Resident Evaluation Research Articles

Practice Makes Perfect: Objective Structured Clinical Examinations Across the UME-to-GME Continuum Improve Care of Transgender Simulated Patients.

Background Residents lack confidence in caring for transgender individuals. More exposure and practice throughout training is needed. Objective To explore whether and how prior exposure to transgender health skills during medical school impacted competency with these skills during residency. Methods In 2022, all 101 internal medicine residents at New York University Grossman School of Medicine participated in an objective structured clinical examination (OSCE) station as part of their annual formative assessment where they cared for a standardized patient (SP) who identified as transgender. Three SPs who were members of the transgender community were recruited through online and social media forums. Two resident groups (continuum vs noncontinuum) differed in their prior experiences with transgender OSCEs during medical school. We analyzed SPs' ratings of resident performance using checklist data and SP open-ended feedback to compare performance between groups and resident post-OSCE evaluations to understand residents' perceptions of the educational value of the case. Results Residents with prior experience with transgender SPs (continuum) were more frequently recommended by SPs (88% [21 of 24] vs 70% [54 of 77]) to a family member or friend, were all rated professional (100% [24 of 24] vs 94% [72 of 94]) and scored better in pain information-gathering (92% vs 65%, mean summary score) and gender-affirming care skills (67% vs 52%, mean summary score). Noncontinuum residents lacked experience, missed opportunities to ask about gender identity, and needed work on demonstrating comfort and using proper language. Most residents completing a post-OSCE evaluation (80%, 41 of 51) rated the case as "very valuable." Conclusions Spaced practice and feedback through early exposure to transgender OSCEs were valuable for skill acquisition, giving continuum residents a learning advantage compared to noncontinuum residents.

Utilization of marketing automation tools for delivery of a faculty development curriculum

Background Physician clinical educators play important roles in teaching, providing feedback, and evaluating trainees, but they often have variable preparation and competing demands on their time that make universal participation in workshops, seminars, or short courses designed to foster these skillsets inefficient or impossible. Methods We designed and implemented a 52-week synchronous curriculum designed to address faculty opportunities to improve teaching skills, feedback for residents and medical students, and evaluation skills, which were delivered using marketing automation tools, including text messaging and email. We evaluated the programmatic impact and feasibility of using the implementation science framework. Results Over a 104-week evaluation period, there were at least 10,499 total content impressions and 4558 unique recipients, indicating the significant reach of this program to approximately 120 faculty members. Faculty engagement with continuing education materials remained stable or increased over the 2-year evaluation period, indicating that programs like ours can have sustainable impacts. Resident evaluations of faculty across the six key domains also improved after the implementation of the program. Conclusions Our experience with digital marketing tools reflects that they can be used to deliver impactful curricular content to faculty for continuing educational purposes and that faculty can use these resources in a sustainable way. However, because of the incomplete reach with any single communication, this type of content delivery is not appropriate for isolation as a material of critical importance. More research is needed to identify the best practices and additional education-related uses of this technology.

The Impact of Faculty Gender on Resident Evaluations of Faculty Performance in Emergency Medicine.

Gender bias impacts the promotion and tenure of female emergency medicine (EM) physicians and limits their ability to advance in academic rank.Many factors influence the promotion and tenure process including research, evaluations, opportunities for leadership, sponsorship, and mentorship. The goal of this study is to determine if resident evaluations of EM faculty differ by faculty gender. A quantitative analysis was used to examine 14,613 teaching evaluations of faculty by residents at a single academic center (The Ohio State University Wexner Medical Center, Columbus) in the years 2017-2019.Anonymized ratings of male and female faculty on a five-point Likert scale were compared using Fischer's exact test and adjusting for multiple comparisons. Male faculty were more likely to hold the rank of Associate Professor or Professor. When taking both faculty gender and rank into account, male Clinical Instructors and Assistant Professors had significantly higher evaluation scores by residents in the domain of resident autonomy than their female counterparts. Regardless of gender or faculty rank, the majority of faculty received scores greater than four. A significant gender difference was found in resident evaluation scores of faculty in the domain ofresident autonomyat the level of Clinical Instructor and Assistant Professor.Resident autonomy refers to the degree of supervision by faculty which evolves over time and is primarily based on level of training.This is important as it demonstrates a gender difference in scores that could be used to determine faculty compensation and promotion. Evaluation tools used for promotion and tenure of academic faculty should be evaluated for implicit bias and appropriate statistical analysis.

Research on the Measurement, Evaluation and Compensation of Traditional Village Residents’ Emotional Perception: A Case of 14 Traditional Villages in Guanzhong Region

Traditional village residents’ emotional perception is a mapping of the man–land relationship in rural areas, which leads to the attitudes and behaviors of the residents. Against the background of previous studies focusing on technical rationality but neglecting the exploration of “human” emotional factors, it is crucial to carry out research on the traditional village residents’ emotional perception to promote people-centered rural development of high quality. The paper selected 123 residents from 14 traditional villages in Guanzhong region and constructs an evaluation index system which includes three dimensions based on the logical framework of “spiritual attachment-functional dependence-developmental cognition”. Next, the questionnaire method was used to collect data and the empirical analysis was conducted using the obstacle degree model and the network analysis model. The research shows that: (1) the overall level of the traditional village residents’ emotional perception is in the middle-upper class and there are significant differences, and there is a non-equilibrium in different evaluation dimensions. (2) The main obstacle to the improvement of the level of traditional village residents’ emotional perception is perception of development, followed by the sense of belonging, and the sense of happiness has a greater supportive role. (3) “Sustainable development of the village” (D-07) is the central node of the network analysis model of traditional village residents’ emotional perception. Meanwhile, the nodes “willingness to live” (G-02) and “basic rights are guaranteed” (X-10) are the central nodes of the sub-networks of sense of belonging and sense of happiness. (4) The residents’ education level and the frequency of community participation have a significant positive effect on their emotional perception level. Finally, the paper explores the dynamic compensation mechanism of traditional village residents’ emotional perception. Our results provide policy guidance for achieving sustainable development of traditional villages.

Training Program Management: Study of the Handmade Training Program at PKBM Rumpun Aksara

This research aims to find out and describe how the handmade training program is managed at PKBM Rumpun Aksara. This research uses descriptive research with a qualitative approach. The research location was located at PKBM Rumpun Aksara Panti Jember using purposive area techniques. The technique for determining informants uses Purposive Sampling. Data collection techniques use observation, interviews and documentation. The data validity checking techniques used are increased persistence, extended observations and triangulation in the form of source triangulation and technical triangulation. Data analysis uses Miles and Hubarman's theory by collecting data, reducing data, presenting data, and verifying data. The research results show that planning activities in handmade training at PKBM Rumpun Aksara are carried out in a structured and systematic manner, starting from identifying needs, to making learning lesson plans, as well as determining the methods and media carried out by the training instructor. The activities for implementing the handmade training program have been running according to the plans that have been determined. Meanwhile, evaluation activities for handmade training include holding meetings with instructors to discuss program implementation. Meanwhile, evaluation of learning residents involves assessing the process, results, level of interest of learning residents and the impact of handmade training on learning residents.

Development of the "LAser Surgical skills Evaluation for Residents" (LASER) Scale Through a Modified Delphi Method.

The CO2 laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees. "LAser Surgical skills Evaluation for Residents" (LASER) Scale aims to facilitate the evaluation of residents' performance and promote constructive feedback. The initial evaluation grid was based on a literature review of CO2 laser laryngoscopy (with an emphasis on indications, technique, safety, and efficacy) using Covidence systematic review software (Veritas Health Innovation). The final version was produced after 4 rounds of Delphi surveys. This study was an international collaboration including 15 otolaryngologists with either laryngology or head and neck surgery subspecialties. Panelists were based in Canada (8), the United States (3), France (1), Spain (1), Belgium (1), and Lebanon (1). The process involved 4 rounds of Delphi surveys. Assessment categories included: anesthesia considerations, pre- and perioperative laser safety measures, and surgical technique. Consensus was reached on final survey completion. Through a modified Delphi method, a novel scale was developed through an international collaborative effort that evaluates resident skillset in CO2 laser MLS. Future studies are warranted to validate this assessment tool.

Case Curve: A Novel Web-Based Platform and Mobile Phone Application to Evaluate Surgical Competence in Graduate Medical Education.

Competency-based medical education is well established, yet methods to evaluate and document acquisition of surgical skill remain underdeveloped. We describe a novel web-based application for competency-based surgical education at a single neurosurgical department over a 3-year period. We used a web-based application to track procedural and cognitive skills acquisition for neurosurgical residents. This process included self-assessment, resident peer evaluations, evaluations from supervising attending physicians, and blinded video reviews. Direct observation by faculty and video recordings were used to evaluate surgical skill. Cases were subdivided into component skills, which were evaluated using a 5-point scale. The learning curve for each skill was continuously updated and compared with expectations. Progress was reviewed at a monthly surgical skills conference that involved discussion and analysis of recorded surgical performances. During an escalating 3-year pilot from 2019 to 2022, a total of 1078 cases in 39 categories were accrued by 17 resident physicians with 10 neurosurgical faculty who participated as evaluators. A total of 16 251 skill performances in 110 categories were evaluated. The most evaluated skills were those that were common to several types of procedures, such as positioning, hemostasis, and wound closure. The concordance between attending evaluations and resident self-evaluations was 76%, with residents underestimating their performance in 17% of evaluations and overestimating in 7%. We developed a method for evaluating and tracking surgical resident skill performance with an application that provides timely and actionable feedback. The data collected from this system could allow more accurate assessments of surgical skills and deeper insights into factors influencing surgical skill acquisition.

Evaluation of green pastoral residence in Grassland of Inner Mongolia based on fuzzy mathematics

Based on the theory of rural habitat, the concept of green pastoral residence is proposed, and the green pastoral residence is taken as the research object. Besides, based on the current situation of grassland ecological environment and pastoral living environment in Inner Mongolia, the green pastoral residence evaluation index system is established by using the hierarchical analysis method, and a fuzzy comprehensive evaluation model is constructed combined with fuzzy mathematical theory. Through case analysis, the evaluation results of the two modeling methods of analytic hierarchy method and fuzzy analytic hierarchy method are compared, and the applicability of the two modeling methods is analyzed, and a multi-level decision-making method more suitable for the evaluation of green pastoral residence is obtained.

Performance of ChatGPT on questions from the Brazilian College of Radiology annual resident evaluation test.

To test the performance of ChatGPT on radiology questions formulated by the Colégio Brasileiro de Radiologia (CBR, Brazilian College of Radiology), evaluating its failures and successes. 165 questions from the CBR annual resident assessment (2018, 2019, and 2022) were presented to ChatGPT. For statistical analysis, the questions were divided by the type of cognitive skills assessed (lower or higher order), by topic (physics or clinical), by subspecialty, by style (description of a clinical finding or sign, clinical management of a case, application of a concept, calculation/classification of findings, correlations between diseases, or anatomy), and by target academic year (all, second/third year, or third year only). ChatGPT answered 88 (53.3%) of the questions correctly. It performed significantly better on the questions assessing lower-order cognitive skills than on those assessing higher-order cognitive skills, providing the correct answer on 38 (64.4%) of 59 questions and on only 50 (47.2%) of 106 questions, respectively (p = 0.01). The accuracy rate was significantly higher for physics questions than for clinical questions, correct answers being provided for 18 (90.0%) of 20 physics questions and for 70 (48.3%) of 145 clinical questions (p = 0.02). There was no significant difference in performance among the subspecialties or among the academic years (p > 0.05). Even without dedicated training in this field, ChatGPT demonstrates reasonable performance, albeit still insufficient for approval, on radiology questions formulated by the CBR.

Performance of ChatGPT on questions from the Brazilian College of Radiology annual resident evaluation test

Resumo Objetivo: Testar o desempenho do ChatGPT em questões de radiologia formuladas pelo Colégio Brasileiro de Radiologia (CBR), avaliando seus erros e acertos. Materiais e Métodos: 165 questões da avaliação anual dos residentes do CBR (2018, 2019 e 2022) foram apresentadas ao ChatGPT. Elas foram divididas, para análise estatística, em questões que avaliavam habilidades cognitivas de ordem superior ou inferior e de acordo com a subespecialidade, o tipo da questão (descrição de um achado clínico ou sinal, manejo clínico de um doente, aplicação de um conceito, cálculo ou classificação dos achados descritos, associação entre doenças ou anatomia) e o ano da residência (R1, R2 ou R3). Resultados: O ChatGPT acertou 53,3% das questões (88/165). Houve diferença estatística entre o desempenho em questões de ordem cognitiva inferior (64,4%; 38/59) e superior (47,2%; 50/106) (p = 0,01). Houve maior índice de acertos em física (90,0%; 18/20) do que em questões clínicas (48,3%; 70/145) (p = 0,02). Não houve diferença significativa de desempenho entre subespecialidades ou ano de residência (p > 0,05). Conclusão: Mesmo sem treinamento dedicado a essa área, o ChatGPT apresenta desempenho razoável, mas ainda insuficiente para aprovação, em questões de radiologia formuladas pelo CBR.

Radiation safety assessments for radioactive concrete recycling workers and residents

Carried out was the assessment of the radiation safety for the recycling workers of the radioactive concrete generated from nuclear power plants and nearby residents. Decommissioning of a nuclear power plant with an electric output of 1000 MW generates approximately 500,000 tons of concrete waste. It is important to reduce the volume of concrete waste to reduce the costs of decommissioning projects. For this purpose, the low-level radioactive cement powder from bioshield concrete is recycled as a solidifying agent. The number of radioactive concrete waste drums to be disposed is reduced by extracting cement from the radioactive concrete and using it as a solidifying agent, rather than using cement from general industrial waste. Various exposure scenarios exist, and it is necessary to evaluate the radiation dose in each scenario. In this study, seven scenarios were selected and evaluated. The radioactive exposure to facility workers, nuclear power plant workers, and landfill management workers is within the annual dose limit, even if they work 2000 h per year. A loader can work close to the drum for 90–93 h per year, and a truck driver can drive 621 one-way trucks per year. Dose evaluations for road users and residents after landfill closure showed that both had values far below the dose limit for the public. Bioshield concrete recycling was confirmed to be radiologically safe in all scenarios if certain conditions were satisfied. Thus, this study showed that cement powder from bioshield concrete could be used safely without exceeding the radiation safety limits for workers and the public when recycling concrete.

SEX AND ETHNICITY-RELATED DISPARITIES IN ALZHEIMER’S DISEASE AMONG RESIDENTS OF SKILLED NURSING FACILITIES

Abstract Residents of nursing homes represent a special subset of the population characterized by increased vulnerability and higher rates of Alzheimer’s Disease (AD). Nursing home ethnic composition does not reflect that of the general population with minorities more likely to be concentrated in facilities with serious deficiencies, and to have lower health status at time of admission. Significant ethnic disparities in quality-of-care aspects such as hospitalizations, preventive care, and the management of chronic conditions exist and these patterns extend to sex and ethnicity-specific subgroups of individuals with AD. However, there is a paucity of knowledge on the actual size of sex and ethnicity-related disparities in AD within this high-risk population. In this study we used 100% of all nursing home resident evaluations (N=23,080,518; Male:40.66%; Female:59.34%; White: 77.29%; Black:11.62%; Other:3.80%; Hispanic:4.97%; Asian:1.81%; Pacific Islander:0.15%; Native American Native:0.39%), 1999-2012, from the Minimum Dataset to assess sex and ethnicity-specific differences in age-specific prevalence of AD. Total AD prevalence increases sharply (numbers are prevalence proportions with 95% confidence intervals in parentheses) from 1.79 (1.75-1.84) at age 60 to 13.45 (13.39-13.51) at 85. Notable statistically significant sex and ethnicity-related disparities were present at all ages. For example, at age 85 the prevalence of AD was for: i)Males: 11.34 (11.24-11.44); ii)Females: 14.53 (14.45-14.62); iii)Whites: 13.21 (13.14-13.28); iv)Blacks: 15.32 (15.09-15.55); v)Other/Unknown: 9.75 (9.42-10.07); vi)Hispanics: 18.17 (17.82-18.52); vii)Asians: 11.30 (10.87-11.72); viii)Pacific Islanders: 10.33 (8.65-12.01); ix)North American Natives: 11.78 (10.62-12.94). In depth analysis of the causes, time-trends, and geographic distribution of these disparities is needed.

Analysis of pressure perception of internal roads in existing settlements based on random forest/deep learning

The quality of road space has an influential role in human psychological health. Quantifying residents' perceptions of road spatial quality and exploring the relationship between perceptions and constituent elements have become topics of interest to many parties. In this study, based on the high-resolution remote sensing images acquired by Baidu Maps, the road images of built-up settlements in Beijing in three different periods (1949-1977, 1978-1997, and 1998-2022) were semantically segmented. The large-scale rating data and subjective evaluations of residents' spatial perceptions of roads were analyzed using random forest and multiple linear regression methods. The results show that stress, a negative perception, is positively correlated with buildings and cars, and negatively correlated with vegetation, sky, and sidewalks. The composition of elements affecting residents' stress perceptions in communities of different build-up years was consistent, but the degree of influence of each element was ranked differently. This study attempts to summarize the road characteristics and residential advantages of different built-up neighborhoods, and proposes optimization strategies for upgrading road space in old neighborhoods and countermeasure suggestions for future improvement of the human living environment.

Characterization of soundscape assessment in outdoor public spaces of urban high-rise residential communitiesa).

Soundscape perceptual models were developed in various contexts. However, as the outdoor public space in high-rise residential communities differs in terms of space planning and management, the soundscape perceptual characteristics are still unclear. In this study, an on-site survey was conducted to obtain the perceptual dimensions of soundscape in outdoor public spaces in urban high-rise residential communities based on evaluations of residents. Meantime, the soundscape of the space in different community layouts were compared. It was found that: (1) Four dimensions of outdoor soundscape in high-rise communities were extracted, namely Relaxation, Communication, Quietness, and Spatiality. The first three dimensions were positively correlated with overall soundscape satisfaction significantly. (2) Relaxation was mostly correlated with dominance of noise; Communication and Quietness were primarily related to sounds from human beings. (3) Lower traffic noise and higher levels of human sounds were perceived in enclosed communities, resulting in higher Relaxation and lower Quietness scores in outdoor public spaces in enclosed communities than non-enclosed ones. These findings evoke insights into the understanding of soundscape assessment in different contexts, and provide implications for sound environment design in urban high-rise communities.

Milestones for neurosurgery sub-interns: a novel evaluation tool to quantitatively differentiate residency applicants.

The study objective was to create a novel milestones evaluation form for neurosurgery sub-interns and assess its potential as a quantitative and standardized performance assessment to compare potential residency applicants. In this pilot study, the authors aimed to determine the form's interrater reliability, relationship to percentile assignments in the neurosurgery standardized letter of recommendation (SLOR), ability to quantitatively differentiate tiers of students, and ease of use. Medical student milestones were either adapted from the resident Neurological Surgery Milestones or created de novo to evaluate a student's medical knowledge, procedural aptitude, professionalism, interpersonal and communication skills, and evidence-based practice and improvement. Four milestone levels were defined, corresponding to estimated 3rd-year medical student through 2nd-year resident levels. Faculty and resident evaluations as well as student self-evaluations were completed for 35 sub-interns across 8 programs. A cumulative milestone score (CMS) was computed for each student. Student CMSs were compared both within and between programs. Interrater reliability was determined with Kendall's coefficient of concordance (Kendall's W). Student CMSs were compared against their percentile assignments in the SLOR using analysis of variance with post hoc testing. CMS-derived percentile rankings were assigned to quantitatively distinguish tiers of students. Students and faculty were surveyed on the form's usefulness. The average faculty rating overall was 3.20, similar to the estimated competency level of an intern. Student and faculty ratings were similar, whereas resident ratings were lower (p < 0.001). Students were rated most highly in coachability and feedback (3.49 and 3.67, respectively) and lowest in bedside procedural aptitude (2.90 and 2.85, respectively) in both faculty and self-evaluations. The median CMS was 26.5 (IQR 21.75-29.75, range 14-32) with only 2 students (5.7%) achieving the highest rating of 32. Programs that evaluated the most students differentiated the highest-performing students from the lowest by at least 13 points. A program with 3 faculty raters demonstrated scoring agreement across 5 students (p = 0.024). The CMS differed significantly between SLOR percentile assignments, despite 25% of students being assigned to the top fifth percentile. CMS-driven percentile assignment significantly differentiated the bottom, middle, and top third of students (p < 0.001). Faculty and students strongly endorsed the milestones form. The medical student milestones form was well received and differentiated neurosurgery sub-interns both within and across programs. This form has potential as a replacement for numerical Step 1 scoring as a standardized, quantitative performance assessment for neurosurgery residency applicants.

National ABSITE Preparation Practices: A Survey of General Surgery Residency Program Directors

The American Board of Surgery In-Training Examination (ABSITE) was designed as a low-stakes, medical knowledge examination for US general surgery residency programs. However, in practice, this exam has been utilized for higher stakes purposes, such as resident promotion or remediation, and fellowship selection. Several studies have demonstrated the efficacy of ABSITE preparation resources, but best practices for ABSITE preparation and national preparatory habits are currently unknown. The aim of this work was to determine current residency programs' strategies for ABSITE preparation. We distributed an electronic survey to program directors or program coordinators of US general surgery programs asking them to anonymously report program ABSITE educational practices and ABSITE scores. We analyzed the proportion of responses using descriptive statistics and compared the effect of various strategies using the Mann-Whitney testing for nonparametric data. An average ABSITE percentile score was calculated for each residency based on program self-reported scores. Association of Program Directors (APDS) Listserv PARTICIPANTS: General surgery residency programs participating at the time of distribution (278). Response rate was 24% (66/278); 41 programs (62.1%) identified as university-affiliated, and 25 (37.9%) were community-based. Median intern class size was 8 (range: 3-14), including preliminary interns. Average ABSITE percentile score was 52.8% (range 36.9%-67.6%). There were no significant differences in ABSITE scores based on affiliation or program size. Educational resources utilized for ABSITE preparation included SCORE (89.3%), Q-banks (50%), and surgical textbooks (25.8%). The majority (56.1%) of programs reported using a year-long curriculum for ABSITE preparation, and 66.6% used a time-limited curriculum completed in the months immediately prior to ABSITE. Most programs reported that ABSITE scores were a low priority (63.6%) or not a priority (13.6%). The existence of a year-long curriculum for ABSITE was positively correlated with score as compared to programs without a year-long curricula (53.9% vs 48.5%, p <0.01). Programs using a time-limited curriculum demonstrated lower scores as compared to programs without time-limited curricula (51.3% v 56.1%, p < 0.01). General surgery programs use a variety of strategies to prepare residents for the ABSITE. Despite reporting that they utilize ABSITE scores for a variety of high stakes purposes including evaluation for promotion and as a predictor of the preparedness for the ABS QE, many programs reported that they consider ABSITE scores as a low priority. A year-long focused curriculum was the only strategy correlated with increased scores, which may reflect the value of encouraging consistent studying and spaced repetition. Additional work is needed to guide programs in optimal utilization of ABSITE scores for remediation and resident evaluation, as well as understanding how ABSITE preparatory strategies correlate with clinical performance.

A Study on the Ephemerality of Public Space in Traditional Village from a Cognitive Perspective

Based on the design method of urban and rural planning, we combine the theories and methods of geography and habitat environment disciplines, and introduce the "schema" theory of psychology to construct the cognitive maps of residents and tourists. Using Zishan Village in Hanwang Town, Xuzhou City as an empirical case, we extracted regional characteristics and explored the cognitive evaluation of residents and tourists, and analyzed the research data in a qualitative and quantitative way. The satellite tracking 3D track function was used to record the travel routes and shooting points of the sample population, and the collected data were overlaid to analyze the overlap of the routes and shooting points, so as to derive the interest points of residents and tourists. The data were summarized in tabular form and imported into SPSS for cross-tabulation analysis and chi-square test. Questionnaire interviews were used to collect the personal feelings of residents and tourists from a qualitative perspective. The cognitive maps of residents and tourists were constructed and their differences were explored to visualize the regional characteristics of traditional village public space and to identify effective landscape design and public space construction, which can provide reference and basis for village construction.

Gender Disparity in Teaching Evaluations of Pediatric Faculty by Residents.

Despite their overrepresentation, female physicians continue to have lower rates of promotion compared with male physicians. Teaching evaluations play a role in physician advancement. Few studies have investigated gender disparity in resident evaluations of pediatric faculty. We hypothesized that gender disparities in resident evaluations of faculty exist and vary across subspecialties and primary work environments. Pediatric faculty institution-specific evaluations completed by residents from January 1, 2015, to March 9, 2020, were obtained from a single academic center. Mean ratings of faculty performance were compared by gender using a Wilcoxon 2-sample test. Fifteen-thousand one-hundred and forty-two evaluations (5091 of male faculty and 10 051 of female faculty) were included. Female faculty were rated higher in overall teaching ability (female = 4.67 versus male = 4.65; P = .004). There was no statistical difference in the mean ratings of male and female faculty in the inpatient setting, whereas outpatient female faculty were rated higher in overall teaching ability (female = 4.79 versus male = 4.73; P = .005). For general pediatric faculty, females received higher ratings for overall teaching ability (female = 4.75 versus male = 4.70; P < .001). By contrast, there was no difference in ratings of subspecialty pediatric faculty. Pediatric female faculty were statistically rated higher than male faculty in overall teaching ability, although these findings may not be educationally significant. The difference was driven by evaluations in the outpatient setting and for general pediatricians. This study is one of the first in pediatrics adding to the continued investigation of gender disparities in academic medicine.

A Prospective Study Measuring Resident and Faculty Contour Concordance: A Potential Tool for Quantitative Assessment of Residents’ Performance in Contouring and Target Delineation in Radiation Oncology Residency

Purpose/Objective(s)Accurate target delineation (ie, contouring) is essential for radiation treatment planning and radiotherapy efficacy. As a result, improving the quality of target delineation is an important goal in the education of radiation oncology residents. The purpose of this study was to track the concordance of radiation oncology residents’ contours with those of faculty physicians over the course of 1 year to assess for patterns. Materials/MethodsResidents in postgraduate year (PGY) levels 2 to 4 were asked to contour target volumes that were then compared to the finalized, faculty physician–approved contours. Concordance between resident and faculty physician contours was determined by calculating the Jaccard concordance index (JCI), ranging from 0, meaning no agreement, to 1, meaning complete agreement. Multivariate mixed-effect models were used to assess the association of JCI to the fixed effect of PGY level and its interactions with cancer type and other baseline characteristics. Post hoc means of JCI were compared between PGY levels after accounting for multiple comparisons using Tukey’s method. ResultsIn total, 958 structures from 314 patients collected during the 2020-2021 academic year were studied. The mean JCI was 0.77, 0.75, and 0.61 for the PGY-4, PGY-3, and PGY-2 levels, respectively. The JCI score for PGY-2 was found to be lower than those for PGY-3 and PGY-4, respectively (all P < .001). No statistically significant difference of JCI score was found between the PGY-3 and PGY-4 levels. The average JCI score was lowest (0.51) for primary head and/or neck cancers, and it was highest (0.80) for gynecologic cancers. ConclusionsTracking and comparing the concordance of resident contours with faculty physician contours is an intriguing method of assessing resident performance in contouring and target delineation and could potentially serve as a quantitative metric, which is lacking currently, in radiation oncology resident evaluation. However, additional study is necessary before this technique can be incorporated into residency assessments.

Sustainability of a Low-Cost Decentralized Treatment System for Wastewater Reuse: Resident Perception-Based Evaluation for Arid Regions

Small communities and most rural settlements in the Kingdom of Saudi Arabia (KSA) store domestic wastewater in residential septic tanks and transport it to the nearest centralized wastewater treatment plant. Without a sanitary sewerage system, the residents encounter various socioeconomic and environmental challenges related to sewage collection vehicles, the production of objectionable gases, and leaking septic tanks. The present study developed a resident perception-based methodology to appraise the sustainability of a low-cost ceramic filter bioreactor-type decentralized wastewater treatment system (DWWTS) for a small community of 1300 residents (160 households) in Qassim (KSA). In addition to six demographic factors, nine indicators assessed residents’ perceptions about existing and proposed wastewater management systems. A hierarchical-based system of sub-indices evaluated the three dimensions of sustainability using four environmental, nine social, and three economic indicators. The indicators translated into dichotomous questions posed to 34 respondents in the study area. The statistical analysis assessed the association of responses with the willingness to accept (WTA) the proposed DWWTS. A subjective rating scheme translated the responses into performance scores, and a fuzzy-based method aggregated the scores into sub- and top-level indices. The top of the hierarchy showed a close agreement between the resident’s perception and DWWTS’ sustainability. The study found that residents’ knowledge about environment and resource conservation resulted in a moderately high willingness to reuse treated effluent and WTA the decentralized system. The study also showed that the economic viability of a DWWTS remained at a moderate performance level due to a low monthly waste disposal cost. The study’s findings present a high potential for sustainable community-maintained DWWTS initially supported by the government. The proposed approach facilitates decision-makers working in ministries concerning water resources, environmental protection, and agricultural production in evaluating the sustainability of DWWTS for small communities in arid regions.