Trainee Perspectives Research Articles

Perspectives of Psychotherapists Regarding Psychedelic Assisted Therapy

ABSTRACTBackgroundThis study explored the perspectives of trainees, recently qualified and experienced psychotherapists regarding psychedelic assisted therapy (PAT).AimsThe aim was to capture meaning, concerns and opportunities of PAT and understand what it means for the field of psychotherapy and to contribute to the growing body of literature on its development and inform subsequent research.Material and MethodsThe study was based on qualitative research capturing the perspectives of a range of counsellors via a questionnaire, two interviews and a focus group comprised of five people, with the dataset being analysed using reflexive thematic analysis (TA; Thematic Analysis—A Practical Guide, Sage, Thousand Oaks, CA, 2022) to capture meaning, experiences and perceptions and to identify descriptive and interpretive themes.ResultsThemes relating to therapeutic relationship, safety, ownership and professionalisation were identified within the dataset.DiscussionThe findings from this study reveal a complex and multi‐layered understanding of PAT, where a range of factors, such as the therapist's experience, the therapeutic relationship, safety concerns and issues of ownership and professionalisation, are all central. The themes demonstrated how counsellors are already aware of, interested in and curious about development in PAT and indicated a sense of inevitability of PAT becoming a professionalised part of the field of psychotherapy.ConclusionThe study concludes that while there are understandable and relevant concerns about safety, there is also a growing body of quality research and recommendations for safe and harm reducing processes and opportunities for psychotherapy bodies to lead the way and ensure the approach of PAT is a professional one underpinned by research, harm reduction, ethical standards and a sensitivity towards its Indigenous roots.

Introducing outcome-based education in obstetrics and gynaecology training: Perspectives of trainees and trainers.

Outcome-based education (OBE) focuses on clearly defined learner goals, offering a structured framework to achieve competency. This study explores the perspectives of trainees and trainers in Obstetrics and Gynaecology (O&G) in Ireland regarding facilitators, barriers, and challenges to implementing OBE. A national cross-sectional survey was distributed to O&G trainees and trainers in Ireland. Responses were analysed using descriptive statistics and chi-squared tests, and qualitative thematic analysis. A total of 151 trainees and trainers participated in the study. While 61.2% of respondents reported familiarity with the concept of OBE, only 22.4% accurately identified its primary focus on learner goals. Participants highlighted several key benefits of OBE, including the establishment of clearly defined goals and the development of competency in essential skills. However, significant challenges were also identified, such as the perception of unattainable goals for trainees and insufficient training facilities. Additionally, trainer engagement and the lack of allocated time for both trainers and trainees to attend training courses were recognized as major barriers to the successful implementation of OBE. OBE presents a promising educational framework for O&G training, with the potential to modernize and enhance learning outcomes. However, its successful implementation hinges on comprehensive education about its principles and benefits, substantial investment in educational facilities and resources, and the prioritization of training through dedicated and protected time for both trainees and trainers.

Surgical Practice in Resource-Limited Settings: Perspectives of Medical Students and Early Career Doctors: A Narrative Review.

Surgical practices in low-resource countries often fail to meet established standards. Both doctors and medical students have limited exposure to surgical cases, which hinders training and the development of surgical specialization. This study highlights the current state of surgical practice from a trainee's perspective, explores existing gaps in training and capacity building, and recommends practical solutions. We conducted a literature search on PubMed, Google Scholar, and other scientific databases using search terms such as "surgical practice," "doctors' perspectives in surgical practice," "surgery in low- and middle-income countries," and "solutions to surgical inadequacy." We included studies published from 2015 to 2024, with exceptions for a few highly relevant studies published prior to 2015. We outline the limitations identified in the literature concerning surgical training and healthcare in low- and middle-income countries. Many centers lack adequate infrastructure, human resources, and training. These challenges negatively affect the skills and quality of surgical care. However, some centers demonstrate that surgical practice is feasible through collaboration with institutions established in higher-income contexts. Telesurgery, task shifting and sharing, high-impact, low-cost surgeries, and collaborations with more developed health systems could effectively bridge the gap in surgical availability in LMICs.

Impact and Insights from the NF–POGO Centre of Excellence in Observational Oceanography: A Trainee Perspective

The Nippon Foundation–Partnership for Observation of the Global Ocean (NF–POGO) Centre of Excellence (CofE, https://pogo-ocean.org/​capacity-development/centre-of-excellence/) has provided advanced training in observational oceanography since 2008. Each year, a cohort of 10 scholars is selected to participate in this 10-month postgraduate-level program, which consists of expert-led instruction and hands-on experience. The CofE targets early-career ocean professionals (ECOPs), primarily from developing economies, and addresses global disparities in oceanographic expertise and resources, offering scholars unique opportunities.

Acceptance of Virtual Reality in Trainees Using a Technology Acceptance Model: Survey Study.

Virtual reality (VR) technologies have demonstrated therapeutic usefulness across a variety of health care settings. However, graduate medical education (GME) trainee perspectives on VR acceptability and usability are limited. The behavioral intentions of GME trainees with regard to VR as an anxiolytic tool have not been characterized through a theoretical framework of technology adoption. The primary aim of this study was to apply a hybrid Technology Acceptance Model (TAM) and a United Theory of Acceptance and Use of Technology (UTAUT) model to evaluate factors that predict the behavioral intentions of GME trainees to use VR for patient anxiolysis. The secondary aim was to assess the reliability of the TAM-UTAUT. Participants were surveyed in June 2023. GME trainees participated in a VR experience used to reduce perioperative anxiety. Participants then completed a survey evaluating demographics, perceptions, attitudes, environmental factors, and behavioral intentions that influence the adoption of new technologies. In total, 202 of 1540 GME trainees participated. Only 198 participants were included in the final analysis (12.9% participation rate). Perceptions of usefulness, ease of use, and enjoyment; social influence; and facilitating conditions predicted intention to use VR. Age, past use, price willing to pay, and curiosity were less strong predictors of intention to use. All confirmatory factor analysis models demonstrated a good fit. All domain measurements demonstrated acceptable reliability. This TAM-UTAUT demonstrated validity and reliability for predicting the behavioral intentions of GME trainees to use VR as a therapeutic anxiolytic in clinical practice. Social influence and facilitating conditions are modifiable factors that present opportunities to advance VR adoption, such as fostering exposure to new technologies and offering relevant training and social encouragement. Future investigations should study the model's reliability within specialties in different geographic locations.

Trainee Autonomy and Supervision in the Inpatient Clinical Learning Environment.

Balancing autonomy and supervision during medical residency is important for trainee development while ensuring patient safety. In the increasingly complex inpatient clinical learning environment, tension exists when this balance is skewed. In this study, we aimed to understand current and ideal states of autonomy and supervision and then describe factors that contribute to imbalance from both trainee and attending perspectives. A sequential mixed-methods design included surveys and focus groups of trainees and attendings at three institutionally affiliated hospitals between May 2019 and June 2020. Survey responses were compared using t-tests, chi-square tests or Fisher's exact tests. Open-ended survey and focus group data were analysed using thematic analysis. Survey response rate was 42% (76/182) for trainees and 49% (101/208) for attendings. Fourteen trainees and 32 attendings participated in 14 focus groups. Trainees perceived current culture to be significantly more autonomous than attendings; both groups described 'ideal' culture as more autonomous than current state. Focus group analysis revealed five core contributors to the balance of autonomy and supervision: attending, trainee, patient, interpersonal and institutional. These factors were found to be complex and interactive and require frequent adjustment to avoid tension. Trainees and attendings agree that resident autonomy should be prioritized more than it currently is. Attendings, trainees and patients contribute to a complex dynamic between autonomy and supervision, further impacted by both interpersonal and institutional factors, in the inpatient clinical learning environment. Capturing complex interactions between individual factors that impact this dynamic is critical to understanding and optimization by both trainees and attending.

Yorkshire and the Humber GP trainee perspectives on incomplete evidence outcomes at ARCP.

June 2023 saw an exceptionally high proportion of Outcome 5s (incomplete evidence) issued at the annual review of competency progression (ARCP) for GP Trainees in Yorkshire and the Humber (Y&H) Deanery. These outcomes created considerable time, administrative and financial costs for the deanery. Additionally, it was believed that receiving non-standard outcomes at ARCP would be detrimental to trainee wellbeing. All GP Trainees in Y&H Deanery who received an Outcome 5 at their ARCP in June 2023 were surveyed. They were asked to report their experience of receiving this outcome with reference to their wellbeing. The survey also sought to understand the reasons for this rise in non-standard outcomes to guide quality improvement work within the deanery. Trainee perspectives revealed through this survey have guided reforms within the deanery to the structure and content of teaching and resources for GP trainees. It is believed these findings may be of similar value to other educators. 47% of eligible trainees responded to the survey. It was significantly reported that receiving an Outcome 5 felt stressful. However, trainees also reported that the time and instruction given upon receiving Outcome 5 was adequate, and they felt well supported by their educational supervisors. Preparation for ARCP was described as a neutral activity. The most frequent causes for receiving Outcome 5 were as follows: accessing and evidencing Basic Life Support (BLS) training, misunderstanding Safeguarding Requirements, incorrectly completing Form R and portfolio evidence not being seen by assessors. Further detail on these issues is described in the report below.

A Qualitative Analysis of Student Perspectives of Their Post-secondary Nutrition and Dietetics Program, Courses, and Instructors: Applying a Critical Pedagogies Perspective

Postsecondary dietetics education is in a time of transition in Canada and specifically in Manitoba. We sought to qualitatively investigate this cohort’s perspectives on the University of Manitoba’s dietetics program. In 2020/21, interviews were conducted with undergraduate dietetics students as well as dietetics interns and graduate students who had recently completed the undergraduate dietetics program. We recruited 25 participants, all of whom self-identified as female, with 60% identifying as white, with an average age of 25 years old. Informed by critical pedagogy, our analysis yielded four themes: motivations for studying dietetics; learning outside the classroom; development of critical awareness; and uncertain career futures and training improvements. Social media featured in each of the themes, particularly in how it exposed participants to various social justice movements. While students acknowledged developing more critical awareness in their programs, they nonetheless felt a disconnect between what they perceived they needed to learn and what was taught. Participants also described uncertainty associated with the future directions of their program or career. Analysis of their perspectives reveal ways dietetics and dietetics education could further incorporate critical pedagogies that highlight social justice issues, enhancing the field’s potential to contribute to public health and health promotion. In this time of transition for dietetics education in Manitoba, drawing inspiration from perspectives of this cohort, there is an opportunity for dietetics and pedagogy to evolve. There is also potential to apply critical pedagogy to analyze trainee perspectives of other health professional education and training programs.

Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience.

The field of pediatric anesthesiology faces an impending shortage of fellowship-trained physicians. Despite this projection, fewer anesthesiology residents are opting to pursue a fellowship. To better understand the current perspective and motivation of trainees to pursue a career in pediatric anesthesiology, we surveyed anesthesiology residents across the United States. Our primary aims were to assess the understanding of the current workforce shortage as well as explore the impact of both exposure and characteristics of the anesthesia resident rotation on the decision to pursue pediatric anesthesiology fellowship. A 25-question Qualtrics survey was distributed to members of the Pediatric Anesthesia Leadership Council and Education Committee within the Society for Pediatric Anesthesia and to anesthesiology residency program directors based in the United States. The survey received 201 responses. Of the respondents, 29% were in Clinical Anesthesia Year 3, 25% in Year 2, 19% in Year 1, and 10% in their intern year. The analysis revealed that self-reported adequate exposure to high-acuity cases and advanced procedures (arterial lines, central lines, and nerve blocks) significantly increased the likelihood of planning to pursue pediatric anesthesiology fellowship (adjusted Odd Ratio 8.47, 95% Confidence Interval, 1.65-43.4). Perceptions of faculty teaching, mentor availability, planned practice environment, and the presence of fellowship programs at the institution were not significantly associated with intentions to pursue pediatric anesthesiology fellowship. The journey toward specializing in pediatric anesthesiology is influenced by a complex interplay of factors. Among these, enhanced exposure to challenging cases and advanced procedures during the residency phase is emerging as a critical element. Such exposure not only equips residents with the necessary skills and confidence to handle complex pediatric anesthesia cases but also plays a pivotal role in attracting more trainees to this essential subspecialty.

Neuropsychiatric Considerations for the Assessment of Psychogenic Non-epileptic Seizures in Youth: A Trainee Perspective

Neuropsychiatric Considerations for the Assessment of Psychogenic Non-epileptic Seizures in Youth: A Trainee Perspective

Barriers and enablers of deprescribing in older adults: Trainee's perspectives.

Barriers and enablers of deprescribing in older adults: Trainee's perspectives.

The humanities in palliative medicine training: perspectives of academic palliative medicine physicians and trainees

BackgroundThe humanities can aid in the development of important skills for trainee physicians. Because of the nature of their work, palliative medicine residents are expected to apply humanities-based skills frequently in their clinical work and are also likely to use humanities-based skills to support their own self-care. Our project explored the role of the humanities in palliative medicine residency programs across Canada.MethodsEach priority topic or objective of the current palliative medicine residency training standards in Canada was reviewed to determine whether they relate to the humanities. A cross-sectional survey was subsequently created using Qualtrics, with the target study population being current palliative medicine residents and palliative medicine staff physicians at academic centers in Canada.ResultsMultiple humanities objectives exist in Canadian palliative medicine training standards, primarily in the ethical, cultural, and spiritual domains. Eighty-seven people completed the cross-sectional survey, for a 17.4% response rate and 94.6% completion rate. The vast majority (90%) of survey participants felt that the humanities had an important role in medical training at the undergraduate and postgraduate levels, and more than 70% of participants felt that the humanities had an important role in palliative medicine residency training. In some areas, the humanities participants felt that their programs would most benefit from ethics, philosophy, and culture. Over 65% agreed or strongly agreed that their own palliative medicine program would benefit from more humanities content.ConclusionCanadian palliative medicine training standards require residents to demonstrate humanities-based skills. Most survey participants state that the humanities have an important role in medical training at the undergraduate and postgraduate levels, and that their own palliative medicine residency program would benefit from more humanities content. These results may guide future studies to better understand why and how more humanities content can be added to palliative medicine residency programs to optimize residents’ learning experiences and better prepare them for careers in palliative medicine.

Are We Supporting Surgical Quality Improvement in Training and Beyond? A Qualitative Study of Surgical Trainees and Practicing Surgeons.

We conducted a qualitative study to describe surgeon and surgical trainee perspectives of quality improvement (QI) in training and practice to elucidate how surgeons and trainees interact with barriers and leverage facilitators to learn and conduct QI. Surgeons and surgical trainees of the American College of Surgeons were recruited via email and snowball sampling to participate in focus groups. Eligible individuals were English speaking surgical trainees or practicing surgeons. We developed a semi-structured focus group protocol to explore barriers and facilitators of quality training and improvement. An inductive thematic approach was used to identify actionable items. Thirty-two surgical trainees and surgeons participated in six focus groups. 28% of participants were trainees (8 residents, 1 fellow) and 72% were practicing surgeons, representing practice settings in university, community, and Veterans Affairs hospitals in urban and suburban regions. Thematic analysis revealed the central theme among trainees was that they lacked necessary support to effectively learn and conduct QI. Dominant sub-themes included lack of formal education, insufficient time, inconsistent mentorship, and maximizing self-sufficiency to promotes success. The central theme among surgeons was that effective QI initiatives require adequate resources and institutional support; however, surgeons in this study were ultimately constrained by institutional limitations. Sub-themes included difficulties in data acquisition and interpretation, financial limitations, workforce and staffing challenges, misaligned stakeholder priorities, and institutional culture. This qualitative evaluation further details gaps in QI demonstrated by previous quantitative studies. There is an opportunity to address these gaps with dedicated QI training and mentorship for surgical trainees and by creating a supportive environment with ample resources for surgeons.

Training the Next Generation of Pediatric Clinical Pharmacologists: Insights and Trainee Perspectives Over 10 Years.

The limited number of researchers with expertise necessary toaddress treatment gaps for children presents an ongoing challenge. The NationalInstitutes of Health established a national Pediatric Clinical Pharmacology T32Training Program in 2012 to train a multidisciplinary, collaborative pediatricclinical pharmacology workforce. We surveyed all current T32 trainees andgraduates since inception to identify strengths and opportunities to enhanceworkforce development. A total of 85 out of 155 (55%) responded, with themajority of respondents being female gender (61%), white race (75%), andworking in academia (75%). Nearly all (97%) reported using clinicalpharmacology in their current position, with 88% planning to remain in clinicalpharmacology in the long term, reinforcing current training efforts. Lifestylefactors and student debt appeared to influence career decisions. Mentors werecritical for introduction and future success in the field. Time and fundinglimitations were perceived as barriers to successful training. There was also apressing need to improve diversity. For workforce development, we suggestsupporting: (1) trainees' lifestyle, by offsetting financial pressures ofresearch training and expanding the geographic footprint of pediatric clinicalpharmacology training; (2) mentorship, by identifying mentors in the field andproviding dedicated support for mentorship; (3) efficiency, by evaluatingcurrent training activities and focusing on activities that maximizeopportunities for future funding; and (4) diversity, by examining barriers todiversity in the workforce in general and expanding early enrichmentopportunities.

A07 - EDI&S Outputs of appointing a Trainee Executive Group in delivering a multi-centre randomized controlled surgical trial: Lessons learnt from The Sunflower Study

Abstract Background Randomised controlled trials (RCTs) are widely accepted as the ‘gold standard’ for evaluating the effectiveness of health interventions. Trial recruitment is notoriously difficult, with approximately 57% of publicly funded RCTs not meeting recruitment target sample sizes. Trainee involvement can be crucial for large scale clinical studies. However, there remains limited knowledge about methods in which trainee collaboration can assist studies in achieving their aims. The Sunflower Study is the UKs largest surgical RCT and is unique in piloting the establishment of a Trainee Executive Group (TEG). Here we explore the outputs of the TEG and its impact on the study. Method The TEG consists of five trainee representatives of different training grades and research backgrounds, all appointed via national selection. The TEG held regular virtual meetings seeking to understand trainee perspectives on RCTs recruitment, champion and disseminate examples of good recruitment, indentify recruitment barriers, optimise The Sunflower Study's social media presence and update digital resources via a trainee section on its website. The TEG also established a network of regional representatives with the purpose of connecting neighbouring recruitment sites with one another, disseminating knowledge at a local level, sharing recruitment tips and encouraging local/national competition. All of these strategies aimed to ultimately boost patient recruitment. Results The regional representative network assisted with setting up a new recruitment site, who have since remained a top recruiter. The TEGs establishment saw the highest number of trainees attend the study's yearly ‘Investigators' Meeting’. The TEGs engagement with the study’s social media led to an increase in follower numbers and consistently maintained high tweet impressions. The Sunflower Study is affiliated with the NIHR API scheme and has 165 collaborators registered with the scheme - the highest of any UK study. Through this, trainees are able to develop leadership, communication and research skills; as well as gain competencies required for CCT. Conclusion The implementation of the TEG illustrates how innovative strategies can be utilised to actively involve trainees in research. Following the establishment of the TEG, new sites participated in the study, the study's social media impact increased and trainee engagement was optimised. The TEG also encouraged trainees' future involvement with research through the API scheme. In the post-COVID-19 era, collaborative studies have proven their role in providing high impact quality research. Future studies could foster the TEG model, with an appointed trainee leadership team focusing on maximising trainee output, providing benefits not only for the trainees themselves, but also recruitment sites and studies overall.

Undergraduate general medicine education in Japan: A nationwide cross‐sectional survey of medical trainees' perspectives

AbstractBackgroundThe 2022 revised version of the Model Core Curriculum (MCC) for Medical Education in Japan includes “generalism” as a new expertise quality and ability, based on the results of surveys of experts in health professions education. However, the perspectives of medical trainees under the pre‐2022 MCC revision were under‐examined. Here, we investigated what these trainees felt they had learned about general medicine (GM)‐related topics.MethodsWe performed a nationwide cross‐sectional study using an anonymous online questionnaire, which was developed with reference to the 2022 revised MCC. The questionnaire consisted of 14 items. For all items, we asked, “Did you learn enough during medical school?” Respondents were asked to respond on a 5‐point Likert scale (from 1 = strongly disagree to 5 = strongly agree).ResultsThree hundred and eighty‐six participants (response rate 55.4%) were included in the analysis. For the item “Behavioral science,” the number of participants who chose “3 = neither agree nor disagree” was highest, at 171 (44.3%) and with an average of 3.28, indicating that this item was perceived as insufficiently studied. Approximately half of the participants chose “4 = agree” for all items other than “Behavioral science.”ConclusionsThe study suggested that behavioral science may be underlearned among medical trainees of the pre‐2022 MCC generation. Medical educators in Japan should formulate curricula in accordance with the 2022 revision MCC and improve curricula regarding behavioral science. Future research should survey the generation of trainees who receive 2022 revision MCC‐compliant medical education; comparison of results with those of this study would be valuable in examining the effects of the revised guideline and inform international medical educators.

Gaming the System? A Qualitative Exploration of Physician Assistant Learner Perceptions of Virtual Patient Education.

Virtual patients (VPs) are increasingly used in health professions education. How learners engage with VPs and the relationship between engagement and authenticity is not well understood. We explored learners' perceptions of VP education to gain an understanding of the characteristics promoting meaningful engagement in learning, including perceived authenticity. Using a constructivist grounded theory approach, we conducted interviews and focus groups with 11 students from 2 Canadian Physician Assistant programs, where VP learning was implemented to supplement clinical education during the COVID-19 pandemic. We explored trainee perspectives on the use of VPs as an educational modality. Data were iteratively collected and descriptively analyzed thematically using a constant comparison approach until theoretical sufficiency was reached. We identified 3 groups of factors influencing these students' VP learning experiences: (1) technical factors related to the VP platform influenced the perceived authenticity of the patient interactions; (2) individual factors of learners' attitudes influenced their engagement and motivation; and (3) contextual factors related to the learning environment influenced the acceptability and perceived value of the learning experience. Overall, the psychological authenticity of the learning platform and students' motivation for self-directed learning were perceived as most important for students' learning experiences. Implementing VP learning as a supplement to clinical education should be done with consideration of factors that enhance the psychological authenticity of the learning platform, promote learner engagement and accountability, and encourage acceptability of the learning modality through curricular placement and messaging.

The Low-Income and Middle-Income Countries' Perspective on Global Neurosurgery Collaborations.

Access to neurosurgical care is limited in low-income and middle-income countries (LMICs) and in marginalized communities in high-income countries (HICs). International partnerships represent one possible means of addressing this issue. Insights from surgeons in HICs have been explored, but data from LMICs' counterparts are scarce. We aimed to study the perspectives of neurosurgeons and trainees from LMICs regarding global neurosurgery (GN) collaborations and interests, motivators, and challenges in participating. An online survey was conducted targeting neurosurgeons and trainees from LMICs. The survey explored demographics, previous experiences, ongoing activities, interests, and barriers related to GN activities. Data were collected between July 2022 and December 2022 and analyzed. Responses involved 436 individuals. The most represented region (25%) was sub-Saharan Africa, and most respondents were male (87.8%) aged 35-49 years. Interest in GN was high, with 91% after its developments. Most respondents (96.1%) expressed interest in training, professional, or research experience in HICs, but only 18.1% could cover the expenses. A majority (73.2%) strongly agreed to return to their home country for work after HIC training. Ongoing HIC-LMIC partnerships were reported by 27.8% of respondents. Clinical exposure emerged as the most relevant motivating factor (87%), while financial concerns, lack of opportunities, and lack of program support were identified as important barriers. Funding and dedicated time were highlighted as the most crucial facilitators. Understanding the perspectives of neurosurgeons and trainees from LMICs is essential to expanding HICs-LMICs collaborations and improving access to neurosurgical care worldwide. Financial support and targeted interventions are needed to address barriers and promote equitable partnerships in GN.

Interventions to mitigate EHR and documentation burden in health professions trainees: A scoping review.

Health professions trainees (trainees) are unique as they learn a chosen field while working within electronic health records (EHR). Efforts to mitigate EHR burden have been described for the experienced health professional (HP), but less is understood for trainees. EHR or documentation burden (EHR burden) affects trainees, although not all trainees use EHRs, and use may differ for experienced HPs. To develop a model of how interventions to mitigate EHR burden fit within the trainee EHR workflow: the Trainee EHR Burden Model. 1) Examine trainee experiences of interventions aimed at mitigating EHR burden(scoping review). 2) Adapt an existing workflow model by mapping included studies(concept clarification). We conducted a 4-database scoping review applying PRISMA-ScR guidance, examining scholarly, peer-reviewed studies that measured trainee experience of interventions to mitigate EHR burden. We conducted a concept clarification categorizing, then mapping studies to workflow model elements. We adapted the model to intervenable points for trainee EHR burden. We identified 11 studies examining interventions to mitigate EHR burden that measured trainee experience. Interventions included: curriculum, training, coaching on the existing EHR for both simulated or live tasks; evaluating scribes' impact; adding devices or technology tailored to rounds; team communication or data presentation at end-of shift handoffs. Interventions had varying effects on EHR burden, most commonly measured through surveys, and less commonly, direct observation. Most studies had limited sample sizes, focused on inpatient settings, and physician trainees. Few studies measured trainee perspectives of interventions aiming to mitigate EHR burden. Many studies applied quasi-experimental designs and focused on inpatient settings. The Trainee EHR Burden Model, adapted from an existing workflow model, offers a starting place to situate points of intervention in trainee workflow. Further research is needed to design new interventions targeting stages of HP trainee workflow, in a range of clinical settings.

INSIGHTS AND PERSPECTIVES: EXPLORING THE TRAINEE EXPERIENCES IN MAXILLOFACIAL POSTGRADUATE TRAINING

Objective: To explore the perspective of maxillofacial trainees about postgraduate training in maxillofacial surgery. Methodology:Exploratory Qualitative study design (Case study) was adopted. A seven-question questionnaire was developed and piloted to identify the different perceptions of dental trainees. Six semi-structured interviews were conducted. Purposive Sampling was used. Thematic analysis was undertaken with Triangulation of transcripts Results:Three main themes emerged from the data analyses. Sculpting Surgeons: Excellence in Maxillofacial Surgical Skills emerged as the first theme. This was based on the need to master the prerequisite skills for a maxillofacial surgeon with a focus on simulation, hands-on training, and workshops. Navigating Complexity: Challenges in Maxillofacial training emerged as the second theme and included the challenges the trainees face. Elevating Excellence: Enhancing Maxillofacial Training was the third theme that emerged from the suggestions of the trainees to improve their development. Conclusion:Development of expertise in surgical skills is paramount for maxillofacial surgeons and opportunities need to be provided to enhance the development of trainees in these skills. The challenges highlighted need to be addressed to enhance the level of postgraduate training and achieve excellence in Maxillofacial Training.