Recent Trainees Research Articles

Religion and spirituality in therapeutic training in the UK: A survey of current and recent trainees

AbstractBackgroundResearch indicates counsellors and psychotherapists receive little training around working with clients who present with religious or spiritual issues and feel unprepared to work with these clients.AimsThis paper presents part of the findings from an online survey that aimed to explore how trainee and newly qualified counsellors and psychotherapists, who identify as religious or spiritual, experienced undertaking therapeutic training in the UK.MethodThis online survey collected data on how much training participants received on their courses in religion/spirituality, how this training was delivered, how satisfied they were with their training, their knowledge base and skills around religion/spirituality, and what areas relating to religion/spirituality participants would like to see incorporated into therapeutic training. The survey data were analysed using descriptive statistics and thematic analysis.ResultsOver half of the participants received no training in this area, with a further third receiving minimal input. Participants reported low satisfaction rates with training received unless integrated throughout their course and identified specific knowledge gaps around religious/spiritual literacy, therapeutic skills, and awareness of religion and mental health research. Participants wanted more input on religion/spirituality in the training syllabus to increase their knowledge base and therapeutic competences.ConclusionThis research employed a non‐randomised sample, which limits the generalisability of these findings to a wider training population. Survey participants were also a highly religious/spiritual group, with 87% indicating they engaged in weekly religious/spiritual practices. Participants identified as Christian and White, and reported receiving person‐centred or integrative training.

Assessing Pediatric Resident Needs in Grief and Bereavement Education

ContextPediatric residents care for dying children during training. Few educational efforts focus on helping trainees better understand their own grief process and the supports available to them and their patients’ families. ObjectivesThis work aims to assess pediatric residents’ needs and preferences for content included in a curriculum on grief and bereavement. MethodsPediatric residents, at a single institution, completed an electronic survey in Spring 2023 on how they cope with patient deaths and their preferences on content in a proposed grief and bereavement curriculum. ResultsThe survey was emailed to 165 current or recent trainees; 71 surveys were fully completed (43% response rate). Most respondents (63/71, 89%) indicated that a formalized bereavement curriculum for pediatric residents is important. The resources most frequently utilized by residents following a pediatric death included peer support (59/71, 83%), attending a debrief coordinated by residency leadership or the supportive care division (38/71, 54%), and reading a patient's obituary (23/71, 32%).The most desired content areas were institutional services provided to bereaved families (66/71, 93%), unique aspects of healthcare professional grief (58/71, 82%), and experiences of bereaved families hearing from providers after their child's death (56/71, 79%). ConclusionPediatric residents indicate a strong desire for structured curricula on grief and bereavement focusing on resources that exist for families, approaches to grieving as a healthcare professional, and better understanding the experiences of bereaved families. These data may inform educators on priorities in training and support of pediatric residents on grief and bereavement.

Introducing Compassionate and Relational Enquiry (CARE): A Three-Day Training for Mental Health Clinicians on Relational Ways of Working.

Research shows that, in mental healthcare, empathy and active listening skills play a fundamental role in the therapeutic relationship. Despite this, clinicians receive little training in cultivating these qualities, and there is a dearth of training in therapeutic relationships and relational care in this field more generally. In response to this paucity of training, a new intensive three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). The CARE training programme has recently been delivered to a number of mental health teams in different boroughs of an NHS Trust and has undergone several rounds of redevelopment. This paper outlines the CARE training programme's objectives and mode of delivery, and subsequently presents questionnaire results from recent CARE trainees regarding their experience of the nature and utility of the training. Four main themes emerged from responses to the question of the utility of the training, these were 'A shift towards more person-centred care', 'Strengthens the therapeutic relationship', 'Facilitates more collaborative care with patients and their families' and 'Development of new skills and therapeutic techniques'. The paper concludes by discussing the potential of this training to help forge a substantial shift in the culture of mental health services in a systemic way.

165 Predicting Success: A Mixed Model of KL2 Trainee Profiles and Outcomes

OBJECTIVES/GOALS: Penn State CTSI supports KL2 career development awards for faculty seeking to become leaders in clinical and translational research. CTSAs can benefit from a better understanding of KL2 applicant profiles and trainee outcomes. Predictive modeling of KL2 records provides insights into institutional processes and continuous improvement goals. METHODS/STUDY POPULATION: Collecting KL2 application records at Penn State CTSI from 2017 to 2023, comprising both accepted and not accepted candidate profiles, this study used a generalized logistic mixed model with binomial distribution to understand the factors predictive of KL2 trainee acceptance, (n=47). The following factors were modeled as potentially predictive of scholars’ acceptance: Institution-specific Processes—Campus; Terminal Degree Type; College of Residency, Applicant Demographics and Portfolio—Minoritized or Protected Groups; Mean Application Score; Rurality Focus; Gender, and Outcomes—Post-Program h-index. RESULTS/ANTICIPATED RESULTS: Only Campus and Degree were significant factors predictive of trainee acceptance (r<.0001), with a particular campus and the MD degree-designation both exerting selectional pressures on acceptance rates. Applicant demographics were not significant historical factors in selection despite the most recent trainee cohort comprised of all women. Similarly, while our CTSA focuses on rural inequality and accessibility, a research proposal focused on rurality was not a significant factor for acceptance. Notably, NIH-scaled application scores and post-program h-indices were not significant for accepted and non-accepted applicants. DISCUSSION/SIGNIFICANCE: The absence of applicant-focused selectional pressure is striking—Penn State CTSI does not significantly select for gender, URM, or URP status. Administration is now empowered to intentionally engage, recruit, and retain from our other affiliated campuses and colleges.

Reforming clinical psychological science training: The importance of collaborative decision-making with trainees.

To effectively address the staggering burden of mental illness, clinical psychological science will need to face some uncomfortable truths about current training practices. In a commentary authored by 23 current or recent trainees, Palitsky and colleagues highlight a number of urgent challenges facing today's clinical interns. They provide a thoughtful framework for reform, with specific recommendations and guiding questions for a broad spectrum of stakeholders. Key suggestions are applicable to the entire sequence of clinical training. While there is cause for cautious optimism, overcoming these systemic barriers will require a coordinated, all-hands approach and a more collaborative approach to policy-making.

Student trainee and paid internship programs have positive results but do little to influence long-term employee diversity in the USDA forest service.

Women and Black, Indigenous, and People of Color (BIPOC) employees are underrepresented in science and natural resource management institutions. Student and recent graduate trainee and internship programs have been used to try to address this in United States federal agencies over the last few decades. Our study evaluates how effective such programs are at improving U.S. federal workforce diversity. We used a comprehensive employee dataset from the United States Department of Agriculture (USDA) Forest Service-which has the largest natural resource management workforce in the country-to analyze the demographic characteristics and career paths of paid interns from 1996-2017. We found that a majority of employees who started as interns later converted to permanent employment with the USDA Forest Service. In addition, Black and Hispanic interns were, respectively, 5 and 3 times more likely than White interns to work for the agency in permanent positions after their internships. However, people who started as interns had significantly shorter USDA Forest Service careers than those who started in permanent positions. White women entering directly into permanent positions typically advanced to higher pay grades through promotion faster than White women who entered as interns. Finally, male BIPOC interns involuntarily separated (i.e., were fired) at significantly higher rates than all other employees. Our study suggests that while internship employment programs can be an effective tool for hiring a diverse workforce, they are not sufficient to close the overall workforce diversity gap. In addition, only a small percentage of new hires every year are interns. To achieve a level of representation that mirrors the civilian labor force, our study suggests that internship programs need to focus on long-term employee retention and be of significantly larger scale.

Are We Training Surgeons to Cement a Femoral Component in Hip Arthroplasty? The Trainees' Perspective.

The importance of surgical technique is widely recognized when cementing a femoral component in hip arthroplasty. Concern exists that surgeon trainees in the United States are not being adequately trained in cement technique. The purpose of this study is to describe recent trainees' perceived experience with their training in this skill. Orthopedic graduate candidates attending a national board review course were polled with an anonymous 15-question survey regarding their experiences during training with cemented femoral components. Means and standard deviations were calculated for Likert scale questions, and univariate statistics were used to compare answers for select questions. A total of 152 surveys were completed. Ninety percent of respondents anticipated that they would be performing hemiarthroplasty for fracture in their future practice, 99% of whom anticipated using cement for stem fixation in at least some of these cases. Only a minority of respondents planned further training in an adult reconstruction fellowship (21%). Only 37% of residents perceived their training in cement technique to be comprehensive or very comprehensive, with 17% reporting that their training was inadequate or nonexistent. Forty percent reported being less than satisfied with their training. Although 96% of residents felt prepared to implant a cementless femoral component, only 82% felt adequately trained to properly cement a femoral implant. Feeling prepared to perform a well done cemented femoral stem correlated with higher percentage of cemented stems in training and higher satisfaction with training (both P= .001). Although most trainees feel prepared to cement a femoral component, many young surgeons do not perceive that they are receiving adequate training in femoral cement technique.

651-P: Continuous Glucose Monitoring in Primary Care: Explaining Characteristics Associated with CGM Prescription

Background: Continuous glucose monitors (CGM) provide clearer, more actionable data than self-monitoring of blood glucose and are associated with improved outcomes (e.g., reduced HbA1c) . Barriers to endocrinology care create disparities in CGM access. Expanding CGM use in primary care can improve outcomes and reduce disparities. We explored barriers and facilitators to CGM use in primary care. Methods: Mixed-methods sequential explanatory study of U.S. primary care clinicians, with survey (n=632) followed by semi-structured interviews (n=55) . Analysis: Multivariable linear and logistic regression, followed by rapid qualitative analysis of interviews to offer a deeper understanding of quantitative data. Results: Qualitative analysis helped explain quantitative findings that residents were less likely than others to have prescribed CGM but had greater intent to prescribe: lack of resident knowledge about CGM hindered prescribing. While quantitative analysis found clinicians >40 miles from endocrinologists were somewhat more likely to prescribe CGM (coef .18, p=.041) , qualitative analysis offered nuance: results were mixed, with many interviewees noting distance as a barrier due to having no endocrinologist to help manage the CGM; for others, proximity was a barrier because they referred patients to endocrinology for CGM rather than prescribing themselves. While survey results showed an association between higher proportion of Medicare patients and greater confidence in using CGM to manage diabetes, qualitative themes around prescribing barriers included lack of public insurers covering CGM, suggesting that, for some, having Medicare may make CGM prescription more difficult. Conclusion: Primary care clinicians can benefit from education and support for CGM use. Targeting recent trainees and clinicians in regions lacking endocrinology could increase CGM use, extending its benefits to more people with diabetes. Disclosure T. Oser: Advisory Panel; Cecelia Health, Dexcom, Inc. T. Hall: None. M.K. Warman: None. M.K. Filippi: None. B. Manning: None. E. Callen: None. L. Dickinson: None. L.C. Michaels: None. S. Oser: Advisory Panel; Cecelia Health, Children with Diabetes, Inc., Dexcom, Inc. Consultant; American Diabetes Association, Association of Diabetes Care & Education Specialists, Jaeb Center for Health Research. Research Support; American Academy of Family Physicians, Leona M. and Harry B. Helmsley Charitable Trust. Funding The Leona M. and Harry B. Helmsley Charitable Trust

AAIM Recommendations to Improve Learner Transitions

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The moderating effect of coworkers’ training participation on the influence of peer support in the transfer process

PurposeThe impact of the number of coworkers participating in training on transfer outcomes has largely been overlooked. This paper aims to examine whether the number of coworkers participating in training interacts with peer support (PS) to influence training motivation and transfer.Design/methodology/approachData were collected using a cross-sectional survey from a sample of 688 employees working in 14 midsize and large companies. All participants were recent trainees in various open skill (e.g. leadership) training programs. Moderated mediation was used to test the hypotheses.FindingsMotivation to transfer (MTT) mediated the relationship between PS and perceived training transfer. When more coworkers participated in the training, PS had a stronger influence on trainee MTT.Practical implicationsOrganizations should consider training coworker cohorts at the same time to influence MTT and training transfer. Generally, whole-team training programs could be used to boost training transfer outcomes, although it could potentially have a negative impact on transfer if PS is low.Originality/valueTo the best of the authors’ knowledge, this was the first study to demonstrate that the number of coworkers participating in training can moderate the effect of PS on MTT and training transfer.

Knowledge and perception of Sepsis among Doctors in Karachi Pakistan.

Objectives:To assess knowledge and perception among Pakistani physicians towards sepsis.Methods:This cross-sectional study was conducted in Indus Hospital and Health Networks from September 2020 to March 2021. The International Sepsis Survey questionnaire was adapted, and its link was sent to trainee physicians as well as specialists, and consultants practicing in various hospitals via social media. Knowledge and perception were scored and 50% was considered the cut-off score for adequacy. Data was analyzed using SPSS version 26.Results:Analysis was done on 222 respondents who completed the survey. 37.9% of the participants had adequate knowledge. Knowledge regarding sepsis was significantly associated with specialty, ICU/CCU/HDU, and work experience (P-value <0.0001). More recent trainee physicians and those with more experience in critical care areas demonstrated better knowledge. Over 2/3rd of the respondents strongly agreed that sepsis remains one of the unmet needs in critical care today.Conclusion:A common belief exists that sepsis remains a challenge to treat among doctors. Moreover, there is consensus that it is the most frequently miss diagnosed condition in critical care and a dire need exists for its early diagnosis. Additionally, prompt management of presumed sepsis is imperative to improve outcomes.

Social work student reflections on training in integrated care: opportunities for social work educators

ABSTRACT Integrated care, an approach designed to improve health/ behavioral health outcomes and increase quality of life, has received international interest. Given the important roles social workers play in this approach, American universities have begun novel training programs to better prepare social workers to work in integrated care. The aim of this study is to better understand the experiences of recent MSW trainees, and how they can inform future educational/ training programs. Focus groups of MSW students who recently completed integrated care training programs were conducted (N = 9). Content analysis of the focus group data resulted in three main themes: Gaps in Knowledge about Integrated Care, Developing Professional Identity on a Team, and Adaptation of Core Social Work Skills. Student feedback aligns with current literature, highlighting variability among placements, need for additional training resources, and value of social workers on interprofessional teams. There were also unique findings, include challenges and rewards of professional identity development on teams and examples of adaptations of traditional social work roles in integrated care. In order to prepare social workers for practice, educational programs must develop effective curricula that span classroom and field education and make better use of expertise of practitioners in the field.

Using qualitative methods, what factors do child &amp; adolescent higher trainees and new consultants (within 1 year of appointment), report in choosing their higher training subspecialty?

AimsThis Research aims to identify factors reported by recent and current trainees in choosing Child &amp; Adolescent (C&amp;A) Psychiatry for their higher training/career path. The hypothesis is that via thematic analysis prominent factors will emerge to inform future recruitment and retention.BackgroundThe need to attract more doctors into Psychiatry has been identified by NHS, Royal College of Psychiatrists and the Media; Health Education England figures show core psychiatry had lowest fill rates of any specialty in 2016,17 &amp;18.Some subspecialties experience particular difficulties e.g. C&amp;A. Royal College of Psychiatry analysis of workforce in March 2018 showed the numbers of C&amp;A psychiatrists of all grades have fallen by 6.3% in four years and for consultants alone the decrease was 6.9% over the same period.However, very little research has been completed investigating why trainees might choose C&amp;A Psychiatry with a literature search revealing only one report of C&amp;A trainees views in the UK in 2006.MethodA qualitative design was chosen to provide insight into the factors affecting participants in choosing their career.The theoretical framework supporting the study relates to capturing experience via a case study approach, aiming to explore reported issues in a real life context and considering similarities in the cases to inform future recruitment.The Research was approved by The Health Research Authority and local Research &amp; Development departments.Purposeful sampling was used with voluntary participation following informed consent and non-identifiable demographic data were collected and analysed quantatively.Semi-structured interviews to saturation were conducted with fourteen (N = 14) participants asked questions exploring their subspecialty choice. Responses were recorded and transcribed verbatim prior to thematic analysis, including triangulation via a co-coding process to check areas were not over-represented and/or subject to researcher thoughts and possible unconscious biases.ResultSemi-structured interviews included all North-East C&amp;A trainees and 3 recently qualified Consultants.Demographics results included 5 male and 6 female participants and 6 non-UK graduates.Emergent themes were analysed into key findings including: –interest in children/specialty–specialty experience–supportive supervisors/team–work-life balance–opportunity to impact/intervene early.Limitations include study of a single geographical area and possible researcher bias.ConclusionThis Research provides novel findings re factors influencing career choice of C&amp;A Psychiatry to inform future recruitment and retention. Clear themes have emerged re important recruitment/retention factors and the study highlights need for more research to investigate reasons why C&amp;A is not chosen.

Trainee Perspectives on the Writing and Implementation of Milestones 2.0.

Trainee Perspectives on the Writing and Implementation of Milestones 2.0.

Editorial on the article: Young surgeons entering the workforce in the City of Buenos Aires. Need for restructuring of the general surgery training system

In the article “Young surgeons entering the workforce in the City of Buenos Aires. Need for restructuring of the general surgery training system”1 published in this issue of Revista Argentina de Cirugia, Sarsur Fernandez et al. present two independent problems that are closely related. By means of a survey, the authors tried to find out whether the recent surgeon graduate trainees continued their practice in general surgery or moved to other specialties. Based on these results, they suggested modifying the residency system to optimize the allocation of resources.

Essentials of neonatal-perinatal medicine fellowship: scholarship perspective.

Neonatal-perinatal medicine fellows must achieve a meaningful accomplishment in scholarly activity as part of their training.Despite the requirement for scholarly training in fellowship, there is a vanishingly small number of MD-only physician-scientists pursuing a research-oriented career.Recent neonatal trainees have identified several factors that preclude their careers in research-focused academic neonatology, including lower pay in academic positions, inadequate training in research techniques, and the perception that individuals in research careers have a poor work-life balance. High competition for limited pediatric research funds also contributes to a diminishing pool of physician-scientists in neonatology. This small number of physician-scientists is threatened by a high rate of attrition among physicians who enter this career path. In order to prevent further declines in the number of neonatal physician-scientists, we need improvements in funding and strong intra- and cross-institutional mentorship to foster individuals interested in a career as a physician-scientist.

4. ARE FUTURE PEDIATRICIANS COMPETENT TO CARE FOR CHILDREN WITH BEHAVIORAL/MENTAL HEALTH CONDITIONS?

Background/Objectives With 20% of children and adolescents suffering from a behavioral and mental health (B/MH) condition, the urgency to prepare pediatricians to meet this need is paramount. This national study evaluates the perceived competence of pediatric residents and recent graduates in the assessment and treatment of B/MH conditions, characterizes variation across residency programs, and identifies program characteristics associated with high competence. Methods Cross-sectional survey of applicants for the initial certifying exam in pediatrics. Questions focused on B/MH training and perceived competence in 7 B.M. assessment skills (e.g. eliciting concerns with history or screening tools/rating scales; diagnosing ADHD, anxiety, or depression; assessing suicide) and 9 treatment skills (e.g. behavioral counseling; psychosocial interventions; dosing and monitoring medications; co-management). Two questions explored who should be competent in B/MH skills. Competence was rated on a 5-point scale, and high levels of assessment and treatment competence were defined as scores of >/4. Composite measures for B/MH assessment and treatment were calculated as mean scores for each domain. We examined variation in self-reported competence across programs and used linear regression to identify factors associated with high levels of competence at the program level. Results 62.3% (n=2,086) responded. 32.8% (n=595) reported high competence in assessment skills and 18.9% (n=337) in treatment skills. The majority of respondents agree that residents entering primary care as well as subspecialties should be competent in B/MH assessment and treatment. There were large variations in reported competence across programs. Respondents from smaller programs ( Conclusions Current and recent pediatric trainees do not report high levels of perceived competence in the assessment and treatment of children with B/MH conditions. The substantial variation across programs indicates the need for national standards for B/MH training.

Competency of Future Pediatricians Caring for Children With Behavioral and Mental Health Problems

There is an urgent need to prepare pediatricians to care for children with behavioral and mental health (B/MH) conditions. In this study, we evaluate the perceived competence of pediatric residents and recent graduates in the assessment and treatment of B/MH conditions, characterize variation in competence across residency programs, and identify program characteristics associated with high competence. Cross-sectional survey of applicants for the initial certifying examination in pediatrics. Questions were focused on (1) who should be competent in B/MH skills, (2) institutional support around B/MH training, and (3) perceived competence in 7 B/MH assessment skills and 9 treatment skills. Competence was rated on a 5-point scale, and high levels of assessment and treatment competence were defined as scores of ≥4. Composite measures for B/MH assessment and treatment were calculated as mean scores for each domain. We examined variation in residents' self-reported competence across programs and used linear regression to identify factors associated with high levels of competence at the program level. Of applicants, 62.3% responded to the survey (n = 2086). Of these, 32.8% (n = 595) reported high competence in assessment skills and 18.9% (n = 337) in treatment skills. There were large variations in reported competence across programs. Respondents from smaller programs (<30 trainees) reported higher competence in assessment and treatment than those from large programs (P < .001). Current and recent pediatric trainees do not report high levels of perceived competence in the assessment and treatment of children with B/MH conditions. The substantial variation across programs indicates that the pediatric community should create standards for B/MH training.

심폐소생술 교육 후 수행 가능성에 영향을 미치는 요인: 2016년 지역사회건강조사를 중심으로

Objectives: This paper aims to describe intentions of possibly performing cardiopulmonary resuscitation (CPR) among lay cardiopulmonary resuscitation trainees and to investigate the utility of the health-belief model as a theoretical model to predict those intention. Methods: We used the Gangwon-do, Gyeongsangnam-do, and Busan data from the 2016 community health survey; 17,577 laypeople who were trained in cardiopulmonary resuscitation were selected as study subjects. Results: This study showed that women, especially housewives, as well as unemployed people and patients diagnosed with a stroke are less likely to perform CPR even though they have been trained in the technique. Recent cardiopulmonary resuscitation trainees are more likely to perform CPR than previous trainees. The study also found that age is not a factor in how likely a subject is to be willing to perform CPR. Conclusion: These findings show that providing tailored interventions depending on the characteristics of the CPR trainees would increase the likelihood of them performing CPR. The study also found that re-training is important to improve trainees’ probability of performing the technique.

Outcomes and future directions for neuroimmunology/multiple sclerosis fellowship training: Survey of recent trainees

BackgroundNeuroimmunology/multiple sclerosis is a rapidly evolving, but still poorly defined subspecialty. Fellowship training is not standardized, and there is substantial variability across sites. Outcomes of fellowship training have not yet been studied. We therefore examined early career choices of neuroimmunology/MS fellowship program graduates and solicited the perspective of current and recent trainees on their fellowship experience as well as opportunities to improve neuroimmunology education. MethodsWe developed a questionnaire to collect information about fellowship training experiences and current medical practice. We identified recent graduates based on records from US training programs and the National MS Society and electronically sent the survey to current trainees and recent graduates (within the last 5 years). ResultsWe identified 179 current/recent trainees and successfully reached 157 with survey distributions. Ninety-five individuals (60.5%) returned surveys. Most graduates assumed an academic practice (68%) focused mostly or exclusively on MS and other CNS neuroimmune diseases (55%), and practiced in regions where there were ≥5 other neuroimmunology specialists (51%). Graduates felt well-prepared to manage diagnoses of MS and neuromyelitis optica spectrum disorders but their comfort with rarer CNS neuroimmune diseases varied substantially. Basic immunology, neuro-rheumatology, grant writing and neuro-rehabilitation were identified as high impact areas for cross-disciplinary didactic training. The majority of recent trainees (57%) favored standardizing a core neuroimmunology curriculum, and 48% favored developing a subspecialty certification. ConclusionsThis is the first study to examine practice outcomes and trainee experiences for neuroimmunology training programs. We anticipate that these data will help educators define a core curriculum for the subspecialty and identify complementary skill sets that enhance the traditional clinic-based model of teaching.