Reimagining Residency Selection: Part 2-A Practical Guide to Interviewing in the Post-COVID-19 Era.
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ABSTRACT:
SUBMITTER: Sternberg K
PROVIDER: S-EPMC7594790 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo evaluate urology applicants' opinions about the interview process during the COVID-19 pandemic.Material and methodsAn anonymous survey was emailed to applicants to our institution from the 2019 and 2020 urology matches prior to issuance of professional organization guidelines. The survey inquired about attitudes toward the residency interview process in the era of COVID-19 and which interview elements could be replicated virtually. Descriptive statistics were utilized.ResultsEighty percent of urology applicants from the 2019 and 2020 matches received our survey. One hundred fifty-six people (24% of recipients) responded. Thirty-four percent preferred virtual interviews, while 41% in-person interviews at each program, and 25% regional/centralized interviews. Sixty-four percent said that interactions with residents (pre/postinterview social and informal time) were the most important interview day component and 81% said it could not be replicated virtually. Conversely, 81% believed faculty interviews could be replicated virtually. Eighty-seven percent believed that city visits could not be accomplished virtually. A plurality felt that away rotations and second-looks should be allowed (both 45%).CommentApplicants feel that faculty interviews can be replicated virtually, while resident interactions cannot. Steps such as a low-stakes second looks after programs submit rank lists (potentially extending this window) and small virtual encounters with residents could ease applicant concerns.ConclusionApplicants have concerns about changes to the match processes. Programs can adopt virtual best practices to address these issues.
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Project description:Anticoagulation clinics were initially developed to provide safe and effective care for warfarin-treated patients with atrial fibrillation, venous thromboembolism, and mechanical valve replacement. Traditionally, these patients required ongoing laboratory monitoring and warfarin dose adjustment by expert providers. With the introduction of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban), many have questioned the need for anticoagulation clinic. However, we think that the growing number of oral anticoagulant choices creates an urgent need for expanding the traditional role of the anticoagulation clinic. We outline 3 key purposes that a reimagined anticoagulation clinic would serve: (1) to assist patients and clinicians with selecting the most appropriate drug and dose from a growing list of anticoagulant options (including warfarin), (2) to help patients minimize the risk of serious bleeding complications with careful long-term monitoring and peri-procedural management, and (3) to encourage ongoing adherence to these life-saving medications. We also describe how repurposing anticoagulation clinics as broader medication safety clinics would promote safe and effective care across a range of cardiovascular conditions for high-risk medications (eg, spironolactone, amiodarone). Finally, we highlight a few existing health systems that are overcoming key challenges to implementing a reimagined anticoagulation or medication safety clinic structure.
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Project description:An organized and rigorous approach to analyzing qualitative data can yield important insights into the intricacies of human behavior and can answer "how" and "why" questions. One process of coding interview responses from study subjects using grounded theory with a constructivist approach is outlined and applied to an example study. The emergent themes can provide insight to medical educators to create interventions that optimize the learning environment. For researchers, they may generate hypotheses to study by quantitative analysis.
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Project description:Methodological innovations have allowed researchers to consider increasingly sophisticated statistical models that are better in line with the complexities of real world behavioral data. However, despite these powerful new analytic approaches, sample sizes may not always be sufficiently large to deal with the increase in model complexity. This poses a difficult modeling scenario that entails large models with a comparably limited number of observations given the number of parameters. We here describe a particular strategy to overcoming this challenge, called regularization. Regularization, a method to penalize model complexity during estimation, has proven a viable option for estimating parameters in this small n, large p setting, but has so far mostly been used in linear regression models. Here we show how to integrate regularization within structural equation models, a popular analytic approach in psychology. We first describe the rationale behind regularization in regression contexts, and how it can be extended to regularized structural equation modeling (Jacobucci, Grimm, & McArdle, 2016). Our approach is evaluated through the use of a simulation study, showing that regularized SEM outperforms traditional SEM estimation methods in situations with a large number of predictors and small sample size. We illustrate the power of this approach in two empirical examples: modeling the neural determinants of visual short term memory, as well as identifying demographic correlates of stress, anxiety and depression. We illustrate the performance of the method and discuss practical aspects of modeling empirical data, and provide a step-by-step online tutorial.
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Project description:Receptor-like kinases (RLK) and receptor-like proteins (RLP) often interact in a combinatorial manner depending on tissue identity, membrane domains, or endo- and exogenous cues, and the same RLKs or RLPs can generate different signaling outputs depending on the composition of the receptor complexes they are involved in. Investigation of their interaction partners in a spatial and dynamic way is therefore of prime interest to understand their functions. This is, however, limited by the technical complexity of assessing it in endogenous conditions. A solution to close this gap is to determine protein interaction directly in the relevant tissues at endogenous expression levels using Förster resonance energy transfer (FRET). The ideal fluorophore pair for FRET must, however, fulfil specific requirements: (a) The emission and excitation spectra of the donor and acceptor, respectively, must overlap; (b) they should not interfere with proper folding, activity, or localization of the fusion proteins; (c) they should be sufficiently photostable in plant cells. Furthermore, the donor must yield sufficient photon counts at near-endogenous protein expression levels. Although many fluorescent proteins were reported to be suitable for FRET experiments, only a handful were already described for applications in plants. Herein, we compare a range of fluorophores, assess their usability to study RLK interactions by FRET-based fluorescence lifetime imaging (FLIM) and explore their differences in FRET efficiency. Our analysis will help to select the optimal fluorophore pair for diverse FRET applications.
| S-EPMC6898725 | biostudies-literature
Project description:Coronavirus disease 2019 (COVID-19) is currently causing a pandemic and will likely persist in endemic form in the foreseeable future. Physicians need to correctly approach this new disease, often representing a challenge in terms of differential diagnosis. Although COVID-19 lacks specific signs and symptoms, we believe internists should develop specific skills to recognize the disease, learning its 'semeiotic'. In this review article, we summarize the key clinical features that may guide in differentiating a COVID-19 case, requiring specific testing, from upper respiratory and/or influenza-like illnesses of other aetiology. We consider two different clinical settings, where availability of the different diagnostic strategies differs widely: outpatient and inpatient. Our reasoning highlights how challenging a balanced approach to a patient with fever and flu-like symptoms can be. At present, clinical workup of COVID-19 remains a hard task to accomplish. However, knowledge of the natural history of the disease may aid the internist in putting common and unspecific symptoms into the correct clinical context.
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Project description: Not available
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Project description:Rationale and objectivesVirtual residency interviews have become crucial in maintaining CDC-recommended precautionary measures throughout the ongoing COVID-era. However, scant literature exists regarding the direct impact the pandemic has had on the radiology program selection process, including preferred modalities of residency interviews and social media utilization. This survey aimed to understand how radiology programs adapted to changes in the 2020-2021 virtual application cycle.Materials and methodsA 32-question survey was distributed to 194 residency programs between July and August of 2021. Data were analyzed primarily by using descriptive statistics and Paired Student's T-testing.ResultsA total of 31 programs completed the survey, yielding a response rate of 16%. When queried about the perceived success of virtual interviews during the 2020-2021 application cycle, 21 programs (68%) said the new interview format was very successful. Twenty-seven of the programs (87%) believed they were able to adequately gauge applicants through virtual interviews. However, when surveyed about personal preferences for interviews, the responses were more evenly distributed between virtual (11/31, 35%) and in-person (14/31, 45%). Pre-COVID, the top three criteria programs used to rank candidates were USMLE Step 1 score (20/31, 65%), letters of recommendation (17/31, 55%), and MSPE (12/31, 39%). Within the virtual, COVID-19 era, these criteria remained statistically unchanged (p = 0.22): USMLE Step 1 score (21/31, 68%), letters of recommendation (17/31, 55%), and MSPE (14/31, 45%). About half of programs who had not previously utilized social media (12 of 23, 52%) created accounts, mostly via Twitter or Instagram.ConclusionThe primary findings indicate that programs perceived success with virtually interviewing and ranking applicants, the criteria to rank applicants remain unchanged despite the virtual environment, and programs' social media utilization increased.
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Project description:Frailty is a common syndrome that is associated with vulnerability to poor health outcomes. Frail older people have increased risk of morbidity, institutionalization and death, resulting in burden to individuals, their families, health care services and society. Assessment and treatment of the frail individual provide many challenges to clinicians working with older people. Despite frailty being increasingly recognized in the literature, there is a paucity of direct evidence to guide interventions to reduce frailty. In this paper we review methods for identification of frailty in the clinical setting, propose a model for assessment of the frail older person and summarize the current best evidence for treating the frail older person. We provide an evidence-based framework that can be used to guide the diagnosis, assessment and treatment of frail older people.
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Project description:In response to the estimated potential impact of coronavirus disease (COVID-19) on New York City hospitals, our institution prepared for an influx of critically ill patients. Multiple areas of surge planning progressed, simultaneously focused on infection control, clinical operational challenges, ICU surge capacity, staffing, ethics, and maintenance of staff wellness. The protocols developed focused on clinical decisions regarding intubation, the use of high-flow oxygen, engagement with infectious disease consultants, and cardiac arrest. Mechanisms to increase bed capacity and increase efficiency in ICUs by outsourcing procedures were implemented. Novel uses of technology to minimize staff exposure to COVID-19 as well as to facilitate family engagement and end-of-life discussions were encouraged. Education and communication remained key in our attempts to standardize care, stay apprised on emerging data, and review seminal literature on respiratory failure. Challenges were encountered and overcome through interdisciplinary collaboration and iterative surge planning as ICU admissions rose. Support was provided for both clinical and nonclinical staff affected by the profound impact COVID-19 had on our city. We describe in granular detail the procedures and processes that were developed during a 1-month period while surge planning was ongoing and the need for ICU capacity rose exponentially. The approaches described here provide a potential roadmap for centers that must rapidly adapt to the tremendous challenge posed by this and potential future pandemics.
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