Quality Of Postgraduate Medical Education Research Articles

The Impact of COVID-19 on the Job Satisfaction of Cardiothoracic Trainees in the United Kingdom: An Insight From the General Medical Council National Training Survey.

Introduction The National Training Survey (NTS) is conducted annually by the General Medical Council (GMC) to monitor and report on the quality of postgraduate medical education and training. The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on training in cardiothoracic surgery due to the unprecedented restructuring of surgical activity across the UK. We aim to evaluate how the job satisfaction of cardiothoracic surgery trainees was impacted by COVID-19 using the National Training Survey. Methods The National Training Survey in cardiothoracic surgery from 2017 to 2024 was obtained from the General Medical Council website. Job satisfaction for trainees was evaluated using 17 indicators: Adequate Experience, Clinical Supervision, Clinical Supervision Out of Hours, Educational Governance, Educational Supervision, Feedback, Handover, Induction, Local Teaching, Overall Satisfaction, Regional Teaching, Reporting Systems, Rota Design, Study Leave, Supportive Environment, Teamwork and Workload. The pre-pandemic score for each indicator was an average of 2017, 2018 and 2019, while the post-pandemic score was an average of 2022, 2023 and 2024. The overall job satisfaction per year, combining all indicators, was also analysed. Results Thirty-eight cardiothoracic centres were included in this study. There was a reduction in trainees' job satisfaction from pre- to post-pandemic surveys when comparing all 17 indicators together (scored out of 100) (73.87 versus 70.97, p<0.001). There were six out of 17 (35.29%) indicators that demonstrated a significant decrease in job satisfaction amongst trainees: Regional Teaching (70.53 versus 54.53, p<0.001), Adequate Experience (78.65 versus 72.34, p=0.003), Local Teaching (68.26 versus 62.92, p=0.037), Educational Governance (73.78 versus 70.36, p=0.033), Clinical Supervision Out of Hours (91.16 versus 87.95, p=0.005) and Clinical Supervision (91.98 versus 88.92, p=0.014). Conclusion Trainees' job satisfaction significantly decreased after the COVID-19 pandemic. Although the most recent survey suggests job satisfaction amongst trainees may be recovering, further work needs to be done to ensure training standards return to pre-pandemic levels.

A questionnaire for quality control in postgraduate medical education in Switzerland

Background To ensure high qualification standards in medical institutions, a questionnaire has been developed to evaluate the postgraduate medical education in Switzerland. Aim This article describes the development and longitudinal analysis of a questionnaire using eight scales to assess the quality of postgraduate medical education. Method The questionnaire has been administered to all residents every year since 2003. In 2020, 8,745 residents returned the questionnaire, resulting in a response rate of 70%. In addition, a survey is conducted annually among the directors of medical institutions. Results We present results of the directors’ survey and the resident evaluation from 2020, as well as longitudinal data over 16 years. The mean values of the eight scales remained stable or increased slightly over the years. The decision-making culture scale is generally rated best by the residents, while the evidence-based medicine scale is rated as the least good. The most important drivers of residents’ satisfaction with a training site are the work environment and leadership culture scales. The directors perceive the evaluation to be fair and useful. Conclusions The questionnaire represents a reliable and useful tool for the quality control in postgraduate medical training. It provides yearly feedback to the directors regarding how the residents perceive their training giving insights for improvments.

The Impact of COVID-19 on Postgraduate Training of Doctors in the United Kingdom: A Narrative Review.

The COVID-19 pandemic caused significant disruption to healthcare systems globally. The delivery of medical education was consequently impacted as a result of this. In order to move past the pandemic, we must identify the gaps in postgraduate education. This literature review examines studies focusing on postgraduate training in the United Kingdom (UK) and attempts to bring together the issues that havebeen highlighted in these studiesand the impact that this has had on trainees. It is important for the providers of healthcare education to have an understanding of the impacts of this disruptionin order to maintain the quality of postgraduate medical education. Health Education England, along with the Royal Colleges, has published a report that sets a framework on how these issues can be addressed, with some of these changes starting to be implemented in 2022.

Standardizing the Basic Medicine Postgraduate Research Management Evaluation System to Promote the Cultivation of Excellent Research Talents

Postgraduate medical education is the highest level of medical education. The training quality of postgraduate medical education is not only the lifeline for the survival and development of medical schools, but also inextricably linked to people’s lives. Given the unique characteristics of medical education, the expanding scale of postgraduate medical education, and the increasingly diversified types of training, without any effective monitoring of the training process for medical postgraduates, both the quality of education and the development of the society will be affected. Master’s education in basic medicine is a crucial part of postgraduate medical education, but its training objectives are completely different from those of students with a master’s degree in clinic. Postgraduate education in basic medicine pays more attention to the mastery of knowledge and the cultivation of scientific and practical ability, showing greater foresight and individuality in its cultivation process. This paper discusses the postgraduate training mode in Wenzhou Medical University and creates an assessment system focusing on “literature reading ability,” “open literature transcription,” “distinctive academic report,” “multidisciplinary cross-opening,” “mid-term assessment with a blind review by an additional expert,” and “laboratory operation technique assessment.” Different assessments and evaluations are conducted at different stages to train postgraduates in mastering various experimental techniques and methods, while developing the ability to think independently, solve problems, and design research projects.

The WFME global standards for quality improvement of postgraduate medical education: Which standards are also applicable in Germany? Recommendations for physicians with a license for postgraduate training and training agents.

Background: In Germany, the (model) regulation for postgraduate medical education 2018, the professional codes of conduct of the regional medical councils and the health professions chamber laws of the federal states are the formal basis of postgraduate medical education, but say little about its structure, processes and results. The World Federation for Medical Education (WFME) has developed global standards for improving the quality of postgraduate medical education and published them in a revised edition in 2015. A German version which takes the specifics of medical training in Germany into account has not been published to date.Objective: The Committee for Postgraduate Medical Education (PGME) of the Society for Medical Education (GMA) has set itself the goal of firstly translating the WFME standards into German and secondly making recommendations for physicians with a license for post-graduate training (PLT) and training agents (TA) in clinics and practices which have been adapted to the German context.Methods: The WFME standards were translated into German by a working group of the GMA Committee for PGME, the terminology adapted to PGME in Germany and checked by an interdisciplinary panel of experts made up of 9 members of the committee. In a second step, the WFME basic standards and quality standards for PGME relevant to PLTs and TAs in Germany were iteratively determined by this panel of experts using the Nominal Group Technique (NGT) and compiled in the form of recommendations. Results: The translation of the WFME guidelines was approved by the expert group without any changes to the content, taking into account the terminological system of PGME in Germany. In a second step, 90 standards were identified which were considered helpful for PGME in Germany, especially for PLTs and TAs (such as development of a professional identity, a more patient-centered approach or support of self-directed learning). Care was taken to only give recommendations which can be influenced by PLTs and TAs. These standards have been summarized as recommendations to PLTs and TAs and take into account all chapters of the WFME standards. Conclusion: The WFME standards selected here are recommended to PLTs and TAs in clinics and practices to achieve high-quality PGME. Empirical longitudinal studies will be required to examine both the implementation and the results of applying the modified WFME criteria in Germany.

Factors affecting PACES success rate–A Singapore experience

Introduction: MRCP (UK) is intentionally renowned for its relevance as a summative assessment in internal medicine training. It is known that the passing rates for the clinical component of MRCP (PACES) examinations for non-UK trainees are lower. Studies involving UK candidates proposed that factors such as availability and quality of postgraduate medical education, candidate demographics, and candidate’s preparation efforts for this examination may affect the prospect of success. However, these factors have not been studied in detail among non-UK candidates. Material and Methods: To study these factors in non-UK candidates, we conducted an online survey of all doctors who took PACES examination from year 2009 to 2017 in a Singapore tertiary hospital to determine if these factors are similar in our population. A total of 107 respondents completed the survey. Pearson Chi-square, Fisher’s exact, and Kruskal-Wallis H tests were used to determine the significance of these factors and their relationship with PACES examination success. Results: Singapore medical graduates perform better than their counterparts who are from medical schools outside Singapore. Males performed equally well as their female counterparts in PACES. Conclusion: It is suggested to look beyond conventional factors for other non-demographic contributors such as training, preparedness, and how organized is the candidate.

PROS AND CONS OF DISTANCE LEARNING FOR MEDICAL STUDENTS UNDER QUARANTINE CONDITIONS

The pandemic of coronavirus disease (COVID-19) had a significant impact on the social life of medical students, which contributed to the active use of distance learning technologies. Distance learning – “a synthetic, integrated humanistic form of learning based on the use of a wide range of traditional and new information technologies and their technical means, which are used to present educational material, its independent study, dialogue between a lecturer and a student, and the learning process, in the general case, is uncritical to their location in space and time, as well as to a specific educational institution. Existing technologies of distance learning through the use of modern digital platforms, high-quality content of educational web resources, the introduction of an effective know­ledge quality control system give us the opportunity to adapt to new realities of the educational process and ensure consistently high quality of postgraduate medical education.&#x0D; This article presents a system of scientific ideas, mechanisms, advantages and disadvantages of distance (remote) learning in medical institution.

Das Logische Modell als Grundlage für ein strukturiertes Konzept der Evaluation und Qualitätssicherung der Kompetenzzentren Weiterbildung Allgemeinmedizin

BackgroundThe Competence Centers for Postgraduate Medical Education (KW) established throughout Germany represent complex programs to increase the efficiency and quality of postgraduate medical education in general practice. So-called Logic Models serve as the framework for evaluations and quality management processes of complex programs in many areas. The aim of this article is to develop such a model, using the example of the Competence Center in Baden-Württemberg (KWBW) in order to structure its complex program logic and use it as a framework for future evaluations and quality management processes. MethodsThe adaptation of the Logic Model to the KWBW took place in an informal, nominal group process with employees and participants of the program. ResultsWe identified 76 core elements of the KWBW. These core elements were classified in one of the five pillars of the Logic Model (input, activity, output, outcome and impact) and categorized according to fields of action and target groups. DiscussionThe Logic Model, which was developed using the KWBW as an example, identifies and structures important core elements of a complex postgraduate medical training program for the first time. It seems to be well suited for visualizing the internal logic of this complex program and the interaction of the various elements within the KWBW. It can thus be used as the basis for a comprehensive and systematic evaluation concept and for quality assurance. ConclusionThe model is also a prerequisite for comparative research questions of other university programs for postgraduate medical education and thus offers an opportunity for cooperative development efforts. This article therefore contributes to promoting quality in continuing medical training.

Increased professionalization and lower burnout scores were associated with structured residency training program: results of a cross sectional survey

ABSTRACT The competence centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical education by offering training and mentoring programmes for residents, and by providing train-the-trainer and mentoring courses for supervisors. Beyond that, regional Residency Training Networks (RTN) on avoluntary basis were developed to facilitate structured and efficient clinical rotation programs. Primary aim was to investigate the burden of burnout and the development of professionalism among CCRTB-residencies within a cross-sectional study. Secondary aim was to evaluate differences between CCRTB-residents with and without participation in aregional RTN. Burnout was determined with the Maslach Burnout Inventory (MBI), comprising the scales emotional exhaustion, depersonalization, and personal accomplishment. Ambulatory professionalization was evaluated using the German Professional Scale (Pro-D), comprising the scales professionalism towards the patient, towards other professionals, towards society, and towards oneself. Statistical significance of group differences was calculated by nonparametric tests. Multivariable linear regression modelling was performed to estimate the independent impact of professionalization and RTN participation on burnout scores. 347 CRRTB residents in ambulatory postgraduate training were invited, 212 (61.1%) participated, and 197 (92.9%) were included in our analyses. Lower emotional exhaustion and depersonalization, and increased personal accomplishment was associated with increased professionalisation, which was significant for nearly all Pro-D scales (p ≤ 0.05). RTN residents showed higher professionalism towards the patient (p = 0.031), other professionals (p = 0.012), and towards the society (p = 0.007) than residents of unstructured programs, and higher levels of personal accomplishment (p < 0.05). Early and efficient professionalization might be akey to reduce burnout and to establish asatisfying career in family medicine. Train-the-trainer and mentoring concepts should be implemented regularly for the training of residents. Thus, increased engagement in medical didactics should be aprerequisite for accreditation as atraining practice for residents.

PECULIARITIES OF DISTANCE LEARNING WITHIN THE FRAMEWORK OF POSTGRADUATE TRAINING OF DOCTORS IN EMERGENCY MEDICINE

To ensure high-quality distance learning at the Department of Emergency Medicine of the National Medical Academy of Postgraduate Education named after P. L. Shupyk, a specialized course of thematic improvement is used, presented by digital lecture and practical material presented in limited access on an exchange server for students registered on the cycle. This form of education has a number of advantages both in terms of the convenience of the educational process for teachers and students, and the reduction of possible risks in case of adverse situations such as the epidemic threat of the COVID-19 pandemic. Distance education provides quality and comprehensive training of the student without separation from daily activities, taking into account the individually most convenient place and time to access the electronic knowledge base of the cycle.&#x0D; Existing technologies of distance learning through the use of modern digital platforms, high-quality content of educational web resources, the introduction of an effective quality control system of knowledge give us the opportunity to adapt to new realities of the educational process and ensure consistently high quality of postgraduate medical education.

How can the training of medical residents be improved? Three suggestions

This article was migrated. The article was not marked as recommended. Background: The requirements for the quality of postgraduate medical education (PGME) have been increasing recently, due to changing demographics, patient service pressures and evolving healthcare systems. Furthermore, changes in medical knowledge and practice, and multiple challenges inherent in residents' training make the development of PGME highly important. Aim: To explore the experiences of internal medicine residents in PGME programme and suggest key features for future training. Method: Twelve internal medicine residents were interviewed concerning their experiences with PGME. Data-driven analysis of the results was conducted, from which three themes regarding areas for development emerged. Results: The most crucial areas to develop in PGME appeared to be: 1) utilisation of feedback and collegial support; 2) support for residents' skills in coping with stress and developing emotion regulation strategies; and 3) fostering residents' teaching skills and pedagogical practices in clinics. Conclusions: The development of residents' training should be supported with curriculum and carefully planned pedagogical solutions. In addition, training for teachers of residents should be improved.

Assessment of current medical specialty programs and new perspectives at training and research hospitals in Turkey

In this study, we aimed to investigate the problems of Medical Specialty Programs (MSPs) at training and research hospitals and suggest new perspectives to increase the quality of postgraduate medical education. For this purpose, we organized seven multidisciplinary roundtable meetings and workshop with the participation of stakeholders of MSPs in Turkey. In the assessment of MSPs at training and research hospitals, lacking standard program for the residents in some clinics were identified. There were no learning objectives of theoretical lectures or guidelines for professional skill training and surgical intervention. Another problem was lacking any standards for the measurement and assessment throughout the specialty program and final evaluation. The last one was not to be standard resident portfolio demonstrating academic progress such as completed professional skills or surgical interventions. After that, the University of Health Sciences Faculty of Medicine established new commissions for postgraduate medical education in five categories to prepare new perspectives and standards, which were presented for the stakeholders of MSPs one year later.

Towards healthy learning climates in postgraduate medical education: exploring the role of hospital-wide education committees

BackgroundPostgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality postgraduate medical education. In several countries, modernization of postgraduate medical education has resulted in hospital-wide responsibilities for monitoring learning climates. This study investigates the association between the actions undertaken by hospital-wide education committees and learning climates in postgraduate medical education.MethodsResearch conducted in December 2010 invited 57 chairs of hospital-wide education committees to complete a questionnaire on their implemented level of quality improvement policies. We merged the survey data from 21 committees that oversaw training programs and used the Dutch Residency Educational Climate Test (D-RECT) instrument in 2012 to measure their training programs’ learning climate. We used descriptive statistics and linear mixed models to analyse associations between the functioning of hospital-wide education committees and corresponding learning climates.ResultsIn total, 812 resident evaluations for 99 training programs in 21 teaching hospitals were available for analysis. The implementation level of the internal quality management systems as adopted by the hospital-wide education committees varied from 1.6 to 2.6 on a 5 point Likert-scale (ranging from 1 (worst) to 5 (best)). No significant associations were found between the functioning of the committees and corresponding learning climates.ConclusionsThe contribution of hospital-wide committees to creating healthy learning climates is yet to be demonstrated. The absence of such an association could be due to the lack of a Plan-Do-Check-Act cycle guiding the policy as implemented by the committees and the lack of involvement of departmental leadership. Insight into the impact of these strategies on learning climates will benefit the quality of postgraduate medical education and, hopefully, patient care.

Learning processes and learning problems in German postgraduate medical education.

Objective: In order to evaluate the quality of postgraduate medical education in Germany, we examined how the learning of theoretical and practical competencies is conceptualized and how the learning process takes place in real terms. The training conditions, as perceived by medical residents, are compared with the learning objectives, as stated by the Federal Chamber of Physicians in its regulation on postgraduate education. The analysis is based on the data of the “KarMed” study (abbreviation of "career progression and career breaks among physicians during postgraduate education"), a multicentre cohort study of medical school graduates from seven universities who arre followed until they receive their licenses as specialist physicians. The study was conducted by the Institute of Primary Medical Care of the University Medical Center Hamburg-Eppendorf starting in 2008.Methodology: The KarMed study is based on annual, standardized surveys of the population described above. 48% responded in the initial survey (n=1012) and 85% or more in each of the following surveys. Descriptive statistics and logistical regressions were used for analysis. Gender-specific analyses were performed where possible in order to highlight the differences in the professional objectives and workloads between female and male physicians. Results: The study shows that both the practical and the theoretical components of postgraduate medical education in Germany are insufficient. There is a lack of a curriculum with precise learning objectives and descriptions of the corresponding educational settings. In fact, the act of learning is identical to daily clinical work. There is no structuring of the work process with regard to learning; for example, documentation procedures and feedback discussions are prescribed but largely omitted. Evidence-based medicine is not a systematic part of the training, nor is the evaluation of residents’ progress. The summative final oral examination pretends that the necessary specialist competencies can be evaluated within 30 minutes.Many factors indicate that female doctors, especially those with children, have fewer learning opportunities than male doctors.Conclusion: The quality of postgraduate medical education in Germany has become inadequate, especially in an international comparison. The deficits are well known. The responsible institutions are called upon to implement sustainable reforms in the sense of postgraduate education that is structured according to educational principles and whose quality is assured.

How changing quality management influenced PGME accreditation: a focus on decentralization and quality improvement

BackgroundEvaluating the quality of postgraduate medical education (PGME) programs through accreditation is common practice worldwide. Accreditation is shaped by educational quality and quality management. An appropriate accreditation design is important, as it may drive improvements in training. Moreover, accreditors determine whether a PGME program passes the assessment, which may have major consequences, such as starting, continuing or discontinuing PGME. However, there is limited evidence for the benefits of different choices in accreditation design. Therefore, this study aims to explain how changing views on educational quality and quality management have impacted the design of the PGME accreditation system in the Netherlands.MethodsTo determine the historical development of the Dutch PGME accreditation system, we conducted a document analysis of accreditation documents spanning the past 50 years and a vision document outlining the future system. A template analysis technique was used to identify the main elements of the system.ResultsFour themes in the Dutch PGME accreditation system were identified: (1) objectives of accreditation, (2) PGME quality domains, (3) quality management approaches and (4) actors’ responsibilities. Major shifts have taken place regarding decentralization, residency performance and physician practice outcomes, and quality improvement. Decentralization of the responsibilities of the accreditor was absent in 1966, but this has been slowly changing since 1999. In the future system, there will be nearly a maximum degree of decentralization. A focus on outcomes and quality improvement has been introduced in the current system. The number of formal documents striving for quality assurance has increased enormously over the past 50 years, which has led to increased bureaucracy. The future system needs to decrease the number of standards to focus on measurable outcomes and to strive for quality improvement.ConclusionThe challenge for accreditors is to find the right balance between trusting and controlling medical professionals. Their choices will be reflected in the accreditation design. The four themes could enhance international comparisons and encourage better choices in the design of accreditation systems.

ДОСВІД ЗАБЕЗПЕЧЕННЯ ЯКОСТІ ОСВІТИ В ХАРКІВСЬКІЙ МЕДИЧНІЙ АКАДЕМІЇ ПІСЛЯДИПЛОМНОЇ ОСВІТИ

&lt;p class="1reziume"&gt;У статті проаналізовано підходи щодо визначення поняття якості освіти та її забезпечення; розглянуто основні питання підвищення якості післядипломної медичної (фармацевтичної) освіти як однієї з передумов її інтеграції до Європейського освітнього та наукового простору; висвітлені політика ХМАПО щодо забезпечення якості та внутрішня система забезпечення якості освітньої діяльності, яка включає аналіз кількісних показників та спрямована на підтримку існуючої системи цінностей і традицій; висвітлено перспективний досвід щодо забезпечення якості післядипломної медичної освіти; окреслено шляхи її підвищення.&lt;/p&gt;

Focus on Quality: Investigating Residents' Learning Climate Perceptions.

BackgroundA department’s learning climate is known to contribute to the quality of postgraduate medical education and, as such, to the quality of patient care provided by residents. However, it is unclear how the learning climate is perceived over time.ObjectivesThis study investigated whether the learning climate perceptions of residents changed over time.MethodsThe context for this study was residency training in the Netherlands. Between January 2012 and December 2014, residents from 223 training programs in 39 hospitals filled out the web-based Dutch Residency Educational Climate Test (D-RECT) to evaluate their clinical department’s learning climate. Residents had to fill out 35 validated questions using a five point Likert-scale. We analyzed data using generalized linear mixed (growth) models.ResultsOverall, 3982 D-RECT evaluations were available to investigate our aim. The overall mean D-RECT score was 3.9 (SD = 0.3). The growth model showed an increase in D-RECT scores over time (b = 0.03; 95% CI: 0.01–0.06; p < 0.05).ConclusionsThe observed increase in D-RECT scores implied that residents perceived an improvement in the learning climate over time. Future research could focus on factors that facilitate or hinder learning climate improvement, and investigate the roles that hospital governing committees play in safeguarding and improving the learning climate.

Quality of postgraduate medical education.

In recent years, huge efforts to improve quality control process and efficiency of healthcare were put in advancing health systems in Russia. There are measurable and noteworthy achievements, there are unresolved issues.It's impossible to manage the process of improving the quality and efficiency of care without high-quality training of respective troops. However, in the last decade a phrase about the poor quality of postgraduate medical education has been heard periodically in the speeches of the leaders at various levels. The source is unknown, but this information continues to be spread by word of mouth as a regular component of speeches about health issues. Considering that the "poor quality" of postgraduate education has not been substantiated by solid evidence, this informational spam, of course, needs to be overcome. It is not only harmful to health system overall, it is harmful in particular for the process of formation of personnel reserve, but it also discredits the whole system of postgraduate education and a titanic work of thousands of teachers, who work as enthusiasts, most of them performing valuable research, teaching and organizational work. To provide situation analysis in the field of postgraduate medical education. First of all, it begs the question - how and who measures the quality of education. What indicators in the evaluation process are key? As a rule, when assessing quality in any field, preference is given to the opinion of the consumer.Our direct customers are the heads of health organs and institutions who regularly undergo advanced training in the specialty "Public Health and Health Care" at sub-faculty. After the completion of each cycle of training and exams, each participant fills out a questionnaire, which points out the level of quality of pedagogical activity of the sub-faculty. The analysis of these questionnaires shows that the students generally give high assessment of the quality of pedagogical process. The health authorities of subjects of Russia that send the heads of their subordinate medical organizations to study public health and healthcare are satisfied with the work of sub-faculty, professorial teaching staff, they send thank-you letters to the educational organization.In this regard, natural questions related to the overall methodology for the assessment of the quality of education in the system of postgraduate training of doctors arise, which today is still very insufficiently developed.The quality of education in the system of continuous medical education of physicians can be assessed in the following levels with the help of quality indicators, which have to be developed appropriately for each particular level. In our opinion, the following levels should be included:1)The level of the sub-faculty2)The level of the faculty3)The level of the medical organization4)The level of the territorial health authority5)The level of the subject of the federation. Multidimensional assessment of the results of evaluation in the mentioned levels will allow providing an integrated assessment system of quality of continuous medical education in the country.

How do Departmental Lead Educators Review the Quality of Postgraduate Medical Education and Training Provided within Their departments?

How do Departmental Lead Educators Review the Quality of Postgraduate Medical Education and Training Provided within Their departments?

Local Assessment of the Quality of Postgraduate Medical Education and Training by Directors of Medical Education

Local Assessment of the Quality of Postgraduate Medical Education and Training by Directors of Medical Education