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Training fellows for retinopathy of prematurity care: a Web-based survey.

ABSTRACT: To characterize the training received by pediatric ophthalmology and retina fellows in retinopathy of prematurity (ROP) management.Pediatric ophthalmology and retina fellowship programs were emailed a Web-based survey to assess fellowship training in ROP management.Of 140 programs contacted, 42 (30%) participated, resulting in 87 surveys for analysis. Of the 87 respondents, 25 (29%) reported that two-thirds or less of ROP examinations performed by fellows were also seen by an attending. When stratified by specialty, this trend was statistically different between pediatric ophthalmology and retina fellows (P = 0.03). Additionally, pediatric ophthalmology fellows performed fewer laser photocoagulation procedures than retina fellows (P < 0.001). Regarding fellows' perceived competency in ROP management, 3 of 51 (6%) felt competent at the start of their fellowship and 43 of 51 (84%) felt competent at the time of the survey. Only 7% of respondents reported the use of formal evaluations at their programs to assess fellow competence in ROP examination.Training programs for fellows in pediatric ophthalmology and retina vary greatly with respect to ROP training and the quality of clinical care. Many clinical ROP examinations are being performed by pediatric ophthalmology and retina fellows without involvement and/or direct supervision by attending ophthalmologists. Our findings have important implications for the development of a future workforce for ROP management.

SUBMITTER: Wong RK

PROVIDER: S-EPMC3338950 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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Training fellows for retinopathy of prematurity care: a Web-based survey.

Wong Ryan K RK Ventura Camila V CV Espiritu Michael J MJ Yonekawa Yoshihiro Y Henchoz Laure L Chiang Michael F MF Lee Thomas C TC Chan Robison V Paul RV

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20120401 2

<h4>Purpose</h4>To characterize the training received by pediatric ophthalmology and retina fellows in retinopathy of prematurity (ROP) management.<h4>Methods</h4>Pediatric ophthalmology and retina fellowship programs were emailed a Web-based survey to assess fellowship training in ROP management.<h4>Results</h4>Of 140 programs contacted, 42 (30%) participated, resulting in 87 surveys for analysis. Of the 87 respondents, 25 (29%) reported that two-thirds or less of ROP examinations performed by ...[more]

PMID: 22525176

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Project description:BackgroundThe incidence of retinopathy of prematurity (ROP) is higher in Indonesia than in high-income countries. In order to reduce the incidence of the disease, a protocol on preventing, screening and treating ROP was published in Indonesia in 2010. To assist the practical implementation of the protocol, meetings were held in all Indonesia regions, calling attention to the high incidence of ROP and the methods to reduce it. In addition, national health insurance was introduced in 2014, making ROP screening and treatment accessible to more infants.ObjectiveTo evaluate whether the introduction of both the guideline drawing attention to the high incidence of ROP and national health insurance may have influenced the incidence of the disease in Indonesia.SettingData were collected from 34 hospitals with different levels of care: national referral centres, university-based hospitals, and public and private hospitals.MethodsA survey was administered with questions on admission numbers, mortality rates, ROP incidence, and its stages for 2016-2017 in relation to gestational age and birth weight.ResultsWe identified 12 115 eligible infants with a gestational age of less than 34 weeks. Mortality was 24% and any stage ROP 6.7%. The mortality in infants aged less than 28 weeks was 67%, the incidence of all-stage ROP 18% and severe ROP 4%. In the group aged 28-32 weeks, the mortality was 24%, all-stage ROP 7% and severe ROP 4%-5%. Both mortality and the incidence of ROP were highest in university-based hospitals.ConclusionsIn the 2016-2017 period, the infant mortality rate before 32 weeks of age was higher in Indonesia than in high-income countries, but the incidence of ROP was comparable. This incidence is likely an underestimation due to the high mortality rate. The ROP incidence in 2016-2017 is lower than in surveys conducted before 2015. This decline is likely due to a higher practitioner awareness about ROP and national health insurance implementation in Indonesia.

Project description:Despite the likely benefits of palliative care (PC) for patients with cirrhosis, physician experiences and perspectives about best practices are variable. We aimed to assess PC experience and gaps in training among transplant hepatology fellows. We conducted a national survey of all transplant hepatology fellows enrolled in accredited fellowship programs during the 2020-2021 academic year. We assessed the frequency of PC provision and comfort with physical and psychological symptom management, psychosocial care, communication skills, advance care planning, and end-of-life care. A total of 45 of 56 (79%) of transplant hepatology fellows responded to the survey; 50% (n = 22) were female. Most trained at centers performing over 100 transplants per year (67%, n = 29) distributed evenly across geographic regions. Most fellows (69%, n = 31) had a PC or hospice care rotation during residency, and 42% (n = 19) of fellows received education in PC during transplant hepatology fellowship. Fellows reported feeling moderately to very comfortable with communication skills such as breaking bad news (93%, n = 41) and leading family meetings (75%, n = 33), but nearly one-third (30%, n = 13) reported feeling not very or not at all comfortable assessing and managing anxiety and depression (30%, n = 13) and spiritual distress (34%, n = 15). Nearly one-quarter (22%, n = 10) had never discussed or documented advance care plans during fellowship. Fellows wished to receive future instruction on the assessment and management of physical symptoms (68%, n = 30) and anxiety and depression (64%, n = 28). Conclusion: Our survey highlights gaps in PC experience and education during transplant hepatology fellowship, lack of comfort in managing psychological distress and advance care planning, and desire to improve skills, particularly in symptom management. Future studies should investigate how to enhance transplant hepatology competencies in these PC domains and whether this impacts clinical care, advance care planning, or patient experience.

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Training fellows for retinopathy of prematurity care: a Web-based survey.

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Training fellows for retinopathy of prematurity care: a Web-based survey.

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