Program Directors Research Articles

Sentiment analysis of letters of recommendation for a U.S. pain medicine fellowship from 2020 to 2023.

Letters of recommendation (LORs) are an important part of pain medicine fellowship applications that may be subject to implicit bias by the letter's author. This study evaluated letters of recommendation for applications to pain medicine fellowships in the United States to characterize biases and differences among applicants over four application cycles. This was a retrospective single-site cohort study. De-identified LORs were collected from 2020 to 2023 from one institution. The Valence Aware Dictionary and sEntiment Reasoner (VADER) natural language processing package scored positive LOR sentiment. In addition, the deep learning tool, Empath, scored LORs for 15 sentiments. Wilcoxon rank-sum and one-way ANOVA tests compared scores between applicant demographics: gender, race, medical school type, residency specialty, and chief resident status, as well as letter writers' academic position. Nine hundred and sixty-four applications were studied over four application cycles. Program directors wrote fewer words (p = 0.020) and less positively (p < 0.001) compared to department chairs and letter writers with neither position. Department chairs wrote with less "negative emotion" compared to both program directors and writers with neither position (p < 0.001). Anesthesiologist applicants received more letters highlighting "achievement" (p < 0.001) while PM&R applicants submitted letters with less "negative emotion" (p < 0.001) compared to other specialties. Chief residents' letters scored higher in "leader" sentiment (p < 0.001) and lower in "negative emotion" (p < 0.001). Linguistic content did not favor certain genders or races over others. However, disparities in LORs do exist depending on an applicant's specialty and chief resident status, as well as the academic status of the letter writer.

National Council on Radiation Protection (NCRP) 2024 annual meeting: advanced and small modular nuclear power reactors**The authors have confirmed that any identifiable participants in this study have given their consent for publication.

On 25-26 March 2023, the U.S. National Council on Radiation Protection and Measurements (NCRP) held its 2024 annual meeting in Bethesda, Maryland, USA. The NCRP dates from 1929, and this meeting celebrated the 60th anniversary of receiving a U.S. Congressional Charter. For this annual meeting the NCRP felt it was essential to provide a briefing about advanced and small modular nuclear reactors (SMRs). The Journal of Radiological Protection is delighted to publish the following synopsis of material presented at the U.S. NCRP meeting. This synopsis is divided into five sections. The first section provides an overview of the whole meeting together with summaries of two context setting overview papers. The following four sessions of this synopsis are specific to advanced and small modular nuclear power reactors. The meeting also included keynote presentations by three of NCRP annual award recipients. The meeting topical areas were Technology Overview and Critical Issues. The individual papers laid the groundwork to understanding reactor technologies, terminology, and the fundamental concepts and processes for electrical generation. The perspectives of the U.S. Environmental Protection Agency and states, through the Conference of Radiation Control Program Directors were provided. The papers included a discussion of diverse topics including potential emergency preparedness considerations, radiological survey requirements, an evaluation of the future of nuclear power, the economics of reactors (both large and small), and the critical issues identified by the recent National Academies of Sciences' study on advanced reactors. The summary papers were developed to briefly document the major points and concepts presented during the oral papers presented at the 2024 NCRP Annual Meeting. The meeting heralded the dawn of a new era for commercial nuclear power.

Navigating Uncertainty: Adapting Guidance for Mental Health During the COVID-19 Public Health Emergency & the Crucial Role of Bi-directional Feedback.

In response to the COVID-19 public health emergency, state and local mental health authorities rapidly developed and disseminated guidance to community mental health agencies. While tailored communication is effective to reach target audiences under usual circumstances, strategies to facilitate the implementation of guidance amidst a rapidly evolving public health emergency are not well understood. This project sought to understand factors informing decision-making about adaptations to guidance, and strategies used to disseminate and facilitate guidance implementation among system-level community partners in OnTrackNY Coordinated Specialty Care (CSC) programs for early psychosis. Semi-structured interviews were conducted with New York State Office of Mental Health (NYS OMH) state and local mental health authorities including state leaders (n = 3) and NYS OMH field office directors (n = 4), OnTrackNY program directors (n = 4), and leadership and trainers of an intermediary organization, OnTrack Central (n = 12). Interviews were analyzed using content analysis. Code reports relevant to guidance decision-making and dissemination were reviewed to identify emerging themes. For state and local mental health authorities, decision-making was influenced by changing COVID-19 risk levels, need for alignment between federal and local guidance, and balancing support for workforce capacity and mental health service continuity. For OnTrackNY program directors, decision-making was influenced by internal infrastructure and processes (e.g., program autonomy), availability of resources (e.g., technology), and perspective on managing risk and uncertainty (e.g., COVID-19, regulatory waiver expiration). For OnTrack Central, decision-making focused on balancing CSC model fidelity with OnTrackNY team capacity and resources. Dissemination of guidance consisted of mass and targeted strategies. Information flow was bidirectional such that top-down dissemination of guidance (e.g., from state mental health authorities to providers) was informed and refined with bottom-up feedback (e.g., from providers to state leadership) through surveys and professional forums (e.g., COVID-19 town halls, provider learning collaboratives). Unlike a planned approach to disseminate new policies, public health emergencies create variable landscapes that may warrant a deeper understanding of how guidance may be adapted to fit rapidly evolving community partner needs. Findings may inform efforts to identify processes that contribute to adaptation and dissemination of guidance for mental health during future public health emergencies.

Burnout among Postgraduate Healthcare Trainees at a Tertiary Healthcare Center in Saudi Arabia.

The aim of this study was to investigate the level of burnout among postgraduate healthcare trainees at a tertiary care center in Riyadh, Saudi Arabia, and assess the need to establish a well-being program. This cross-sectional study was conducted between December 2021 and January 2022 and used two validated questionnaires: the Copenhagen Burnout Inventory (CBI) for assessing burnout among postgraduate healthcare trainees, and a questionnaire for assessing program directors' opinion on the need for a well-being program. A total of 386 trainees and 85 program directors completed the questionnaire. In both groups, the majority of the respondents were male (trainees: 53.9%; program directors: 61.2%). A total of 226 trainees (58.5%) scored above the CBI burnout cut-off score, with the median score being highest in the personal domain (62.5,IQR: 45.8-75). In the univariate analysis, the mean burnout score was higher among trainees who were married (P = 0.036), had children (P = <0.001), and were seniors (P = 0.028), whereas in the multivariate analysis, the only significant predictor of burnout was having 1-2 children (P = 0.023) or 3-4 children (P = 0.013). In the program directors survey, 90.6% agreed that improving physicians' well-being would directly rectify patients' overall well-being, but only 28.2% stated that it is currently incorporated in the curriculum. This study found that a large proportion of postgraduate healthcare trainees experience burnout, particularly in the personal domain. Although program directors supported the concept of trainees' well-being, its incorporation into the curriculum was lacking, suggesting the necessity of establishing a well-being program.

Exploring Impact and Variability of Research Productivity Among Academic Orthopaedic Leaders.

Assessing scholarly contributions in academic orthopaedic surgery remains challenging, despite the importance of publication productivity in evaluating academic leaders. The Hirsch (h)-index and its derivative, the m-index, offer objective measures to compare and evaluate publication productivity. The primary aims of this study were to compare h- and m-indices of department chairs and residency program directors of orthopaedic training programs in the United States and assess the association between h-index and program rank. A publicly available Doximity report was used to identify and rank orthopaedic surgery residency programs in the United States. Internet-based searches of institution-specific websites were performed to confirm current department chairs and residency program directors as of January 2024. H-index data were collected from a publicly available database known as Scopus. The m-index was calculated as the quotient of h-index and years in practice. Gender and years in practice were obtained through available biographies on institution-specific websites. Department chairs had significantly higher h- and m-indices at both the career and 5-year time intervals compared with program directors. Upon subgroup analysis, department chairs and program directors at top-10 ranked programs had significantly higher h- and m-indices compared with the entire population of department chairs and program directors. Linear regression analyses demonstrated a direct linear association between department chair/program director h- and m-indices and program rank. Publication productivity was higher for department chairs than residency program directors. Orthopaedic leaders at top-10 institutions had higher publication productivity compared with those at institutions outside of the top 10, per Doximity rankings. Finally, there is substantial variation in publication productivity of orthopaedic surgeons in leadership roles at academic institutions in the United States. This study highlights the publication productivity of orthopaedic surgery department chairs and residency program directors and describes the linear association between publication productivity of academic orthopaedic leaders and program rank. This information can be utilized by those interested in learning more about the publication productivity among academic orthopaedic surgeons across different institutions and can assist those who are involved in the hiring and promotion process at these academic institutions.

Preference Signals and Interview Invitations: Insight Into Recent Updates to the Oto-HNS Residency Application Process.

While students in the 2023 Otolaryngology-Head and Neck Surgery (Oto-HNS) residency match were allowed 7 preference signals, this number increased to 25 for the 2024 match with the goal of reducing the overall application volume. We sought to understand the impact of this change to application volume and interview patterns. Cross-sectional survey. Program directors of US Oto-HNS residency programs were invited to participate in an anonymous, electronic survey. An anonymous REDCap questionnaire was sent via email to all current Oto-HNS program directors in January 2024. Data were analyzed using R Version 4.3.1. Forty-four program directors completed the survey. While programs received a median [interquartile range] of 400 [363, 445] applications last year, this year they reported receiving 295 [233, 339] applications of which a median of 110 applicants (40%) signaled the program. While the median percent of applicants who were interviewed by a program was 16%, the percent of interviews among applicants who had signaled the program was 37%. Of all interviews, nearly all (median 100% [91, 100]) were of applicants who had signaled the program. Finally, 40 (91%) of program directors reported that signaling played an important role in deciding to interview a candidate. Preference signals play an important role in a residency program's decision to interview a candidate. Our findings suggest that the implementation of preference signals successfully decreased the average number of applications received by each program and that medical students applying to more programs than available signals may experience diminishing returns.

"Ardor and diligence": Quantifying the faculty effort needed in emergency medicine graduate medical education.

Regulatory requirements around protected faculty effort to support graduate medical education (GME) programs have changed. The amount of labor required to run a GME program is unknown. We sought to describe the work performed by program leadership and core faculty in emergency medicine (EM). We performed a prospective survey study of core faculty in EM. Participants completed a demographic questionnaire followed by quarterly time surveys, covering activities in eight domains: evaluation, teaching and education, scholarly activity, service, interview/recruitment, clinical supervision, student responsibilities, and wellness and administration. We collected data from April 2022 to March 2023. We calculated descriptive statistics and used analyses of variance (ANOVA) to assess differences by faculty role and quarter. A total of 596 physicians completed the demographic questionnaire and 347 (58.2%) completed at least one quarterly time survey including 142 (41%) females, 48 (14%) program directors (PDs), 84 (24%) assistant/associate program directors (APDs), and 215 (62%) general core faculty (GCF). The mean number of hours per week spent on nonclinical education work was 60 h for PDs, 47 h for APDs, and 44 h for GCF. ANOVA found significant differences in mean hours per week and faculty role in domains of evaluation (p < 0.001), service (p = 0.007), and interview/recruitment (p < 0.001). We detected differences in mean hours per week and quarter in domains of evaluation (p < 0.001), teaching and education (p < 0.001), interview and recruitment (p < 0.001), and clinical supervision (p < 0.001). Running a residency program requires many hours of faculty work, which can vary based on faculty role and time of year. These results can inform decisions regarding faculty support.

Diversity, Equity, and Inclusion Efforts in Graduate Medical Education: Identifying Opportunities for Collaborative Learning.

Background Physician-patient racial and cultural concordance is essential to address health care disparities. Yet, limited literature on diversity, equity, and inclusion (DEI) outcomes in graduate medical education (GME) suggests the need for high-yield DEI resources. Objectives To describe and identify DEI efforts by US residency program director (PD) associations and areas for collaboration among the GME community. Methods Through bimonthly teleconferences and 5 iterative revisions from June to September 2022, the DEI workgroup of the US Organization of PD Associations developed a 17-question needs assessment survey to investigate DEI activities across residency PD associations, which was delivered twice electronically from September to November 2022 to 30 specialty PD association representatives. Results Survey response rate was 73% (22 of 30). Specialties track resident demographics more than PD demographics (11 of 22, 50% vs 7 of 22, 32%). Tracked demographics vary and include race, gender, and sexual orientation. Most PD associations have DEI committees (16 of 22, 73%) implementing various initiatives, the most common of which was providing resources to ensure diverse representation (11 of 16, 69%). Most specialties provide residency recruitment resources (14 of 22, 64%) and funding for visiting rotations or mentorship for underrepresented trainees (12 of 22, 54%). Resources for pipeline programs (7 of 22, 32%) and retention of diverse residents (7 of 22, 32%) were less common. Faculty development training focused more on teaching DEI to residents (14 of 22, 64%) than on teaching health disparities (7 of 22, 32%). Conclusions Our study demonstrates substantial DEI interventions among specialty PD associations. Yet, educational gaps exist in specific DEI content, faculty development, and curricular dissemination.

Mapping out Remediation: An Actionable Roadmap to Support Trainees Through Remediation

What’s NewThis qualitative analysis offers an actionable, stepwise approach to remediation. IntroductionThe goal of graduate medical education is for trainees to develop the competence needed to practice independently; however, some residents struggle to achieve competency and require remediation. Evidence around how to best facilitate remediation is lacking. The objective of this study was to understand best practices for remediation in pediatrics. MethodA national web-based survey of pediatric residency program directors (PDs) on remediation practices was performed. The survey included 3 open-ended questions about PDs’ experiences with remediation. Self-reported barriers to and strategies for remediation were systematically analyzed using inductive thematic analysis to develop a theory of effective remediation in pediatric residency training. ResultsA total of 99 out of 195 (50.8%) program directors responded. Two main themes emerged: developing a personalized plan that ensures competency attainment and fostering psychological safety. Twelve categories outline actionable steps that PDs can take to make the remediation process successful. DiscussionBuilt from insight from pediatric PDs, we propose a conceptual model for effective remediation that accounts for competency attainment while safeguarding the emotional health of the resident. The conceptual model breaks the remediation process down into four phases: identification of the learner who struggles, planning the remediation process, implementation of the plan, and assessing the outcome of the process.

ChatGPT Solving Complex Kidney Transplant Cases: A Comparative Study With Human Respondents.

ChatGPT has shown the ability to answer clinical questions in general medicine but may be constrained by the specialized nature of kidney transplantation. Thus, it is important to explore how ChatGPT can be used in kidney transplantation and how its knowledge compares to human respondents. We prompted ChatGPT versions 3.5, 4, and 4 Visual (4V) with 12 multiple-choice questions related to six kidney transplant cases from 2013 to 2015 American Society of Nephrology (ASN) fellowship program quizzes. We compared the performance of ChatGPT with US nephrology fellowship program directors, nephrology fellows, and the audience of the ASN's annual Kidney Week meeting. Overall, ChatGPT 4V correctly answered 10 out of 12 questions, showing a performance level comparable to nephrology fellows (group majority correctly answered 9 of 12 questions) and training program directors (11 of 12). This surpassed ChatGPT 4 (7 of 12 correct) and 3.5 (5 of 12). All three ChatGPT versions failed to correctly answer questions where the consensus among human respondents was low. Each iterative version of ChatGPT performed better than the prior version, with version 4V achieving performance on par with nephrology fellows and training program directors. While it shows promise in understanding and answering kidney transplantation questions, ChatGPT should be seen as a complementary tool to human expertise rather than a replacement.

Musculoskeletal imaging fellowship program directors: A study of educational paths, and scholarly engagement in the United States

PurposeThe overall aim of the study is to analyze and provide a comprehensive understanding of the demographics, educational backgrounds, and scholarly activities of musculoskeletal imaging fellowship program directors across the United States. MethodsA list of all members of the Society of Skeletal Radiology was obtained and musculoskeletal imaging fellowship program directors across the US were included. Publicly available online sources were used to gather demographic and educational information about each musculoskeletal imaging fellowship program director, which included the online curriculum vitae from the program websites, Health Grades, Doximity, and Elsevier's Scopus database. Demographic and educational data including age, gender, educational background (medical school, residency, fellowship), additional degrees, academic rank, prior leadership positions, and metrics of scholarly activity were recorded. Fellowships in diagnostic musculoskeletal radiology along with additional degrees were recorded. A two-tailed unpaired t-test was used to calculate the difference between means of scholarly activity between male and female PDs. ResultsIn this study encompassing 92 programs across the United States, the majority (88) were dedicated to pure Musculoskeletal (MSK) Imaging Fellowship, while one each offered combined training in MSK and Body Imaging, MSK, and Emergency Imaging, MSK Sports, and Interventional Spine, and Pediatric MSK Imaging. Program directors were identified for 90 out of 92 programs, revealing a regional distribution of 29 in the South (31.5 %), 24 in the North East (26.1 %), 20 in the Midwest (21.74 %) and 19 in the West (20.65 %). Gender analysis unveiled a predominantly male representation, with 71 male directors compared to 17 female directors, while age ranged from 30 to 70 years, with a mean age of 47.17 ± 7.4 years. Medical school backgrounds predominantly featured MD degrees (80), followed by IMG (7) and DO (4) degrees, with the most common IMG source being India. Faculty positions were mainly distributed among Assistant Professors (35), Associate Professors (32), and Professors (11). Research output metrics showcased a mean of 41.943 publications and an h-index of 10.625. Extra degrees were obtained by 31 directors, with common additions being other fellowships, MBAs, MS degrees, and PhDs. Notably, some directors held previous or current leadership positions, while a few had completed residencies outside of Radiology or pursued fellowships beyond MSK Imaging. ConclusionMusculoskeletal imaging fellowship program directors across the United States are predominantly male, with approximately 8 % having graduated from international medical schools. The most common training pathway for these directors is completing a diagnostic radiology residency followed by a musculoskeletal radiology fellowship. This study highlighted the gender disparity within this leadership group and emphasized the diverse educational backgrounds that contribute to the field of musculoskeletal imaging.

Nephrology Program Director and Fellow Home Hemodialysis (HHD) Curriculum Survey

Nephrology Program Director and Fellow Home Hemodialysis (HHD) Curriculum Survey

Survey of Clinical Knowledge and Procedural Readiness of Pulmonary Fellows to Start Interventional Pulmonary Fellowship: A Survey of Interventional Pulmonary Fellowship Directors.

Entry into the interventional pulmonary (IP) fellowship requires prerequisite training in pulmonary and critical care medicine (PCCM) fellowship in the United States. IP fellowship has become standardized, but the prerequisite training may be quite variable depending on the learner's exposure to IP during their PCCM fellowship. A survey study was conducted to identify potential foundational knowledge and/or skills gaps of new fellows entering IP fellowships. This may help both PCCM and IP fellowship directors to identify common knowledge gaps within PCCM training specific to IP. Based on components of the ACGME's common program requirements for PCCM fellowships, a survey was developed and categorized into 5 domains: nonprocedural skills, didactic knowledge, diagnostic bronchoscopy, pleural procedures, and airway/percutaneous procedures. The survey was then sent to 42 IP fellowship directors after the content validity review and approval by the Association of Interventional Pulmonary Program Directors. The survey response rate was 88.1% (37/42). The overall mean scores in all 5 domains were perceived as below competent (<3). The highest mean domain was nonprocedural skills, and the lowest was airway/percutaneous procedures. Within the domains, there were 4/ 30 topics that were considered competent with a score of ≥3 as competent or higher; bronchoscopy lavage (mean: 3.5/5, SD: 0.87), interpersonal skills (mean: 3.03/5, SD: 0.76), thoracentesis (mean: 3.14/5, SD: 0.89), and ultrasound for pleural effusion (mean: 3.19/5, SD: 0.84). There are perceived gaps in PCCM training pertaining to IP fellowship readiness.

Transfusion Camp: The UK experience and its value in improving knowledge of transfusion medicine among postgraduate trainees.

To report the UK experience of rolling out Transfusion Camp. Transfusion Camp is a structured education programme developed in Toronto, with the aim of reducing knowledge gaps in transfusion medicine in postgraduate trainees. It consists of didactic lectures viewed online by the participants, then interactive, locally delivered seminars. Since 2015, it has been rolled out in the United Kingdom, and is now available in four centres. Here, we report the UK experience of Transfusion Camp and outcomes. Trainees are recruited via the training programme directors in each region. Pre- and post-course assessments are administered using the validated BEST (Biomedical Excellence for Safer Transfusion) test, with possible scores 0-20, and confidence measured on an A-E Likert scale. Since 2015, 130 trainees have participated in Transfusion Camp in the United Kingdom. Trainees from all specialties significantly improved their BEST-test scores after attending the course (mean score 11.6/20 before the course, compared with 14.3/20 after the course), and confidence in managing transfusion-related issues was also significantly improved. We recommend that all centres consider offering Transfusion Camp to trainees in haematology and other specialties that frequently use blood transfusions, such as anaesthesia/ICU, Internal Medicine and others.

Providing Delayed, In-Person Collected Feedback From Residents to Teaching Faculty: Lessons Learned.

Background Teaching faculty request timely feedback from residents to improve their skills. Yet even with anonymous processes, this upward feedback can be difficult to obtain as residents raise concerns about identification and repercussions. Objective To examine faculty perception of the quality and content of feedback from residents after increasing anonymity and sacrificing timeliness. Methods Between 2011 and 2017, an associate program director at a large internal medicine residency program met briefly with each resident individually to obtain feedback about their teaching faculty shortly after their rotation. To improve anonymity, residents were promised their feedback would not be released until they graduated. In 2019, all feedback was collated and released at one time to faculty. We administered 3 timed, voluntary, anonymous, 36-item closed-ended surveys to faculty asking about the content and value, and to self-identify whether the feedback was praise, constructive, or criticism. Results Exactly 189 faculty participated with 140 completing all 3 surveys (74.1% response rate). Faculty reported this feedback content to be of higher quality (81.0%, 81 of 100) and quantity (82.4%, 84 of 102) in contrast to prior feedback. More than 85.4% (88 of 103) of faculty agreed this feedback was more specific. Faculty identified less praise (median 35.0% vs median 50.0%, P<.001) and more negative constructive feedback (median 20.0% vs median 5.0%, P<.001) compared to prior feedback. More than 82% (116 of 140) of faculty reported it would change their behavior, but 3 months after receiving the feedback, only 63.6% (89 or 140) felt the same way (P<.001). Faculty were divided on the necessity of a time delay, with 41.4% (58 of 140) believing it reduced the feedback's value. Despite the delay, 32.1% (45 of 140) felt they could identify residents. Conclusions Offering a substantial delay in feedback delivery increased anonymity and enabled residents to furnish more nuanced and constructive comments; however, faculty opinions diverged on whether this postponement was valuable.

Success stories: exploring perceptions of former fellows of a global faculty development program for health professions educators

BackgroundFaculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadership for over two decades through the International FAIMER Institute in the USA and FAIMER Regional Institutes located globally. This paper explores perceptions of former program participants (Fellows) of FAIMER global FDPs by eliciting their success stories.MethodsThe study utilized a modified Success Case Method approach. Study participants recruited were 14 FAIMER Fellows nominated as exemplars of success cases by program directors and faculty members from seven global sites, using extreme case sampling technique. Of the 14 Fellows, two were from Africa, nine from Asia and three from Latin America. In-depth interviews were conducted with each Fellow to understand their self-perceived success, and factors from both their local context and FAIMER’s FDPs that have contributed to their success. Theoretical thematic analysis method was used to analyze the data.ResultsThe top three areas of success perceived by Fellows were career advancement & recognition, professional development, and advancement of HPE. Fellows identified both institutional-level factors and personal attributes as contributing to their success. They also reported that FAIMER global FDPs have substantially contributed to their success by expanding professional networks, fostering academic achievement, and enhancing interpersonal development and leadership skills.ConclusionsThe findings show that Fellows perceive that there are multiple pathways for them to succeed in advancing the field of HPE. The Fellows’ stories highlight the continuing value of FAIMER global FDPs for HPE educators worldwide in professional development and leadership. The study also proposes recommendations for enhancing faculty development activities in HPE.

Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement.

In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education. To recommend nutrition competencies for inclusion in medical education to improve patient and population health. The research team conducted a rapid literature review to identify existing nutrition-related competencies published between July 2013 and July 2023. Additional competencies were identified from learning objectives in selected nutrition, culinary medicine, and teaching kitchen curricula; dietetic core competencies; and research team-generated de novo competencies. An expert panel of 22 nutrition subject matter experts and 15 residency program directors participated in a modified Delphi process and completed 4 rounds of voting to reach consensus on recommended nutrition competencies, the level of medical education at which they should be included, and recommendations for monitoring implementation and evaluation of these competencies. A total of 15 articles met inclusion criteria for competency extraction and yielded 187 competencies. Through review of gray literature and other sources, researchers identified 167 additional competencies for a total of 354 competencies. These competencies were compiled and refined prior to voting. After 4 rounds of voting, 36 competencies were identified for recommendation: 30 at both undergraduate and graduate levels, 2 at the undergraduate level only, and 4 at the graduate level only. Competencies fell into the following nutrition-related themes: foundational nutrition knowledge, assessment and diagnosis, communication skills, public health, collaborative support and treatment for specific conditions, and indications for referral. A total of 36 panelists (97%) recommended nutrition competencies be assessed as part of licensing and board certification examinations. These competencies represent a US-based effort to use a modified Delphi process to establish consensus on nutrition competencies for medical students and physician trainees. These competencies will require an iterative process of institutional prioritization, refinement, and inclusion in current and future educational curricula as well as licensure and certification examinations.

Pediatric Dentistry Program Directors as stakeholders in the process of Board certification.

Board certification is an important credential for pediatric dentists to achieve for purposes of career advancement, hospital privileges, and reputation. The purpose of this pilot study was to assess the engagement of residency Program Directors (PDs) with the Board certification process in terms of criteria for clinical readiness, curriculum development, and value. An additional objective was to identify challenges and ways in which PDs may need support as they prepare residents for Board certification. Eighty-seven PDs were invited to participate in this study, out of which 32 agreed to participate (36% response rate). The study included a digital non-validated survey and verbal interviews. Digital and verbal survey results were analyzed using descriptive statistics. PDs had recurrent themes in their descriptions of clinical readiness, including information gathering, application of knowledge, and professional awareness. Half of the participants used the American Board of Pediatric Dentistry (ABPD) exam domains as a guideline in their curriculum development. Of the verbal interview participants (N=32), 30(94%) felt that Board certification was very important to their residents and program. Many barriers to successful completion of the Board exam were discussed, and a diverse array of suggestions were made for mechanisms to better support PDs as they prepare residents for Board certification. Board certification is valued by PDs and influences their criteria for clinical readiness. Increased engagement with the ABPD will facilitate better support for PDs and will enhance the consistency of training standards in residency programs.

Education as an e-resilient system: Empirical insights from stakeholder perspectives in public affairs education

ABSTRACT This paper explores the concept of e-resilience in educational systems, particularly in Public Affairs Education, in response to the COVID-19 pandemic. We investigate the drivers and challenges faced by actors from an educational system perspective, which is conceptualized by adjusting Bronfenbrenners’ ecological model using dimensions of Technology, Human, and Intersections and levels Macro, Meso and Micro, during this global shock. Utilizing a multiple case study approach across Argentina, Nigeria, South Africa, the Netherlands, and the United States, we examine e-resilience through 36 group interviews involving 41 students, staff, administration, and program directors. Our findings reveal that challenges within the technological system impact overall system performance, while human-level challenges disrupt learning and pose greater obstacles for the system. Despite these challenges, each context exhibits various drivers, providing insights for building more robust educational systems. By better understanding the dynamics of e-resilience within each educational system context, we can enhance educational systems in the face of unprecedented shocks.

Digital technology implementation in prosthodontics postgraduate programs in Saudi Arabia: a multi-institutional survey of program directors

ObjectiveTo assess the current status of digital technology (DT) implementation in prosthodontics post-graduate (PG) programs in Saudi Arabian dental institutions.MethodologyA 19-item survey was created using Google forms and the link was emailed to the 29 prosthodontics PG program directors (advanced clinical training and joint program) in Saudi Arabia. The questionnaire contained five Sect. 1) didactic training and DT usage in PG preclinical, clinical and laboratory training, 2) incorporation of DT in PG program, 3) utilization of DT and the types of cases treated by PG students during their course, 4) information on the faculties involved in prosthodontics PG education, and 5) potential challenges encountered and program directors’ satisfaction of the PG program. Descriptive statistics was used to present the frequencies and proportions, and Chi square inferential test was used to compare the participants’ response based on the type of PG programs (α = 0.05).ResultsOnly 28 program directors responded to the survey, yielding a 95.5% response rate. Among the program directors, 24 (85.7%) and 4 (14.3%) directors supervised the advanced clinical training and joint programs, respectively. Among the DT, CAD/CAM was the most used technology (50–80%), followed by intra-oral scanning (28–96%). Digital technology implementation was largely limited by lack of resources or equipment (67%), cost (53%) and scarcity of PG teaching staff (46%). A significant difference was observed between the programs regarding the mandatory use of DT for their cases (p = 0.03).ConclusionsThis multi-institutional survey of program directors revealed that DT is continuously implemented in the last few years. Saudi dental institutions must prioritize implementing and utilizing DT in PG training to graduate competent prosthodontists in this fast-paced digital era. While DT is pivotal in dental education, its implementation is limited in many institutions due to resources or equipment, cost, and lack of trained faculty.