Training Directors Research Articles

Pediatric flexible airway endoscopy training during a pandemic and beyond: Bending the curve.

Flexible airway endoscopy, for diagnostic and therapeutic purposes, is a vital aspect of pediatric pulmonology practice, and has become an integral aspect of formal training in pediatric pulmonology. This article is protected by copyright. All rights reserved.

Who We Are Today: a National Survey of Diversity Among Psychiatry Program Directors.

In March 2018, the American Association of Directors of Psychiatric Residency Training (AADPRT) formed the Diversity and Inclusion (D&I) Committee. One of the committee's goals was to understand the AADPRT membership's composition and their perceptions of D&I. This study's objective was to identify the demographic characteristics of the AADPRT membership. Program directors were invited by email to participate in an anonymous survey. The survey collected participants' demographic information including gender, race/ethnicity, training background, age, disability/differently abled status, job role, geographic region where their program is located, type of program, and their program's community setting. Two hundred fifty six of 657 AADPRT members (39%) completed the survey. Respondents were mostly White (64.5%) followed by Asian/Southeast Asian (17.6%), Hispanic/Latinx (4.3%), and Black (1.6%). Only 13.3% of the participants were international medical graduates. Women were more prevalent (61.7%) than men (37.5%), and 9.4% self-identified as members of the LGBTQ+ Community. This study represents the first systematic investigation into the diversity among psychiatry program directors throughout the USA and Canada. Future qualitative studies are needed to better understand the reasons behind this initial study's findings. Potential concerns requiring exploration include the possibility of the program director role serving as a "glass ceiling" for some women and a "leaky pipeline" in academia for groups underrepresented in medicine.

Editorial introductions.

Editorial introductions.

ИСПОЛЬЗОВАНИЕ «СЕРОЙ ТЕНИ» В ТЕАТРАЛЬНОМ ИСКУССТВЕ КАК СПОСОБ СОЗДАНИЯ ЭФФЕКТА ТАИНСТВЕННОГО

The phenomenon of light and shadow is discussed by many sciences, including art criticism. And what does the shadow really represent? What is the relationship between light and shadow? When and why do we use shadows as a technique in theatrical performances? This work explores the shadow as a consequence of the action of light on an object that does not allow it to pass through - the "gray shadow" in theatrical performances. There Are numerous theatrical performances in which diverse projections and shadows are used as expressive means. We use shadow in the theater when we want to know, to see the unlit, hidden side of someone or something. This physical phenomenon has always attracted the attention of people of different cultures and eras and naturally found application in theatrical performances. They involve in either multi-colored or gray shadows. When an object does not transmit light completely appears - a "gray shadow", denoting only the contours of a certain object, the silhouette of the object used in the theatrical performance. Folk art in the form of riddles, games and other things created phrases that are an important guide in understanding and determining the laws of their existence in theatrical works. Shadows turned out to be interesting and useful in training actors and directors of the puppet theater.

Editorial introductions.

Current Opinion in Gastroenterology was launched in 1985. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of gastroenterology is divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor and Section Editors for this issue. EDITOR Ciarán P. KellyCiarán P. KellyCiarán P. Kelly, MD, is Professor of Medicine at Harvard Medical School, Director of Gastroenterology Training and Medical Director of the Celiac Center at Beth Israel Deaconess Medical Center, Boston, Massachussets, USA. Dr Kelly earned his medical degree from Trinity College in Dublin, Ireland where he was a Foundation Scholar and recipient of numerous academic awards. Dr Kelly has also received postgraduate clinical and research awards from the Crohn's and Colitis Foundation of America, the American Gastroenterological Association and the National Institutes of Health. He is an American Gastroenterology Association Fellow and a Fellow of the American College of Gastroenterology. Dr Kelly has longstanding clinical and research interests in intestinal infection and inflammation. He has been involved in patient care and research in Clostridium difficile infection for more than 25 years and leads NIH-funded research programs that evaluate potential C. difficile vaccines and other immune-based treatments. His interest in the pathophysiology, diagnosis and management of celiac disease is also longstanding and, as Medical Director of the Celiac Center at BIDMC which he founded in 2004, he heads clinical, research and educational programs in celiac disease. Dr Kelly has served as a committee member of the NIH, Center for Scientific Review as well as FDA, CDC and NIH committees on celiac disease and C. difficile infection. Dr Kelly is the author of more than 250 clinical and basic research book chapters, invited reviews, and peer-reviewed, original articles appearing in such journals as Infection & Immunity, American Journal of Physiology, Gastroenterology, Journal of Biological Chemistry, Journal of Clinical Investigation, New England Journal of Medicine and Lancet. SECTION EDITORS Mark H. WilcoxMark H. WilcoxProf. Mark H. Wilcox is a consultant microbiologist and the Head of Research and Development in Microbiology at the Leeds Teaching Hospitals (LTHT), where he is also the Infection Lead of Leeds NIHR Diagnostic Technologies Medical Technology and In Vitro Diagnostic Co-operative; Professor of Medical Microbiology at the University of Leeds, UK; and Lead on Clostridium difficile for Public Health England (PHE). He serves in multiple advisory roles, including to UK SAGE (COVID-19), as co-chair of the UK Technical Validation Group for COVID-19 test, as a medical advisor to the National Infection Prevention & Control Lead (NHSImprovement/England, the Medical Research Council's Infection and Immunity Panel, as Chair of PHE's Rapid Review Panel (reviews the utility of infection prevention & control products for the NHS) and member of the UK NHS Antimicrobial Resistance Programme Board. He has formerly been the Director of Infection Prevention (4 years), Infection Control Doctor (8 years), Clinical Director of Pathology (6 years) at LTHT and Head of Microbiology (15 years). Prof Wilcox leads a Healthcare Associated Infection Research Group at the University of Leeds, comprising ∼30 doctors, scientists and nurses. Projects include multiple aspects of Clostridium difficile infection, diagnostics, antimicrobial resistance and the gut microbiome, infection prevention and control interventions, and the clinical development of new antimicrobial agents. Eamonn M.M. QuigleyEamonn M.M. QuigleyEamonn M.M. Quigley is Chief of Gastroenterology and Hepatology at Houston Methodist Hospital in Houston, Texas, USA, Professor of Medicine at Weill Cornell Medical College and David M Underwood Chair of Medicine in Digestive Disorders. A graduate of University College Cork, Ireland, Dr Quigley trained in internal medicine in Glasgow and Manchester, and in gastroenterology in Glasgow, the Mayo Clinic, Rochester, Minnesota, USA, and Manchester. In 1986, he joined the faculty at the University of Nebraska Medical Center in Omaha, Nebraska, USA, where he ultimately served as Chief of Gastroenterology and Hepatology. Returning to Cork in 1998, he served as Dean of the Medical School at UCC for 7 years and was a principal investigator at its Alimentary Pharmabiotic Center from its inception. He served as president of both the American College of Gastroenterology and the World Gastroenterology Organization and is a past editor-in-chief of the American Journal of Gastroenterology. Clinical and research interests include irritable bowel syndrome, gastrointestinal motility and the role of the gut microbiota and probiotics in health and in gastrointestinal and metabolic disorders.

Consideration on Development of Teaching Materials for Training Director in Advertising.

Consideration on Development of Teaching Materials for Training Director in Advertising.

Blockchain and Business Analysis: Making the Case

Abstract Blockchain technology is here to stay, so should your business be taking advantage of its capabilities? asks Martin Maya, Director of Amatis Training.

Benefits, Detriments of Screen Time for Children Debated at AACAP

Benefits, Detriments of Screen Time for Children Debated at AACAP

‘A solid foundation for a career in indexing’: the story of the Society of Indexers’ training course

With the publication in 2020 of the fifth edition of the Society of Indexers’ training course, the current Training Director traces the development of training in the Society of Indexers (SI) since its foundation in 1957. From lectures held in London, through a paper-based course relying on the postal service, to a modern online course using digital technology to deliver a more immediate and personalized experience, indexing training has been through many transformations. Throughout, an emphasis on rigour and the maintenance of standards has been paramount.

Utilizing Psychodynamic Principles to Teach Professionalism to Medical Students Through an Innovative Curriculum.

Professionalism is a fundamental expectation of practicing medicine and a core competency in medical education, yet the methods of how to teach and evaluate it are still experimental. Professionalism involves self-reflection, a psychodynamic understanding of the patient's and the doctor's predicament, and conflict resolution, so psychiatrists are uniquely qualified to teach it. This article describes an innovative course that utilizes psychodynamic principles to teach professionalism to medical students. The authors present a novel 2-year curriculum for teaching professionalism to first- and second-year medical students utilizing psychodynamic principles to help develop awareness of others' feelings and motivations, self-reflection, compassion, empathy, and skills in ethical conflict resolution by means of written and oral narrative exercises. Outcomes are evaluated by the student ratings about the course and the faculty, and by using the test for emotional intelligence (EI), administered as a baseline and then at the end of each year. Each subsequent year the students demonstrated a statistically significant increase in EI scores, student evaluations of the course ranked among the highest in the medical school, clerkship supervisors and residency training directors noted the high degree of professionalism of the students, and the number of student applicants to psychiatry residency were consistently higher than the national average. In addition, this course was awarded the 2018 Alpha Omega Alpha Honor Medical Society's Edward B. Harris Medical Professionalism Award for the best professionalism course of U.S. medical schools. Psychodynamic principles are fundamental for teaching medical professionalism at a medical-student level. Professionalism also serves as a way to introduce students to psychiatry early in the curriculum, and psychiatrists and other mental health professionals are uniquely qualified to teach medical professionalism.

A Delphi study to prioritize genetic counseling outcomes: What matters most.

Research on genetic counseling outcomes has examined a range of metrics many that differ in quality and extent of psychometric assessment and in some cases fail to encompass potential benefits of genetic counseling for patients. Although a variety of possible outcomes have been explored, selecting the most important or relevant outcomes and identifying well-validated measures remain challenging. An online, modified Delphi method was used to prioritize genetic counseling outcomes from the viewpoint of individuals from four stakeholder groups - clinical genetic counselors, outcome researchers, genetic counseling training directors, and genetic counseling consumers/advocates. A survey of 181 genetic counseling outcomes were rated based on perceived importance and then sorted and categorized using the Framework for Outcomes of Clinical Communication Services in Genetic Counseling (FOCUS-GC) framework. Three of the FOCUS-GC domains (Process, Patient Care Experience, and Patient Changes) were assessed as most important, while none of the most highly rated outcomes fell into the domains of Patient Health or Family Changes. The majority of outcomes deemed most important by stakeholder groups were within the process domain. When looking at the proportion of outcomes that overlapped with the consumer group, clinical genetic counselors had the highest degree of similarity with consumers when looking at the high relative importance band outcomes (61.1% overlap), followed by training directors (58.3%), and outcome researchers (41.7%). Variability in importance according to stakeholder groups was an important consideration and prioritizing outcomes was challenging given that the majority of outcomes were rated as important. Working to bridge the realities of clinical care and fundamental differences in the viewpoints and priorities of genetic counseling research directions is an area for future exploration.

A statement on the current status and future needs of the pediatric pulmonology workforce: Pipeline Workgroup.

There is growing concern that current trends in pediatric pulmonology will lead to a workforce shortage resulting in patients having difficulty accessing subspecialty care. As part of the Pediatric Pulmonology Division Directors Association and Pediatric Pulmonary Training Directors Association Workforce Summit, we examined factors affecting the recruitment of learners into pediatric pulmonary fellowship training (PPFT) programs. The goal of our workgroup was to describe these issues and develop a plan to increase the pipeline of learners who ultimately pursue PPFT. Specifically, we summarize factors that impact decisions to undertake PPFT, describe existing initiatives to enhance recruitment, and propose future strategies to increase early career learner interest.

The gap between attitudes and processes related to 'family-friendly' practices in anaesthesia training in New Zealand: A survey of anaesthesia supervisors of training and departmental directors.

Gender inequity persists within the anaesthetic workforce, despite approaching numerical parity in Australia and New Zealand. There is evidence, from anaesthesia and the wider health workforce, that domestic gender norms regarding parental responsibilities contribute to this. The creation of 'family-friendly' workplaces may be useful in driving change, a concept reflected in the gender equity action plan developed by the Australian and New Zealand College of Anaesthetists. This study aimed to explore the extent to which a family-friendly culture exists within anaesthesia training in New Zealand, from the perspective of leaders in anaesthesia departments. An electronic survey composed of quantitative and qualitative questions was emailed to all supervisors of training, rotational supervisors and departmental directors at Australian and New Zealand College of Anaesthetists accredited training hospitals in New Zealand. Twenty-eight of the 71 eligible participants responded (response rate 39%). The majority (61%) agreed with the statement 'our department has a "family friendly" approach to anaesthesia trainees'; however, there was a discrepancy between views about how departments should be and how they actually are. Several barriers contributing to this discrepancy were identified, including workforce logistics, governance, departmental structures and attitudes. Uncertainty in responses regarding aspects of working hours, parental leave and the use of domestic sick leave reflect gaps in understanding, with scope for further enquiry and education. To redress gender bias seriously through the development of family-friendly policies and practices requires supportive governance and logistics, along with some cultural change.

Trusting our trainees: competency-based training of cardiologists using Entrustable Professional Activities (EPA)

Abstract Assessment of trainees is a core activity of educators, ensuring that trainees can be trusted to provide high quality care with no supervision. Training and the demands on trainees have changed with specialization, need for more technical skills, digitization, needs for teamwork and greater communication skills. Competency-based medical education was introduced to capture these changing needs for trainees. The 7th ESC Education Conference – “From competence to good clinical care” – brought together national directors of training (39), young cardiology representatives (7), patients (7), ESC partners in education (10), and the ESC Education Committee (22) to discuss contemporary challenges in cardiology training and Entrustable Professional Activities (EPAs)-based solutions. Methods Pre- and post-conference surveys were conducted. The different issues were discussed in 4 workshops: core knowledge and evidence, skills and competence, performing into context, and training the trainers. Results Pre-conference, 90% of respondents believed that trainees should be certified only when they can be entrusted to perform in an unsupervised fashion, and 84% thought that specific training for educators should be required. From the workshops 4 themes emerged: 1) Core knowledge and evidence: rotations to different centres are needed to enable trainees to meet EPA requirements. 2) Skills and competence: a learning agreement between trainers and trainees should be established with protected time to achieve EPAs, and patient feedback on trainee performance should be obtained. 3) Performing into context (when is a trainee ready to practice): clinicians do informal assessment on a daily basis; EPAs formalize this with regular observation linked with progression in responsibility. 4) Train the trainer: good doctors are not automatically good trainers and should be required to undergo specific training themselves. We reviewed complex training frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) that contains too many components to be useful for clinical teachers. EPAs were identified as a practical way to implement competency-based cardiology training across the ESC. The 2020 ESC Core Curriculum contains EPAs that a cardiologist should be able to perform independently by the end of training. Post-conference there was unanimous agreement (100%) that EPAs are a valuable concept in training. A majority of participants (69%) agreed that EPA's are applicable in practice today. Conclusion Trainee assessment is a daily challenge for educators. The ESC Education Conference identified distinct goals to be achieved before, during and at the completion of a training programs. The EPA concept was widely accepted as an efficient method to monitor trainees progress, while trusting them to perform activities in which they are proficient. Trusting our trainees should be a major educational goals for cardiologists in Europe. Funding Acknowledgement Type of funding source: None

Positive Psychology: Not a ‘Just Be Happy’ Approach to Physician Wellness in 2020

Positive Psychology: Not a ‘Just Be Happy’ Approach to Physician Wellness in 2020

The Radicalization of a White Psychiatrist.

The Radicalization of a White Psychiatrist.

The history of workforce concerns in pediatric pulmonary Medicine.

Children are affected by a broad spectrum of acute and chronic respiratory disorders. The number of children with respiratory disease is increasing, as are the complexity of disease pathophysiology and the management demands on pediatric pulmonologists. Despite slowly increasing numbers of board-certified pediatric pulmonologists, large areas of the country are underserved and there is a perception of an impending workforce crisis. There are multiple reasons for these concerns. A joint effort between the Pediatric Pulmonology Division Directors Association and Pediatric Pulmonary Training Directors Association was undertaken to address these issues.

60.4 THE TRAINEE'S EXPERIENCE IN AN INFANT MENTAL HEALTH CLINIC

Creating a training experience in a variety of early childhood settings that can be applied to the Accreditation Council for Graduate Medical Education (ACGME) milestones requires a great deal of creativity. This presentation will describe an infant and preschool training that includes experiences in a therapeutic nursery, preschool, early autism spectrum disorder and primary school programs, intensive outpatient program, and an outpatient psychiatric clinic, from both the training director's and the trainee's perspectives.

Training in Neurology: Feedback from Graduates About the Psychiatry Component of Residency Training.

To obtain feedback from early career adult and pediatric neurologists about the psychiatry component of residency training. A survey was developed and administered electronically to 4 cohorts of recently certified American Board of Psychiatry and Neurology diplomates. The response rate was 16% (431/2,677) and included 330 adult neurologists and 101 pediatric neurologists. Fewer than half of the respondents described themselves as extremely or quite satisfied with their psychiatry training whereas 26% of the adult neurologists and 33% of the pediatric neurologists felt slightly or not at all prepared for this component of practice. Four themes were identified in the respondents' suggestions for improving psychiatry training: provide more outpatient experience; provide more time/teaching in psychiatry; provide more experience with both pharmacologic and nonpharmacologic psychiatric treatments; and provide more exposure to patients with conditions likely to be encountered in neurology/child neurology practice. These recent graduates of adult and pediatric neurology residency programs felt underprepared for the psychiatric issues they encountered in their patients. They suggested a number of strategies for better alignment of psychiatry training with the likely demands of practice. A model curriculum recently developed by the American Academy of Neurology's Consortium of Neurology Program Directors and the American Association of Directors of Psychiatric Residency Training also provides guidance for both neurology and psychiatry program directors.

To Increase Diversity, Medicine Should Rethink USMLE Scores, Psychiatrists Say

To Increase Diversity, Medicine Should Rethink USMLE Scores, Psychiatrists Say