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Professionalism Milestones Assessments Used by Emergency Medicine Residency Programs: A Cross-sectional Survey.

ABSTRACT: INTRODUCTION:Professionalism is a vital component of quality patient care. While competency in professionalism is Accreditation Council for Graduate Medical Education (ACGME)-mandated, the methods used to evaluate professionalism are not standardized, calling into question the validity of reported measurements. We aimed to determine the type and frequency of methods used by United States (US) -based emergency medicine (EM) residencies to assess accountability (Acc) and professional values (PV), as well as how often graduating residents achieve competency in these areas. METHODS:We created a cross-sectional survey exploring assessment and perceived competency in Acc and PV, and then modified the survey for content and clarity through feedback from emergency physicians not involved in the study. The final survey was sent to the clinical competency committee (CCC) chair or program director (PD) of the 185 US-based ACGME-accredited EM residencies. We summarized results using descriptive statistics and Fisher's exact testing. RESULTS:A total of 121 programs (65.4%) completed the survey. The most frequently used methods of assessment were faculty shift evaluation (89.7%), CCC opinion (86.8%), and faculty summative evaluation (76.4%). Overall, 37% and 42% of residency programs stated that nearly all (greater than 95%) of their graduating residents achieve mastery of Acc and PV non-technical skills, respectively. Only 11.2% of respondents felt their programs were very effective at determining mastery of non-technical skills. CONCLUSION:EM residency programs relied heavily on faculty shift evaluations and summative opinions to determine resident competency in professionalism, with feedback from peers, administrators, and other staff less frequently incorporated. Few residency programs felt their current methods of evaluating professionalism were very effective.

SUBMITTER: Stehman CR

PROVIDER: S-EPMC6948707 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Professionalism Milestones Assessments Used by Emergency Medicine Residency Programs: A Cross-sectional Survey.

Stehman Christine R CR Hochman Steven S Fernández-Frackelton Madonna M Volz Emilio G EG Domingues Rui R Love Jeffrey N JN Soares William W

The western journal of emergency medicine 20191219 1

<h4>Introduction</h4>Professionalism is a vital component of quality patient care. While competency in professionalism is Accreditation Council for Graduate Medical Education (ACGME)-mandated, the methods used to evaluate professionalism are not standardized, calling into question the validity of reported measurements. We aimed to determine the type and frequency of methods used by United States (US) -based emergency medicine (EM) residencies to assess accountability (Acc) and professional value ...[more]

PMID: 31913837

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Project description:IntroductionResidency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM).MethodsThis was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track.ResultsOf 267 residency programs 199 (74.5%) completed the survey. Fifty-seven (28.6%) had a POCUS scholarly track as of the 2019-2020 academic year. Scholarly tracks in POCUS were more common in university-based/academic sites and larger residency programs. Of the 57 programs with POCUS scholarly tracks, 48 (84.2%) required residents to present at least one POCUS lecture, 45 (78.9%) required residents to serve as instructor at a hands-on workshop, and 42 (73.7%) required residents to participate in quality assurance of departmental POCUS scans. Only 28 (49.1%) tracks had a structured curriculum, and 26 (45.6%) required POCUS research. In total, 300 EM residents completed a POCUS scholarly track over the past three academic years, with a median of 4 (2-9) per program. Seventy-five (25.0%) proceeded to a clinical ultrasound fellowship after residency graduation, with a median of 1 (interquartile range 0-2) per program. A total of 139 POCUS-specific abstracts (median 2 [0-3]) and 80 peer-reviewed manuscripts (median 1 [0-2]) were published by scholarly track residents over the past three years.ConclusionThis survey study describes the current prevalence, characteristics, and outcomes of POCUS scholarly tracks across EM residency programs. The results may inform the decisions of residency programs to create these tracks.

Project description:IntroductionThe 2019 novel coronavirus pandemic has caused significant disruptions in the clinical operations of hospitals as well as clinical education, training, and research at academic centers. New York State was among the first and largest epicenters of the pandemic, resulting in significant disruptions across its 29 emergency medicine (EM) residency programs. We conducted a cross-sectional observational study of EM residency programs in New York State to assess the impact of the pandemic on resident education and training programs.MethodsWe surveyed a cross-sectional sample of residency programs throughout New York State in June 2020, in the timeframe immediately after the state's first "wave" of the pandemic. The survey was distributed to program leadership and elicited information on pandemic-prompted curricular modifications and other educational changes. The survey covered topics related to disruptions in medical education and sought details on solutions to educational issues encountered by programs.ResultsOf the 29 accredited EM residency programs in New York State, leadership from 22 (76%) responded. Of these participating programs, 11 (50%) experienced high pandemic impact on clinical services, 21 (95%) canceled their own trainees' off-service rotations, 22 (100%) canceled or postponed visiting medical student rotations, 22 (100%) adopted virtual conference formats (most within the first week of the pandemic wave), and 11 (50%) stopped all prospective research (excluding COVID-19 research), while most programs continued retrospective research.ConclusionThis study highlights the profound educational impact of the pandemic on residency programs in one of the hardest- and earliest-hit regions in the United States. Specifically, it highlights the ubiquity of virtual conferencing, the significant impact on research, and the concerns about canceled rotations and missed training opportunities for residents, as well as prehospital and non-physician practitioner trainees. This data should be used to prompt discussion regarding the necessity of alternate educational modalities for pandemic times and the sequelae of implementing these plans.

Project description:BackgroundAcademic emergency medicine (EM) communities have viewed anonymous online communities (AOC) such as Reddit or specialty-specific "applicant spreadsheets" as poor advising resources. Despite this, robust EM AOCs exist, with large user bases and heavy readership. Insights about applicants' authentic experiences can be critical for applicants and program leadership decision-making. To date, there are no EM studies to qualitatively assess EM AOC narratives during the application cycle. Our goal was to perform a qualitative analysis of students' EM program experiences through a publicly available AOC.MethodsThis was a qualitative analysis of a publicly available, time-stamped, user-locked AOC dataset: "Official 2020-2021 Emergency Medicine Applicant Spreadsheet." We extracted and then de-identified all data from selected sub-sheets entitled "Virtual Interview Impressions" and "Rotation Impressions." Four investigators used constant comparative method to analyze the data inductively, and they subsequently met to generate common themes discussed by students. Preliminary thematic analysis was conducted on a random sample of 37/183 (20%) independent narratives to create the initial codebook. This was used and updated iteratively to analyze the entire narrative set consisting of 841 discrete statements. Finally, two unique codes were created to distinguish whether the identified sub-themes, or program attributes, were likely "modifiable" or "non-modifiable."ResultsWe identified six major themes: living and working conditions; interpersonal relationships; learning experiences, postgraduate readiness, and online/virtual supplements. Common sub-themes included patient population (13%); resident personality (7%); program leadership personality (7%); relationship with faculty/leadership (6%); geography (4%); practice setting (4%); program reputation (4%), and postgraduate year-3 experiences (4%). Modifiable sub-themes outnumbered non-modifiable sub-themes, 60.7% to 39.3%.ConclusionIn this analysis of selected medical students' narratives in an AOC, the majority of identified themes represented topics that may serve as external feedback for EM residency programs and their clerkships. Selective use of AOCs may set a precedent for future program assessments by applicants and inform program leadership of important programmatic elements in the eyes of applicants. It elucidates important themes in their interactions or learning experiences with programs and creates opportunities for learner-centric program improvement.

Project description:IntroductionRecent research demonstrates burnout prevalence rates as high as 76% in emergency medicine (EM) residents. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) required that all training programs provide dedicated wellness education for their trainees as a requirement for accreditation. We aimed to conduct a systematic review of published wellness interventions conducted in EM residency programs following the implementation of the 2017 ACGME Common Program Requirements change in order to characterized published intervention and evaluate their effectiveness.MethodsWe applied a published approach to conducting systematic reviews of the medical education literature. We performed a search of the literature from January 1, 2017-February 1, 2020. Studies were included for final review if they described a specific intervention and reported outcomes with the primary goal of improving EM resident wellness. Outcomes were characterized using the Kirkpatrick training evaluation model.ResultsEight of 35 identified studies met inclusion criteria. Most described small convenience samples of EM residents from single training programs and used the satisfaction rates of participants as primary outcome data. Only quantitative assessment methods were used. Studies addressed only a limited number of factors affecting resident wellness. The majority of interventions focused on personal factors, although a few also included sociocultural factors and the learning and practice environment.ConclusionThere is a relative dearth of literature in the area of research focused on interventions designed to improve EM resident wellness. Furthermore, the studies we identified are narrow in scope, involve relatively few participants, and describe programmatic changes of limited variety. Future directions include an increase and emphasis on multi-institutional studies, randomized controlled trials, qualitative methodology, and opportunities for funded research.

Project description:IntroductionThere are over 200 emergency medicine (EM) residency programs in the United States. While there are basic criteria defined by the Accreditation Council for Graduate Medical Education (ACGME), there can be significant variation between programs with regard to rotation distribution. Therefore, it would be valuable to have a benchmark for programs to understand their rotation mix in the context of the national landscape. This study aimed to provide a breakdown of the length and percentage of EM residency programs with each clinical rotation in the United States. This study also sought to examine trends and changes in EM residency programs since 1986.MethodsA list of all current EM residency programs was obtained using the ACGME website. All program websites were reviewed, and data were independently dual extracted by two investigators with discrepancies resolved by consensus with a third investigator. Programs without curricular data available online were queried via e-mail for the data. Programs were separated into 3- versus 4-year lengths. Mean, standard deviation, and range were calculated for each rotation.ResultsA total of 200 of 202 programs (99%) had data available. Of these programs, 84.5% had a dedicated pediatric EM rotation with mean length of 9.7 weeks among 3-year programs and 12.1 weeks among 4-year programs. A total of 88% had a dedicated ultrasound rotation, 60% had a dedicated toxicology rotation, 73.5% had a dedicated emergency medical services rotation, 74% had a dedicated orthopedics rotation, 60% had a dedicated administration rotation, 29% had a dedicated research rotation, and 95% had dedicated elective time.DiscussionThis study provides summative data regarding the rotation distribution among EM programs in the United States. Compared with prior data, there is less time dedicated to internal medicine rotations and increased pediatric, trauma, ultrasound, toxicology, and critical care experiences. These data will inform current and new EM residency programs when determining rotation selection.

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Professionalism Milestones Assessments Used by Emergency Medicine Residency Programs: A Cross-sectional Survey.

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Professionalism Milestones Assessments Used by Emergency Medicine Residency Programs: A Cross-sectional Survey.

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