Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
26,250
result(s) for
"Residency"
Sort by:
Doctors in China: improving quality through modernisation of residency education
There is growing recognition that the ultimate success of China's ambitious health reform (enacted in 2009) and higher education reform (1998) depends on well educated health professionals who have the clinical, ethical, and human competencies necessary for the provision of quality services. In this Review, we describe and analyse graduate education of doctors in China by discussing the country's health workforce and their clinical residency education. China has launched a new system called the 5 + 3 (5 year undergraduate and 3 year residency [standardised residency training]), which aims to set national quality standards. To improve understanding for the Chinese model, we present a comparative perspective with systems from the UK and USA. To succeed, the 5 + 3 model will need to overcome major challenges of accreditation and certification, alternative education pathways, and China's unique degree and credentialing system. We conclude by reviewing the challenges of clinical competencies in China, especially the complementarity of specialist training and general practitioner training, which are essential for the quality and equity of China's health-care system.
Journal Article
Learning in action : designing successful graduate student work experiences in academic libraries
Learning in Action brings together a range of topics and perspectives from authors of diverse backgrounds and institutions to offer practical inspiration and a framework for creating meaningful graduate student work experiences at your institutions.
eBook
A year in the life of a third space urban teacher residency : using inquiry to reinvent teacher education
\"This book weaves together voices of faculty, residents, mentors, administrators, community organizers, and students who have lived together in a third space urban teacher residency program in Newark as they reinvent math and science teaching and teacher education through the lens of inquiry. Each chapter includes narratives from multiple perspectives as well as tools we have used within the program to support and build change, providing readers with both real cases of how an urban teacher residency can impact school systems, and concrete tools and examples to help the reader understand and replicate aspects of the process. Capturing both the successes but also the tensions and challenges, we offer a kaleidoscopic view of the rich, complex, and multi-layered ways in which multiple stakeholders work together to make enduring educational change in urban schools. Our third space NMUTR has been a fragile utopian enterprise, one that has relied on a shared commitment of all involved, and a deep sense of hope that working collaboratively has the potential, even if not perfect, to make a difference.\"--Publisher's website.
Book
In the Wake of the 2003 and 2011 Duty Hours Regulations, How Do Internal Medicine Interns Spend Their Time?
ABSTRACT
BACKGROUND
The 2003 and 2011 Accreditation Council for Graduate Medical Education (ACGME) common program requirements compress busy inpatient schedules and increase intern supervision. At the same time, interns wrestle with the effects of electronic medical record systems, including documentation needs and availability of an ever-increasing amount of stored patient data.
OBJECTIVE
In light of these changes, we conducted a time motion study to determine how internal medicine interns spend their time in the hospital.
DESIGN
Descriptive, observational study on inpatient ward rotations at two internal medicine residency programs at large academic medical centers in Baltimore, MD during January, 2012.
PARTICIPANTS
Twenty-nine interns at the two residency programs.
MAIN MEASURES
The primary outcome was percent of time spent in direct patient care (talking with and examining patients). Secondary outcomes included percent of time spent in indirect patient care, education, and miscellaneous activities (eating, sleeping, and walking). Results were analyzed using multilevel regression analysis adjusted for clustering at the observer and intern levels.
KEY RESULTS
Interns were observed for a total of 873 hours. Interns spent 12 % of their time in direct patient care, 64 % in indirect patient care, 15 % in educational activities, and 9 % in miscellaneous activities. Computer use occupied 40 % of interns’ time. There was no significant difference in time spent in these activities between the two sites.
CONCLUSIONS
Interns today spend a minority of their time directly caring for patients. Compared with interns in time motion studies prior to 2003, interns in our study spent less time in direct patient care and sleeping, and more time talking with other providers and documenting. Reduced work hours in the setting of increasing complexity of medical inpatients, growing volume of patient data, and increased supervision may limit the amount of time interns spend with patients.
Journal Article
Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis
The burnout syndrome is characterized by emotional exhaustion, depersonalization, and reduced personal achievement. Uncertainty exists about the prevalence of burnout among medical and surgical residents. Associations between burnout and gender, age, specialty, and geographical location of training are unclear. In this meta-analysis, we aimed to quantitatively summarize the global prevalence rates of burnout among residents, by specialty and its contributing factors. We searched PubMed, PsycINFO, Embase, and Web of Science to identify studies that examined the prevalence of burnout among residents from various specialties and countries. The primary outcome assessed was the aggregate prevalence of burnout among all residents. The random effects model was used to calculate the aggregate prevalence, and heterogeneity was assessed by I2 statistic and Cochran’s Q statistic. We also performed meta-regression and subgroup analysis. The aggregate prevalence of burnout was 51.0% (95% CI: 45.0–57.0%, I2 = 97%) in 22,778 residents. Meta-regression found that the mean age (β = 0.34, 95% CI: 0.28–0.40, p < 0.001) and the proportion of males (β = 0.4, 95% CI = 0.10–0.69, p = 0.009) were significant moderators. Subgroup analysis by specialty showed that radiology (77.16%, 95% CI: 5.99–99.45), neurology (71.93%, 95% CI: 65.78–77.39), and general surgery (58.39%, 95% CI: 45.72–70.04) were the top three specialties with the highest prevalence of burnout. In contrast, psychiatry (42.05%, 95% CI: 33.09–51.58), oncology (38.36%, 95% CI: 32.69–44.37), and family medicine (35.97%, 95% CI: 13.89–66.18) had the lowest prevalence of burnout. Subgroup analysis also found that the prevalence of burnout in several Asian countries was 57.18% (95% CI: 45.8–67.85); in several European countries it was 27.72% (95% CI: 17.4–41.11) and in North America it was 51.64% (46.96–56.28). Our findings suggest a high prevalence of burnout among medical and surgical residents. Older and male residents suffered more than their respective counterparts.
Journal Article
Use of artificial intelligence for gender bias analysis in letters of recommendation for general surgery residency candidates
Letters of recommendation (LoRs) play an important role in resident selection. Author language varies implicitly toward male and female applicants. We examined gender bias in LoRs written for surgical residency candidates across three decades at one institution.
Retrospective analysis of LoRs written for general surgery residency candidates between 1980 and 2011 using artificial intelligence (AI) to conduct natural language processing (NLP) and sentiment analysis, and computer-based algorithms to detect gender bias. Applicants were grouped by scaled clerkship grades and USMLE scores. Data were analyzed among groups with t-tests, ANOVA, and non-parametric tests, as appropriate.
A total of 611 LoRs were analyzed for 171 applicants (16.4% female), and 95.3% of letter authors were male. Scaled USMLE scores and clerkship grades (SCG) were similar for both genders (p > 0.05 for both). Average word count for all letters was 290 words and was not significantly different between genders (p = 0.18). LoRs written before 2000 were significantly shorter than those written after, among applicants of both genders (female p = 0.004; male p < 0.001). Gender bias analysis of female LoRs revealed more gendered wording compared to male LoRs (p = 0.04) and was most prominent among females with lower SCG (9.5 vs 5.1, p = 0.01). Sentiment analysis revealed male LoRs with female authors had significantly more positive sentiment compared to female LoRs (p = 0.02), and males with higher SCG had more positive sentiment compared to those with lower SCG (9.4 vs 8.2, p = 0.03). NLP detected more “fear” in male LoRs with lower SCGs (0.11 vs 0.09, p = 0.02). Female LoRs with higher SCGs had more positive sentiment (0.78 vs 0.83, p = 0.03) and “joy” (0.60 vs 0.63, p = 0.02), although those written before 2000 had less “joy” (0.5 vs 0.63, p = 0.006).
AI and computer-based algorithms detected linguistic differences and gender bias in LoRs written for general surgery residency applicants, even following stratification by clerkship grades and when analyzed by decade.
•Letters of recommendation (LoR) are important in surgical resident selection.•Gender bias can implicitly alter LoR strength.•LoR readers can use artificial intelligence to improve gender bias detection.•Implicit bias detection can provide deeper meaning and guide resident selection.
Journal Article
An evaluation of social media utilization by general surgery programs in the COVID-19 era
Our study investigates how general surgery residency programs utilized social media to adapt to the challenges of COVID-19.
319 participating general surgery residency programs provided by the Electronic Residency Application Service were analyzed in this study. Associated Twitter, Instagram, and Facebook accounts were assessed to find virtual open houses and externships.
Of the 319 program, 188 (59%) were found to have a social media presence. A total of 348 social media accounts were found, as some of the programs had separate residency and department accounts. Of all the social media accounts, 112 (32%) of the accounts were created after March 1, 2020. Virtual open houses opportunities were found to be advertised across all platforms.
Many general surgery programs responded to the physical limitations of COVID-19 pandemic by increasingly utilizing social media during the COVID-19 pandemic. Virtual opportunities should be considered as a novel approach for future outreach and recruitment.
•Many general surgery programs utilized social media to adapt to COVID-19 challenges.•Virtual open houses opportunities were created and publicized through social media.•Noticeably more general surgery social media accounts were made after March 2020.•Twitter, Instagram, and Facebook were all platforms used by general surgery training programs.
Journal Article
Opportunities and Challenges of Establishing a VA Residency
A Nurse Practitioner is an Advanced Practice Registered Nurse (APRN) with a master's or doctorate and advanced clinical training obtained through didactic and clinical courses beyond initial professional Registered Nurse (RN) preparation. As many newly graduated Nurse Practitioners (NP) enter the workforce, they face difficulty transitioning from experienced Registered Nurses (RN) to novice NP roles. The literature was reviewed to examine the benefits of participating in an NP residency, and a program evaluation was conducted in the Veterans Healthcare Administration. Current NP residents of the South Texas Veteran Healthcare System's first NP Residency have shared their personal experiences through the trials of a first-year program and the COVID-19 pandemic. Residency programs offer an excellent postgraduate experience to newly graduated NPs, including hands-on training and mentorship, mitigating risk, and facilitating the transition; however, opportunities for improvement were identified for program enhancement.
Journal Article