Faculty Supervision Research Articles

A Highly-Configurable Session Designer for VR Nursing Training

Virtual Reality (VR) has proven to be a valuable tool for medical and nursing education. VR simulators are available at any time and from anywhere, and can be used with or without faculty supervision, which results in a significant optimization of time, space, and resources. In this paper we present a highly-configurable session designer for VR-based nursing education following the Standards for QUality Improvement Reporting Excellence: SQUIRE 2.0 and SQUIRE-EDU. Unlike existing platforms, we focus on letting educators quickly customize the training sessions in multiple aspects. This is achieved through the use of a visual editor, where educators can choose the environment and the elements in the session, and a node-based visual system for programming the behavior of the sessions. Thanks to end-user customization, educators can develop different variants of a session, adapt the sessions to new nursing protocols, incorporate new equipment or instruments, or accommodate custom environments. We have implemented the designer and tested it on various nursing training scenarios. The designer can be integrated into VR simulators to help educators save time in delivering highly customizable training.

The Singular Therapeutic Project As A Learning And Comprehensive Care Tool: Experience Report On The Management Of Chronic Pain In An Elderly Patient

Background: Chronic pain is a complex condition that affects patients physically, emotionally, and socially. Addressing it effectively in primary care requires a holistic approach that integrates non-pharmacological and pharmacological strategies. The Singular Therapeutic Project (STP) enables personalized, patient-centered care through multidisciplinary collaboration. Aim: This experience report aims to describe the practical learning experience of medical students implementing a STP for a patient with chronic pain, highlighting the impact on care and medical education. Experience Report: During the second semester of 2024, medical students from Bragança, Pará, engaged in home visits through the STP framework under faculty supervision. These visits facilitated an expanded understanding of the patient’s clinical and psychosocial context using tools such as genograms, ecomaps, and functional assessments. Students applied interventions to manage chronic pain and address barriers to medication adherence. Additionally, collaboration with the healthcare team ensured adjustments to care based on the patient’s evolving needs, promoting reintegration into physical activities. Conclusion: The implementation of the STP fostered practical and humanized learning by emphasizing empathy, teamwork, and communication skills. This approach strengthened the students' understanding of primary healthcare, enabling the development of professional competencies essential for managing complex patient cases and contributing to the patient’s improved quality of life.

Entrenamiento de habilidades clínicas en Kinesiología: implementación de una estrategia mediada por tecnología en un contexto de retorno al aprendizaje presencial

IntroductionDuring the COVID-19 pandemic, remote teaching provided valuable insights into technology use, applicable on return to in-person education. Hybrid education emerges as a solution to limitations in faculty resources and practical experiences for acquiring clinical competencies in Health Sciences. This study describes a clinical skills training strategy using a feedback oriented platform, following the return to in-person education in Physiotherapy. MethodsThe methodology involves autonomous training sessions with asynchronous feedback, where students are assessed and provided feedback by an instructor through video demonstrations of skills. The extent of student training, performance, learning strategy appreciation, skill improvement and skill transfer to in-person exams were analyzed. ResultsIn total, forty-two undergraduate Physical Therapy clinical skills were trained. Results emphasize individualized feedback delivery to all students, significant performance improvement, and positive strategy appreciation. ConclusionsRemote training facilitated deliberate practice of clinical skills in students, offering opportunities for autonomous, peer-guided training prior to faculty supervision.

Is Close Supervision by a Senior Surgeon Necessary During the Initial Days of Performing Endoscopic Lumbar Discectomy? A Retrospective Comparative Study between Two Fellowship Trained Surgeons to Assess the Learning Curve.

Endoscopic lumbar discectomy is a minimally invasive technique with a steep learning curve. The studies in the literature base the learning curve on the operative duration. We conducted this study to determine the learning curve based on the presence or absence of supervision by an experienced surgeon. This study involved two spine surgeons (surgeon A and surgeon B), who after their fellowship training from the same institute started practising in two different hospitals with different settings. The data of the first 80 patients operated by these two surgeons were extracted, and the patients were followed up for a minimum of 1 year. The data were split into first 30 cases and late 50 cases, which were compared to see the difference between the two surgeons. The first 30 cases were evaluated between the two surgeons, and the most significant difference between the two was the operative duration. There was difference between the two surgeons in approach towards migrated and foraminal/extra foraminal discs (P = 0.02). The surgeon B started operating on upper lumbar levels in his later 50 cases, but the foraminal and extraforaminal disc herniations were rarely treated by surgeon B. Endoscopic discectomy when supervised by senior faculty helps to reduce the operative duration especially in the initial phases of a surgeon's career. The surgeon under the supervision of a senior faculty performs more of migrated and foraminal herniated discs.

Impacts of COVID‐19 on social work teaching and learning in Bangladesh

AbstractThe COVID‐19 pandemic had a significant impact on both classroom instruction and practical learning within Social Work Departments in Bangladesh. This research took two state universities in Bangladesh as case studies, using a qualitative methodology. Researchers conducted 10 Key Informant Interviews, with professors and field supervisors, 20 in‐depth interviews with Master of Social Sciences (MSS) students and two Focus Group Discussions with MSS students. During the pandemic, University faculty experimented with virtual classrooms, pre‐recorded lectures, and online chat forums to interact with postgraduate students. However, these approaches were not completely successful due to the limitations of digital infrastructure at the Universities and at students' residences. Shortcomings in virtual education included technological barriers, insufficient access to educational resources, and an unusual mental health situation for many students. Student practica were difficult to organize, due to technological barriers, restricted field placement opportunities, disruption in client interaction, and community outreach, interruptions in fieldwork and data collection, as well as insufficient faculty supervision and support. Universities ought to take proactive measures to integrate technology into teaching and learning in normal times so that both can continue during public health emergencies without adding educational crisis to the general state of emergency.

Teaching Strategies for Nonpharmacological Pain Management to Nursing Students

BackgroundPain management is an essential concept to be integrated throughout undergraduate nursing curricula. Many studies have identified a lack of knowledge in pain assessment and management among nurses. Educators have significant roles in preparing students with pain knowledge and application of alternative nonpharmacological pain management techniques. AimThe purpose of this research study was to explore the impact of instruction on nonpharmacological pain management techniques in both didactic and simulated laboratory settings on nursing students’ application of these techniques in clinical settings. DesignA mixed-method descriptive study, with a survey that included closed and open-ended questions. ParticipantsThe sample included 144 first-semester senior prelicensure baccalaureate nursing students. MethodInvestigators developed two research questionnaires. All students were given nonpharmacological pain management instruction didactically and practiced in the simulation lab and a hospital-based obstetrical practicum under faculty supervision. The students completed research questionnaires at the semester's conclusion and again prior to graduation. ResultsStudents reported that they implemented taught nonpharmacological pain management techniques in the clinical setting under faculty supervision. A review of the follow-up questionnaire indicates that graduating seniors did implement the nonpharmacological pain management techniques in other clinical settings and plan to utilize them in their future nursing practice. ConclusionsTeaching nonpharmacological pain management techniques didactically, in a simulation lab and a supervised clinical setting contributes to students’ ability to apply these techniques. The findings of this study have implications for nursing education and students’ future clinical practice to foster their utilization of nonpharmacological pain management techniques across all settings.

Coachability: A Longitudinal Curriculum to Promote Medical Students' Growth Mindset, Feedback Utilization, and Resilience.

The concept of medical student coachability, adapted from athletics and business management, offers a framework for characterizing students' roles as clinical learners. We defined coachability as effectively seeking, receiving, and using feedback-even negative feedback-to change behavior and reach learning goals. To facilitate success in our clinical clerkships, we sought to empower preclerkship students' capacity to be coached. Our curriculum comprised two large-group presentations and three small-group seminars totaling approximately 5 hours, distributed over 2 years: a year 1 orientation, a year 2 refresher, and a longitudinal year 2 seminar series. Medical students designed and first implemented the curriculum under faculty supervision in academic year (AY) 2015-2016 and have continuously managed and run it since. The AY 2022-2023 curriculum management team evaluated the curriculum cross-sectionally via student survey and focus groups. Approximately 575 students have completed the curriculum since 2015. Immediately following curriculum delivery, AY 2022-2023 year 2 students (response rate: 70%-97%) rated it a valuable educational experience and described plans to implement the lessons learned in their clerkship. Focus group participants (eight clerkship students who participated in the coachability curriculum in AY 2021-2022) reported using coachability strategies to positive effect for their clinical learning and well-being. Our curriculum's flexible, modular format facilitates adoption by others. Future development could expand coachability offerings across the continuum of medical school. However, the curriculum should remain led by students passionate about medical education and willing to try new things to continuously adapt content and instructional strategies.

Management of the Electronic Health Record Inbox: Results From a National Survey of Internal Medicine Program Directors.

Background Internal medicine (IM) resident physicians spend a considerable amount of time managing their inbox as part of their longitudinal continuity clinic experience. There are no standardized guidelines for how programs should train, monitor, or supervise residents in this type of patient care. Objective To understand how IM residency programs educate, monitor, and supervise resident electronic health record (EHR) inbox management as part of their longitudinal continuity clinic and determine whether patient safety events have occurred due to EHR inbox-related patient care decisions made by unsupervised resident physicians. Methods In August 2021, 439 program directors at accredited US IM residency programs who were members of the Association of Program Directors in Internal Medicine (APDIM) were asked 12 questions developed by the study authors and APDIM survey committee members regarding resident EHR inbox management as part of the annual APDIM survey. Results Two hundred and sixty-seven (61%) PDs responded. The majority (224 of 267, 84%) of programs provided guidelines for expected message response times; less than half (115, 43%) monitored timeliness metrics. Only half (135; 51%) of programs required faculty supervision of inbox messages for all residents; 28% (76) did not require supervision for any residents. Twenty-one percent of PDs (56) reported awareness of a patient safety event occurring due to an unsupervised resident inbox-related patient care decision. Conclusions Substantial variability exists in how IM residency programs train, monitor, supervise, and provide coverage for resident inbox work. Program directors are aware of patient safety events resulting from unsupervised resident inbox management.

754. Utilization of Internal Special Program Review to Institute Change in an Academic ID Fellowship

Abstract Background Fellowship accreditation is crucial to ensure adequate clinical education for physicians in training, yet there is limited data on use of accreditation survey results for program quality improvement. The Accreditation Council for Graduate Medical Education (ACGME) administers annual surveys to trainees and core faculty to monitor education and identify potential non-compliance with ACGME accreditation standards. Our purpose is to describe the creation of an internal program review process for program improvement based on results of nationally implemented accreditation surveys. Methods We collected data from standardized ACGME survey responses administered to core faculty and fellows at our academic Infectious Diseases fellowship program. The identification of areas scoring lower than 20% in comparison with national average prompted creation of a Special Program Review (SPR) committee comprised of a program director, a program coordinator, and a trainee from programs outside of the program under review. This committee met separately with core faculty, trainees, and program leadership to compile an assessment of each survey component and opportunities for improvement. This review process of survey results was completed annually from 2020-2022. Results Between 2020-2022, surveys were completed by 100% of fellows (7/7 or 8/8) and up to 92% of core faculty (11/12). Key findings raised concerns involving clinical education, faculty supervision, patient safety, and teamwork. Actions taken in response to the SPR included the creation of: an updated backup and weekend coverage system, new didactic curricula, a morbidity and mortality conference, documentation limits, informal fellow/faculty dinners, opt out counseling, and a division culture committee. Conclusion A non-punitive internal review process mimicking accreditation standards is valuable for program assessment and improvement as means to identify areas of risk for accreditation issues at a national level. This review process is generalizable, as all accredited programs complete the survey annually. The quality improvement interventions taken will differ depending on survey findings and areas to be addressed. Disclosures All Authors: No reported disclosures

A Case Study of Curriculum Co-creation During a Seminar-Style Course for Senior Medical Students.

Opportunities to learn about education theory underpinning medical education are limited in both undergraduate and graduate medical education and predominantly focus on "student as teacher." Key components of education theory relevant to medical education, including learning theory, curricular design, and assessment design, are rarely included in student-as-teacher training. Opportunities for medical students to co-create curricula with faculty are scarce. We present the case study of a month-long, seminar-style course titled, Applications and Foundations of Education in Medical Education. We describe the course, report student feedback, and identify the value of curriculum co-creation expressed in student reflections. The course was designed by a faculty member with formal medical education training; students co-created their own learning outcomes through self-selected articles and personal reflections on the topics: How do people learn; what is the best way to teach; what is a curriculum; and how should students be assessed? Forty-seven post-clinical students completed the course; 28 completed course evaluations. They strongly agreed that the class met its stated goals (4.89/5) and that faculty teaching (4.93/5) and supervision (4.93/5) were appropriate. Themes from student reflections expressed that the co-creation process was insightful about the profession itself, from the perspective of their own participation in learning how to become a member of the profession. This course offered a unique opportunity for medical students to learn medical education beyond the skill of teaching. The course allowed deep immersion into current literature and offered the chance to plan and execute one's own learning.

RaT race: A standardized open-access education resource provides a structured resident-as-teacher experience.

There is no unified approach for training residents to be teachers. Foundations of Emergency Medicine (FoEM) is a national program that provides free resident education in emergency medicine (EM) utilizing small-group, case-based instruction delivered by individual program faculty and residents. This study seeks to explore the FoEM resident-as-teacher (RaT) experience. We conducted a mixed-methods study of FoEM faculty site leaders and resident teachers in 2022. Site leaders completed an online survey consisting of multiple-choice, completion, and free-response items. We calculated descriptive statistics and applied a thematic qualitative analysis to free-response items. We conducted semistructured interviews with resident teachers. Interview transcripts were analyzed using a thematic approach with a constructivist-interpretivist paradigm. A total of 133 of 180 (74%) site leaders completed the survey and 11 resident teachers were interviewed. Forty-nine (37%) programs utilize resident instructors. The frequency of residents teaching and degree of faculty supervision varied. Commonly identified advantages include reinforcement of core content for resident teachers (44/49), structured format (35/49), and reduced need for faculty instructors (30/49). The most commonly identified challenges include variable instruction by residents (33/49) and challenge to providing feedback on teaching (20/49). Resident teachers identified benefits including strengthening residency community, improved EM knowledge, and greater teaching skills. For nearly all resident participants, FoEM RaT impacted their career goals by affirming their interest in teaching. The FoEM curricular model appears to be a valuable and feasible method to incorporate a RaT experience into EM residency training programs.

Dropout Prediction Model for College Students in MOOCs Based on Weighted Multi-feature and SVM

Due to the COVID -19 pandemic, MOOCs have become a popular form of learning for college students. However, unlike traditional face-to-face courses, MOOCs offer little faculty supervision, which may result in students being insufficiently motivated to continue learning, ultimately leading to a high dropout rate. Consequently, the problem of high dropout rates in MOOCs requires urgent attention in MOOC research. Predicting dropout rates is the first step to address this problem, and MOOCs have a large amount of behavioral data that can be used for such predictions. Most existing models for predicting MOOC dropout based on behavioral data assign equal weights to each behavioral characteristic, despite the fact that each behavioral characteristic has a different effect on predicting dropout. To address this problem, this paper proposes a dropout prediction model based on the fusion of behavioral data and Support Vector Machine (SVM). This innovative model assigns different weights to different behavior features based on Pearson principle and integrates them as data inputs to the model. Dropout prediction is essentially a binary problem, Support Vector Machine Classifier is then trained using the training dataset 1 and dataset 2. Experimental results on both datasets show that this predictive model outperforms previous models that assign the same weights to the behavior features.

A model for competency-based training of undergraduate medical students to perform screening and brief intervention in alcohol use disorder—Findings from a study in a medical college in Delhi

Background: Alcohol use disorder (AUD) is a major cause of prolonged disability and an economic burden on communities across the world. The undergraduate (UG) curriculum in medical school in India does not allow adequate time to a structured learning about alcohol use disorder, its treatment, and prevention. The screening and brief intervention module (SBI) developed by the World Health Organisation (WHO) is an effective way to reduce drinking among risky drinkers. Training of undergraduates in SBI may go a long way in early intervention among problem drinkers. Hence, there is a felt need to incorporated the module in the clinical training schedule to enhance SBI skills among UGs to provide appropriate intervention at the primary healthcare level. Methodology: 50 final year UG students of a medical college in Delhi were exposed to a competency-based training in alcohol SBI comprised of lectures, focused group discussions (FGD), and role-play during their 2-week clinical posting in psychiatry along with a hands-on training under supervision of faculty. Subsequently, they were assessed for knowledge and skills gained through objective-structured clinical examination (OSCE) and feedback taken from students about changes in their knowledge and attitudes towards alcohol use disorder SBI. Results: Pre- and post-self-reported outcome variables revealed significant positive impact (p < 0.001) of SBI module on competency of students in implementing SBI on patients. Assessment of knowledge on OSCE revealed mean scores of 9.48 ± 1.20 on 10 MCQs (of 01 mark each) with 47 students scoring 80% or above. On integrated OSCE assessment of competencies, 94% students made satisfactory demonstration at a desired level. Attendance in lectures and supervised SBI, attitudes pre- and post-intervention and confidence level post-intervention were found to be predictors of a high MCQ score. All faculty agreed about the feasibility of implementing competency-based SBI in existing clinical posting schedule. Conclusion: The study has demonstrated the feasibility of teaching competency-based alcohol SBI to undergraduate medical students in existing clinical posting curriculum in psychiatry and its efficacy in having a positive impact on the perception and approach of the students towards patients with alcohol use disorder.

Program Website Evaluation Regarding Dedicated Research Years Offered in General Surgery Residency Programs in the United States

IntroductionResearch is a vital component in the advancements of surgical sciences due to the reliance of treatment options on innovations and outcomes of patient care. This study aimed to identify research pathways, opportunities, and academic productivities of different general surgery residency programs in the United States. Materials and MethodsA web-based review was conducted concerning accredited US general surgery residency programs. Each program's official website was assessed for the availability of research year, compulsory status, duration, type, structure, and location. The study also identified faculty supervision, research day, funding, output, and opportunities to obtain an advanced degree. ResultsData were collected from all 313 general surgery programs in the United States, out of which 127 (41%) offered a dedicated research year to their residents. The research year was deemed mandatory in 27 programs (8%) and optional in 100 programs (32%). Seventy-two programs (23%) offered to start the dedicated research year after postgraduate year 2 or postgraduate year 3. Twenty-two programs (7.02%) provided examples of resident publications and presentations. Resident research day was cited by 42 programs (13.41%). On campus research opportunity was mentioned by nine programs (2.8%), while the off campus chance was provided by 10 programs (3.19%). Furthermore, 36 programs (11.5%) demonstrated potential funding sources. Finally, 38 (12.14%) programs mentioned receiving advanced degrees after the research year. ConclusionsAlthough dedicated research time is provided to trainees for some research programs, there is a lack of structure and the need to expand the available content and information regarding research opportunities for the various general surgery residency programs.

Nursing Shortage in Pakistan

The health workforce including Medical, Nursing and Allied Health Professionals is the foundation of any health care system. Investment in the health sector reduces disease burden, improves productivity and ultimately contributes positively in economic growth of the country. Pakistan is generally confronted with dire shortage of qualified health professionals especially the nursing staff that is the backbone of every healthcare systems across the world. Nurses have incredible contribution in assisting the doctors in every aspect of patient care, thus ensuring that individuals receive the best possible care at all stages [1]. The nursing profession continues to face shortages due to a lack of potential educators, high turnover, and inequitable workforce distribution. The nursing staff employed in the hospitals is primarily responsible to provide all kind of nursing care to the admitted patients i.e., monitoring of vital signs, fluid management, and administration of medication in line with the orders of the attending physicians. Nurses are also responsible to monitor the nutrition intake, look after personal hygiene of patients and care of bowels, prevention of bedsores etc., maintain medical record and ensure the ambiance conducive to recovery. Their role therefore, requires essential nursing skills, apart from commitment and vigor. There are however, issues of quality in nursing education, particularly regarding development of proficiency in basic nursing & midwifery skills [2]. Nursing Institutions lack in quality output, due to deficiencies in nursing faculty, infrastructure and professional supervision. It is expedient to remain abreast with contemporary advancements in nursing education and practices to produce competent and skillful nursing workforce for better clinical outcomes. According to the Pakistan Economic Survey 2020-2021, Pakistan had a total of 116,659 registered nurses in 2020 for a population of about 200 million people. In the general wards of Pakistani hospitals, the current nurse-patient ratio is 1: 40, while the Pakistan Nursing Council recommends a nurse-patient ratio of 3:10 [3]. The deficiency in the actual number of nurses rendering services is further aggravated by positions remaining vacant due to shortage of skilled nurses, thus compromising quality of nursing care. This shortage in nursing strength is also worsened by an urge to move overseas particularly the Gulf countries, as large number of nurses opt for employment abroad for better financial incentives [4]. The situation is even worst in the private sector particularly, in the smaller hospitals that end up with hiring semi- qualified and poorly trained or self-trained staff on meager salary and poor employment terms on the pre-text of shortage of qualified nurses. Larger private setups often resort to make shift arrangements by engaging nurses employed in the public hospital for second shift. Such nurses are therefore, required to work for up to 16 hours a day, thus, further compromising quality of care. It is highly recommended to increase the number of nursing training opportunities and slots to overcome this serious shortfall and to ensure availability of sufficient number of nurses in the public as well as private sector to comply with the recommended Nurse: Bed ratio and to fill vacancies as per the sanctioned strength in public hospitals on priority basis. Also to improve the training facilities at Nursing Colleges in terms of qualified faculty and proper infrastructure to improve quality of training of the nursing cadre. Introduction of Continuous Professional Development (CPD) Programs for nurses with mandatory completion of credit hours on regular basis for continually building the skills and improving the quality of nursing and midwifery services can also prove to be a great initiative [5]. Enrolling more male nurses can help provide nursing care at hospitals located in the relatively hard to reach areas.

Teaching how to navigate difficult conversations: A combined palliative care–oncology didactic simulation intervention for hematology/oncology fellows.

11028 Background: ASCO strongly endorses the integration of palliative care to improve patient outcomes and support patients in their cancer trajectories. Developing core palliative care skills for trainees is therefore essential, with few ACGME approved pilot programs offering combined fellowship training. Our institution’s Heme/Onc fellows reported a need for additional education in leading difficult conversations. Methods: We piloted a didactic simulation (sim) session for each fellowship class, led by a faculty member who is dual board-certified in Medical Oncology and Hospice/Palliative Medicine. Trainees received a lecture on validated communication tools and oncology-specific language to help navigate difficult conversations. Trainees then role-played in small groups using sample cases, with Heme/Onc faculty supervision and real-time feedback, followed by class reflection. Pre- and post-sim surveys were electronically administered to assess knowledge of communication tools and comfort in discussing difficult topics. Comfort questions were scored on a 5-point Likert Scale, using student t-tests to detect differences pre- and post-sim, and ANOVA to compare responses among classes. Results: A total of 16/21 (76.2%) fellows completed both pre- and post-sim surveys. Knowledge of communication tools increased from 21.9% pre-sim to 79.7% post-sim. Comfort significantly increased for explaining palliative-intent chemotherapy, hospice, and discussing an uncertain prognosis (Table). There was a significant difference among classes pre-sim for addressing negative emotions (mean comfort level: 1st years 2.8, 2nd years 3.4, 3rd years 3.83; p=0.046) and for discussing an uncertain prognosis (mean comfort level: 1st years 2.6, 2nd years 3.6, 3rd years 3.83; p=0.043); however, these interclass discrepancies were eliminated post-sim. Overall, fellows reported that the sim sessions were effective for developing their knowledge and comfort in having difficult conversations. Conclusions: A novel sim intervention led by a physician who is dual board-certified in palliative care and medical oncology improves trainee competency with navigating difficult conversations. Analysis of the intervention’s durability of response and iterative refinement of its curriculum are ongoing. [Table: see text]

Evaluating the Experience of a Postgraduate and Faculty Study Tour Program in the Field of Mental Health: A Mixed-methods Study.

Study tours are known to have an important role in enriching the knowledge of students in all fields. Our study aimed to evaluate the experience of a postgraduate and faculty study tour in the field of mental health. We obtained both quantitative and descriptive feedback from 31 participants who had taken part in the annual study tour conducted in the years 2014-2018 using a specially designed feedback pro forma. All the participants reported overall satisfaction with the tour. Learning was enhanced, and most found the tour relevant to their current field of study. They particularly enjoyed the experience of traveling in a peer group without faculty supervision and learning to make decisions as a group. Their chief concerns were about the continuous travel and the limited time allotted to each center. A well-planned study tour during training helps trainees in the mental health field improve their knowledge, hone practical skills, and learn life lessons; it promotes bonding with peers and fosters self-directed learning and independence. The limitations were the inability to have direct face-to-face interviews with most participants and the study tour centers being limited to a small geographical area.

Integrated Care Education for General Psychiatry Residents in the US: a Review of the Literature.

The purpose of this review was to synthesize published literature describing integrated care education available to general psychiatry residents in the United States (US) in order to better understand curricular models and summarize curriculum barriers and facilitators. The authors searched electronic databases for articles describing integrated care education for general psychiatry residents. Minimum inclusion criteria were focus on an ambulatory integrated care curriculum, description of the study population and training program, publication in English, and program location in the US. Data extracted included trainee, faculty, or collaborator evaluations, educational model, level of care integration, and barriers or facilitators to implementation. The literature search identified 18 articles describing curricula at 26 residency programs for inclusion. Most programs offered clinical and didactic curricula to advanced trainees across a variety of care integration levels. Common barriers included fiscal vulnerability and difficulties identifying team members or clarifying team member roles. Common facilitators included institutional and interdepartmental support, dedicated space, and faculty supervision. No statistical analysis was able to be performed due to study heterogeneity. This review found a relatively small number of articles written about integrated care education for psychiatry residents. Resident evaluation suggests this training is valuable regardless of curriculum structure, training years, or level of care integration. Dedicated funding, staff, and space were crucial for successful curricula. This review highlights a need for more rigorous research characterizing and evaluating integrated care education.

Preface

The University Scholar Conference: Engineering and Innovation (USC) is a conference organized by the Association of Mechanical Engineering (AMES) at Kathmandu University (KU). The first edition, USC 21, was successfully completed in virtual mode, and the second edition, USC 22, was held on May 17-18, 2022, in a hybrid mode. USC 22 was hosted by Kathmandu University, co-hosted by the Himalayan University Consortium (HUC-ICIMOD), and supported by the Department of Mechanical Engineering - KU, the University Grant Commission (UGC), the Nepal Technology Innovation Center (NTIC), and the Green Hydrogen Lab (GHL). The inauguration ceremony of the two-day conference event was held at ICIMOD head office with a keynote session delivered by Dr. David Molden, Director General of ICIMOD, and the closing ceremony was organized at Kathmandu University.The University Scholar Conference 2022 provided an excellent platform for graduate and undergraduate students to share their cutting-edge developments and state-of-the-art research work in the fields of science and engineering. One interesting fact about this conference is that it was completely organized by a student club under the supervision of faculty. Thus, the USC conference is a student-level conference organized by university students for university students. The conference was attended by a mix of academia, researchers, industrialists, professors, students, and policymakers. The conference committee highly encouraged the participation of graduate and undergraduate students engaged in engineering and science education within Nepal and abroad.With the tagline “Women Empowerment in Engineering,” four thematic areas were defined for USC 22: i) Automotive Systems, ii) Materials and Design for Transformation, iii) Digitalization and Emerging Technologies, and iv) Advances in Energy Systems. A total of 103 abstracts were received at the initial phase, out of which 48 papers were selected for presentation in the conference. Participants from 10 different universities from 5 different countries presented their research works in 12 plenary sessions during the two conference days. In addition to the parallel plenary sessions, a poster presentation was also conducted for funded projects. Based on the quality of the presented work, four best paper awards were declared for each thematic area, and a gift hamper was presented to the winners. The 48 papers presented at the conference were considered for further publication in the IOP Conference Series: Materials Science and Engineering. After a detailed peer-review process, a total of 10 papers were selected for final publication in this volume.List of Conference Chair, Organizing Committee, Advisory Committee, Scientific Committee, Conference Session Chairs, Conference Publication Editors, Supporting Partners are available in this Pdf.

Separate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics.

At some US Academic Health Centers (AHCs), patients with predominantly Medicaid insurance are seen in one clinic and patients with other insurance are seen in another. The extent of this practice and implications are unknown. To estimate the proportion of AHCs that have at least two primary care internal medicine clinics that differ substantially in proportion of patients with Medicaid and to compare patient demographic, staffing, and operational features. General internal medicine chiefs and clinic directors at 40 randomly selected US AHCs plus the top 10 AHCs in terms of NIH funding. An AHC was classified as maintaining clinics that differed substantially in the proportion of patients with Medicaid if any two differed by ≥ 40% (absolute). Other criteria were used for pre-specified secondary analyses (e.g., ≥ 30%). Thirty-nine of 50 AHCs (78%) participated. Four of 39 (10%; 95% CI, 3 to 24%) had two clinics differing by ≥ 40% in the proportion of patients with Medicaid, eight (21%; 95% CI, 9 to 36%) had clinics differing by ≥ 30%, and 15 (38%; 95% CI, 23 to 55%) had clinics differing by ≥ 20%. Clinics with more patients with Medicaid by any of the three criteria were more likely to employ resident physicians as providers of longitudinal care (with faculty supervision) and more likely to have patients who were Black or Hispanic. Some US AHCs maintain separate clinics defined by the proportion of patients with Medicaid. Clinics with a higher proportion of patients insured by Medicaid are more likely to employ residents (with faculty oversight), feature residents as providers of longitudinal care, and serve patients who are Black and Hispanic. Further research is needed to understand why some AHCs have primary care clinics distinguishable by insurance mix with the goal of ensuring that racism and discrimination are not root causes.