Resident Skills Research Articles

Clinical decision-making training using the Script Concordance Test and simulation: A pilot study for pediatric residents

BackgroundEach year, new pediatric residents begin their shifts in the pediatric emergency room. While technical skills are often acquired during workshops, non-technical skills such as communication, professionalism, situational awareness, or decision-making are rarely tested. Simulation enables non-technical skills to be developed in situations frequently encountered in pediatric emergencies. Adopting an innovative approach, we combined two pedagogical methods: the Script Concordance Test (SCT) and simulation to improve clinical reasoning and non-technical skills of first-year pediatric residents in dealing with clinical situations involving febrile seizures. The aim of this work is to report the feasibility of such a combined training. MethodsThe first-year pediatric residents participated in a training session on how to manage a child attending the emergency department with a febrile seizure. At the beginning of the session, the trainees had to complete the SCT (seven clinical situations) and then participated in three simulation scenarios. Student satisfaction was assessed by means of a questionnaire at the end of the session. ResultsIn this pilot study, 20 residents participated in the training. The SCT scores for the first-year pediatric residents were lower and more widely distributed than those of the experts with better concordance for diagnostic items compared to investigation or treatment items. All were satisfied with the teaching methods employed. Further sessions on additional topics relating to the management of pediatric emergency cases were requested. ConclusionAlthough limited by the small size of our study, this combination of teaching methods was possible and seemed promising for the development of non-technical skills of pediatric residents. These methods are in line with the changes being made to the third cycle of medical studies in France and can be adapted to other situations and other specialties.

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

Development of a Departmental Resident Educational Program to Increase Knowledge and Confidence Related to Obstetric Anal Sphincter Injuries [ID: 1375536

INTRODUCTION: Obstetric anal sphincter injuries (OASIS) have been reported in up to 35% of vaginal deliveries; thus, understanding these injuries is a critical part of obstetrics and gynecology training. Formal educational programs with incorporated simulation training can have an advantageous effect, particularly when provided as part of residency education. This project seeks to evaluate the positive effect of departmental resident education related to OASIS, on confidence and knowledge of obstetrics and gynecology residents at Wake Forest University. METHODS: A structured OASIS curriculum was developed by the urogynecology program, including 2 hours of didactic lecture followed by stepwise simulation with swine models to demonstrate and practice anatomic repair techniques. Participants completed pre- and post-class surveys including skill confidence assessments via Likert scale (range 1–10), and standardized knowledge assessments adapted from ACOG Obstetric Laceration Repair Module, along with educational experience reports. These items were scored and analyzed. RESULTS: In August 2022, 16 residents (4 per residency year) participated. Prior to education, mean confidence level with techniques was 4.2 among all areas (range 1.6–7.4), with mean knowledge assessment score 64% (range 33–100%). Post-education, confidence improved across several domains including effectively applying perineal support (7.3–7.9), identifying lacerations and performing rectal examinations (6.1–8.0), and OASIS repair (1.9–5.4) (P<.05). Knowledge assessment scores remained similar, at 70% (P>.05). In qualitative analysis, all individuals reported beneficial aspects of the program. CONCLUSION: Introduction of an OASIS curriculum including repair simulation utilizing an animal model, increased resident skill confidence. Future research will investigate longitudinal data to improve outcomes.

Inclusion of the workshop model in the standardized training of emergency medicine residents

BackgroundStandardized training of resident physicians (STRP) includes clinical practice, professional required courses, and public required courses, among others. Of them, clinical practice is the most important as it allows residents to implement what they have learned in theoretical education to practice. Clinical practice includes different teaching methods, such as traditional lectures, bedside teaching, and workshops, and each method has its advantages and disadvantages in different situations of interest. Emergency medicine (EM) focuses on the diagnosis and treatment of urgent medical conditions and entails several emergency procedures. In this study, we aimed to compare the effects of workshop-based STRP and traditional STRP on emergency physicians. MethodsOverall, 125 residents who received STRP in EM between January and December 2021 were selected and randomly divided into two groups: the control group (n = 60; received traditional teaching) and the intervention group (n = 65; received workshop-based training). The theoretical performance, operative performance, and satisfaction of both groups were compared and analyzed. ResultsRegarding theoretical assessment, the scores of airway management, cardiopulmonary resuscitation, and trauma management in the intervention group were 4.81 (t = 5.82, p < 0.001), 6.90 (t = 7.72, p < 0.001), and 5.25 (t = 6.14, p < 0.001), respectively. Regarding skill assessment, the scores for the same items in the intervention group were 4.43 (t = 5.30, p < 0.001), 4.55 (t = 5.61, p < 0.001), and 5.62 (t = 6.65, P < 0.001), respectively. Regarding satisfaction evaluation, the scores in the intervention group were 1.99 (t = 6.03, p < 0.001), 1.98 (t = 6.41, p < 0.001), and 1.96 (t = 6.14, p < 0.001), respectively. Overall, the scores were higher in the intervention group than in the control group. ConclusionThe workshop training model effectively improves the theoretical knowledge and practical skills of EM residents undergoing standardized training. The residents found the training and its outcomes satisfactory, ultimately improving their emergency response and first-responder skills.

Pemberdayaan Masyarakat Pesisir Kecamatan Sungai Sembilan Melalui Program Technofisheries Park Melalui Olahan Sirup Buah Mangrove

Technofisheriespark is an integrated area (specially designed/planned, developed &amp; managed) consisting of one or more IPTEKIN activity centers. The introduction and socialization activities were carried out in an effort to develop coastal communities and fishermen in the Geniot River area, Sungai Sembilan with the aim of providing mentoring and counseling programs regarding the potential of mangroves as raw materials for making syrup. This activity is carried out through the method of Design and socialization, operational assistance, and application of technology. At the beginning of the observation, it was seen that the entrepreneurs were interested in this training work program. Entrepreneurs looked enthusiastic until the end of the finalization of the training activities. This activity is expected to increase the income level of entrepreneurs in the Sungai Geniot community, foster creativity in making packaging and labels as well as product marketing, and the entrepreneurial skills of residents of Sungai Geniot Village, Sungai Sembilan District, Dumai City.

Transumbilical laparoscopic-assisted appendectomy versus laparoscopic appendectomy in children: a single center experience.

Laparoscopic Appendectomy (LPSA) is the first choice for appendectomy in pediatric surgery. Trans-Umbilical Laparoscopic Assisted Appendicectomy (TULAA) is another used technique. We compared both these procedures used for the treatment of acute appendicitis. The study was conducted between January 2019 to December 2020. Patients were divided into two groups: LPSA and TULAA groups. The collected data were: operative time, number of conversions, time of canalization and hospital stay. A total of 181 patients were included: 73 were kept in the LPSA and 108 in the TULAA group. Mean operative time was 70.9 minutes (range 45-130 min) for LPS and 56.4 (30-145 min) for TULAA group (p <0.0001). Complications rate showed no statistically significant difference between both the two groups. However, conversions showed a statistically significant difference (p=0.04). Both techniques showed similar results. TULAA technique takes a significantly shorter operating time. The selection between LPSA and TULAA techniques depends on the experience of the surgeon's work and the personal laparoscopic learning curve. In our experience LPSA was a useful technique to improve the laparoscopic skill of the pediatric surgery residents.

A Telehealth Training Program for Neurology Residents (P8-2.005)

<h3>Objective:</h3> Neurologists in-training will become proficient in skills needed for an effective teleneurology visit. <h3>Background:</h3> Telehealth has improved patient access to clinicians and reduced time/cost burden on patients. Video appointment are now offered in most practices. The AAMC has outlined telehealth domains whereby clinicians must demonstrate proficiency. The Neurology RRC has endorsed support for resident telehealth encounters. We developed a no-cost reproducible telehealth training program to improve resident skills. <h3>Design/Methods:</h3> Thirteen residents recorded a telehealth counseling session pre-intervention for a patient considering botulinum toxin injections for migraines. (Time 1) Feedback was provided. Residents received a one-hour lesson outlining tele-etiquette, communication and exam skills. Trainees then underwent two 20-minute encounters with faculty trained as standardized patients. (Time 2) A second reviewer also scored the session on video review. Each resident received feedback then completed a third 20-minute clinical encounter at one-year follow-up. (Time 3) Resident confidence in skillset was also measured prior to Time 1 and upon training completion. Statistical analysis was conducted via Wilcoxin Paired t-test <h3>Results:</h3> Comparison of pre and post-course resident surveys revealed significant improvement in telehealth comfort in all categories (3.2 ± 0.8 to 4.3 ± SD 0.5 (p &lt;0.005)). Comparison of initial recording and post-course encounter revealed improvement in tele-communication and “webside” manner ((2.4 ± 0.3, 2.7 ± 0.3), (1.9 ± 0.3, 2.4 ± 0.5) (p &lt;0.05)). Comparison of initial visit and one-year follow up revealed improvement in communication, professionalism and “web-side” manner ((2.4 ± 0.3, 3 ± 0), (2.4 ± 0.7, 3 ± 0), (2.4 ± 0.7, 3 ± 0) (p &lt;0.05)). Additionally, improvement was observed in professionalism between post-course encounter and one year follow up (2.4 ± 0.7, 3 ± 0, (p &lt;0.05)). <h3>Conclusions:</h3> A low resource, no cost, telehealth training program can be effectively integrated into resident curriculum and improve tele-related interpersonal skills, communication skills, and professionalism. <b>Disclosure:</b> Dr. Davitz has nothing to disclose. Dr. Leaver has nothing to disclose. Dr. Skliut has nothing to disclose. Dr. Katsnelson has nothing to disclose. Dr. Swan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NACME. The institution of Dr. Swan has received research support from Sanofi Genzyme. The institution of Dr. Swan has received research support from Abbvie. The institution of Dr. Swan has received research support from Biogen. The institution of Dr. Swan has received research support from Sage . Dr. Shanker has nothing to disclose.

Does Internet use connect smallholder farmers to a healthy diet? Evidence from rural China.

Undernutrition and micronutrient malnutrition remain problems of significant magnitude among small-scale subsistence farmers, posing a serious threat to their health and well-being. Developing a healthy diet can effectively reduce this threat. Fortunately, the Internet can speed up the process. Based on survey data from 5,114 farm households in nine provinces in China, this study quantitatively assesses the impact of Internet use on the dietary quality of smallholder farmers using OLS regression models and PSM models. (1) Internet use can significantly contribute to dietary diversity and dietary rationality among smallholder farmers, thus optimizing their dietary structure. (2) Internet use significantly increased the average consumption amounts of milk and its products (2.9 g), fruits (21.5 g), eggs (7.5 g), and vegetables (27.1 g), while also decreasing the intake of salts (1.5 g) and oil (3.8 g). (3) The pull of internet use to improve diet quality is more significant for smallholder households with lower levels of education, older heads of households, and higher household incomes. (4) A possible mechanism is that Internet use increases household income and information access skills of rural residents, thus improving their dietary quality. In summary, governments should further promote Internet penetration in rural areas for health purposes.

Analyzing communication skills of Dentistry Post Graduate Residents with Geriatric Patients in Clinical Encounter by using Video Recordings

Background: An effective communication between the doctor and patient is the foremost factor in establishing good interpersonal relationships. This comprises of both verbal and non-verbal communicators. Particularly in the geriatric population, communication can be hindered due to physiological and psychological deterioration. This study was designed to assess the communication skills of dentistry postgraduate residents (PGRs), with their geriatric patients and provide a baseline for the shortcomings and improvements. Methods: Four postgraduate residents of both genders were selected to take clinical interviews of geriatric patients. Audio-video recordings were made by an expert and reviewed by all researchers. The interviews were transcribed individually and thematic analysis was done. Open and axial coding was done for data organization under themes and subthemes. Results: Data transcription led to initial generation of 61 codes. These codes were categorized under nine codes through axial coding and grouping of similar codes. Persistent overlapping of content was found in data transcription, which may indicate data saturation. Conclusion: Workshop-trained postgraduate students of dentistry demonstrated relatively instrumental communication skills at their clinical encounter with geriatric patients. However, the professional demeanor demands further finesse in soft skills, which can be achieved through its regular practice.

Leadership Program Encourages Residents, Fellows to Advance Equity

Leadership Program Encourages Residents, Fellows to Advance Equity

Utilization of a 3D Printed Simulation Training Model to Improve Microsurgical Training.

A prospective cohort study was conducted at our institution. A progressive microsurgical training curriculum was developed. A bespoke three-dimensional printed training platform was produced to enable residents to record training and assessment tasks. Microsurgical skills were blindly assessed before and after completing the training program using the University of Western Ontario Microsurgical Skills Assessment instrument. Plastic surgery residents at various stages of training were recruited (n = 10). A significant improvement in vessel preparation from a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, P = 0.0035) and suturing with a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, P = 0.0047) domains of the University of Western Ontario Microsurgical Skills Assessment score was demonstrated after completion of the training program. There was a significant improvement in the global rating score (3 ± 1 versus 5 ± 1, P = 0.0045). Participants felt more confident performing a microsurgical anastomosis following the training program. The use of the Konjac noodle model and video-based assessment using a three-dimensional printed model is an effective teaching tool that improves resident's microsurgical skills.

747 Operative Objectives—A Pilot Study

INTRODUCTION: Surgical graduate medical education requires residents to learn a wide array of skills and apply them practically in a progressively independent manner, ultimately allowing them to practice independently. We devised "Operative-Objectives" as a tool to define the learning goals for each resident at a particular epoch of their training. This approach is operationalized, measurable, and consistently carried over time. METHODS: The Residents at a neurosurgical training program set their "Operative-Objectives" at the beginning of each 3-month rotation. These goals were then reviewed by the Program Director (PD) and faculty and appropriately tailored and finalized--forming a compact between residents and faculty whereby their commitment to the learning and teaching objectives are defined. The outcomes are reviewed with the PD following each rotation and scored. Residents and faculty were provided a pre-and post-implementation survey that sought to understand the impact of implementing "Operative-Objectives" on resident preparedness, objectives for improvement, resident satisfaction with, and objective improvement in resident's surgical skills. RESULTS: A total of eight residents and five faculty completed both a pre-and post-implementation survey. Residents reported significantly increased case preparedness (p = .048), ability to track improvement (p = .044), clear objectives for improvement (p = .021), and satisfaction with improvement in surgical skill (p = .044). The faculty reported a significant increase in resident preparedness for surgery (p = .049), ability to track improvement (p=.044), focus for improvement (p=.033), and goals for improvement (p = .033). CONCLUSIONS: "Operative Objectives" provide a focused delineation and tracking of a resident's surgical learning at the intersection of three vectors: level of training, location, and ability. The deliverables are measurable. They can be followed over time and allow for an organized and focused framework for improvement and feedback. As such, they can significantly improve the learning skills of the residents as well as the teaching abilities of the faculty.

MP66-03 LEARNING CURVE OF ROBOTIC-ASSISTED TRANSPERINEAL MRI/ULTRASOUND FUSION-GUIDED PROSTATE BIOPSY

You have accessJournal of UrologyCME1 Apr 2023MP66-03 LEARNING CURVE OF ROBOTIC-ASSISTED TRANSPERINEAL MRI/ULTRASOUND FUSION-GUIDED PROSTATE BIOPSY Vitkor Alargkof Anagnostou, Christian Engesser, Pawel Trotsenko, Hanns-Christian Breit, David Winkel, Helge Seifert, and Christian Wetterauer Vitkor Alargkof AnagnostouVitkor Alargkof Anagnostou More articles by this author , Christian EngesserChristian Engesser More articles by this author , Pawel TrotsenkoPawel Trotsenko More articles by this author , Hanns-Christian BreitHanns-Christian Breit More articles by this author , David WinkelDavid Winkel More articles by this author , Helge SeifertHelge Seifert More articles by this author , and Christian WetterauerChristian Wetterauer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003329.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic-assisted fusion prostate biopsy platforms promise precision, while offering user-friendliness, short procedure times and low complication rates. To date, there is no study investigating the learning curve (LC) of robotic-assisted transperineal MRI/Ultrasound fusion-guided prostate biopsy (RA-TP-FBx). A LC is essential to facilitate efficient training, maintain institutional biopsy quality and assess potential for widespread use. Herein, we are the first to assess the learning curve of RA-TP-FBx using the iSR’obot MonaLisa device (Biobot). METHODS: We prospectively analyzed consecutive RA-TP-FBx performed at the University Hospital Basel from January to October 2022. Cases were randomly assigned to the urology chief resident, a first-year biopsy-naive resident and an expert in RA-TP-FBx senior consultant. All resident cases were supervised by the expert. We used multiple parameters to define the LC: 1) efficiency – measured by time for completion of individual procedure steps, 2) accuracy – defined as detection rate of prostate cancer (PCa) and clinically significant PCa (csPCa) stratified by PI-RADS score, 3) operator and supervisor performance evaluation – measured by entrustable professional activities (EPA) questionnaires, 4) workload assessment – measured by the NASA task load index and 5) complication rates. RESULTS: We collectively performed 75 procedures. Procedure time reduction is shown in Graphic 1. The major difference in procedure time between residents and expert stemmed from probe positioning and biopsy time. PCa was detected in 62% and csPCa in 44%. csPCA detection for PI-RADS 4 was 46%. PCa detection rate for PI-RADS 4 lesions was similar between operators and over time. 13 biopsies were necessary before stable independent completion of all procedure steps. The most difficult skill for residents was ultrasound probe positioning. A transition point for workload reduction was observed at 13 biopsies. Complications rates were similar among operators and over time. CONCLUSIONS: Urology residents can quickly acquire skills to independently perform RA-TP-FBx regardless of previous biopsy experience. RA-TP-FBx is a procedure with low workload stress. Safety and accuracy are ensured during the LC when supervised by an expert. Source of Funding: Department of Surgery, University Hospital Basel © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e932 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vitkor Alargkof Anagnostou More articles by this author Christian Engesser More articles by this author Pawel Trotsenko More articles by this author Hanns-Christian Breit More articles by this author David Winkel More articles by this author Helge Seifert More articles by this author Christian Wetterauer More articles by this author Expand All Advertisement PDF downloadLoading ...

MP25-10 IMPLEMENTING A NOVEL STRESS RESILIENCE TRAINING CURRICULUM AMONG UROLOGY TRAINEES: PROOF OF CONCEPT IN CURRICULUM DESIGN

You have accessJournal of UrologyCME1 Apr 2023MP25-10 IMPLEMENTING A NOVEL STRESS RESILIENCE TRAINING CURRICULUM AMONG UROLOGY TRAINEES: PROOF OF CONCEPT IN CURRICULUM DESIGN Angeline Johny, David Wittkower, William Whitworth, Carter Lebares, and Jennifer Taylor Angeline JohnyAngeline Johny More articles by this author , David WittkowerDavid Wittkower More articles by this author , William WhitworthWilliam Whitworth More articles by this author , Carter LebaresCarter Lebares More articles by this author , and Jennifer TaylorJennifer Taylor More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Burnout is a pervasive issue in healthcare, with urology trainees reporting burnout rates as high as 63.8%. Resilience training is a proven tool to prevent burnout and improve performance in high stress working environments, with demonstrated efficacy in surgical residency programs. Enhanced Stress Resilience Training (ESRT) is a mindfulness-based cognitive skills training developed and validated by Dr. Carter Lebares and the UCSF Center for Mindfulness in Surgery. ESRT offers tools to reframe thoughts and promote emotional regulation. The primary goal of this study is to assess feasibility and to introduce a curriculum to expand a pre-existing program focused on wellness and individual skill development. METHODS: Through consultation with Dr. Lebares, we customized course structure to include a didactics presentation and five ESRT sessions taught over Zoom by a certified ESRT instructor, a retired surgeon. We conducted the sessions in place of standard departmental conferences to mitigate personal time used for the training. Baseline descriptive pre and post course data was collected using validated surveys, including the Mental Health Continuum Short Form, Physician Wellbeing Index, and the Connor Davidson Resilience Index, with a subsequent focus group to gain qualitative data on overall course perception. Using two-sample t-tests, we compared differences between and pre and post course responses. RESULTS: There were 33 participants in the course, with 20 residents, 7 faculty, and 6 others (student/APP). Surveys were completed by 30 participants pre course and 15 participants post course, with 15 sets of paired data. There were no statistically significant differences in self-reported wellbeing or stress response after course participation; however, participants were significantly more likely to use meditation as a stress coping mechanism after the course (p=0.008). Qualitative descriptive results demonstrated a 15% increase in participants’ understanding of the impact mindfulness practices have on work performance. CONCLUSIONS: Our program successfully implemented ESRT via a novel remote delivery format. Although our analysis was limited by small sample size, our pilot study highlights feasibility in implementation. This curriculum also showed resident skill development in stress regulation through mindfulness practices. Next steps would include repeat delivery within the program to promote durability, and possible expansion beyond our single program. Source of Funding: Norton Rose Fulbright Educational Grant © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e346 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angeline Johny More articles by this author David Wittkower More articles by this author William Whitworth More articles by this author Carter Lebares More articles by this author Jennifer Taylor More articles by this author Expand All Advertisement PDF downloadLoading ...

Design, assembly and validation of a low-cost, high-fidelity simulator for heart exploration.

Heart exploration is an essential clinical competence that requires continuous training and exposure. Low availability and accessibility to patients with heart disease constitutes a barrier to acquiring this competence. Inadequate cardiac auscultation skills in medical students, residents, and graduate physicians have been documented. To develop and validate a low-cost, high-fidelity simulator for heart exploration. A low-cost, high-fidelity heart examination simulator capable of reproducing normal cardiac sounds was designed and developed. Subsequently, the simulator was validated by a group of experts who gave their opinion according to a Likert scale. Ninety-four percent agreed that the simulator motivates the learning of heart exploration, and 92 % considered it to be a realistic model; 91 % considered that the simulator is an attractive tool to reinforce learning and 98 % recommended its further use. The use of the simulator facilitates the acquisition of skills and stimulates learning in the student, which can be attributed to repeated practice, longer exposure time and cognitive interaction.

Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics.

To assess the skill level and self-confidence of medical residents in geriatrics with regard to conducting the lumbar puncture (LP) procedure and to study the potential benefits of training with simulation and virtual reality. First, a questionnaire survey was conducted among all French residents in geriatrics in the Paris area to assess their knowledge and self-confidence regarding the practice of LP in older adults. Second, we set up a simulation LP training session combined with virtual reality (3D video) training for selected respondents of the first survey. Third, we performed post-simulation survey for the attendees of the simulation training. Finally, a follow-up survey was conducted to examine the change in self-confidence and the success rate in clinical practice. Fifty-five residents responded to the survey (response rate = 36.4%). The importance of mastering LP was fully recognized by the residents in geriatrics (95.3%), so most of them (94.5%) advocated for the need for additional practical training. Fourteen residents took part in the training (average rating = 4.7 on a 5-point scale). Simulation was regarded by 83% of the respondents as the most useful tool for their practice. We observed a significant pre/post-training mean improvement in self-estimated success of 20.6% (Wilcoxon matched-pairs signed-rank W = -36, p = 0.008). The post-training success rate of the residents in real-life clinical practice was good (85.8%). Residents were aware of the importance of mastering LP and requested additional training. Simulation may represent a major driver to improve their self-confidence and practical skills.

Sculpting a teaching and learning curriculum to better meet the career needs of postgraduate year 1 and 2 pharmacy residents.

To describe implementation of the University of Oklahoma College of Pharmacy (OUCOP) teaching and learning curriculum (TLC) for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) residents, including the required components, evaluation structure, residency graduate outcomes and perceptions captured by a survey following program completion, generalizability to other institutions, and opportunities for future directions. As part of their residency training, pharmacy residents are required to develop and refine teaching, precepting, and presentation skills. To meet the required and elective competency areas, goals, and objectives on teaching, precepting, and presentation skills, many American Society of Health-System Pharmacists-accredited residency programs have utilized TLC programs. OUCOP offers 2 distinct TLC programs for PGY1 and PGY2 residents, respectively. The OUCOP TLC program provided residents with opportunities for development of teaching and presentation skills in a variety of settings. The majority of residency graduates currently practice as a clinical specialist, and the majority lecture, precept, and deliver continuing education presentations. Graduates felt that the mentorship and diversity of teaching activities were the most beneficial qualities of the program. In addition, the majority noted that mentorship in lecture preparation was helpful in creating presentations after graduation. On the basis of the feedback from the survey, several changes have been made to better prepare residents for their postgraduate careers. TLC programs should conduct ongoing assessments to continue to foster the development of precepting and teaching skills for residents' future careers.

A Novel Serious Illness Communication Curriculum Improves Neurology Residents' Confidence and Skills.

Background and Purpose: Competency in serious illness communication is mandated by the Accreditation Council of Graduate Medical Education. Previous efforts to teach communication skills have been hampered by intensive time requirements. In this study, we developed and evaluated a brief goals-of-care communication curriculum for neurology residents. Methods: We developed and implemented a two-part curriculum based on themes identified from a needs assessment: (1) fundamental physician-patient communication skills; and (2) counseling surrogate decision makers and providing neuroprognostication. We used a three-pronged pre-post study design to evaluate the impact of the curriculum: resident self-assessment surveys, direct observations of resident-patient interactions, and patient perception surveys using the Communication Assessment Tool. Results: Residents reported a significant increase in mean scores [standard deviation] of confidence practicing fundamental communication skills, such as offering opportunities for emotion (3.84 [0.9] vs. 4.54 [0.6], p = 0.002), and goals-of-care communication skills, such as using triggers for serious conversations (2.65 [0.7] vs. 3.29 [0.5], p = 0.004). Observed resident-patient interactions showed significant improvement in fundamental communication skills, such as involving the patient in decision making (1.89 [0.6] vs. 4.0 [0.9], p < 0.001). There was no significant impact on patient perception of resident communication skills in the three months following the intervention. Conclusions: A brief, learner-centered curricular intervention improved neurology residents' confidence in serious illness communication and improved their skills as judged by trained observers.

Resident-teaching of ethics in undergraduate medical education: a grounded theory analysis

Background In graduate medical education, teaching is a required subcompetency largely fulfilled via clinical teaching, journal clubs, and grand rounds. Evidence shows that when moving to undergraduate teaching, residents often face a steep learning curve. We aimed to assess residents’ perspective of the experience of teaching medical students. Methods Psychiatry residents taught small group sections of bioethics to first- and second-year medical students in December 2018. We conducted two 1-hour focus group interviews with four residents on their perspectives on the teaching experience. Results Resident-teachers described receiving certain benefits from teaching, such as meeting their altruistic desire to give back to the profession. Nonetheless, some participants felt frustrated by students’ varying engagement and respect, while also feeling insecure and intimidated. Resident-teachers experienced some of the medical students as disrespectful and limited in their appreciation for diversity and the profession of medicine and perceived the students’ disengagement and lessened professionalism. Conclusion As residency programs seek to implement initiatives to improve teaching skills of residents, resident experiences should be considered when implementing these initiatives.

Creating Teams of Family Medicine Residents and High School Culinary Students Reduces Some Barriers to Implementing a Culinary Medicine Hands-On Workshop.

Barriers to implementation of culinary medicine in resident training include lack of facilities, administrative support, and community engagement. Twenty-five family medicine residents were teamed with 17 high school culinary arts students to prepare recipes aligned with the Mediterranean diet (MED) and the USDA low, moderate, and liberal cost food plans. The workshop took place in the high school teaching kitchens. A pre-survey informed the planning committee's design of a 4-h hands-on workshop that was considered a success. Post-surveys documented improved resident confidence and skills in recommending MED to their patients and interaction with their own peers and high school students, as well as enjoyment by all participants of this hands-on approach.