Final Year Of Training Research Articles

Emergency Medicine Milestones Final Ratings Are Often Subpar.

The emergency medicine (EM) milestones are objective behaviors that are categorized into thematic domains called "subcompetencies" (eg, emergency stabilization). The scale for rating milestones is predicated on the assumption that a rating (level) of 1.0 corresponds to an incoming EM-1 resident and a rating of 4.0 is the "target rating" (albeit not an expectation) for a graduating resident. Our aim in this study was to determine the frequency with which graduating residents received the target milestone ratings. This retrospective, cross-sectional study was a secondary analysis of a dataset used in a prior study but was not reported previously. We analyzed milestone subcompetency ratings from April 25-June 24, 2022 for categorical EM residents in their final year of training. Ratings were dichotomized as meeting the expected level at the time of program completion (ratings of ≥3.5) and not meeting the expected level at the time of program completion (ratings of ≤3.0). We calculated the number of residents who did not achieve target ratings for each of the subcompetencies. In Spring 2022, of the 2,637 residents in the spring of their last year of training, 1,613 (61.2%) achieved a rating of ≥3.5 on every subcompetency and 1,024 (38.8%) failed to achieve that rating on at least one subcompetency. There were 250 residents (9.5%) who failed to achieve half of their expected subcompetency ratings and 105 (4.0%) who failed to achieve the expected rating (ie, rating was ≤3.0) on every subcompetency. When using an EM milestone rating threshold of 3.5, only 61.2% of physicians achieved the target ratings for program graduation; 4.0% of physicians failed to achieve target ratings for any milestone subcompetency; and 9.5% of physicians failed to achieve the target ratings for graduating residents in half of the subcompetencies.

Preparing for the Transition to Academic Practice: A Graduate Medical Education Elective.

Background Residents and fellows as educators (RFAE) programs typically focus on clinical teaching skills in single departments, which may not be sustainable for those with limited trainees or faculty. Objective To determine the feasibility and value of a 2-week interdepartmental RFAE elective for advanced teaching skill development and transition to practice as clinician educators. Methods Facilitated discussion, simulation, and critiqued peer presentations developed participants' skills in teaching, curriculum design, professional development, and scholarship. Assessments in this prospective intervention included 2 self-reported surveys addressing: (1) teaching process and motivation (Conceptions of Learning and Teaching [COLT]), and (2) skills and attitudes. We administered both surveys at baseline, immediate-post, and 3-month-post elective with data compared across time points using Kruskal-Wallis tests. Program evaluation comprised daily open-ended surveys on engagement and an end-of-course feedback survey. Results There were 79 participants from 2019 to 2023. Survey response rates were 84.8% (67 of 79) at baseline, 58.2% (46 of 79) immediate-post, and 51.9% (41 of 79) 3-month-post. Most participants were residents (89.9%, 71 of 79), female (60.8%, 48 of 79), from pediatrics and/or medicine departments (77.2%, 61 of 79), and in their final year of training (77.2%, 61 of 79). COLT factor orientation to professional practice scores increased in the immediate-post (3.3) compared to baseline (2.5) surveys (P=.008). Teaching skills attitudes scores increased for all questions in 3-month-post compared to baseline surveys. In open-ended questions, participants emphasized the importance of professional development sessions in guiding their careers toward medical education. Conclusions This interdepartmental elective was feasible, favorably received, and sustained over time, with observed changes in participants' teaching skills attitudes.

The clinical pharmacology and therapeutics course for graduating medical students at Dartmouth: Preparation for internship and residency.

This manuscript is a description of the clinical pharmacology and therapeutics (CPT) course that is required to be taken, and passed, by all medical students at the Geisel School of Medicine at Dartmouth during their final year of training, prior to entering their internship/residency. We present a detailed CPT course curriculum, which includes the novel use of simulated expected professional activities (EPAs) and an analysis of the level of confidence the students who took the course had at the beginning and at the end of the course in performing the three simulated EPAs. The course currently consists of 31 h of presentations on what are considered major clinical pharmacology topics and is led by two clinical pharmacologists at Dartmouth (D.W.N. and L.D.L.) supplementedby therapeutic area specialist faculty. In addition, the Dartmouth CPT course incorporates three required simulated entrustable professional activities (EPAs) focused on drug prescribing. These are written exercises, completed outside scheduled class hours, and submitted to and evaluated by the course directors with individual feedback to each medical student. We present preliminary data on the benefits of using these simulated EPAs in undertaking what we consider are three pivotal prescribing skills. The Dartmouth CPT course is unique and is only mirrored by a small number of US medical schools. The students showed a significant improvement in their level of confidence in performing the three simulated EPAs at the end of the course.

The Effectiveness of Occupational Health and Safety Practices in Public Technical Training Institutes

The study aimed to evaluate the extent of occupation-related injuries and accidents, the use of Personal Protective Equipment (PPE), Occupational Health and Safety (OHS) training, and awareness and implementation of OHS policy among Technical Training Institutes (TTIs). The study used qualitative and quantitative methods to analyze data from 99 final-year trainees, including 47 auto mechanics, 24 electricians, 16 welders, and six OHS focal persons. Data was collected through self-administered questionnaires and in-depth interviews and analyzed using SPSS-16 and MAXQDA-2020. The study revealed a commendably low rate of hazards in training institutes (TTIs), with a mere 10.26% and a mean score of 2.1. This positive outcome, a testament to the high awareness of OHS and PPEs, should give reassurance about the current state of OHS practices in TTIs. The training system was a resounding success, with a mean rating of 4.09 for trainees' understanding and use of PPEs. However, the study also identified areas for improvement, particularly the urgent need for improved monitoring and management support. This need for immediate action is crucial for sustaining and enhancing these standards, and it should make the audience feel the urgency of the situation. [Abstract continued in PDF]

Design and Validation of a Novel 3D-Printed Retrograde Intrarenal Surgery Trainer

ObjectivesTo report on the design of a novel 3D-printed retrograde intrarenal surgery (RIRS) benchtop trainer and detail its validation against real-life experiences. MethodsDigital Imaging and Communications in Medicine (DICOM) files of two patients with normal computed tomography of the kidney and bladder were converted into stereolithography files to create 3D triangular mesh models. These images were further refined using Autodesk Meshmixer. These 3D models were fabricated through additive manufacturing, a process commonly known as 3D printing and assembled in a polypropylene case. After development, the model was validated by 40 experienced urologists and urology residents in their final year of training. They were asked to rate the components of the simulation using a nine-point questionnaire. ResultsThe model’s value in understanding the principles of RIRS and simulating contextual anatomy had mean scores of 9.43 (standard deviation [SD] = 0.74) and 9.21 (SD = 1.03), respectively. Mean scores for specific steps in RIRS were 8.07 (SD 1.47) for cannulating the ureteric orifice, 8.61 (SD 1.24) for inserting the ureteric access sheath, 9.29 (SD 0.97) for performing a renoscopy and evaluating all the calyces, 9.46 (SD 0.87) for laser lithotripsy, and 9.17 (SD 0.94) for manual stone retrieval. Participants scored the model with a mean score of 9.04 (SD 0.87) regarding realism and a mean score of 9.18 (SD 0.89) when evaluating its ability to enhance a trainee’s confidence in RIRS. ConclusionsThe model performed well for all components of RIRS. This model allows high fidelity of the simulation, and is cost-effective, portable, durable, reusable, and compatible with standard ureteroscopes.

Exploring the interplay between vocational competence and dropout intention: insights and perspectives

High drop-out rates from Vocational Education and Training (VET) remain a severe problem in VET systems globally. Despite decades of drop-out research revealing numerous influencing factors, the role of trainees’ vocational competence in their drop-out behavior has been neglected. This study aims to define the structure of vocational competence and analyze its effects on drop-out intention. Using longitudinal data from 458 commercial trainees in Germany, vocational competence is measured at three time points using a validated competence test, subdivided into domain-linked and domain-specific dimensions (Gelman and Greeno, 1989). Four different directions of drop-out intentions are considered, enabling a detailed effect inspection of the prevailing research gap. Additionally, factors identified in previous studies, such as educational level, age, language, and the degree of having chosen one’s desired occupation, are controlled for. We conducted 12 rounds of ordinal logistic regression to test three lagged temporal combinations of the effect relationship between vocational competence and dropout intention over different time spans (T0- > T1, T1- > T2, T0- > T2). We find that lower domain-specific competence increases the intention to drop out from VET without qualification over different time spans. Initial lower domain-specific competence also affects trainees’ intention to change their occupation in the final year of training. Furthermore, higher levels of domain-linked competence at the beginning increase the intention to leave VET to pursue higher qualifications in the midterm of training.

When to take the primary certification examination: sooner or later?

Most Pathology residents take the Anatomic Pathology and/or Clinical Pathology primary pathology certification examination(s) near the end of their final year of training (i.e., Spring), whereas some postpone the examination(s) to the Fall administration of that year or even later. We compared the Spring and Fall administration pass rates of initial primary certification candidates for those who graduated in the same year they took the examination. We also compared the pass rates of same-year graduates with individuals who postponed the examination for a year or more. We also surveyed the candidates regarding the reasons they chose the Spring or Fall administration. Candidates who chose the earlier (i.e., Spring) administration were more likely to pass compared with those who took the later Fall administration (p = 0.0026 for Anatomic Pathology; p = 0.0004 for Clinical Pathology). Delaying the certifying exams beyond the calendar year of residency graduation was associated with a higher failure rate (p < 0.0001 for both Anatomic and Clinical Pathology). The survey results suggest that residents often take their certification examinations earlier to not interfere with fellowship training, because it coincides with the completion of residency training, or it is expected by their program. Pathology residents are more likely to pass the primary certification examinations when they are taken closer to the end of training, rather than postponing it to a later administration. Pathology residency program directors should encourage residents, who are deemed ready, to take their certification examinations at the earliest possible administration.

Quantification of Radiation Exposure in Canadian Orthopaedic Surgery Residents.

Natural radiation exposure in the general population averages 3 milliSieverts (mSv) annually; however, radiation exposure in orthopaedic residents is not well defined. Despite protective measures, evidence of radiation-related diseases in orthopaedic surgeons is increasing. The purpose of this study was to quantify radiation exposure in orthopaedic residents and to determine the variability of exposure among post graduate year (PGY) of residency. Monthly radiation exposure was measured prospectively over a 12-month period in orthopaedic surgery residents from a single program. Participants wore dosimeters above ("exposed") and beneath ("shielded") protective lead. The primary outcome measure was the absolute value of radiation exposure in mSv. Repeated measures analysis was used to assess exposure with age, sex, year of training, operating room (OR) days, and height. Mean annual occupational radiation exposure was 3.30 ± 0.64 mSv over an average of 107 ± 38 OR days. Mean exposure per OR day was 0.033 ± 0.008 mSv. PGY-2 and PGY-3 residents had the highest cumulative exposure, and PGY-5 residents had the highest mean exposure per OR day (0.044 ± 0.009 mSv/d). Number of OR days per month and PGY level were significant predictors of radiation exposure (p < 0.05). Sex, age, and height were not significant in predicting radiation of the exposed dosimeter. Orthopaedic residents' exposure to radiation is nearly twice the general population's exposure. Given that yearly radiation exposure was highest during early residency years, but exposure based on number of OR days was highest in the final year of training, it is essential for resident education regarding radiation safety and safe clinical practices throughout their training.

Transitioning From Trainee to Practicing Pathologist: A Prospective Multi-institutional Survey of the Challenges Early Career Anatomic Pathologists Encounter When Entering Independent Practice.

Pathology training programs generally prepare graduates well for the workforce, but there may be other aspects to navigating a job that make the transition from being a trainee to a practicing pathologist challenging. To identify perceived challenges of independent practice for early career pathologists and assess how these impressions evolve throughout their first year. A survey was distributed to 12 anatomic pathology fellows from 4 institutions near the end of their final training year, and 6 months and 1 year after starting their first job. The surveys queried participants' comfort level with signing out cases independently and interacting with colleagues/trainees via Likert attitude scale questions with free-text segments to elaborate on challenges experienced. The response rate to all 3 surveys was 100%. Confidence and comfort level with different aspects of independent sign-out increased incrementally over time. Main challenges encountered at 6 months included a high case load, signing out cases in areas outside of their subspecialty, time management, balancing teaching while signing out, laboratory issues, and developing relationships with clinicians. At 12 months, main challenges included time management, high case load, understaffing, laboratory issues, and signing out cases in areas outside of their subspecialty. This study identified real-time challenges faced by those adjusting to their first year of independent practice. By gaining a better understanding of the factors that make this transition challenging, we can find tailored ways to support our early career pathologists.

Variation in Competence of Graduating General Surgery Trainees

To examine the readiness of general surgery residents in their final year of training to perform 5 common surgical procedures based on their documented performance during training. Intraoperative performance ratings were analyzed using a Bayesian mixed effects approach, adjusting for rater, trainee, procedure, case complexity, and postgraduate year (PGY) as random effects as well as month in academic year and cumulative, procedure-specific performance per trainee as fixed effects. This model was then used to estimate each PGY 5 trainee's final probability of being able to independently perform each procedure. The actual, documented competency rates for individual trainees were then identified across each of the 5 most common general surgery procedures: appendectomy, cholecystectomy, ventral hernia repair, groin hernia repair, and partial colectomy. This study was conducted using data from members of the SIMPL collaborative. A total of 17,248 evaluations of 927 PGY5 general surgery residents were analyzed from 2015 to 2021. The percentage of residents who requested a SIMPL rating during their PGY5 year and achieved a ≥90% probability of being rated as independent, or "Practice-Ready," was 97.4% for appendectomy, 82.4% for cholecystectomy, 43.5% for ventral hernia repair, 24% for groin hernia repair, and 5.3% for partial colectomy. There is substantial variation in the demonstrated competency of general surgery residents to perform several common surgical procedures at the end of their training. This variation in readiness calls for careful study of how surgical residents can become more adequately prepared to enter independent practice.

Factors associated with the attraction and retention of family and community medicine and nursing residents in rural settings: a qualitative study

BackgroundThe current shortage of primary care doctors and nurses is causing difficulties in replacement, and this shortage is expected to increase. This situation is more pronounced in rural environments than in urban ones. Family and community care specialty training is a key component of both the transition to clinical practice and the retention of new professionals. The aim of this study is to explore the attitudes and perceptions of internal medicine residents and internal nurse residents trained in a rural teaching unit on factors associated with recruitment and retention, including the role of the specialty training programme.MethodsA qualitative study was conducted. Purposive sampling was used, and thirteen residents from the central Catalonia teaching unit who were in their final year of training participated in semistructured interviews. The data were collected during 2022 and were subsequently analysed with thematic analysis. The study is reported using the COREQ checklist.ResultsSix themes emerged from data related to perceptions and attitudes about the factors associated with recruitment and retention: training programme, characteristics of the family and community specialty, concept of rural life, family and relational factors, economic and resource factors, and recruitment and job opportunities.ConclusionsFamily and community medicine and nursing residents trained in rural settings expressed satisfaction with the specialty programme and most features of primary care, but they experienced a wide range of uncertainties in deciding on their professional future in terms of living in rural areas, family support, financial support and recruitment. This study identifies individual and structural factors that could be of great use to retain doctors and nurses in rural areas.

The Association of ACGME Milestones With Performance on American Board of Surgery Assessments: A National Investigation of Surgical Trainees.

To determine the relationship between, and predictive utility of, milestone ratings and subsequent American Board of Surgery (ABS) vascular surgery in-training examination (VSITE), vascular qualifying examination (VQE), and vascular certifying examination (VCE) performance in a national cohort of vascular surgery trainees. Specialty board certification is an important indicator of physician competence. However, predicting future board certification examination performance during training continues to be challenging. This is a national longitudinal cohort study examining relational and predictive associations between Accreditation Council for Graduate Medical Education (ACGME) Milestone ratings and performance on VSITE, VQE, and VCE for all vascular surgery trainees from 2015 to 2021. Predictive associations between milestone ratings and VSITE were conducted using cross-classified random-effects regression. Cross-classified random-effects logistic regression was used to identify predictive associations between milestone ratings and VQE and VCE. Milestone ratings were obtained for all residents and fellows(n=1,118) from 164 programs during the study period (from July 2015 to June 2021), including 145,959 total trainee assessments. Medical knowledge (MK) and patient care (PC) milestone ratings were strongly predictive of VSITE performance across all postgraduate years (PGYs) of training, with MK ratings demonstrating a slightly stronger predictive association overall (MK coefficient 17.26 to 35.76, β = 0.15 to 0.23). All core competency ratings were predictive of VSITE performance in PGYs 4 and 5. PGY 5 MK was highly predictive of VQE performance [OR 4.73, (95% CI, 3.87-5.78), P <0.001]. PC subcompetencies were also highly predictive of VQE performance in the final year of training [OR 4.14, (95% CI, 3.17-5.41), P <0.001]. All other competencies were also significantly predictive of first-attempt VQE pass with ORs of 1.53 and higher. PGY 4 ICS ratings [OR 4.0, (95% CI, 3.06-5.21), P <0.001] emerged as the strongest predictor of VCE first-attempt pass. Again, all subcompetency ratings remained significant predictors of first-attempt pass on CE with ORs of 1.48 and higher. ACGME Milestone ratings are highly predictive of future VSITE performance, and first-attempt pass achievement on VQE and VCE in a national cohort of surgical trainees.

Critical gaps in knowledge and implementation of recommendations by the US Preventive Services Task Force

IntroductionThe United States Preventive Services Task Force (USPSTF) has issued 31 recommendations applicable to non-pregnant adults. We hypothesized variability in knowledge and implementation of these recommendations among US family medicine resident physicians. MethodsWe performed two electronic surveys: a local survey, and then a nationally-representative, multicenter, survey. We evaluated self-reported knowledge and implementation of USPSTF recommendations related to non-pregnant adults. Results84 family medicine residents from 40 residency programs across 25 states participated. Knowledge and implementation of recommendations varied widely. Most residents lacked knowledge relating to breast cancer chemoprophylaxis (9.9 % “known in detail” or “mostly know”), BRCA-related genetic counseling (BRCA-GC) referral (30 %), tuberculosis (TB) screening (41 %), and sexually transmitted infection (STI) counseling (45 %). There is virtually no implementation of recommendations for breast cancer chemoprophylaxis (90 % never/rarely implement). Many residents never/rarely implement recommendations for BRCA-GC referral (75 %), TB screening (62 %), and HIV pre-exposure prophylaxis (61 %). This remained true even for residents in their final year of training. Relative to their male counterparts, female physicians more frequently implemented recommendations for BRCA-GC referral (11 % vs 0 % always/often implement, p = 0.019), cervical cancer screening (100 % vs 83 %, p = 0.019), and folic acid supplementation (60 % vs 29 %, p = 0.007). Knowledge and implementation of recommendations were strongly related (β = 0.75, 95 % CI 0.50–1.00, p < 0.001, Spearman R2 = 0.56). ConclusionCritical gaps exist in resident knowledge and implementation of USPSTF recommendations. We discuss urgent implications for cancer prevention, public health, and health equity.

“We’re all there to learn”: The experience of novice workplace-based assessors in anaesthesia training

Introduction: Workplace-based assessments (WBAs) are used in competency-based training programs to facilitate learning and inform decisions on trainees’ progression. Competency in assessing WBAs is generally assumed; how assessors develop these skills remains largely unknown. This study explored how novice assessors acquire WBA skills to generate insights to inform future faculty development. Methods: We conducted seven semi-structured interviews with provisional fellows, who are final-year trainees of the Australian and New Zealand College of Anaesthetists. Provisional fellows assess junior trainees as part of their preparation for consultant practice. We used constructivist grounded theory methods to analyse their experience of learning to perform WBAs. Results: Participants primarily learned WBA skills through experiential learning and self-reflection on their practice. They developed practical skills to accommodate WBA into clinical practice, including finding time to facilitate WBAs and selecting appropriate cases. Simultaneously, participants developed expertise in the critical aspects of the assessment, particularly learning to determine the standard required of trainees and improving their feedback skills. This learning engendered an increased appreciation of the purpose of WBA, helped participants develop their clinical expertise and prompted them to envision themselves in the consultant role. Participants felt underprepared for their assessor role and appreciated access to the “safety net” ongoing supervision provided. Conclusion: This study provides valuable insights into what is learned in becoming a WBA assessor and how it is learned. These insights could inform future faculty development initiatives to help improve graduating consultants’ development in this important area of consultant practice.

The vascular surgery in-training examination predicts performance on qualifying examination.

Vascular surgery trainees participate in the vascular surgery in-training examination (VSITE) during each year of their training. Although the VSITE was developed as a low-stakes, formative examination, performance on that examination might correlate with the pass rates for the Vascular Surgery Board written qualifying examination (VQE) and oral certifying examination (VCE) and might, therefore, guide both trainees and program directors. The present study was designed to examine the ability of the VSITE to predict trainees' performance on the VQE and VCE. All first-time candidates of the Vascular Surgery Board VQE and VCE were analyzed from 2016 to 2020, including those from both the integrated and independent training pathways. VSITE scores from the final year of training were associated with the VQE scores and the probability of passing the VQE and VCE both. Linear and logistic regression models were used to determine the ability of VSITE results to predict the VQE scores and the probability of passing each board examination. VSITE scores available for the 559 candidates (69.3% male; 30.7% female) who had completed the VQE and 369 candidates (66.7% male; 33.3% female) who had completed both the VQE and the VCE. The linear regression model results for the final year of training showed that the VSITE scores explained 34% of the variance in the VQE scores (29% for the integrated and 37% for the independent trainees). Logistic regression demonstrated that the final year VSITE scores were a significant predictor of passing the VQE for both integrated and independent trainees (P< .001). A VSITE score of 500 during the final year of training predicted a VQE passing probability of >90% for each group of candidates. The probability of passing the VQE decreased to 73% for candidates from integrated programs, 61% for candidates from independent programs, and 64% for the whole cohort when the score was 400. The VSITE scores were a significant predictor of passing the VCE only for the candidates from independent programs (odds ratio, 1.01; 95% confidence interval, 1.00-1.02; P< .01), for whom a VSITE score of 400 correlated with an 82% probability of passing the VCE. VSITE performance is predictive of passing the VQE for trainees from both integrated and independent training paradigms. Vascular surgery trainees and training programs should optimize their preparation and educational efforts to maximize performance on the VSITE during their final year of training to improve the likelihood of passing the VQE. Further analysis of the predictive value of VSITE scores during the earlier years of training might allow the board certification examinations to be administered earlier in the final year of training.

Readiness to care and factors influencing readiness to care for patients in the intensive care units among novice nurses

Problem consideredNurses are the heart and soul of any healthcare institution. A skilled, qualified nurse with the readiness to care for patients in critical care setting is the dire need for today's world. MethodsA cross-sectional descriptive survey was conducted among novice nurses working in the selected tertiary care hospitals to assess the readiness to care for patients in the intensive care unit (ICU) and the factors influencing readiness to care. The sample were selected using purposive sampling technique. ResultsThe majority 157 (52.4%) had moderate readiness, 143 (47.6%) novice nurses had high readiness to care for patients in ICUs. The top six factors expressed by the participants were: knowledge of the fundamental subjects 292(97.3%), continuing nursing education 278(92.7%), feedback by peers and superiors 283(94.3%), internal motivation 277(93.3%), communication skills 277(92.3%), and proper documentation of care given 278(92.7%). There was a statistically significant association between readiness to care and gender (χ2 = 9.060; p = .011), area of work (χ2 = 10.009; p = .040), duration of clinical exposure in ICUs during the course of study (χ2 = 18.301; p = .011), duration of clinical experience during final year of training (χ2 = 10.315; p = .016), specific ICU related training (χ2 = 6.511; p = .011), and duration of induction programme (χ2 = 50.23; p= <.001) ConclusionThe novice nurses had moderate readiness to practice in ICUs. The nursing educational sector and the nursing service sector can devise certain structures which can help increase the readiness of novice nurses to work in ICUs by focusing on the factors identified.

The role of agency in the construction and development of professional identity

ABSTRACT The aim of this article is to achieve greater understanding of the relationship between professional teacher identity and agency. From our perspective, agency is a necessary consequence of the process of construction and development of professional teacher identity. On this basis, we conducted a qualitative study involving analysis of the subjective learning experiences of three future teachers engaged in their final year of training. We analysed these experiences using a previously published analytical model based on the positional changes that occur as a consequence of the evaluation of certain objects that are key to professional identity. Our results allow us to confirm that in the case of subjective learning experiences involving positional changes, agency is key to the consolidation of an enabling professional identity.

Senior Resident Grand Rounds: Results From a Survey of 15 Years of Radiology Residency Graduates

ObjectiveRadiology residents in their final year of training at our institution are required to deliver a grand rounds presentation prior to graduation in order to facilitate resident involvement in the medical tradition of ground rounds. We evaluated this requirement by conducting a survey of recent residency alumni on their experience delivering grand rounds and its perceived value in radiology training. Materials and methodsWe developed an anonymous, 10-question survey regarding the alumni experience with the grand rounds presentation requirement, which has been required since 2007. Question formats included yes-or-no and 5 point Likert-type formats, as well as a space to provide comments. ResultsEighty-three alumni were contacted and 39 responded (46.9% response rate). Current practice setting was academic in 41.0%, 46.2% have reused material from their presentation, and 46.2% have given a grand rounds presentation since completing residency. When asked if delivering the presentation was a valuable experience, 2.6% disagreed, 23.1% were neutral, 35.9% agreed, and 38.5% strongly agreed. When asked if they would recommend future senior residents to give a grand rounds presentation, 2.6% strongly disagreed, 30.8% were neutral, 30.8% agreed, and 35.9% strongly agreed. ConclusionsThe majority of survey respondents agree or strongly agree their grand rounds presentation experience was valuable and would recommend future residents to continue this process. Based on survey comments, we conclude this experience is valuable for multiple reasons, including the opportunity to demonstrate mastery of a radiology topic, the ability to repurpose presentation material in the future, and the experience of delivering a formal presentation.

Longitudinal impact of preregistration interprofessional education on the attitudes and skills of health professionals during their early careers: a non-randomised trial with 4-year outcomes

ObjectiveTo assess whether a preregistration interprofessional education (IPE) programme changed attitudes towards teamwork and team skills during health professionals’ final year of training and first 3 years of professional practice.DesignProspective,...

Estrategias de comunicación para la atención a la población inmigrante: desafíos en la formación de los estudiantes de Ciencias de la Salud

IntroductionTo explore the communication strategies used by Health Sciences students with the immigrant population during health care. Materials and methodsQualitative research of phenomenological/interpretive type with a Multiple Case Study design. 106 students from three universities and different Health Sciences careers in their final year of training were interviewed, with prior authorization from two institutional Ethics Committees, in addition to requesting informed consent. The content analysis was of inductive and was supported by the ATLAS.ti version 9 software. ResultsTwo categories were established; one, with the different semiotic modes used by the students and another, of personal skills present during clinical interaction. The student body reported having used different multimodal communication resources, from the non-verbal mode to the translator application mode, to provide care to foreigners, although they acknowledged not having received training on it. The choice and combination of the different modalities was guided by the context and personal skills were relevant for monitoring and adjustments during care. ConclusionsMultimodal communication and personal skills facilitate communicative interaction and allow offering quality health care for the immigrant population, overcoming linguistic and cultural barriers. This indicates that professional training in Health Sciences requires the explicit and systematic development of communication skills, as well as intra and interpersonal skills with a practical approach. Likewise, it needs technical and practical knowledge as well as praxeological knowledge that fosters a reflective attitude.