Postgraduate Residency Research Articles

Diagnóstico situacional del proceso enseñanza aprendizaje en posgrados de una unidad académica de Medicina. Una aproximación desde la percepción de docentes y profesionales estudiantes

IntroductionThe objective of the study was to verify the progress of implementation of the pedagogical model oriented to postgraduate competencies of a medical school, since it implemented a new curricular framework since 2016, achieving a first cohort of graduates, who will seek to consolidate their training in subspecialties offered by the academic unit. MethodsQualitative study with a hermeneutic, interpretive approach with teachers and final year residents of selected postgraduate courses. The data were obtained through semi-structured interviews and focus groups. The training programs were analyzed. The pedagogical model oriented to postgraduate competencies was the main category that guided the questions, the following dimensions being analyzed: academic management, teaching practice, professional student learning and curricular structure. Data collection concluded once theoretical saturation was obtained. ResultsAnalyzing 22 interviews with teachers and focus groups with 16 final-year postgraduate residents, it was identified that the pedagogical model currently implemented is mostly content-based, with insufficiently developed innovations. Teachers with heterogeneous training and involvement in higher education and implementation of the new model. Residents of specialties perceived as spectators, not involved in the training process that should have been integrated into the postgraduate degree to ensure the necessary competencies indicated. ConclusionIn the postgraduate field, the pedagogical model by content prevails, without the orientation by competencies having had continuity, verifying the need for interventions in teacher training, student involvement, improvement of infrastructure and assurance of educational quality, to saturate the objectives of the plan institutional strategic.

Assessment of imposter syndrome among postgraduate residents using Clance imposter phenomenon scale: a multicentric, cross-sectional study.

Imposter syndrome develops when high-achieving individuals, despite external measurements of achievement, have a chronic sense of self-doubt paired with a fear of being exposed as a hoax. This endangers one's mental health and well-being. The objective of the study was to determine the prevalence and severity of imposter syndrome among postgraduate residents and to identify the risk factors associated with imposter syndrome. This is a cross-sectional study conducted among the postgraduate trainees working in four different training hospitals in Pakistan. Imposter syndrome was assessed using the Clance Imposter Phenomenon Scale. A total of 146 postgraduate residents participated in this study. The majority had significant imposter syndrome, with females more suffered than males. Trainees of the pediatrics department were affected the most while of the dentistry were least to be affected. Multiple factors including marital status, number of children, working hours, extracurricular activities, and private practice have been shown to affect the prevalence of imposter syndrome. Imposter syndrome is a prevalent phenomenon among the residents of Pakistan. Efforts to identify and establish a proper relationship between general demographics and imposter syndrome are required for the healthy work experience of the trainees.

Perceptions of Dental Faculty and Postgraduate Residents towards Learning Professionalism through DOPS Assessments of Implants

ABSTRACT Objective: One of the essential characteristics that define a career is professionalism, which encompasses commitments, actions, standards, and objectives. Background: The study was aimed to assess the perception of dental faculty and residents towards DOPS as a method to assess professionalism and also the perception of participants towards inclusion of professionalism assessments in the dental curriculum. Method: This descriptive cross sectional study was conducted amongst forty three Prosthodontic postgraduate residents and twenty faculty members from ten different dental colleges in India in the year 2023.Views regarding professionalism were assessed using the Modified Australian Medical Council (AMC) DOPS assessment form. We measured Professionalism score from the DOPS assessments conducted six times within a year of the residents in different dental colleges of India. The resident was evaluated by two different faculty members in order to minimize subjective bias. The scores range from 1 to 5, with 1 representing the least amount of professionalism displayed and 5 representing the best. Data was analyzed using SPSS version 23. Descriptive statistics was done using mean score. Results: DOPS Assessment score of professionalism for Prosthodontic postgraduate residents and feedback from participants, post graduates and faculty at the end of last assessment was considered for conclusion. They showed increase in DOPS score and positive attitude towards dental professionalism. The participants believed that DOPS assessment is an effective way to improve professionalism. Conclusion: Academic dishonesty may continue with unethical behaviors in professional practice of a healthcare professional. Hence, it becomes vital to address academic dishonesty lapses among oral health sciences students to ensure the future safety of patients and improvement in patient care.

A qualitative study exploring graduated medical residents’ research experiences, barriers to publication and strategies to improve publication rates from medical residents

BackgroundIn Kenya, postgraduate medical residents must complete a research dissertation for their Master of Medicine studies. However, the subsequent publication rate is lower than in higher-income settings, limiting the availability of population-specific data. This study explored residents’ experiences with research, reasons for the low publication rate, and strategies to improve publication rates.MethodsIn-depth interviews were conducted with 9 faculty members and non-academic support staff, as well as 18 Master of Medicine graduates who had successfully completed their research projects, to investigate their experiences with conducting, supervising, and publishing research. The interview data was analysed using inductive thematic analysis. The study also explored strategies to improve publication rates.ResultsThe graduates (former medical residents) described difficult research journeys – from concept development to final submission of dissertation – which discouraged them from seeking publication. Many faculty and staff lacked time or sufficient expertise to successfully guide residents to publication. Departmental research culture, faculty expertise as supervisors and prioritisation of clinical work over research and lack of dedicated research time impacted both residents’ and faculty capacity for research. Strategies to improve publication rates focused on developing faculty research expertise, more protected research time, and a more structured approach to teaching research methodology, including academic writing skills.ConclusionsResidents in low- and middle-income countries such as Kenya encounter systemic and personal challenges to successful publication of research. The ease or difficulty of a resident’s research journey influences their attitudes to subsequent publication. Strategies to improve publication rates can improve the dissemination of relevant research data in such settings.

ChatGPT and Its Role in Outpatient Departments

Background: ChatGPT is a language-based model built with a ‘super brain' containing a database with adequate medical knowledge used in diagnosis, investigations and management of diseases. Objectives: This study aims to explore the possibility of using ChatGPT as an assistive tool in outpatient clinics. Methods: This is a descriptive cross-sectional study. Our study targeted a population of 259 post graduate residents and consultants from reputable institutions of Punjab using convenient sampling techniques. The data collection tool was a structured questionnaire shared via google forms and distributed manually. It assessed physicians use of ChatGPT, perceived usefulness in management of patients and its role in prevention of disease and improvement of the healthcare system. Results: The responses were taken on a 5-point scale, and consisted of a greater population of female physicians 138(53.3%) as compared to males 121 (46.7%). A whopping majority of physicians found ChatGPT to be efficacious in outpatient settings (59.1%).A significant percentage of people highlighted a decrease in burn out (61%), aid in correct diagnosis (62.5%) and adequate treatment plans laid out by ChatGPT (46.7%). The responses indicated 78.4% of the participants believed that ChatGPT has a positive impact in outpatient departments Conclusion: ChatGPT shows significant potential in serving as a cognitive assistant to physicians as we inculcate it into our healthcare system. It is set to make the outpatient experience much improved for both the physicians and the patients.

Conference Equity in Community Medicine: A Brief Analysis of Financial and Geographical Barriers to Participation at Community Medicine Conferences

Background: Academic conferences in community medicine offer valuable learning platform for postgraduate residents and faculty. However, to demonstrate commitment towards conference equity, financial and geographical barriers need to be enumerated and eliminated. Materials & Methods: Academic medical conferences representing the specialty of community medicine or preventive and social medicine, held between 1st April 2023 – 31st March 2024, were included under the study. Variables identified for the study included registration fees, location, affiliation to professional society, geographical scope, presence of virtual/hybrid component, and availability of scholarship/travel grant for postgraduate residents. Results: None of the conferences were held in resource-constrained states of India – the North Eastern Region (except Assam) and islands of Andaman, Nicobar, and Lakshadweep. Only 2 out of 31 conferences had virtual or hybrid component and none of the conferences offered financial support for postgraduate residents. The study found no significant difference in conference registration fees between members and non-members for postgraduate residents and faculty. Conclusions: Registration fees and location of conferences are critical geographical and financial barriers to effective participation. Membership to societies offer no advantage over non-membership in terms of financial benefits of participation at conference.

How do mandatory emergency medicine rotations contribute to the junior residents’ professional identity formation: a qualitative study

BackgroundThis study aims to investigate the impact of short-term mandatory emergency medicine rotations on professional identity formation of Japanese junior residents. Using situated learning theory as a theoretical framework, we explore how this rotation, which is part of a two-year Junior residency in the transition period from students to qualified physicians.MethodsWe conducted a qualitative study conducting semi-structured face-to-face interviews with Year 1 postgraduate residents in the 2020–2021 classes of the junior residency program in Okinawa Chubu Hospital, Japan (n = 10). The data obtained from the interviews were analysed using inductive thematic analysis to identify the themes regarding professional identity formation.ResultsFour main themes regarding professional identity formation emerged from the data analysis: patient care, teamwork, role models, and peers. Junior residents said they had the opportunity to participate in the emergency department community and experience training in authentic clinical contexts. Clinical exposure influenced the professional identity formation of the junior residents. Nurses and peers played a crucial role in this. Junior residents see the training in the emergency department as the beginning of their careers.ConclusionShort-term mandatory rotations enabled junior residents to integrate into the emergency department community, demonstrating autonomy and responsibility. These experiences fostered their professional identity by helping their socialisation within the community of practice.

Assessing resident experience of a new experiential learning health advocacy curriculum: a mixed methods study

BackgroundHealth Advocacy is considered one of the most difficult skills to teach. Many medical learners feel ill-equipped in social competencies and identify it as a significant gap in their medical training. Experiential learning has recently been emerging as a more effective method to teach health advocacy. The Post Graduate Medical Education (PGME) Health Advocacy Day is a new experiential learning curriculum designed to teach important competencies of health advocacy and social accountability to post-graduate medical residents at the University of Ottawa in Ottawa, Canada. The objective of this mixed-methods study was to assess resident experiences.MethodsSecond-year trainees from all adult residency programs attended the Advocacy Day as part of a mandatory academic day. All participants completed a mandatory pre-and post-session quiz to assess knowledge of key topics before and after the course. We also distributed a voluntary survey to all participants and invited residents to participate in semi-structured interviews to provide feedback on the course. We used descriptive statistics to analyze quiz scores and survey results and conducted a paired t-test of pre and post-test quiz scores. We also performed a thematic analysis of qualitative feedback, specifically survey comments and semi-structured interviews.ResultsOne hundred and eighty-three residents participated in the Advocacy Day and 112 (61.2%) completed the post-course survey. Ten residents volunteered to be interviewed. Respondents were generally satisfied by the session and felt it was of good quality. Most residents felt the course enhanced their ability to advocate for individual patients or communities (N = 80; 71.5%) and understand patients and families’ lived experience with illness (N = 87; 77.5%). Most residents also felt the course improved their knowledge of the impact of social determinants of health (N = 91; 81.2%) and increased their awareness of local resources that can support patients and their families (N = 88; 78.3%). Visiting community sites in-person and meeting persons with lived experiences were highlighted as the most valuable components of the course.ConclusionExperiential learning can be integrated within post-graduate medical curricula to teach health advocacy competencies. Future studies should examine the longitudinal impact of the curricula, to determine whether shifts in perspectives persist over time.

Empathy ability and influencing factors among pediatric residents in China: a mixed-methods study

BackgroundEmpathy is one of the fundamental factors enhancing the therapeutic effects of physician–patient relationships, but there has been no relevant research in China on the pediatric resident physicians’ capacity for empathy or the influencing factors.MethodsA mixed-methods study was undertaken. The student version of the Jefferson Scale of Empathy was used to assess 181 postgraduate residents at Shanghai Children’s Medical Center and Shanghai Children’s Hospital. Differences in empathy ability among pediatric resident physicians of different genders and specialties were analyzed using independent sample t-tests and Mann–Whitney U tests. A one-way analysis of variance was used to analyze the differences in empathy ability at different educational levels and years of medical residency training. Seven third-year postgraduate pediatric residents from Shanghai Children’s Medical Center participated in semi-structured interviews exploring the influencing factors. We analyzed the interview transcripts using thematic analysis.ResultsThe scale was completed by 154 pediatric residents. No statistically significant differences in empathy were found between educational level, postgraduate year, gender, or specialty. The factors influencing empathy in doctor–patient communication included the person who accompanied the child to see the doctor, how the children cooperated with doctors for medical treatment, the volume of pediatric outpatient and emergency visits, and the physician’s ability to withstand pressure. All interviewed resident physicians regarded learning empathy as important but rarely spent extra time learning it.ConclusionsThe evaluation results of resident physicians on changes in empathy after improving clinical abilities vary according to their understanding of empathy, and the work environment has an important impact on pediatricians’ empathy ability. Their empathy score is relatively low, and this requires exploration and intervention.

What We Know, We See and Do: Formative Assessments Practices of Psychiatry: Postgraduate Residency from a General Hospital Psychiatry Unit in India

What We Know, We See and Do: Formative Assessments Practices of Psychiatry: Postgraduate Residency from a General Hospital Psychiatry Unit in India

Knowledge, attitude and practices of surgeons regarding venous thromboembolism prophylaxis in tertiary healthcare hospitals of the Rawalpindi Districts.

To assess doctors' knowledge, attitudes and practices regarding venous thromboembolism prophylaxis. The cross-sectional study was conducted from April to September 2021 in three public-sector hospitals affiliated with the Rawalpindi Medical University: Holy Family Hospital, Benazir Bhutto Hospital and Rawalpindi District Headquarters Hospital, Rawalpindi, Pakistan, and comprised physicians of either gender who were actively involved in patient care. Data was collected using a predesigned questionnaire regarding venous thromboembolism. Data was analysed using SPSS 25. All the 220(100%) subjects approached responded positively to the study questionnaire. There were 144(65.45%) general surgeons, 50(22.72%) gynaecologists and 26(11.81%) orthopaedic surgeons. Overall, there were 26(11.81%) senior consultants, 65(29.54%) postgraduate residents and 129(58.63%) house officers. There were 150(68.2%) doctors who reported having witnessed deep-vein thrombosis in their patients, and 113(51.4%) had witnessed deaths related to pulmonary embolism. Among the methods employed for DVT diagnosis, the use of clinical criteria was the most common 136(36.1%), while venography was the least common technique used by 8(2.2%). While 210(95.5%) subjects expressed the desire for adopting an institute-wide regimen for venous thromboembolism prophylaxis, only 66(30%) were currently following such a regimen.

Faculty’s Forum: Approach to Learning Dermatopathology during Postgraduate Residency

Faculty’s Forum: Approach to Learning Dermatopathology during Postgraduate Residency

Predictors of Success in Obtaining Postgraduate Residency or Fellowship

ObjectiveAs more pharmacy students are pursuing postgraduate training, colleges of pharmacy are investigating ways to predict success in matching for residency or fellowship. While data have been published about characteristics predictive of matching, we sought to study student scores, rotation types, and rotation evaluations as predictors of success. MethodsData were collected from students in the graduating classes of 2021, 2022, and 2023. Students were surveyed on participation in mock interviews, numbers of programs to which they applied, and number of interviews received. In addition, data were collected on impostor phenomenon, grit, perceived stress, anxiety, grade point average (GPA), types of patient care rotations, and preceptor evaluations. ResultsOverall, 295 students were included, with 69 unsuccessful and 226 successful students. Successful students were more likely to have lower Perceived Stress Scale-10 scores in the final 3 semesters of school, a higher GPA, more elective patient care rotations, and more preceptors who answered “Yes” to “Would you hire this student?” after graduation. In the multivariate logistic regression analysis, final GPA and preceptors answering affirmatively to “Would you hire this student?” were independent predictors of success in obtaining a postgraduate position. ConclusionAs colleges of pharmacy prepare students for postgraduate residencies or fellowships, in addition to GPA, stress levels during the final 3 semesters of pharmacy school may be areas on which to focus. Given that willingness of a preceptor to hire a student after graduation was a predictor of success in securing a postgraduate position, this should be explored in future research.

Nontechnical Skills Assessment in Acute Care Trauma Simulations: A Mixed Methods Approach Using Eye Tracking and Behavioral Marker Systems.

The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations. After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman's Rho tests were used to assess correlations between ET and subjective NTS ratings. Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \pm $0.61, maximum = 5) and NOTSS (2.87$ \pm $0.66, maximum = 4). We found significant differences in trauma team leaders' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics. This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

Medical Negligence by Postgraduate Students and Residents: The Liability Trail.

Postgraduate students or physicians in training are bound to make mistakes. In medical negligence litigation involving the postgraduate students, the supervising faculty members as well as the hospital where the alleged act has occurred could also be found liable. In this review article, the applicable legal principles and a brief summary of the case laws are presented.

Evaluating the Role of Objective Structured Clinical Examination as a Summative Assessment Tool in Undergraduate and Postgraduate Psychiatry Residents.

The Objective Structured Clinical Examination (OSCE) is the gold standard and universal format to assess medical students' clinical competence in a comprehensive, reliable, and valid manner. OSCE is gaining global popularity for assessing medical students in various specialties. Our country uses it in multiple disciplines, but its application in psychiatry remains limited. OSCE is a resource-demanding assessment method that can face numerous challenges. A comprehensive assessment of perceptions regarding OSCE can help identify areas that need improvement. Therefore, this study was conducted to assess the perceptions of students and examiners toward OSCE in psychiatry. This study aims to evaluate the role of Objective Structured Clinical Examination as a summative assessment tool in assessing competency in undergraduate (as part of their ward leaving examinations in psychiatry) and postgraduate psychiatry residents (as part of their six-monthly assessments) and analyze the perceptions of students as well as of the faculty members regarding OSCE. Six MD students and 49 MBBS students took the OSCE as part of their ward-level exams in psychiatry. In the presence of four faculty members of the psychiatry department, students completed their six-month summative exams. The OSCE was held at separate times for UG and PG students. UG and PG students utilized different stations (PG students had a harder level). A 10-item questionnaire was given to examiners and students at the end of the OSCE to get their opinions regarding the OSCE. Furthermore, data gathered from the faculty through an open-ended questionnaire was compiled and displayed thematically. Since the Likert scale survey generated ordinal data, the statistical analysis was conducted using the median, interquartile range (IQR), and chi-square test. The chi-square test was used to compare the variables. A P-value of less than 0.05 was deemed statistically noteworthy. Four faculty members and fifty-five students in all answered the questionnaire. Regarding the OSCE's characteristics, validity, reliability, and transparency, the majority of students expressed positive opinions. In a similar vein, most examiners had positive perceptions pertaining to OSCE's administration, structure, and procedures. Certain areas, such as "improved confidence in teaching clinical skills" and "improved confidence in giving students structured feedback," were also emphasized by thematic analysis of faculty members. In general, both students and examiners had extremely favorable perceptions of and embraced the OSCE. Improved faculty orientation and student preparation for the OSCE may help allay anxiety and overcome hesitation related to the exam.

Burnout among medical residents, coping mechanisms and the perceived impact on patient care in a low/ middle income country

BackgroundBurnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.MethodsThis was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and < 33 in personal accomplishment. Overall high risk of burnout was defined as high-risk scores in 2 or more of the 3 categories. Categorical variables were analysed using descriptive statistics and reported as frequency counts and corresponding percentages. Chi-square test was applied to test for association of burnout and the categorical variables. P value of < 0.05 was considered statistically significant. To assess the impressions on patient care and evaluate the coping mechanisms employed in the context of burnout residents participated in four focus group discussions reaching thematic saturation.Results95 out of 120 residents consented to participate in the study, 47.3% of whom had a high risk of burnout. A significant association was found between gender and burnout risk with more female residents having high risk of burnout compared to their male counterparts; 58.0% and 35.6% respectively (P value 0.029). Residents in paediatrics and child health had the greatest risk of burnout (8 out of 10) compared to those in other programmes (P value of 0.01). Thematic analysis from focus group discussions revealed that main sources of stress included departmental conflict and struggle to balance work and other aspects of life. All focus group discussions revealed that burnout and stress are associated with negative coping mechanisms. Respondents reported that when under stress, they felt more likely to make medical errors.ConclusionThis study reported high risk of burnout among post graduate residents which is consistent with other global studies. The sources of stress cited by residents were mostly related to the workplace and many perceived sub-optimal patients care resulted from burnout. This highlights a need for preventive measures such as wellness programs within the training programmes.Trial registration numberNot applicable.

Collaboration cognizance: Development of a self-assessment tool to measure intra-professional collaborative practices (IPCP) in postgraduate medical residents at tertiary care hospitals

BackgroundThe ever-evolving healthcare system of today demands physicians who steer their roles as treatment providers, managers and collaborators. Professionals are highly interdependent due to increased complexity of health problems and risk of errors increases with transitions in care. In hospitals, the main workforce is postgraduate residents; therefore, intraprofessional collaboration amongst residents is essential. Several instruments are available to evaluate interprofessional collaboration amongst physicians, nurses and hospital teams but none specifically assessed intra-professional collaborative practices amongst residents working in tertiary care hospitals in multi-disciplinary teams. This study intends to develop and validate an instrument to self-assess intraprofessional collaborative practices in postgraduate residents undergoing residency in multiple specialties at tertiary care hospitals.ApproachThis study on Instrument Development employed mixed method study design executed in two phases. In phase 1, six domains of intraprofessional collaborative practices were identified from literature and 35 items were developed. Fifteen experts participated in qualitative content validation and provided comments. To establish content validity in phase 2, content validity index (CVI) and content clarity average (CCA) were assessed by seventeen experts. Response process validity was established by cognitive interviewing of 5 postgraduate residents. Pilot testing was done on a sample of 407 residents. Cronbach’s alpha was determined, and confirmatory factor analysis established construct validity.ResultsDuring phase 1, items were modified based on qualitative feedback from 15 experts. In round 2, CVI and CCA were determined based on responses of 17 experts. The items having an I-CVI greater than 0.90 were accepted and six items underwent modifications as their I-CVI fell between 0.78 and 0.90. Similarly, four items with a CCA of less than 2.4 were modified to increase clarity. Cognitive interviews of participants on 30 items resulted in the deletion of 1 item and changes in 5 items. The final instrument had 29 items categorized under six constructs. All items had good factor loadings during CFA, so none was deleted. Cronbach’s Alpha α was 0.937.ConclusionIntraprofessional collaborative practices in residents is a valid and reliable self-assessment tool comprising 29 items measuring six constructs. It may be used by residents to assess their collaborative practices and incorporated in curricula to help develop collaborative practices and their assessment during training of postgraduate residents.

Are healing abutments being reused in periodontics residency programs in the United States? A survey-based study.

Recent studies indicate that reusing healing abutments (HAs) may pose a risk of biomaterial cross contamination among patients. The intent is to investigate whether postgraduate periodontics residency programs in the United States are reusing dental implant HAs and determine if there is a standardization in the decontamination and sterilization protocol of used HAs. An electronic survey consisting of-seven multiple choice and/or short answer questions pertaining to the re-use of HAs among postdoctoral periodontics programs was sent to program directors of 57 accredited dental schools in the United States via an online survey system (Qualtrics). Three follow-up remainder emails were sent to programs that did not respond after over a 6-month period. Data were analyzed using descriptive statistics. Of the 57 postdoctoral periodontics program directors contacted, only 14 responded with three programs (3/14, 21%) reported reusing HAs. Approximately, 46% stated their residents place dental implants in two stages, while ∼54% stated they used a one-stage protocol indicating varied time exposure of HA to the oral cavity. Even in a two-stage protocol, the extended time HA remained in situ varied from 4 weeks to 6 months. Each program reusing HAs employed a distinct decontamination approach highlighting a notable lack of standardization in practices. The findings from our study suggest that a minority of residency programs in the United States are reusing HAs. However, the limited number of responses leaves uncertainty regarding whether our findings underestimate the prevalence of this practice and accurately reflect the reality. Among those re-using HAs, there seems to be a lack of standardization in their decontamination, potentially leading to cross-contamination of residual biomaterial among patients.

An Analysis of Trainee Salaries Offered in Nurse Practitioner and Physician Assistant/Associate Postgraduate Residency and Fellowship Programs in the United States.

Background Although there has been steady growth in the number of postgraduate nurse practitioner (NP) and physician assistant/associate (PA) residency and fellowship programs in the United States, little is known about annual salaries paid to trainees across a national sample of postgraduate programs and specialties. We describe postgraduate program NP and PA trainee salaries and the relationship to specific variables. Methodology An electronic survey was distributed via email to 336 postgraduate NP, PA, and joint NP/PAresidency/fellowship programs between November 2023 and December 2023.Frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarize the data. Chi-square tests of independence were used to determine the relationship between trainee salary and program type, geographical location, and clinical setting. Results There was a statistically significant association between trainee salary for primary care and clinical profession (χ2(6) = 13.993, p = 0.022). Over half of NP respondents(52.1%) reported that their trainees had an annual salary between $76000 and $86000. The majority of PA respondents (57.1%) reported that their trainees had an annual salary below $75000. Respondents who were non-clinical professionals(50.0%) reported that their trainees had an annual salary of over $86000. The single physician respondent also reported that their trainees' had an annual salary of over $86000.It appears that PA respondentswere more likely to report lower trainee salaries than respondents who were NPsand non-clinical professionals. Additionally, respondents associated with primary carejoint NP/PA cohorts were more likely to report higher trainee salaries than participants having NP-only cohorts. Lastly, there was a statistically significantly positive relationship between trainee salary and the number of postgraduate advanced practice provider (APP) trainees in psychiatric mental health (τb= 0.451, p = 0.006). Conclusion To the best of our knowledge, this national study is the first of its kind to examine and summarize APP postgraduate trainee annual salaries across multiple specialties. Additional studies are needed to clarify the relationships between trainee salaries and other variables.