Postgraduate Training Programs Research Articles

Perceptions of Nurse Practitioners and Physician Assistants/Associates Toward the Concept of Developing an Advanced Practice Postgraduate Residency/Fellowship Program at a Large Academic Medical Center.

Introduction There have been exponential growth and increased interest in postgraduate residency/fellowship formalized training among nurse practitioners (NPs) and physician assistants/associates (PAs). Although not a requirement for state licensure and entry-level practice, postgraduate NP and PA residency/fellowship programs offer a structured pathway for new graduates and experienced PAs and NPs looking to transition into a new medical or surgical specialty/subspecialty. In this article, we examine the perceptions of employed NPs and PAs toward postgraduate training including the concept of developing a program at our institution. Methodology This was a cross-sectional single-large academic medical center (AMC) study, where an anonymous electronic survey was initially developed by the director of advanced practice providers (APPs). The survey was piloted by members of the Advanced Practice Council (APC) comprising NPs, PAs, and certified registered nurse anesthetists (CRNAs), and their collective feedback was used to finalize the survey prior to distribution. Descriptive statistics were used to describe and summarize the data. In addition, we assessed the association between respondents' characteristics and perceptions regarding NP and PA residency/fellowship programs using chi-squared tests of independence. Results The majority of the respondents (69.1%; 65/94) believed that starting an advanced practice residency/fellowship program at our AMC has many benefits such as increasing specialty-specific knowledge and training (79.8%; 75/94), improving medical decision-making (73.4%; 69/94), promoting professional development and clinical education (73.4%; 69/94), and improving procedural competency (60.6%; 57/94). Moreover, over half of the respondents (53.2%; 50/94) indicated that there is value in an APP residency/fellowship program obtaining optional accreditation. Additionally, over half of the respondents (56.4%; 53/94)indicated that they would be interested in participating as a clinical preceptor if an APP residency/fellowship program was developed at our AMC. Lastly, about one-third of the respondents felt strongly that APP residency/fellowship training programs should offer post-professional doctoral degree options such as Doctor of Nursing Practice (DNP), Doctor of Medical Science (DMSc), and Doctor of Health Science (DHSc). Conclusion Although most respondents have never completed a formalized postgraduate training program and were less familiar with the published literature regarding these programs, our findings suggest that the attitudes ofemployed NPs and PAs aregenerally positivetoward the concept of postgraduate specialty-specific training.

Climate change and mental health: postgraduate psychology student and program coordinator perspectives from Australia and Aotearoa New Zealand

ABSTRACT Objective There is growing evidence that climate change can negatively impact people’s mental health. Therefore, it is important for psychologists to receive adequate training in this area. However, little is known about current levels of training, including the amount of climate change mental health education within postgraduate psychology programs in Australia and Aotearoa-New Zealand. Method Two cross-sectional surveys regarding climate change and mental health were emailed to postgraduate psychology programs in Australia and Aotearoa-New Zealand. The first invited participation from program coordinators (n = 17), the second students (n = 159). We conducted quantitative content analysis and thematic analysis of qualitative responses. Results Most participants believe this is an important topic of training for psychologists as climate change will impact the mental health of their clients. Further, results indicate minimal climate change mental health content in postgraduate psychology training programs in Australia and Aotearoa-New Zealand. Conclusions Integration of climate change mental health education into postgraduate psychology curriculum will work towards equipping the emerging mental health workforce to address this growing demand, which in turn can improve mental health outcomes in a changing climate.

Integrating Trauma-Informed Clinical Interviewing Skills in Medical Education for Screening Domestic Violence and Abuse.

A pre-post-training workshop was conducted among 22 postgraduate trainees of the Psychiatry and Emergency Department of a public sector hospital in Karachi. The workshop aimed to build the capacity of postgraduate trainees in trauma management by providing training on screening, clinical interviewing skills, and Psychological first aid to those exposed to domestic violence (DV). The effectiveness of each training module was evaluated by conducting a brief assessment before and after each module and scores were compared using the Wilcoxon signed-rank test. The post-test showed significant improvement in participants' knowledge on screening of domestic violence and trauma symptoms (p = 0.026) and psychological first aid (p <0.001). Postgraduate training programmes need to integrate trauma screening and management education, to prepare healthcare professionals to deal with sensitive clinical presentations at their work settings. Key Words: Postgraduate trainees, Trauma, Domestic violence, Medical education, Workshop.

Designing a Roadmap for Health Technology Assessment Implementation in Algeria.

Background The scarcity of resources restricts healthcare financing decisions, affecting the population's health. Health technology assessment (HTA) balances restricted budgets with the best possible health outcomes. We aim to characterize the current status of HTA in Algeria and describe the future directions for HTA implementation according to the priorities set by local stakeholders. Methods Stakeholders from the public and private sectors responded to a policy survey about the current and preferred future status of HTA implementation in Algeria. The survey was administered during an online workshop and used a widely accepted international scorecard covering eight domains: capacity building, HTA financing, process and organizational structure, scope of HTA implementation, decision criteria, standardization of methodology, use of local data, and international collaboration. After that, one-on-one interviews with another local expert were conducted to validate and modify the draft recommendations. The interviewees were representatives from government agencies, hospitals, and pharmaceutical companies. Results Thirty-one experts filled out the HTA scorecard survey; most of them were from the public sector (74%). They highlighted that project-based HTA workshops or short courses were the most common form of HTA education in Algeria and recommended the establishment of postgraduate HTA training programs in the future to build sustainable capacities. They reported a lack of funding for HTA research and critical appraisal and recommended an increased public budget for HTA and the introduction of submission fees by manufacturers. There was consensus about the need for local HTA evidence generation in the future. Most of the experts advocated an explicit soft decision threshold. The interviewees further recommended using multi-criteria decision analysis in the short term. The application of quality indicators was believed to improve the reliability of the HTA process. Conclusion The results of our policy research delineate the gap between the current and preferred future status of HTA in Algeria based on insights from multiple stakeholders. The need to improve the educational HTA programs in Algeria, use local data in policy decisions, and increase funding for HTA were the most advocated recommendations.

Graduating resident and fellow readiness for general urologic practice during the COVID-19 pandemic A survey-based assessment of trainees and program directors.

Our goal was to compare the perceived readiness of graduating urologic residents and fellows to program directors (PDs) in U.S.-based postgraduate training programs. Additionally, we set out to assess the impact of COVID-19 on postgraduation plans to pursue fellowship training. Graduating residents, fellows, and PDs of accredited residency/fellowship programs in the U.S. were surveyed. The ranked preparedness of trainees to perform common urologic procedures was measured using a Likert scale from 1 (not comfortable) to 5 (fully proficient). The impact of COVID-19 was measured using a three-point Likert scale. Chi-squared and Kruskal-Wallis analyses were used to compare the groups. From 93 responders, 21 were residents, 19 were fellows, 24 were residency PDs, and 29 were fellowship PDs. The median levels of comfort for trans-urethral resection of the prostate, hydrocelectomy, vasectomy, and urethral sling were at or above (≥3) moderate for both PDs and trainees. PDs were more likely to report underperformance for hypospadias repair (60% vs. 39%), penile prosthesis implantation (39% vs. 26%), and orthotopic neobladder formation (57% vs. 18%) than the trainees. Fifty-three (57.0%) of the surveyors felt that COVID-19 did not impact the trainees' comfort in performing general urologic procedures. COVID-19 influenced trainees' decision to pursue a fellowship or opt to practice as general urologists (p=0.002). Our study suggests there may be a self-reported discrepancy between graduating trainees and their PDs regarding trainees' comfort levels performing general urologic procedures.

Not in the file: How competency committees work with undocumented contributions.

Competence committees (CCs) centre their work around documentation of trainees' performance; undocumented contributions (i.e. informal, unrecorded material like personal judgements, experiential anecdotes and contextual information) evoke suspicion even though they may play a role in decision making. This qualitative multiple case study incorporates insights from a social practice perspective on writing to examine the use of undocumented contributions by the CCs of two large post-graduate training programmes, one in a more procedural (MP) speciality and the other in a less procedural (LP) one. Data were collected via observations of meetings and semi-structured interviews with CC members. In the analysis, conversations were organised into triptychs of lead-up, undocumented contribution(s), and follow-up. We then created thick descriptions around the undocumented contributions, drawing on conversational context and interview data to assign possible motivations and significance. We found no instances in which undocumented contributions superseded the contents of a trainee's file or stood in for missing documentation. The number of undocumented contributions varied between the MP CC (six instances over two meetings) and the LP CC (22 instances over three meetings). MP CC discussions emphasised Entrustable Professional Activity (EPA) observations, whereas LP CC members paid more attention to narrative data. The divergent orientations of the CCs-adding an 'advis[ing]/guid[ing]' role versus focusing simply on evaluation-offers the most compelling explanation. In lead-ups, undocumented contributions were prompted by missing and flawed documentation, conflicting evidence and documentation at odds with members' perceptions. Recognising other 'red flags' in documentation often required professional experience. In follow-ups, purposes served by undocumented contributions varied with context and were difficult to generalise; we, therefore, provide deeper analysis of two vignettes to illustrate. Our data suggest undocumented contributions often serve best efforts to ground decisions in documentation. We would encourage CC practices and policies be rooted in more nuanced approaches to documentation.

Surgical Handover Core Outcome Measures (SH-CORE): a protocol for the development of a core outcome set for trials in surgical handover

BackgroundSurgical handover is associated with a significant risk of care failures. Existing research displays methodological deficiencies and little consensus on the outcomes that should be used to evaluate interventions in this area. This paper reports a protocol to develop a core outcome set (COS) to support standardisation, comparability, and evidence synthesis in future studies of surgical handover between doctors.MethodsThis study adheres to the Core Outcome Measures in Effectiveness Trials (COMET) initiative guidance for COS development, including the COS-Standards for Development (COS-STAD) and Reporting (COS-STAR) recommendations. It has been registered prospectively on the COMET database and will be led by an international steering group that includes surgical healthcare professionals, researchers, and patient and public partners. An initial list of reported outcomes was generated through a systematic review of interventions to improve surgical handover (PROSPERO: CRD42022363198). Findings of a qualitative evidence synthesis of patient and public perspectives on handover will augment this list, followed by a real-time Delphi survey involving all stakeholder groups. Each Delphi participant will then be invited to take part in at least one online consensus meeting to finalise the COS.Ethics and disseminationThis study was approved by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee (202309015, 7th November 2023). Results will be presented at surgical scientific meetings and submitted to a peer-reviewed journal. A plain English summary will be disseminated through national websites and social media. The authors aim to integrate the COS into the handover curriculum of the Irish national surgical training body and ensure it is shared internationally with other postgraduate surgical training programmes. Collaborators will be encouraged to share the findings with relevant national health service functions and national bodies.DiscussionThis study will represent the first published COS for interventions to improve surgical handover, the first use of a real-time Delphi survey in a surgical context, and will support the generation of better-quality evidence to inform best practice.Trial registrationCore Outcome Measures in Effectiveness Trials (COMET) initiative 2675. http://www.comet-initiative.org/Studies/Details/2675.

Mapping Science Communication in Higher Education in Portugal: A Systematic Evidence Analysis of PhD and Master’s Programs

Science communication training plays a crucial role in enabling scientists to effectively connect with the public, emphasizing essential skills such as building trust in scientific and technological advancements. Despite significant progress, some studies show a notable deficiency in higher education (HE) institutional structures and mechanisms dedicated to science communication training, addressing a diverse audience including researchers, teachers, and science monitors. This study delves into the key characteristics of current science communication postgraduate training programs within the HE landscape of Portugal. Our analysis is based on a comprehensive examination of the curricula of five science communication doctoral programs offered by four public universities in Portugal. The research involves a meticulous review of course documents and insights gathered from five directors through a detailed questionnaire. The primary objectives of this research are to discern the specific goals pursued by each course, uncover the content and development of competencies within their curricula, and explore the market opportunities envisioned by each offering. The results underscore that these programs equip students with the necessary competencies to effectively address challenges in science communication, notably enhancing public understanding of science. Significant findings suggest that Portugal’s current higher education scenario predominantly emphasizes cultivating postgraduate training activities in authentic settings, fostering collaborative partnerships with society. This article is a foundational resource for further exploration into the discipline-specific applications of science communication, aiming to elevate academic engagement with society.

A multi-method approach to drafting candidate entrustable professional activities for a general internal medicine residency programme.

Entrustable professional activities (EPAs) are units of concrete daily clinical tasks that trainee physicians should be able to handle with increasing autonomy during their postgraduate training. EPAs are gaining international recognition as an essential component of competency-based medical training programmes. The process of developing EPAs for a nationwide training programme is complex and requires an in-depth understanding of EPAs as a concept and good knowledge of appropriate development processes. This article provides a detailed description of the methodology and results of a multi-step approach for developing a list of candidate EPAs for Switzerland's postgraduate training programme in general internal medicine (GIM). We took a multi-step approach including a systematic review of international literature, four national focus groups, a national consensus process using a RAND appropriateness method, and a quality check of the selected candidate EPAs using EQual criteria. These steps generated a final list of 247 candidate EPAs in general internal medicine that were submitted for the national consensus process. After two rounds of rating, experts agreed on the appropriateness for general internal medicine postgraduate training of 225 candidate EPAs. Twenty-two were deemed inappropriate, and disagreement persisted only for two EPAs. This multi-step programme is one of the few describing in detail the process of developing a list of EPAs and providing evidence of validity at each step. The clinical breadth of our candidate EPAs, together with the detailed description of our methodology, could serve as a useful starting point from which medical education specialists or clinicians could develop or revise applicable lists of EPAs, particularly for postgraduate training programmes in either general internal medicine or family medicine.

Differences in Perceived Stress During the COVID-19 Pandemic Among Military Dental Postgraduate Residents.

In military training settings, stress can improve focus and motivation fostering effective learning. However, high perceived stress can be debilitating resulting in poor learning and clinical errors. Multiple studies have focused on medical residency stress; but there has been minimal focus on dental residents and even less on the impact of the unique stressors from the COVID-19 pandemic. The objectives of this study were to determine the impact of the COVID-19 pandemic on perceived stress of residents in a military dental residency training program and explore the association among perceived stress and anxiety, depression, sleep quality, and social support. Dental residents (N = 20) at the Naval Postgraduate Dental School participated in this study. Residents were assessed via self-report measures quarterly from March 2020 through June 2021. The assessment included measures of anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS), fatigue (FSI), and social support (DUKE-SSQ). Before the pandemic shutdown, 60% of participants reported high perceived stress. These residents reported an initial decrease in symptoms of anxiety, depression, and fatigue compared to residents reporting low pre-pandemic perceived stress but returned to baseline levels post-shutdown. Additionally, the high stress participants reported lower social support. Based on pre-pandemic perceived stress, participants responded differently to the impact of the pandemic shutdown. The low baseline stress participants may have a more robust sense of grit and resilience. These findings suggest that postgraduate dental training programs should integrate coping skills training opportunities, especially for residents reporting high perceived stress before residency.

Training Future Teachers in Genre Pedagogy: Does it Improve their Written Texts?

Recently, there has been growing interest in studying the factors affecting the development of academic writing competences of university students in different disciplinary areas. Less attention, however, has been devoted to the influence on this phenomenon of the specialised training students receive, even in undergraduate and postgraduate teacher training programmes where models of writing development are analysed and implemented. In this paper we measure the effect on the writing of 22 students in the Bachelor´s Degree in Primary Education of the knowledge of the genre pedagogy in the Reading to Learn model, based on Systemic Functional Linguistics. For this purpose, two groups of students in the subject Spanish Language Didactics wrote a descriptive report or an anecdote before and after a didactic intervention. From the 82 participants, texts by 11 from each group were selected. The 44 texts were evaluated by applying a scoring scheme with 8 items (rated from 1 to 4) covering features from genre to clause level, following the field, tenor and mode components established by Systemic Functional Linguistics. The statistical study shows post-intervention improvements in all the variables analysed. The Wilcoxon test shows these were significant for the narrative texts (TN1: 23.36; TN2: 30.91), but not for the informative ones (TED1: 25.20; TED 32:26).

Analysis and evaluation of peer group support for doctors in postgraduate training following workplace violence and aggression.

Workplace violence and aggression toward healthcare staff has a significant impact on the individual, causing self-blame, isolation and burnout. Timely and appropriate support can mitigate harm, but there is little research into how this should be delivered. We conducted multi-speciality peer groups for London doctors in postgraduate training (DPT), held over a 6-week period. Pre- and post-group burnout questionnaires and semi-structured interviews were used to evaluate peer support. Thematic analysis and descriptive statistical methods were used to describe the data. We found four themes: (a) the experience and impact of workplace violence and aggression on DPT, (b) the experience of support following incidents of workplace violence and aggression, (c) the impact and experience of the peer groups and (d) future improvements to support. DPTs showed a reduction in burnout scores. Peer groups are effective support for DPT following workplace violence and aggression. Embedding support within postgraduate training programmes would improve access and availability.

Was it all worth it? A graduating resident perspective on CBME

Background Our institution simultaneously transitioned all postgraduate specialty training programs to competency-based medical education (CBME) curricula. We explored experiences of CBME-trained residents graduating from five-year programs to inform the continued evolution of CBME in Canada. Methods We utilized qualitative description to explore residents’ experiences and inform continued CBME improvement. Data were collected from fifteen residents from various specialties through focus groups, interviews, and written responses. The data were analyzed inductively, using conventional content analysis. Results We identified five overarching themes. Three themes provided insight into residents’ experiences with CBME, describing discrepancies between the intentions of CBME and how it was enacted, challenges with implementation, and variation in residents’ experiences. Two themes – adaptations and recommendations – could inform meaningful refinements for CBME going forward. Conclusions Residents graduating from CBME training programs offered a balanced perspective, including criticism and recognition of the potential value of CBME when implemented as intended. Their experiences provide a better understanding of residents’ needs within CBME curricula, including greater balance and flexibility within programs of assessment and curricula. Many challenges that residents faced with CBME could be alleviated by greater accountability at program, institutional, and national levels. We conclude with actionable recommendations for addressing residents’ needs in CBME.

Interprofessional Curriculum Delivery: Experience of a Primary Care Education Program.

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011-2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were calculated for interprofessional professional education (IPE) program domains, system impacts, and program practices. Qualitative responses were coded based on curricular domains and key program components. The study cohort included 369 HPTs. Site and profession standardized indirect ratios across all professions indicated improvements in curricular domains, system impacts, and program practices, with significant differences observed for associated health HPTs as compared to other HPTs for performance improvement. Qualitative data indicated that profession was associated with differences in perceptions of the curriculum. Although improvements occurred over time, our findings support the need for the thoughtful consideration of profession-specific identity characteristics when designing interprofessional curricula.

Experiences and Perspectives of Racism Among Trainees in Canadian Postgraduate Training Programs

Experiences and Perspectives of Racism Among Trainees in Canadian Postgraduate Training Programs

Legacy of Compassion: The Life and Contributions of Dr. Ronald Joseph Garst in Advancing Orthopaedic Surgery in Bangladesh.

Dr. Ronald Joseph Garst, a distinguished spine surgeon and missionary, significantly impacted the field of orthopaedic surgery in Bangladesh, especially during and after the country's Liberation War, when the nation had no orthopaedic specialists.His experiences during Bangladesh's struggle for independence inspired him to establish rehabilitation centers for injured freedom fighters and to found the Rehabilitation Institute and Hospital for the Disabled (RIHD), which later became the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Bangladesh's first tertiary-level trauma center. In Bangladesh, Dr. Garst was critical in organizing care for injured freedom fighters, setting up a central limb and brace center, and launching a post-graduate training program for orthopaedics, physiotherapists, and occupational therapists. He successfully raised funds, attracted international support, and provided essential training to Bangladeshi doctors, nurses, and limb-makers. Dr. Garst's legacy extends beyond his medical achievements; his humanitarian spirit and dedication to helping the underprivileged earned him honorary citizenship in Bangladesh. He remained committed to supporting ongoing efforts at RIHD, frequently visiting Bangladesh and contributing equipment and training materials until his passing. Dr. Garst's contributions, such as initiating morning academic sessions at RIHD, continue to influence the orthopaedic community in Bangladesh. Thisarticle explores Dr. Garst's remarkable journey, his influence on orthopaedic surgery in Bangladesh, and the enduring impact of his work.

Holistic Review of Applicants by the United States Postgraduate Training Programs Is Not Associated With the Percentage of Female Residents.

Introduction Given the underrepresentation of female physicians in most specialties and the aim of holistic review in residency applicationsto improve the diversity of matriculating resident physicians in the United States (US) postgraduate medical training programs, we examined the association between holistic review and female resident representation among US postgraduate training programs. Methods We conducted a cross-sectional survey of US postgraduate training programs to inquire about their use of holistic review for resident applications (independent variable). The primary outcome was the percentage of female residents in each program, which was obtained along with other program-level characteristics from the Fellowship and Residency Electronic Interactive Database Access (FREIDA) catalog in April 2023. We limited the analysis to the 10 specialties with the most training spots in 2022, including anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, orthopedic surgery, pediatrics, psychiatry, and surgery (general). We also examined the interactions between holistic review and specialtyand the percentage of female facultyusing model comparison and simple slopes analyses. Results Of the 3,364 total programs surveyed from the 10 specialties, 222 (6.6%)responded. Responders and nonresponders had similar program-level characteristics, including program type (e.g., university, community), specialty, and reported minimum board examination scores. Of the 222 responders, 179 (80.6%) reported performingholistic review. The percentage of female residents was 49.0% (interquartile range 37.5 to 66.7) in the no holistic review group and 47.8% (35.4 to 65.0) in the holistic review group (median difference 0.9%, 95% confidence interval -6.7 to 8.3). Furthermore, there was no evidence of interaction between holistic review and either the specialty or the percentage of female faculty on the outcome of the percentage of female residents. Conclusions Holistic review of residency applications in this limited sample of US postgraduate training programs was not associated with the percentage of female residents. The role of holistic review in addressing the imbalance of male and female physicians in the healthcare workforce, particularly between specialties, remains unknown.

Registrars' experience with research in family medicine training programmes in South Africa.

Completion of a research assignment is a requirement for specialist training in South Africa. Difficulty with completion delays graduation and the supply of family physicians. The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes. An explorative descriptive qualitative study. Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes. Saturation was achieved after 12 semi-structured interviews. The framework method was used for data analysis, assisted by ATLAS.ti software. The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed. Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory. Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays. The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive. The individual research experience was dependent on choosing a feasible project and having dedicated time. The balancing of personal, professional and academic responsibilities was challenging. Training programmes should revise the teaching of research and improve institutional processes. Supervisors need to become more responsive, with adequate expertise. Provincial support is needed for streamlined approval and dedicated research time.Contribution:The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country.

National Survey on Support for Nurse Practitioner and Physician Assistant/Associate Postgraduate Fellowship/Residency Programs and Director Compensation.

Introduction Although there has been a significant and steady increase nationwide in the number of physician assistant/associate (PA) and nurse practitioner (NP) postgraduate residency/fellowship programs, there remains a paucity of research related to the level of operational support available in many of these programs to facilitate specialty training. Therefore, the primary aim of this study is to conduct a national survey to gather foundational data regarding advanced practice provider (APP) postgraduate fellowship/residency operational support and program director total compensation data in the United States. Methodology A descriptive cross-sectional survey consisting of 27 questions was distributed via email to 336 postgraduate NP, PA, joint NP/PA, and certified nurse-midwifery residency/fellowship programs between November 2023 and December 2023. Frequency tables and descriptive statistics were used to summarize the survey data. Additionally, Spearman's rank correlation coefficients were performed to determine the relationship between the dependent variables and the independent variable. Results There was a statistically significant positive relationship between the organization values the postgraduate program and having sufficient administrative time (rs = 0.342, p < 0.001), having adequate support staff (rs = 0.340, p < 0.001), and being fairly compensated (rs = 0.356, p < 0.001) for program roles and responsibilities. Moreover, slightly less than half of respondents reported having adequate support staff and sufficient administrative time to address program responsibilities. Only 50% of respondents believed they were fairly compensated for their position. Respondents moderately agreed that their organization values the postgraduate training program (M = 4.00, SD = 1.00). Conclusions The results of this study highlight the perceptions of postgraduate program directors regarding adequate administrative support and resources to facilitate specialty-specific training for NPs and PAs. Further research is warranted to evaluate the level of operational support needed to develop and sustain postgraduate APP residency/fellowship training programs now and in the future.

Credentialing and training advanced practice providers for advanced tertiary care pediatric otolaryngology: A curriculum for hospital and ambulatory practice

ObjectivesInclusion of advanced practice providers (APPs) in hospital-based pediatric otolaryngology has been growing rapidly, aligning with a 70% increase in physician assistants in all surgical subspecialties in recent years. A post-graduate training program is developed to reflect these growing and changing responsibilities. MethodsCurriculum development took place at one institution over eight years for 16 APPs following a standard Six Step Approach to medical curriculum: 1) Problem Identification and General Needs Assessment, 2) Targeted Needs Assessment, 3) Goals & Objectives, 4) Education Strategies, 5) Implementation, and 6) Evaluation and Feedback. This was integrated into an onboarding process for new hires and a continuing education plan for established providers. Gaps were identified throughout the process to improve education, skills required for competency, and readiness for independent practice. ResultsThe curriculum incorporated a subset of goals and objectives from the familiar resident curriculum with significant differences in orientation and onboarding. A Clinical Competency Checklist was used initially for feedback and later to support credentialing after completion of the curriculum. A Procedure Rating Form was used for feedback and documentation of the number of performances required for credentialing. Self-Assessment was utilized to further identify readiness for independence and tailor additional education to meet practice needs. ConclusionThe curriculum and onboarding process presented can be used for any advanced practice provider joining an individual or team of pediatric otolaryngology providers. A standardized curriculum is helpful to the supervisors and trainees. Further collaboration between institutions and development of benchmarks will help ensure excellence in education and in care of pediatric otolaryngology patients.