Resident Performance Research Articles

Vaginal delivery of the second twin: simulation to improve trainee knowledge and comfort.

Vaginal delivery in twins is feasible but challenging. Successful vaginal delivery of a non-vertex second twin depends on knowledge of specific obstetrical maneuvers. Skill acquisition at the patient's bedside is difficult, making simulation training an integral part of obstetrics and gynecology residency programs. This prospective, randomized, controlled, single-center study involved obstetrics and gynecology residents. Group A attended a frontal lecture followed by practical simulation; Group B received digital home learning. One month later, both groups underwent a simulation test to identify fetal small parts using a birth simulator with a fetus model placed in a simulated amniotic cavity. Training was conducted with an actor facilitator and supervised by six specialists, focusing on obtaining information, using external and internal hands. A 25-question Likert scale questionnaire was administered via Google Forms. Metrics evaluated included time to reach foot/feet, number of attempts, and answers on Kirkpatrick levels 1-4. Twenty-four participants were recruited and randomized into two groups, with five lost to follow-up at the time of the simulation test. Group A required less time for internal podalic version and breech extraction of the second twin (P=0.02) and fewer attempts to reach the foot/feet of the second twin (P=0.01). Supervisor evaluations of "asking information" and "internal hand use" were better in Group A. Simulation training for the vaginal delivery of a non-vertex second twin is feasible and has a favorable impact on resident performance.

Machine Learning-Aided Diagnosis Enhances Human Detection of Perilunate Dislocations.

Perilunate/lunate injuries are frequently misdiagnosed. We hypothesize that utilization of a machine learning algorithm can improve human detection of perilunate/lunate dislocations. Participants from emergency medicine, hand surgery, and radiology were asked to evaluate 30 lateral wrist radiographs for the presence of a perilunate/lunate dislocation with and without the use of a machine learning algorithm, which was used to label the lunate. Human performance with and without the machine learning tool was evaluated using sensitivity, specificity, accuracy, and F1 score. A total of 137 participants were recruited, with 55 respondents from emergency medicine, 33 from radiology, and 49 from hand surgery. Thirty-nine participants were attending physicians or fellows, and 98 were residents. Use of the machine learning tool improved specificity from 88% to 94%, accuracy from 89% to 93%, and F1 score from 0.89 to 0.92. When stratified by training level, attending physicians and fellows had an improvement in specificity from 93% to 97%. For residents, use of the machine learning tool resulted in improved accuracy from 86% to 91% and specificity from 86% to 93%. The performance of surgery and radiology residents improved when assisted by the tool to achieve similar accuracy to attendings, and their assisted diagnostic performance reaches levels similar to that of the fully automated artificial intelligence tool. Use of a machine learning tool improves resident accuracy for radiographic detection of perilunate dislocations, and improves specificity for all training levels. This may help to decrease misdiagnosis of perilunate dislocations, particularly when subspecialist evaluation is delayed.

Impact of trauma center status on radiology resident performance in detecting non-accidental trauma on the WIDI SIM exam.

To evaluate whether adult and pediatric trauma center status, as well as the presence of dedicated child protection teams, influences radiology resident performance in detecting non-accidental trauma on the Emergent/Critical Care Imaging Simulation (WIDI SIM) exam. We retrospectively analyzed 639 WIDI SIM exam scores for four pediatric non-accidental trauma cases completed by radiology residents across 33 programs. Residents were stratified by level (R1-R4) and institutional factors, including adult trauma center status, pediatric trauma center status, and child protection team presence. Additionally, 2022 pediatric physical abuse counts per state were obtained from the National Child Abuse and Neglect Data System and normalized between 0 and 1. We employed a negative binomial generalized linear model (GLM). The outcome was regressed on resident level, trauma center status variables, child protection team presence, and normalized abuse counts. Higher resident training level was significantly associated with better performance (R1=3.6, R2=5, R3=6.1, R4=7.9; P<0.001). Adult trauma center accreditation was also associated with higher scores (4.6 vs. 3.3; P<0.001). In contrast, pediatric trauma center status, child protection team presence, and normalized state-level abuse counts were not significantly associated with resident performance (all P>0.05). Resident experience and adult trauma center accreditation were significantly associated with better radiology resident performance in detecting non-accidental trauma in a simulated call environment. Pediatric trauma center status, child protection team presence, and statewide abuse prevalence were not associated with detection performance. These findings suggest the need for targeted educational interventions at non-adult trauma centers and emphasize the importance of experience in developing diagnostic proficiency for non-accidental trauma.

Association Between Resident In-Service Exam Scores by Postgraduate Year and Subsequent Board Qualifying Exam.

Prior work notes the AUA In-Service Exam (ISE) percentile ranking of chief residents correlates with the American Board of Urology Qualifying Exam (QE) performance. We present a 5-year analysis of resident performance on the ISE and subsequent QE to determine if earlier time points in training may identify those needing additional educational support. Participant ISE scores over a 5-year period from 2014 to 2018 and subsequent QE scores in 2019 were recorded. Pearson's correlation coefficient measured the association between percentage questions correct for each ISE year and QE. Youden Index calculated the optimal cut point for yearly ISE percentage correct that would predict scoring greater than the lowest quartile and decile on the QE. Median percent questions correct on ISE increased over postgraduate year (PGY) 1 (47%), PGY2 (56.5%), and PGY3 (70%) but remained stable thereafter (PGY4-PGY5) at approximately 70%. Median QE percent correct in 2019 was 66% (SD 7.6%). Correlation of percent questions correct between ISE and QE improved from 0.31 to 0.53 over training duration. The lowest decile and quartile percent correct scores on the QE were 56% and 60%, respectively. Percent correct ISE score predicting performance above the lowest decile 2019 QE score increased from 38% in PGY1 to 57% in PGY2 and leveled off after PGY3 (∼70%). Similar observations were noted with lowest quartile QE score. Scoring approximately 70% of questions correct on the ISE during PGY3 and later years was associated with a low risk of failing the QE. Such information provides benchmarks for residency programs to offer targeted educational content for at-risk candidates.

Training in Lumbar Pedicle Screw Instrumentation Using a 3D-Printed Model: From Validation to Transferability Onto a Cadaver Model.

Lumbar pedicle screw placement in spinal surgery is complex and prone to errors, with notable risks to patients. Standard training methods, such as mentorship in operating rooms, pose safety concerns, prompting the need for alternative training tools. This study aimed to validate and use a three-dimensional (3D)-printed simulation model for lumbar pedicle screw insertion training and assess its effectiveness compared with standard methods. The study proceeded through four phases: model design and validation, construct validation, learning curve assessment, and transfer to a cadaver model. A 3D-printed lumbar spine model was created and refined based on expert feedback. Construct validation demonstrated the model's ability to differentiate between experts and novices. Training sessions with residents showed a notable improvement in performance over multiple attempts, but performance still lagged that of experts. However, skills learned on the simulation model were effectively transferred to a cadaver model, with no notable difference in performance observed. The trained group outperformed a control group trained using standard methods in the cadaver test. The study concludes that the 3D-printed simulation model is a valid training tool for lumbar pedicle screw insertion, effectively transferring skills to a cadaver setting and improving resident performance compared with standard training methods. Additional research is warranted to explore the sustainability of acquired skills and optimize training protocols.

USMLE Performance, Subsequent Standardized Testing, and ABIM Certification Exam Preparation for Internal Medicine Residency Programs: A Narrative Review.

Standardized examinations measure progress throughout medical education. Successful completion of the American Board of Internal Medicine Certification Examination (ABIM-CE) benchmarks completion of internal medicine (IM) residency training. Recent declines in initial ABIM-CE pass rates may prompt residency programs to examine strategies to improve learner performance. We synthesized published literature on associations between the United States Medical Licensing Examination (USMLE), in-training examination (ITE), and board preparation to support residents for ABIM-CE. We searched MEDLINE for test performance and preparation strategies for IM board certification during training. Relevant articles published until March 15, 2024, were screened using pre-defined criteria for narrative review, then codified into three domains (USMLE, ITE, curriculum/program strategies). Findings were grouped by theme into considerations for training programs seeking guidance on learning augmentation plans to improve resident performance on ABIM-CE. Themes drawn from articles focused on USMLE include validity in predicting CE performance, noting (1) failing USMLE Step 1 is associated with failing ABIM-CE, (2) any USMLE score < 220 increases failure probability, and (3) a mean USMLE ≥ 250 approximates ~ 100% pass rates on board examination. Inferences from ITE-focused articles support use as a predictive tool; specifically, a score < 35th percentile signals a resident at risk for failing the ABIM-CE while > 70th percentile is predictive of passing. Lastly, inferences from curriculum- and program-focused articles suggest standard contents (conferences) do not correlate with CE passage, while targeted clinical reasoning and remediation plans do. IM residency programs should consider adopting learning augmentation strategies targeted to at-risk residents to support CE passage.

Correlation between adult trauma center status and radiology resident performance on trauma cases in the WIDI SIM exam.

To assess whether adult trauma center status influences radiology resident performance on trauma cases in the Emergent/Critical Care Imaging SIMulation (WIDI SIM) exam. This retrospective study analyzed 29,290 WIDI SIM exam scores from 110 adult trauma cases across 55 radiology residency programs. Residents were categorized by training level-R1 (n = 17,801), R2 (n = 9,136), R3 (n = 1,826), R4 (n = 527)-and by their program's adult trauma center designation: Level 1 (n = 20,121), Level 2 (n = 1,870), Level 3 (n = 1,029), Level 4 (n = 487), and no trauma designation (n = 5,834). A Generalized Linear Mixed Model with a negative binomial distribution was used to evaluate the effect of trauma center status on resident performance, adjusting for resident level, imaging modality, and case specialty. After adjusting for confounding variables, there was no statistically significant difference in resident scores based on adult trauma center status (p > 0.05 for all trauma levels compared to no trauma designation). Resident level significantly influenced performance, with higher-level residents scoring better than R1 residents (p < 0.001 for R2-R4). Imaging modality and case specialty also significantly affected scores. Residents performed better on MR, US, and XR modalities compared to CT (p ≤ 0.002), and scored lower on chest, cardiovascular, musculoskeletal, and neuro cases compared to abdominopelvic cases (p < 0.001). Adult trauma center status did not significantly impact radiology resident performance on trauma cases in the WIDI SIM exam. Resident training level, imaging modality, and case specialty were significant factors influencing performance. These findings suggest that resident education and exposure to diverse imaging modalities and specialties are more critical determinants of diagnostic accuracy than the trauma center designation of their training program.

Comparing performances of french orthopaedic surgery residents with the artificial intelligence ChatGPT-4/4o in the French diploma exams of orthopaedic and trauma surgery

IntroductionThis study evaluates the performance of ChatGPT, particularly its versions 4 and 4o, in answering questions from the French orthopedic and trauma surgery exam (Diplôme d’Études Spécialisées, DES), compared to the results of French orthopedic surgery residents. Previous research has examined ChatGPT's capabilities across various medical specialties and exams, with mixed results, especially in the interpretation of complex radiological images. HypothesisChatGPT version 4o was capable of achieving a score equal to or higher (not lower) than that of residents for the DES exam. MethodsThe response capabilities of the ChatGPT model, versions 4 and 4o, were evaluated and compared to the results of residents for 250 questions taken from the DES exams from 2020 to 2024. A secondary analysis focused on the differences in the AI's performance based on the type of data being analyzed (text or images) and the topic of the questions. ResultsThe score achieved by ChatGPT-4o was equivalent to that of residents over the past five years: 74.8% for ChatGPT-4o vs. 70.8% for residents (p = 0.32). The accuracy rate of ChatGPT was significantly higher in its latest version 4o compared to version 4 (58.8%, p = 0.0001). Secondary subgroup analysis revealed a performance deficiency of the AI in analyzing graphical images (success rates of 48% and 65% for ChatGPT-4 and 4o, respectively). ChatGPT-4o showed superior performance to version 4 when the topics involved the spine, pediatrics, and lower limb. ConclusionThe performance of ChatGPT-4o is equivalent to that of French students in answering questions from the DES in orthopedic and trauma surgery. Significant progress has been observed between versions 4 and 4o. The analysis of questions involving iconography remains a notable challenge for the current versions of ChatGPT, with a tendency for the AI to perform less effectively compared to questions requiring only text analysis. Level of evidenceIV; Retrospective Observational Study.

Understanding characteristics of internal medicine residents matching into pulmonary critical care medicine fellowships

BackgroundInternal medicine (IM) residents face significant challenges when pursing subspecialty fellowships. This study determined the factors that differentiate IM residents entering pulmonary and critical care medicine (PCCM) fellowships from those pursuing other careers.MethodsWe completed a retrospective study of 12 classes of IM residents at a single institution completing residency between 2010 and 2021. Data included pre-residency characteristics, global residency performance, and PCCM-specific experiences. Logistic regression models examined associations between these variables and the primary outcome of matching into a PCCM fellowship within one year of completing IM residency.ResultsAmong 522 residents, 10.3% matched into PCCM. Completing a pulmonary elective significantly increased the odds of matching into PCCM (OR 7.78, 99% CI 3.10–19.53, p < 0.0001). Residents who match into PCCM were more likely to have < 3 publications than 3 + (OR 3.51 (1.20–10.25), p = 0.003).” A stated intent to enter PCCM was positively associated with matching into PCCM in the univariable, but not the multivariable, model.ConclusionsMatriculating into PCCM fellowship was significantly associated with completing a pulmonary elective during residency. PCCM-bound residents were less likely to achieve high numbers of publications, suggesting these residents’ preferences for clinical learning and practice over scholarship. This study provides insights into characteristics of residents who match into PCCM and guides mentors as they counsel residents considering PCCM.

Radiology resident proficiency in pediatric trauma cases: a comparative analysis based on trauma center status using the WIDI SIM exam.

To investigate the correlation between pediatric and adult trauma center status and radiology resident performance on pediatric trauma cases using the WIDI SIM exam. The WIDI SIM is a validated computer-aided simulation that assesses radiology residents' preparedness for independent call duty. It includes 65 cases across various imaging modalities derived from actual patient encounters. Faculty score free-text responses using a standardized 0-10 scale rubric. We analyzed 8,488 WIDI SIM exam scores from 35 pediatric trauma cases across 52 programs. A negative binomial regression model adjusting for resident level, imaging modality, and case specialty was employed to evaluate the impact of pediatric and adult trauma center status on resident performance. Both pediatric trauma center status (p = 0.0005) and adult trauma center status (p = 0.0003) were significant predictors of higher resident scores. Resident level was also significant, with higher-level residents performing better than first-year residents (p < 0.001). Residents performed worse on MR and US modalities compared to CT, and performance varied by case specialty. Radiology residents' pediatric trauma imaging skills are significantly linked to pediatric and adult trauma center status. Given most pediatric traumas occur outside pediatric trauma centers, targeted training strategies should be considered to ensure residents develop essential diagnostic skills.

Factors associated with eating performance in nursing home residents living with dementia and other comorbidities

BackgroundEating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia.MethodsThis was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities.ResultsNearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p = .002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p < .001), depressive symptoms (OR = 0.94, 95% CI = 0.89, 0.98, p = .007), and anxiolytic use (OR = 0.64, 95% CI = 0.42, 0.99, p = .046).ConclusionsFindings supported that better eating performance was associated with less cognitive impairment, higher functional ability, fewer depressive symptoms, and less anxiolytic use. Targeted interventions to accommodate to cognitive function, optimize functional ability, minimize anxiolytic use, and manage depressive symptoms are encouraged to support eating performance in residents with dementia.

Just In Time! Assessment of Internal Medicine Resident Point of Care Ultrasound (POCUS) Attitudes and Behaviors After Spaced Intervention at Two Residency Programs.

Point of care ultrasound (POCUS) is a complex psychomotor skill that requires scaffolded support for skill acquisition. However, the effect of spaced curricular elements on learner POCUS behaviors are not clearly understood. Using a multi-site observational cross-sectional survey study, we measured resident baseline POCUS use, behaviors, and attitudes and then implemented POCUS workflow and just-in-time POCUS curricula during internal medicine resident ward rotations and assessed changes. Self-reported personal and team POCUS use and documentation habits all improved between baseline and the just-in-time teaching. Personal POCUS use correlated with team POCUS use (ρ=0.431; p<0.001) and co-resident POCUS use (ρ=0.242; p=0.035). Attending POCUS use correlated with team POCUS use (ρ=0.523; p< 0.001), but not personal use. Overall, we found moderate, but statistically significant, improvements in reported resident and team performance of POCUS and documentation habits, suggesting that just-in-time interventions may promote POCUS use. Co-learning also appears to be a key influencer for POCUS use.

Bias Sensitivity in Diagnostic Decision-Making: Comparing ChatGPT with Residents.

Diagnostic errors, often due to biases in clinical reasoning, significantly affect patient care. While artificial intelligence chatbots like ChatGPT could help mitigate such biases, their potential susceptibility to biases is unknown. This study evaluated diagnostic accuracy of ChatGPT against the performance of 265 medical residents in five previously published experiments aimed at inducing bias. The residents worked in several major teaching hospitals in the Netherlands. The biases studied were case-intrinsic (presence of salient distracting findings in the patient history, effects of disruptive patient behaviors) and situational (prior availability of a look-alike patient). ChatGPT's accuracy in identifying the most-likely diagnosis was measured. Diagnostic accuracy of residents and ChatGPT was equivalent. For clinical cases involving case-intrinsic bias, both ChatGPT and the residents exhibited a decline in diagnostic accuracy. Residents' accuracy decreased on average 12%, while the accuracy of ChatGPT 4.0 decreased 21%. Accuracy of ChatGPT 3.5 decreased 9%. These findings suggest that, like human diagnosticians, ChatGPT is sensitive to bias when the biasing information is part of the patient history. When the biasing information was extrinsic to the case in the form of the prior availability of a look-alike case, residents' accuracy decreased by 15%. By contrast, ChatGPT's performance was not affected by the biasing information. Chi-square goodness-of-fit tests corroborated these outcomes. It seems that, while ChatGPT is not sensitive to bias when biasing information is situational, it is sensitive to bias when the biasing information is part of the patient's disease history. Its utility in diagnostic support has potential, but caution is advised. Future research should enhance AI's bias detection and mitigation to make it truly useful for diagnostic support.

Performance of Chatgpt in ophthalmology exam; human versus AI.

This cross-sectional study focuses on evaluating the success rate of ChatGPT in answering questions from the 'Resident Training Development Exam' and comparing these results with the performance of the ophthalmology residents. The 75 exam questions, across nine sections and three difficulty levels, were presented to ChatGPT. The responses and explanations were recorded. The readability and complexity of the explanations were analyzed and The Flesch Reading Ease (FRE) score (0-100) was recorded using the program named Readable. Residents were categorized into four groups based on their seniority. The overall and seniority-specific success rates of the residents were compared separately with ChatGPT. Out of 69 questions, ChatGPT answered 37 correctly (53.62%). The highest success was in Lens and Cataract (77.77%), and the lowest in Pediatric Ophthalmology and Strabismus (0.00%). Of 789 residents, overall accuracy was 50.37%. Seniority-specific accuracy rates were 43.49%, 51.30%, 54.91%, and 60.05% for 1st to 4th-year residents. ChatGPT ranked 292nd among residents. Difficulty-wise, 11 questions were easy, 44 moderate, and 14 difficult. ChatGPT's accuracy for each level was 63.63%, 54.54%, and 42.85%, respectively. The average FRE score of responses generated by ChatGPT was found to be 27.56 ± 12.40. ChatGPT correctly answered 53.6% of questions in an exam for residents. ChatGPT has a lower success rate on average than a 3rd year resident. The readability of responses provided by ChatGPT is low, and they are difficult to understand. As difficulty increases, ChatGPT's success decreases. Predictably, these results will change with more information loaded into ChatGPT.

Resident Performance on the Obstetrics and Gynecology In-Training Examination After Implementation of a New Academic Curriculum.

Background The goals of the annual Council on Resident Education in Obstetrics and Gynecology In-Training Examination (CREOG-ITE) are to provide residents with an assessment of their knowledge and program directors an assessment of their residency programs. Research has shown that a score greater than 200 is correlated with passing the qualifying board examination. We observed a substantial number of our residents were not performing well on the exam, which prompted the implementation of a new academic program aimed at determining the impact of an academic curriculum addition on CREOG-ITE scores in an American College of Graduate Medical Education (ACGME) accredited obstetrics and gynecology (OB/GYN) residency program. Methods We performed a prospective cohort study of residents at a single institution to evaluate the effect of a remediation course for residents identified as "at risk." Residents with CREOG-ITE scores of <180 were placed into the experimental group who underwent a year-long remediation programand were compared to the control group (those with scores >180 who did not undergo remediation).Each resident in the experimental group served as their internal control by comparing their pre-intervention score to their post-remediation score. Results Themean improvement of the experimental group of the remediation programwas 23.2 points. After controlling for post-graduate year (PGY), their score improvement remained significant and was not simply a by-product of the inherent academic knowledge of a resident further along in training. Conclusions This scholastic remediation program was associated with a statistically significant improvement in CREOG-ITE scores, even when accounting for PGY level. This program may serve as a model for improving OB/GYN resident education.

PP456 Topic: AS16–Medical, Nursing and AHP Workforce &amp; Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: EFFECTS OF JUST IN TIME SIMULATION ON RESIDENT COMFORT AND PERFORMANCE DURING MOCK CODES

PP456 Topic: AS16–Medical, Nursing and AHP Workforce &amp; Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: EFFECTS OF JUST IN TIME SIMULATION ON RESIDENT COMFORT AND PERFORMANCE DURING MOCK CODES

Prompting better feedback: investigating the effect of targeted form design on quality of narrative feedback in ophthalmology CBME assessments

ObjectiveCompetency-based medical education (CBME) requires a variety of assessments evaluating resident performance. Assessment form design may influence narrative feedback quality. To evaluate the effect of including targeted written comment prompts in entrustable professional activity (EPA) assessment forms on the quality of narrative feedback in CBME ophthalmology resident trainee assessments. MethodsTransition to discipline (TTD) assessment data from three distinct time periods were anonymized; the first 2 groups contained assessments completed with the original form design, whereas the last group represented assessments completed after the introduction of revised EPA forms. Written feedback was scored using the Quality of Assessment for Learning (QuAL) score. One-way ANOVA and a Tukey post hoc test were used to compare mean QuAL scores of each group. ResultsOne-thousand one-hundred and forty-five assessments were analyzed, including 680 Original EPA forms, 322 intermediate forms, and 143 revised forms. QuAL scores significantly increased after revisions were made to the assessment form, with original, intermediate, and revised form mean QuAL scores of 2.14 ± 1.76, 2.77 ± 1.75, and 4.33 ± 1.11; P < 0.001 for all comparisons, respectively. ConclusionsRevising EPA form design to include targeted prompts and examples of evidence-based coaching words to guide written comments results in higher-quality narrative feedback in CBME assessments.

The Importance of a Champion in Leading Major Improvements in Residency Programs.

Residency programs are expected to meet many requirements in training their residents, including providing adequate numbers of pediatric visits and procedures opportunities. In the residency program studied here, these numbers were inadequate, despite the efforts of faculty members over the years. A self-designated faculty champion (with traits including vision, persuasiveness, proactivity, and tenacity) launched a series of clinical initiatives to combat these problems. The number of pediatric visits in the Family Medical Center (FMC) were tracked and compared from 2012, prior to the intervention led by the faculty champion, through 2023. The number of procedures performed in the FMC were tracked and compared from 2015, when the procedures-only clinic was launched by the faculty champion, through 2023. The number of pediatric visits in the FMC in 2012-2013 was a total of 12. By 2022-2023, that number had grown to 1,454. The number of procedures in the FMC was four in 2015-2016, but by 2022-2023 had grown to 470. The improved numbers support competency-based medical education, with increased faculty observation, teaching, and evaluation. For procedures training, the improved numbers support faculty members in using the Procedural Competency Assessment Tools to evaluate resident performance. A faculty champion who is interested, self-motivated, persistent, and focused on leading the project from beginning to end can bring about significant improvements in a residency program, despite the program's track record of difficulty in making such improvements.

Assessing the Role of Social Studies Curricula in Enhancing Tourism Awareness among High School Students: A Student Perspective

Tourism awareness plays a pivotal role in promoting cultural understanding and supporting economic growth, especially in regions with rich heritage and tourism potential. This study aims to evaluate the effectiveness of social studies curricula in fostering tourism awareness among high school students in the Irbid region of northern Jordan. The research addresses the problem of limited integration of tourism-related topics within the existing curricula, which tend to prioritize general knowledge over specialized subjects such as sustainable tourism and cultural diversity. A total of 979 students were randomly selected to participate in the study, and data were gathered using a structured survey designed to assess how well the curricula promote tourism awareness. The research employed a quantitative approach to examine relationships between tourism awareness and variables such as gender, residence, and academic achievement. The results showed significant gaps in the curricula, with minimal focus on hands-on learning experiences like field trips or interactive projects, leading to generally low levels of tourism awareness among students. Furthermore, the lack of career guidance related to tourism hinders students from exploring potential tourism-related career paths. There were no significant differences in tourism awareness based on gender, residence, or academic performance. The study concludes by recommending a comprehensive revision of the social studies curricula to include more specialized tourism concepts, practical learning opportunities, and career exploration activities. Such changes would enhance students’ understanding of the tourism industry and its importance, preparing them for future roles in this sector.

A qualitative assessment of behavioral interview method among anesthesiology residency applicants

Background The objective of residency recruitment is to select the most appropriate candidate. While cognitive skills are identified before an interview and can be measured objectively, non-cognitive skills can be harder to discern. These non-cognitive skills though are a good predictors of future residency performance. A structured behavioral interview is better at identifying noncognitive skills compared to a traditional interview. Objective Compare the noncognitive traits identified in the interviews with those identified in resident evaluations Methods Using the semi-annual evaluations 6 residents were split between satisfactory group and excellent group. Behavioral-based interviews and traditional unstructured interviews conducted on the same individual were compared and the results of the interview were compared to the semi-annual and annual evaluations submitted by the teaching faculty and the program directors. The interviews were analyzed for non-cognitive skills. Results Qualitative analysis of behavioral interview narratives and the narrative part of the semiannual evaluations independently identified the non-cognitive characteristics of adaptability, decisiveness, time management, judgment, and the ability to work in a team. It also identified other essential non-cognitive skills necessary for an anesthesiologist, such as ability to prioritize, study techniques, ability to destress. Conclusion The noncognitive traits found in the excellent group response to the structured interview match those found in the semi-annual evaluations. In this case individuals who are suited to the field of anesthesiology are adaptable, decisive, team-players with excellent judgment.