for its focus on self-reflection as well as on the importance of the expression and consideration of those diverging perspectives. The goal was collaboration to generate a discussion that deepens a complex understanding of socialization in and professional commitment to academia.FindingsThe central insight that surfaced from the analysis of our duoethnography data is the enhanced understanding of the “nameless-faceless” dimension of academic socialization. Endeavoring to understand why faculty leave and how those who are left behind make sense of that departure led the authors to examine the unknown entities the authors are responsible to and for so they may better understand their commitment to academia.Research limitations/implicationsThe authors’ findings reveal that the nameless–faceless element is just a generalized behavior adopted in the interest of restricted and individual advantage. Diversity and equity practices are touted as a priority, but frequently, institutions act in ways that establish their own self-interests. The authors argue that we are all the nameless–faceless when they participate in academic norms that work to uphold and perpetuate traditional practices in academia.Practical implicationsThe authors’ findings point to intentional mentoring and integration of responsibility in faculty roles as potential recruitment and retention tools.Originality/valueThe authors extend the importance of collaboration and mentorship in retaining graduate students and EFC to the concept of intertwined professional commitment, or the theory that it is not simply the outcomes that are influenced by the support and cooperation between faculty with minoritized identities but that our professional commitment to academia is strengthened by that collaboration and witnessing each other's purpose and motivation to remain in academia.

Factors affecting glycemic control among Egyptian people with diabetes attending primary health care facilities in Mansoura District

BackgroundDiabetes is a rapidly growing health problem worldwide. In 2019, the International Diabetes Federation (IDF) estimates that Egypt is the 9th country worldwide with about 8,850,400 cases and a prevalence of 15.2% in adults. By 2045, Egypt is expected to be the 7th country worldwide. Several factors affecting glycemic control are related to patients, physicians, and the infrastructure of primary health care facilities (PHCFs). The effect of health care infrastructure and resources is not well studied. This cross-sectional study aims to explore factors affecting glycemic control among subjects with diabetes visiting PHCFs in the Mansoura District. A questionnaire was done to assess these factors among subjects with diabetes, primary care physicians (PCPs), and PHCFs infrastructure and resources. Three hundred and two subjects with diabetes attending PHCFs in the Mansoura District underwent a detailed clinical history. Also, HbA1c was obtained.ResultsFactors in patients that affect diabetic control include patient’s education and occupation and their smoking status. Practicing physical exercise is important for diabetes control. Physicians can affect diabetes control by their rural residence, older age, participation in diabetes training, early graduation year, longer durations since started dealing with subjects with diabetes, and following guidelines. Resources of infrastructure have a role in diabetes control. Metformin and investigation availability has a positive association with diabetes control.ConclusionPatients, physicians, and resources of infrastructure have a role in diabetes control.

COVID-19 as an Opportunity to Expand the Instructional Portfolio of STEM Librarians

The pivot to online teaching caused by the COVID-19 pandemic enabled science and engineering librarians at Vanderbilt University to expand their teaching roles within graduate-level courses in biomedical engineering, chemistry, and physics. In addition to addressing traditional information literacy skills related to information retrieval and resource evaluation, these new lessons addressed important science process skills such as academic reading, responsible conduct of research, and research data management. A facility with cloud-based teaching tools such as Zoom breakout rooms and Excel for Microsoft 365 allowed for engaging instructional experiences, even within synchronous online instructional environments. By integrating these topics into the graduate curricula, these guest lectures supported the professional development of early career graduate students and deepened relationships with the course instructors of record.

Scope of Practice of US Interventional Cardiologists from an Analysis of Medicare Billing Data

The contemporary scope of practice of interventional cardiologists (ICs) in the United States and recent trends are unknown. Using Medicare claims from 2013 to 2017, we categorized ICs into 4 practice categories (only percutaneous coronary intervention [PCI], PCI with noninvasive imaging, PCI with specialized interventions [peripheral/structural], and all 3 services) and evaluated associations with region, hospital bed size and teaching status, gender, and graduation year. Of 6,083 ICs in 2017, 10.9% performed only PCI, 68.3% PCI with noninvasive imaging, 5.7% PCI with specialized interventions, and 15.1% all 3 services. A higher proportion of Northeast ICs (vs South ICs) were performing only PCI (24.8% vs 7.3%) and PCI with specialized interventions (12% vs 3.4%), but lower PCI and noninvasive imaging (53.8% vs 71.7%) and all 3 services (9.3% and 17.6%). Regarding ICs at larger hospitals (bed size >575 vs <218), a higher proportion was performing only PCI (23.8% vs 5.2%) or PCI with specialized interventions (13.5% vs 1.7%) and lower proportion was performing PCI with noninvasive imaging (48.8% vs 78%), similar to teaching hospitals. Female ICs (vs male ICs) more frequently performed only PCI (18.9% vs 10.6%) and less frequently all 3 services (8.3% vs 15.4%). A lower proportion of recent graduates (2001 to 2016) performed only PCI (9.8% vs 13.8%) and PCI with noninvasive imaging (66.3% vs 72.6%) but a higher proportion performed all 3 services (18% vs 8.4%) than earlier graduates (1959 to 1984). From 2013 to 2017, only PCI and PCI with noninvasive imaging decreased, whereas PCI and specialized interventions and all 3 services increased (all p <0.001). In conclusion, there is marked heterogeneity in practice responsibilities among ICs, which has implications for training and competency assessments.

Graduating During the Great Recession: The Effects of Student Loan Debt on Early Career Labor Market Outcomes and Graduate School Enrollment

: Total U.S. student loan debt has grown substantially, raising concerns about its impacts. Previous work has suggested that indebted graduates pursue higher-wage careers. However, other trade-offs are possible in adverse economic conditions. Graduates may reduce search effort or hold multiple low-wage jobs to enable debt repayment. This article assesses student debt’s impacts on the outcomes of U.S. bachelor’s degree recipients entering the labor market during the 2008 Recession. We find that indebted students graduating into a recession face the repayment burden with wages that are no higher than average and are less or no more likely to enroll in graduate school.

Factors Influencing Water Quality Perceptions in an Urban and Rural Watershed in Southern Ecuador

River water quality and quantity are declining globally as a result of land use and population growth. Enhanced river management that includes input from local watershed residents is needed to sustain this resource. As an international framework, integrated water resources management (IWRM) aims to support inclusive governance of water systems. Ecuador is one of the countries that has looked to IWRM as a guide, though little research on water quality is available in the country. Our case study describes both the research process and outcomes of an integrated assessment of water quality and perceptions in the south Ecuador city of Loja, through which flow two rivers: Rio Zamora and Rio Malacatos. Our team sought to take both biophysical and perceptual measures of water quality in these rivers and tributaries and build interdisciplinary research skills among undergraduate and early graduate students in collaboration with faculty researchers from the Universidad Técnica Particular de Loja and the University of Idaho. In this case article, we concentrate on the process and results of the social scientific dimension of this interdisciplinary project, describing how surveys and interviews were used to build our understanding of the connections between the biophysical water quality measures and water quality perceptions of different communities within the watershed. Readers will learn about the possibilities of conducting interdisciplinary, international team projects to answer applied socioenvironmental questions along with challenges that should be anticipated when designing this kind of research.

National Resident Matching Program Performance Among US MD and DO Seniors in the Early Single Accreditation Graduate Medical Education Era.

Introduction: As of the 2020 National Resident Matching Program (NRMP), nearly all applicants are evaluated together for graduate medical education (GME) candidacy. We set out to characterize US MD and DO Senior residency match performance in the single-accreditation GME era.Methods: A retrospective study was conducted in 2021 utilizing data collected from the 2018 and 2020 NRMP Charting Outcomes in the Match publications aggregated and subdivided into three groups based on competitiveness: low (LC), moderate (MC), and high (HC). Nonparametric analysis was performed using Chi square or Fisher exact tests if counts were less than five. Significance was determined at p < 0.05.Results: A total of 46,853 candidates were included, with 36,194 (77.3%) US MD and 10,659 (22.7%) DO Seniors. Match rates for US DO Seniors were lower than US MD Seniors across all competitiveness strata (p < 0.0001). Research item production, national licensing examination scores, and mean number of contiguous programs ranked were lower for matched US DO Seniors compared to matched US MD Seniors, with significant differences depending on competitiveness group.Conclusions: With recent changes to GME and its application process, understanding how various groups compare will be increasingly important. US DO Seniors have lower first-rank match rates for all specialty competitiveness levels. This may be due to lower research output or nuanced specialty selection. This study could aid GME stakeholders to more effectively allocate resources and better prepare residency candidates.

Nursing informatics competences of Finnish registered nurses after national educational initiatives: A cross-sectional study

BackgroundNursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates. ObjectivesTo examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined. DesignCross-sectional study. SettingsThe study was carried out between October–December 2018 in Finland. ParticipantsRegistered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives. MethodsNursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance. ResultsNurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence. ConclusionsThe national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs.

First-Year Graduate Clinicians' Perceptions of Synchronous Telepractice Delivery

Purpose Telepractice in speech-language pathology is a continually evolving part of clinical service delivery. Despite its popularity, little evidence exists on how to educate beginning-level student clinicians in telepractice provision. The purpose of this study is to assess the perceived comfort level of first-year graduate clinicians providing telepractice services during the COVID-19 pandemic. Identifying these perceptions and potential challenges allows faculty and clinic supervisors to improve their instruction for telepractice service delivery. Method Survey data were collected from graduate clinicians ( n = 23) during the onset of the COVID-19 pandemic regarding their perceptions of telepractice-based clinical service delivery. Results All student clinicians surveyed had accrued between 1 and 15 hr of telepractice hours during the Spring 2020 semester (February–May 2020). Student clinicians were largely comfortable finding evidence to support therapies, providing basic therapeutic services, and completing clinical documentation for telepractice sessions. They noted challenges in using cloud-based computing software and selecting appropriate therapeutic intervention approaches for telepractice services. Conclusion The findings from this study may provide insight into preservice training using telepractice and yield recommendations in integrating telepractice into early graduate training curricula.

Persistence of Gender Bias Over Four Decades of Surgical Training

Female surgeons face gender-specific obstacles during residency training, yet longitudinal data on gender bias experienced by female surgery residents are lacking. We aimed to investigate the evolution of gender bias, identify obstacles experienced by female general surgery residents, and discuss approaches to supporting female surgeons during residency training. Between August 2019 and January 2021, we conducted a retrospective cohort study using structured telephone interviews of female graduates of the UCLA General Surgery Residency training program. Responses of early graduates (1981-2009) were compared with those of recent graduates (2010-2020). Quantitative data were compared with Fisher's exact tests and Chi-squared tests. Interview responses were reviewed to catalog gender bias, obstacles experienced by female surgeons, and advice offered to training programs to address women's concerns. Of 61 female surgery residency graduates, 37 (61%) participated. Compared to early graduates (N = 20), recent graduates (N = 17) were significantly more likely to pursue fellowship training (100% vs. 65%, p < 0.01) and have children before or during residency (65% vs. 25%, p = 0.02). A substantial proportion in each cohort experienced some form of gender bias (71% vs. 85%, p = 0.43). Compared to early graduates, recent graduates were significantly less likely to report experiencing explicit gender bias (12% vs. 50%, p = 0.02) but equally likely to report implicit gender bias (71% vs. 55%, p = 0.50). Female graduates across the decades advocated for specific measures to champion work-life balance in residency (51%), strengthen female mentorship (49%), increase childcare support (41%), and promote women into leadership positions (32%). While having children during residency has become more common and accepted over the decades, female surgery residents continue to experience implicit gender bias in the workplace. Female surgeons advocate for targeted interventions to establish systems for parental leave, address gender bias, and strengthen female mentorship.