Residency Program Coordinators Research Articles

Work-related musculoskeletal symptoms among otolaryngologists by subspecialty: A national survey.

Given the high prevalence of work-related musculoskeletal symptoms, increased appreciation for workplace ergonomics is critical. The purpose of this study is to assess work-related musculoskeletal symptoms and injury among otolaryngologists across subspecialties, as well as to quantify the understanding and application of ergonomic principles in the operating room. Cross-sectional study. An online REDCap survey was distributed electronically to University of Kansas faculty, alumni, and residents; members of the American Academy of Facial Plastic and Reconstructive Surgery; and residency program coordinators for distribution to residents and faculty between August 2016 and March 2017. The survey assessed caseload, ergonomic practices, and associated musculoskeletal symptoms by type of procedure and impact of symptoms on surgeon practice. The survey was distributed to 3,006 individuals. We received 377 responses (12.5%), with 63.9% reporting symptoms. The majority of respondents began to experience symptoms in residency or fellowship. Neck and shoulder were the most affected body areas across all types of surgeries. One-third of surgeons were formally taught or actively sought information on ergonomics principles. Among those who applied ergonomics in practice, 69.6% observed improvement in their symptoms. Although musculoskeletal issues are prevalent among otolaryngologists, awareness of surgical ergonomics principles among otolaryngologists remains limited. Early instruction in ergonomic principles is important because work-related musculoskeletal symptoms commonly present in residency. Most respondents reporting the application of ergonomic principles also acknowledge symptom improvement. NA. Laryngoscope, 128:632-640, 2018.

The Science of Selection: Using Best Practices From Industry to Improve Success in Surgery Training

The selection of high-quality applicants is critical to the future of surgery. However, it is unclear if current practices meet industry criteria of a successful selection system, as measured by administrative efficiency and performance and attrition of those selected. We performed a modified systematic review process to gain an understanding of current selection processes, remediation practices, and attrition rates in surgery residency training programs in the United States. We also conducted semistructured interviews with local residency program directors and coordinators to obtain a specific snapshot of the amount of time and resources dedicated to these activities in various sized programs. The associated financial costs of these activities are also presented. The administrative costs for current residency selection processes are substantial, ranging from $45,000 to $148,000 for each program per year. Approximately 30% of residents require at least 1 remediation intervention, costing programs $3400 to $5300 per episode, and typically involve concerns around nontechnical skills. Attrition rates range from 20% to 40%. This review suggests that additional methodologies may allow surgery residency programs to identify best-fit candidates more efficiently and effectively, while also decreasing remediation and attrition rates. Possible solutions include incorporation of structured interviews, personality inventories, and situational judgment tests. Resources dedicated to current interview practices, remediation efforts, and attrition management can be redirected to support these methodologies. By applying the science of selection and assessment to the recruitment process, programs may be able to make more data-driven decisions to identify candidates who will be successful at their institution.

Survey of OBGYN Residents to Assess Awareness and Use of the U.S. CDC Medical Eligibility Criteria for Contraceptive Use [15A

INTRODUCTION: The CDC created the US Medical Eligibility Criteria (MEC) for Contraceptive Use in 2010 to serve as a tool for provider guidance when counseling patients with various medical conditions on safe use of contraception. Our study sought to assess US OB/GYN residents’ knowledge and use of this tool and how they choose to use it. METHODS: All US OBGYN residency program coordinators were emailed and asked to distribute a link to our online survey to their residents. Descriptive statistics and Fisher’s exact test were used to analyze the results. RESULTS: Ninety responses were obtained. Of the respondents, 91% were aware of the MEC, and 82% had used them. Of those who had used the MEC, 61% used the free smartphone app. Of those who did not use the MEC, most used UptoDate or asked a colleague to obtain contraception counseling information. There was no significant difference in use of the MEC among programs with and without Family Planning Fellowships or Ryan Programs. CONCLUSION: Most respondents were aware of and using the MEC, most often the downloadable smart-phone app. Due to a low response rate, additional assessment of resident use of the MEC is needed to fully understand how to improve OBGYN awareness and use of the MEC.

Impact of Nightfloat on Obstetrics and Gynecology Resident Education [27I

INTRODUCTION: Nightfloat rotations are common in Obstetrics and Gynecology residency programs. The impact of this type of schedule on resident education in OB/Gyn has not been evaluated. This study was initiated to determine how the scheduling challenges of nightfloat rotations may impact OB/Gyn residents’ ability to participate in educational opportunities. METHODS: A cross-sectional study was conducted via two surveys. One survey was sent to all U.S. OB/Gyn residency program coordinators to collect information on their rotation structure and educational activities. A separate survey was sent to residents in these programs to evaluate their perspective on participation in educational activities while on nightfloat rotations. RESULTS: 58 program directors (24.8% response rate) and 202 residents (16.1% response rate) from 54 programs responded. Of the program coordinators who responded, 98.2% reported having nightfloat rotation. Of these, only 8.8% had nightfloat specific educational activities. Attendance at regular didactic sessions was required by 33.9% of programs, however 76.9% of residents felt that they were not alert during these sessions. The survey also revealed that 66.4% of residents thought that their educational experience on nightfloat could be improved but most stated that required attendance at didactics would be ineffective. Residents’ suggestions for alternative options included ideas such as dedicated modules and recordings of regular didactic sessions. CONCLUSION: There is a need to improve the educational experience for residents on nightfloat rotations.

Radiology Resident' Satisfaction With Their Training and Education in the United States: Effect of Program Directors, Teaching Faculty, and Other Factors on Program Success.

Radiology residency education must evolve to meet the growing demands of radiology training. Resident opinions are a major resource to identify needs. However, few published data are available on a national level investigating the radiology resident perspective on factors that influence the resident experience. Our study investigates factors that affect residents' satisfaction with their residency experience and education. A 67-item survey was sent to all radiology residency program directors and coordinators in the United States to be distributed at their discretion. Questions were multiple choice, free-text answer, or 5-point Likert scale. Statistical significance (p < 0.05) was determined using chi-square test, t test, and logistic regression analysis, respectively. Two hundred seventeen radiology residents responded to the survey (range, 212-217 responses per question). Overall, 77.8% (168/216) of residents were satisfied with their residency programs. Subcategories that showed a statistically significant correlation with overall satisfaction, in decreasing strength according to the odds ratio (OR), include the program director or administrative office (OR, 72.2; 95% CI, 27.4-221.9), the daily workstation experience (OR, 30.5; 95% CI, 12.8-80.9), the faculty (OR, 19.5; 95% CI, 8.9-45.4), educational conferences (OR, 7.9; 95% CI, 3.9-16.4), work hours (OR, 6.4; 95% CI, 3.2-13.2), teaching opportunities (OR, 6.5; 95% CI, 3.1-13.8), research opportunities (OR, 5.1; 95% CI, 2.6-10.6), personal study (OR, 2.1; 95% CI, 1.1-4.1), and compensation (OR, 1.9; 95% CI, 1.0-3.7). Our study provides incremental data to the existing literature that offers insight into factors that contribute to a successful radiology residency program.

The Current State of Musculoskeletal Ultrasound Education in Physical Medicine and Rehabilitation Residency Programs

BackgroundExposure to musculoskeletal ultrasound (MSUS) is now a mandatory component of physical medicine and rehabilitation (PM&R) residency training. However, reports on the extent of the implementation and efficacy of MSUS education are lacking in the literature. ObjectiveTo determine the extent to which PM&R residencies are implementing MSUS education. DesignCross-sectional. SettingInstitutional. ParticipantsThirty-six of the 78 United States PM&R residency programs accredited by the Accreditation Council for Graduate Medical Education. MethodsAll 78 programs were solicited with an online survey via the residency program director and coordinator in July 2014. The 25 questions on the survey were aimed at determining program MSUS educational characteristics and their effectiveness. Main Outcome MeasuresDescription of teaching methods used for MSUS, residency demographics, characteristics of MSUS faculty expertise, and faculty-perceived competency in MSUS examinations and procedures among residents. Data were analyzed using both descriptive statistics and tests for independence to identify correlations between program characteristics and resident MSUS competency. ResultsA response was received from 36 of the 78 residency programs (46.2%). Of the 36 residency programs that responded, 97.2% provide exposure to MSUS (a figure that drops to 44.9% when nonrespondents are included); 61% had mandatory MSUS training (28.2% when including nonrespondents); and 44.4% had a formal curriculum (20.5% when including nonrespondents). The most common MSUS educational tools used were lecture (88.9%), outpatient clinic (86.1%), and hands-on workshops (86.1%). Sixty-one percent of responding programs evaluate residents with formal assessment tools. Overall, faculty at 38.8% and 44.4% of programs believed that at least 50% of residents who graduate are competent in diagnostic and interventional MSUS, respectively. These rates were significantly associated with the use of formal assessment. ConclusionMSUS education is growing in PM&R, but many programs still have not adopted a formal educational curriculum. Formal assessment to evaluate resident MSUS skills significantly improves faculty-perceived MSUS competency.

Response to Let Me Heal Book Reviews

The September 2014 issue of the Journal featured a series of reviews of Kenneth Ludmerer's recent book Let Me Heal: The Opportunity to Preserve Excellence in American Medicine.1 As I read the reviews, I was intrigued, and I ordered a copy of the book.The authors of the reviews comprised a spectrum of individuals with varying experiences in graduate medical education—residents, medical educators, a designated institutional official, an expert on education from abroad, and a patient. All offered fascinating perspectives, yet I could not help but think that 1 group was missing, a group with close interactions to all those people mentioned previously, and that have a solid understanding of graduate medical education at a program level—residency program coordinators.As a program coordinator who is dedicated to her profession and has a passion for graduate medical education, I thought I might provide an alternative perspective and weigh in on some of the changes in graduate medical education that we have experienced as a profession.As Ludmerer1 points out, residency programs initially were run by department chairs. It wasn't until the 1970s and 1980s that the administrative duties were delegated to a designated “program director.” During this transition, there typically were office personnel who assisted in the running of the program; they may have been “secretaries” or “office assistants,” and they helped administer the residency program, either in part or as a whole function of their job.It did not take long for the members of this group to find each other and form a professional network. One of the earliest formal groups of residency coordinators was the Association of Residency Coordinators in Surgery,2 established in 1988, only 11 years behind the specialty Association for Program Directors in Surgery. The formal organization of such groups showed an early propensity for the members of this group to hold a vital and important role in the life of a resident.With the increased oversight by the Accreditation Council for Graduate Medical Education (ACGME), and the advent of duty hour limits and the competencies, the administration work for each program director grew immensely. It was during this time that the position of a dedicated residency program coordinator really took hold. As listed in Common Program Requirements for many specialties, a need was identified for “professional personnel for the effective administration of the program.”Program coordinators play a multitude of roles. We often are the administrative organizers, experts on the program requirements, life coaches, and connectors,3 to name a few. Our skills, resourcefulness, responsiveness, and professionalism are essential to the attainment of accreditation goals and for full compliance with the ACGME.Let Me Heal1 is an invaluable historical account of graduate medical education that residency program coordinators are proud to be a part of. I would like to think that residency program coordinators today are the “Uncle Hanks” of the early days of residency (this is a reference in the book to Henry Hurd, an early hospital administrator who had profound interest in the success of the residency program and in residents personally).I agree with the author that this book should be required reading for everyone involved in residency training, including residency program coordinators.

Appropriateness of Imaging Studies Ordered by Emergency Medicine Residents: Results of an Online Survey

The purpose of this study is to determine the proficiency of emergency medicine residents in selecting appropriate radiologic examinations for specific clinical scenarios and to ascertain whether their training improves competency in this area over the course of their residency. An online multiple-choice questionnaire was created. It included 10 clinical scenarios excerpted from the American College of Radiology Appropriateness Criteria guidelines and instructed residents to select the most appropriate initial imaging study. A link and invitation to the survey were e-mailed to the residency program directors and coordinators of all American Council for Graduate Medical Education-accredited emergency medicine residency training programs with the request that they be forwarded to their current residents. Responses were graded, with correct answers derived from the American College of Radiology guidelines. Results were stratified by year of emergency medicine training, and an analysis of variance was performed. A total of 583 residents from at least 77 different emergency medicine residency training programs completed the survey. Overall, the average number of questions answered correctly was 7.1 of 10 (SD, 1.2). First-through fourth-year residents averaged 6.9 (SD, 1.3), 7.1 (SD, 1.2), 7.1 (SD, 1.1), and 7.5 (SD, 1.1) correct answers, respectively. Analysis of variance found no significant difference between the scores of the four classes (p = 0.09). Emergency medicine residents do not show significant improvement over the course of their residency in their ability to choose appropriate imaging studies. This finding suggests that there is a role for more-rigorous focused instruction to better familiarize residents with appropriateness guidelines for diagnostic imaging selection.

Pharmacy innovation across the nation

Pharmacy innovation across the nation

The Design and Implementation of an Automated System for Logging Clinical Experiences Using an Anesthesia Information Management System

Residents in anesthesia training programs throughout the world are required to document their clinical cases to help ensure that they receive adequate training. Current systems involve self-reporting, are subject to delayed updates and misreported data, and do not provide a practicable method of validation. Anesthesia information management systems (AIMS) are being used increasingly in training programs and are a logical source for verifiable documentation. We hypothesized that case logs generated automatically from an AIMS would be sufficiently accurate to replace the current manual process. We based our analysis on the data reporting requirements of the American College of Graduate Medical Education (ACGME). We conducted a systematic review of ACGME requirements and our AIMS record, and made modifications after identifying data element and attribution issues. We studied 2 methods (parsing of free text procedure descriptions and CPT4 procedure code mapping) to automatically determine ACGME case categories and generated AIMS-based case logs and compared these to assignments made by manual inspection of the anesthesia records. We also assessed under- and overreporting of cases entered manually by our residents into the ACGME website. The parsing and mapping methods assigned cases to a majority of the ACGME categories with accuracies of 95% and 97%, respectively, as compared with determinations made by 2 residents and 1 attending who manually reviewed all procedure descriptions. Comparison of AIMS-based case logs with reports from the ACGME Resident Case Log System website showed that >50% of residents either underreported or overreported their total case counts by at least 5%. The AIMS database is a source of contemporaneous documentation of resident experience that can be queried to generate valid, verifiable case logs. The extent of AIMS adoption by academic anesthesia departments should encourage accreditation organizations to support uploading of AIMS-based case log files to improve accuracy and to decrease the clerical burden on anesthesia residents.

EASE: Development Program for Residency Program Directors and Coordinators

Abstract EASE (Educator, Administrator, Scholar, Evaluator) includes two parallel development programs for residency program directors and coordinators. Each of the 10 sessions comes with objective...

A Graduate Medical Education Initiative to Promote Professional Excellence Among Residency Program Coordinators

Background: The authors describe the scope and impact of a professional development program for residency and fellowship program coordinators (PCs) at the University of Arkansas for Medical Sciences (UAMS) College of Medicine. PCs are vital in the success of their residency programs, yet few articles to date have addressed their increasingly complex roles.Purpose: This exploratory study examines PCs’ professional characteristics, perceptions that influence professional development meeting attendance, and the impact of the Program Coordinators’ Organization (PCO).Methods: All 44 PCs serving 53 residency and fellowship programs at UAMS were surveyed about their perceptions of the PCO in January 2006.Results: The majority of respondents agreed that the PCO has improved their abilities and interactions with their supervisors, colleagues, and residents and that the PCO has made an institution-wide impact on residency education.Conclusions: Sponsoring a PCO may be an effective tool for organizations to enhance the role of PCs and their graduate medical education programs.

Educational Development Program for Residency Program Directors and Coordinators

Background: Residency program directors and program coordinators have increasing demands placed on them by accrediting agencies and require educational development specifically tailored to their needs.Description: We created, piloted, and evaluated an educational development program consisting of 10 sessions spanning 1 year for program directors and a parallel set of sessions for program coordinators.Evaluation: On average, more than half the residency programs participated in the sessions. Programs improved in residency activities related to their program's handbook, interviewing, evaluations, rotation descriptions, and program evaluation. They did not improve in educational scholarly activities. Program directors and coordinators indicated that the program improved their skills, and they would recommend the program for others.Conclusions: This 10-session program improved important elements of residency education and was favorably received.

Is Your Residency Program Coordinator Successful?

Is Your Residency Program Coordinator Successful?

Importance of the Radiology Program Coordinator 1

The Accreditation Council for Graduate Medical Education (ACGME) requires that each program have a dedicated residency program coordinator (1). This was recently added to the program requirements when it became apparent to the members of the Radiology Residency Review Committee (RRC) that the success of a program was dependent upon the program having such a dedicated person. The ACGME requires there to be a single program director responsible for a diagnostic radiology residency program. This person is accountable for the operation of the program including overseeing and organizing the activities of the educational program in all institutions that participate in the program; preparing an accurate statistical and narrative description of the program as requested by the RRC (as well as updating annually both program and resident records through the ACGME Accreditation Data System); ensuring the implementation of fair policies, grievance procedures, and due process; and seeking prior approval of the RRC for any changes in the program that may significantly alter the educational experience of the residents. The labor-intensive nature of these responsibilities led to the ACGME requirement that the program director be provided at least 1 day per week of protected time to administer the program. The role of the coordinator interfaces with nearly every aspect of the program director’s role. Although the program director is held accountable for every aspect of the program, much of the effort that is involved in administering a program is delegated to the coordinator. It is vitally important that the program director and coordinator have a close and

A COMPUTERIZED SYSTEM FOR EVALUATION OF ANESTHESIA RESIDENTS

S181 INTRODUCTION: Feedback on performance is essential for the clinical development of anesthesiology residents and is required by the Residency Review Committee [1] and the ABA. Traditionally, it has been difficult to obtain written evaluations from the entire faculty on each resident. Although only requested quarterly, faculty compliance has been low due to the time consuming nature of the evaluation process. Poor faculty compliance led to omissions or delays in conveying feedback to residents, allowing undesirable patterns of study and clinical care to become entrenched. Also, performance criteria were not standardized, causing inconsistencies in methods of evaluation among faculty members and between time periods. Objective comparisons of performance among residents was also difficult. A new, economical, user-friendly process was sought that would give residents monthly written feedback, promote faculty participation, and standardize performance criteria. METHODS: A resident-evaluation committee reviewed evaluation forms from 6 other residencies and searched the resident-evaluation literature back to 1984. Members listed what they considered the most important evaluation criteria and a composite list was made. This was then configured into a user-friendly "fill in the circle with a No. 2 pencil" computerized form by the Dept. of Institutional Research and this was finally approved by the entire Anesthesiology faculty. RESULTS: A twenty-nine item Likert-scale evaluation form resulted. This one-page Scantron form (Scantron Corp, Omaha, NE) is readable by a Scantron 8600 optical scanner. The form addressed four categories of resident performance: knowledge and clinical performance, technical skills, quality of documentation, and personal qualities. The Likert scale is: 1 = "unsatisfactory" to 6 = "excellent" and 7 = "unable to evaluate or does not apply." Numeric codes were assigned to each resident, faculty member, anesthesiology rotation (subspecialty service or general operating room), and month and year of evaluation. Each faculty member is strongly encouraged to complete an evaluation on each resident with whom he/she has worked during the month. Less than five minutes is required to complete this form, slightly more if written comments are included. Forms are placed in a sealed box, collected daily by the residency program coordinator, and processed as a batch on the 5th day of the new month. The completed forms are then taken to Institutional Research for optical scanning, analysis, and individual resident report generation. Group (summarizing performance of the entire residency) and individual reports are generated within 48 hours. Each report includes scores for all twenty-nine evaluation items and lists the number of participating faculty, the percentage of respondents assigning a given score to each item, and the mean score for each item. Reports are returned to the Education Director and each resident. Under the old narrative evaluation system, faculty compliance was poor (10%) and, consequently, evaluations reflected a few individual opinions, not a wide-spread departmental impression. Compliance with the new system is over 65%. The form was designed for monthly resident evaluation; however, it can be adapted for daily use in special resident circumstances which indicate the need for intense evaluation. DISCUSSION: The new form systematically leads users through the evaluation process and enhances consistency and uniformity of evaluations. Faculty advisors monitor their respective residents' reports and review them with their resident advisees on a quarterly basis or more often if indicated. This new process allows for earlier acquisition of data and helps identify residents experiencing difficulty. Key results are communicated to the faculty at its weekly meeting by the Director of Resident Education. Resulting strategies for remediation are promptly formulated and implemented. The ease of this evaluation system has increased faculty compliance, provided critical timely feedback to residents, and promoted clinical improvements. This resident evaluation system has served as a model for other clinical departments in the University of Mississippi Medical Center.

Statistics for the residency review committee: A clear windows approach

Because the reporting requirements imposed by the Residency Review Committee (RRC) for Obstetrics and Gynecology have become more extensive, we sought to develop a Microsoft Windows 3.1 (Microsoft Corp., Redmond, WA)-based computer program for maintaining an on-line record of resident surgical experience. Data input for our program occurs in two stages. All residents are responsible for maintaining separate obstetrics and gynecology-primary care statistical booklets. Each booklet consists of individual perforated data sheets. The front of the obstetrics data sheets is a replica of the bottom portion of RRC S Form Obstetrics. The reverse side is a replica of the top half of S Form Obstetrics, listing all "accountable" obstetric procedures, coded by level of operator responsibility. The front of the gynecology data sheet replicates the S Form Primary and Preventive Ambulatory Medicine. The reverse of this sheet is a replica of S Form Gynecology and lists all "accountable" gynecologic procedures, again coded by level of operator responsibility. Residents submit data sheets on a daily basis to the residency program coordinator, who then enters each patient encounter into a user-friendly data base program. Data entry screens are essentially identical to the individual encounter forms, and input requires fewer than 30 seconds per form. Once the individual patient's data is entered on the screen, the computer program automatically updates the resident's cumulative surgical experience and stratifies experience by year of training. At any time, program administrators have on-line access to a comprehensive record of an individual resident's or group of residents' clinical experience.