Specialist Training In Medicine Research Articles

Assessments Used for Summative Purposes during Internal Medicine Specialist Training: A Rapid Review

Assessments used for summative purposes of patient-facing clinical competency in specialist internal medicine training are high-stakes, both to doctors in training, as it is a prerequisite for qualification, as well as their community of prospective patients. A rapid review of the literature evaluated methods of assessments used for summative purposes of patient-facing clinical competency during specialist internal medicine training in Australia. Four online databases identified literature published since the year 2000 that reported on summative assessment in specialist medical training. Two reviewers screened and selected eligible studies and extracted data, with a focus on evidence of support for the criteria for good assessment as set out in the 2010 Ottawa Consensus framework for good assessment. Ten eligible studies were included. Four studied the mini-clinical evaluation exercise (mini-CEX), two the Royal Australasian College of Physicians short case exam, three a variety of Entrustable Professional Activities (EPAs) or summative entrustment and progression review processes, and one a novel clinical observation tool. The mini-CEX assessment demonstrated the most evidence in support of the Ottawa criteria. There was a paucity of published evidence regarding the best form of summative assessment of patient-facing clinical competency in specialist internal medicine training.

Team Method for Teaching First Aid Skills in a Simulation Center

Simulation technologies are now being actively introduced at all levels of higher education in the training of qualified specialists in medicine: starting with basic general medical skills in junior courses, and ending with teamwork skills for interns and residents, as well as practicing doctors with work experience in the course of additional professional education.

Community specialist palliative care services in New Zealand: a survey of Aotearoa hospices.

Community specialist palliative care (SPC) in Aotearoa New Zealand is provided by independent hospices. Substantial increase in demand for palliative care is projected in the next 20 years. We aimed to describe the current landscape of SPC services across Aotearoa whilst incorporating an equity lens. A descriptive cross-sectional survey was undertaken to describe aspects of hospice service and populations served. Survey links were emailed to clinical, or service leads of hospices identified via Hospice New Zealand Website. All eligible hospices (n=32) completed the online survey. All hospices provided care at home, with 94% (n=30) also providing care for patients in aged residential care facilities. All 32 hospices provided symptom management, family and carer support and bereavement care. Six hospices (19%) did not provide afterhours cover. Fifteen (47%) hospices did not have Māori cultural position and median full time equivalent across all hospices for such position was one day per week. Only nine (28%) hospices provided palliative medicine specialist training. Areas of inconsistency were highlighted including afterhours access and cultural support for Māori. The capacity of the present system to address current and future shortages of palliative medicine specialist is questioned.

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study.

Dyspnea caused by pleural effusion is a common reason for admission to the emergency department (ED). In such cases, thoracentesis performed in the ED may allow for swift symptom relief, diagnostics, and early patient discharge. However, the competence level of thoracentesis and training in the ED are currently unclear. This study aimed to describe the current competencies and training in thoracentesis in Danish EDs. We performed a nationwide cross-sectional study in Denmark. A questionnaire was distributed to all EDs in March 2022 including questions on competencies and thoracentesis training methods. Descriptive statistics were used. In total, 21 EDs replied (response rate 100%) between March and May 2022. Overall, 50% of consultant and 77% of physicians in emergency medicine specialist training were unable to perform thoracentesis independently. Only 2 of 21 EDs (10%) had a formalized training program. In these 2 EDs, there were no requirements of maintaining these competences. Informal training was reported by 14 out 21 (66%) EDs and consisted of ad-hoc bedside procedural demonstration and/or guidance. Among the 19 EDs without formalized training, 9 (47%) had no intention of establishing a formalized training program. We found a major lack of thoracentesis competencies in Danish EDs among both consultant and physicians in emergency medicine specialist training. Moreover, the vast majority of EDs had no formalized thoracentesis training program.

Higher School Instructors’ Pedagogical Skills Improvement as a Basis of Educational Strategy for Development of Students’ Professional Training

The article substantiates the expediency of acquaintance of higher school’s teachers with the essence, rules and regularities of pedagogical skills improvement. The necessity of developing a strategy for improving pedagogical skills of the instructors of non-pedagogical institutions of higher education (IHE) are emphasized, as evidenced by the coverage of this problem in many scientific researches of philosophical, psychological, pedagogical directions. It is generalized that the development of pedagogical skills involves understanding by instructors the essence and productive effectiveness of own pedagogical activity regardless of the disciplines’ content they teach. Pedagogical skills provide the disclosure of teacher’s creativity, understanding the meaning of developing professionalism, which is required from modern instructor of IHE according to the level of solving new tasks of education. In the article, the theoretical basics of the research are connected in four groups. The first group includes the fundamental works of scholars, who opened the essence of the basic principles of the philosophy of education. The second group – works, which reflect ontology and phenomenology of pedagogical skills as higher expression of the freedom of being a teacher in professional activity, as the highest level of quality of instructor’s work. The third group consists of the scientific works, where the structure of pedagogical skills as the top of teacher’s creative activity, in which the harmony, perfection and beauty are realized, is revealed. The fourth group includes scientific-methodical materials, the main purpose of which is directing of instructors on the formation and development of different aspects of pedagogical skills as the criterion of teacher’s professionalism. A particular attention is paid to the disclosure of methods for improving pedagogical skills of instructors of non-pedagogical IHE that is considered as an advanced training of scientific and pedagogical staff. Considering this, special courses were organized in I. Horbachevsky Ternopil State Medical University in 2018 in order to perfect instructors’ pedagogical skills. Classes were conducted in the form of lectures and study trainings in order to expand pedagogical knowledge and ideas about the essence of pedagogical skills and possibilities of educational technologies use in the professional training of future specialists in medicine. Instructors acquainted themselves with the extra active regime of information exchange, peculiarities of the organization interactive cooperation, were aware of the feasibility of interactive technologies use in IHE, tested in practice methods of doing exercises “Press Method”, “Six Thinking Hats” – the method of parallel thinking by E. de Bono. As a result of the final questionnaire, it was found that most instructors seek to increase their own level of pedagogical skills in different directions.

The competency-based medical education evolution of Canadian emergency medicine specialist training.

Canadian specialist emergency medicine (EM) residency training is undergoing the most significant transformation in its history. This article describes the rationale, process, and redesign of EM competency-based medical education. The rationale for this evolution in residency education includes 1) improved public trust by increasing transparency of the quality and rigour of residency education, 2) improved fiscal accountability to government and institutions regarding specialist EM training, 3) improved assessment systems to replace poor functioning end-of-rotation assessment reports and overemphasis on high-stakes, end-of-training examinations, and 4) and tailored learning for residents to address individualized needs. A working group with geographic and stakeholder representation convened over a 2-year period. A consensus process for decision-making was used. Four key design features of the new residency education design include 1) specialty EM-specific outcomes to be achieved in residency; 2) designation of four progressive stages of training, linked to required learning experiences and entrustable professional activities to be achieved at each stage; 3) tailored learning that provides residency programs and learner flexibility to adapt to local resources and learner needs; and 4) programmatic assessment that emphasizes systematic, longitudinal assessments from multiple sources, and sampling sentinel abilities. Required future study includes a program evaluation of this complex education intervention to ensure that intended outcomes are achieved and unintended outcomes are identified.

Computer Application of Ultrasound and Nuclear Magnetic Resonance Images for the Anatomical Learning of the Pelvis and the Female Pelvic Floor.

Computer applications have been incorporated as valuable components in teaching, especially thanks to the advancement and innovation of new technologies during the last decades. The implementation of these computer developments in medicine and in the field of medical teaching with different utilities has been a revolution. This is manifested with greater intensity in certain medical specialties and in different areas of medical education, for example in the study of human anatomy, especially in parts of the human body of great complexity such as the pelvis and the pelvic floor of women. New technologies are also important in the use, study and interpretation of radiological tests, including ultrasound and nuclear magnetic resonance. This implies a change in the study and learning techniques of students, resident doctors and specialists in gynecology, radiodiagnosis, urology and many other medical specialties, considering new computer developments as a good alternative or complement to existing teaching methods. For this reason, we consider that computer programs like the one we present in this work can be very useful in the future of education and more specifically in the training of specialists in medicine.

ACEM involvement in a successful African emergency medicine programme.

In the past 5 years Botswana graduated its first home-grown doctors and emergency medicine specialists for the country. The postgraduate emergency medicine specialist training arrangement between Botswana and South Africa was challenging in development, implementation and maintenance. Numerous varied supports from ACEM and its International Emergency Medicine Network were integral to these successes. This article encourages further investment of ACEM grants and scholarships in Africa by describing how ACEM supported significant advances in Botswana emergency medicine.

Clinical Informatics Competencies in the Emergency Medicine Specialist Training Standards of Five International Jurisdictions.

The field of clinical informatics (CI), and specifically the electronic health record, has been identified as a key facilitator to achieve a sustainable evidence-based health care system for the future.International graduate medical education (GME) programs have been challenged to ensure that their trainees are provided with appropriate skills to deliver effective and efficient health care in an evolving environment. This study explored how international emergency medicine (EM) specialist training standards address competencies and training in relevant areas of CI. A list of categories of CI competencies relative to EM was developed following a thematic review of published references documenting CI curriculum and competencies. Publicly available documents outlining core content, curriculum, and competencies from international organizations responsible for specialty GME and/or credentialing in EM for Australasia, Canada, Europe, the United Kingdom, and the United States were identified. These EM training standards were reviewed to identify inclusion of topics related to the relevant categories of CI competencies. A total of 23 EM curriculum documents were included in the review. Curricula content related to critical appraisal/evidence-based medicine, leadership, quality improvement, and privacy/security were included in all EM curricula. The CI topics related to fundamental computer skills, computerized provider order entry, and patient-centered informatics were only included in the EM curricula documents for the United States and were absent for the other jurisdictions. There is variation in the CI-related content of the international EM specialty training standards reviewed. Given the increasing importance of CI in the future delivery of health care, organizations responsible for training and credentialing specialist emergency physicians must ensure that their training standards incorporate relevant CI content, thus ensuring that their trainees gain competence in essential aspects of CI.

Hekimlerin, Defansif Tıp Uygulamaları Hakkındaki Bilgi ve Tutumları, İşe Bağlı Gerginlik ve Tükenmişlik Düzeyleri

Giriş: Defansif tıp, hekimlerin kendilerini tıbbi malpraktis davalarına karşı korumak amacı ile tanı ve tedaviye yönelik gereksiz işlemler kullanmaları veya malpraktis davası ile sonuçlanma riski yüksek tıbbi uygulamaların sorumluluğunu almamak için, bu tür uygulamalardan kaçınmalarıdır. Bu çalışma, Dicle Üniversitesi Tıp Fakültesi Hastanesinde, dahili ve cerrahi tıp bilimlerinde çalışan araştırma görevlisi hekimlerin, defansif tıp uygulamaları hakkındaki bilgi ve tutumları, işe bağlı gerginlik ve tükenmişlik düzeylerini etkileyen faktörleri ortaya koymak amacıyla yapılmıştır. Yöntem: Tanımlayıcı-kesitsel tipteki bu çalışmanın örneklemi, orantılı tabakalı yöntemle oluşturulmuştur. Sosyodemografik veri formu, defansif tıp uygulamaları tutum ölçeği ve Maslach tükenmişlik ölçeğini içeren anket, 200 hekime uygulanmıştır. Bulgular: Yaş ortalaması 29,4±3,0 olan katılımcıların, % 70,5’i (n=141) erkek, %56’sı (n=112) evliydi. Pozitif ve negatif defansif tıp sıklığı, sırasıyla %98 (n=196), %92 (n=184) olarak bulunmuştur. Defansif tıp puanları, erkeklerde, cerrahi bilimlerde çalışanlarda, uzmanlık eğitiminin ilk 2 yılındakilerde, hakkında malpraktis davası açılanlarda ve sigara kullananlarda anlamlı derecede yüksek bulunmuştur. İşe bağlı gerginlik düzeyi, cerrahi bilimlerde çalışanlarda, ayda 8 ve üzeri sayıda nöbet tutanlarda, hakkında malpraktis davası açılanlarda, sigara kullananlarda, alkol kullananlarda anlamlı derecede yüksek bulunmuştur. Hekimlerin, Maslach tükenmişlik ölçeğinden aldıkları puan ortalamaları, duygusal tükenme için 31,57±11,67, duyarsızlaşma için 11,75±6,49, kişisel başarı için 29,46±7,72 olarak belirlenmiştir. Sonuç: Çalışmamızda, araştırma görevlisi hekimlerin büyük kısmının meslek ve uzmanlık dalı seçiminden memnun olmadıkları, defansif tıp kavramı hakkında bilgilerinin yetersiz ve tüm tükenmişlik boyutlarında, yüksek tükenmişlik oranlarının olduğu sonucuna varılmıştır. Defansif tıbbı daha fazla uygulayanların tükenmişlik düzeylerinin daha yüksek olduğu görülmüştür.

Selection into Emergency Medicine specialist training: A commentary on the science of selection

Selection into Emergency Medicine specialist training: A commentary on the science of selection

Selection into Emergency Medicine specialist training: The art of selection.

Selection into Emergency Medicine specialist training: The art of selection.

Reflection on the Death of San Diego Hospice and the Institute for Palliative Medicine

Journal of Palliative MedicineVol. 16, No. 6 Letters to the EditorReflection on the Death of San Diego Hospice and the Institute for Palliative MedicineThomas D. AllainThomas D. AllainSearch for more papers by this authorPublished Online:31 May 2013https://doi.org/10.1089/jpm.2013.0123AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Reflection on the Death of San Diego Hospice and the Institute for Palliative Medicine." , 16(6), p. 602FiguresReferencesRelatedDetailsCited ByTraining in Global Palliative Care Within Palliative Medicine Specialist Training Programs: A Moral ImperativeJournal of Pain and Symptom Management, Vol. 55, No. 5 Volume 16Issue 6Jun 2013 InformationCopyright 2013, Mary Ann Liebert, Inc.To cite this article:Thomas D. Allain.Reflection on the Death of San Diego Hospice and the Institute for Palliative Medicine.Journal of Palliative Medicine.Jun 2013.602-602.http://doi.org/10.1089/jpm.2013.0123Published in Volume: 16 Issue 6: May 31, 2013Online Ahead of Print:April 23, 2013PDF download

Was ist künftigen Hausärzten bei der Niederlassungsentscheidung wichtig? Ergebnisse einer postalischen Befragung junger Ärzte in Deutschland

Although the estimated need for primary health care is covered to 108% in Germany, a primary care physician shortage is emerging in some regions. Moreover, the number of young physicians completing a specialist medical training for general medicine is decreasing. Therefore the present study aimed to investigate factors influencing young physicians to aspire to such a specialist training as well as aspects considered as important for practice establishment by these physicians. 14 939 young physicians aged under 40 years without completed specialist medical training were contacted by mail using databases of five state chambers of physicians (Lower Saxony, Westfalen-Lippe, Saxony, Saxony-Anhalt, Mecklenburg-Western Pomerania). The physicians were asked to answer questions regarding socio-demographic characteristics, the aspired medical speciality, their purpose to establish a practice as well as a questionnaire regarding factors which could be important for the latter decision. The questionnaire had been developed based on qualitative interviews with young physicians and an additional literature search. The answers of 5 053 respondents were eligible for data analysis. The questionnaire regarding factors influencing practice establishment was evaluated using a principal component analysis. Variables predicting the decision for a general medicine specialist training and the weighting of different factors for practice establishment were analysed using logistic or linear regression models. A general medicine specialist training was rather aspired by women, physicians who grew up in rural areas, living with a partner/spouse and having children. No differences were found between physicians living in the Old or New Federal States. Principal component analysis revealed 6 relevant factors for practice establishment. Of these, surrounding conditions for family as well as professional duties (e. g., on-call duty) were most important for the physicians. Opportunities for professional cooperation, working conditions and quality of life in the surrounding area had least importance. On average financial conditions ranged, being for men and physicians without children especially important, but not being influenced by the aspired specialist medical training or the purpose the establish a practice. The results point to measures which could be suited for rendering the decision-making in favour of the establishment of a primary care practice by young physicians in rural areas more attractive again.

History and development of training in occupational medicine

After a reminder of the wide scope of the subject of occupational medicine, the issues of training are described as set in a context of societal and professional development. Undergraduate training will be touched on, referring to experiences from the UK. In discussing the training of specialists in occupational medicine, reference is made to experiences gained in Norway. The implications for training and education, occasioned by major changes in roles and tasks of the occupational medicine professionals, will be commented on while observing developments in the Netherlands. The links between training and the need for competencies in the real-life context of a health market will be touched on. After a short reminder of the European aspects of occupational medicine specialist training, attention is directed towards the extreme patchwork nature, amounting to absence in important aspects, of documentation of the history of the development of training and education in occupational medicine. This also applies to the evaluations of strategies aiming at change and development of programmes for vocational training on undergraduate, graduate and postgraduate levels, including programmes for sustaining competencies and competence development.

Working with the Clinton HIV/AIDS initiative in Liberia: a personal account

In July 2007, as I approached the end of the third year of my genitourinary medicine specialist training in London, I made contact with the Clinton HIV/AIDS Initiative (CHAI), via...

Specialist training of Slovene family physicians

Family medicine in Europe started to develop in the 1960s with the introduction of obligatory specialist training. Slovenia is a country with a long tradition of family medicine specialist training, but up until 2002 this was neither elaborated on nor conducted by peers in general practice/family medicine. When the country's socialist system started to transform due to political reforms, Slovenia began to modify its system in order to meet the criteria of the European Union. One of the changes was the introduction of a new healthcare system with an influential Medical Chamber responsible for postgraduate training in all specialities. A new model for vocational training in family medicine was established in 2002, following the recommendations of the European Union of General Practitioners (UEMO). According to the new programme, which lasts 4 years, trainees spend half of their training in a hospital setting and half in general practice, where they are supervised by a trainer in practice. This article describes the legal process of introducing new forms of specialist training in Slovenia, and its content.Conclusion: A comparison with UEMO countries shows that the new model is comparable to other countries.

Specialist Training in Medicine

Specialist Training in Medicine