Graduate medical education

Program director (PD) orientation to roles and responsibilities takes on many forms and processes. This article describes one institution's innovative arm of faculty development directed specifically toward PDs and associate PDs to provide institutional resources and information for those in graduate medical education leadership roles.

Since 1994, higher education policy has been committed to equity of access for all, irrespective of race and gender. We investigated progress towards these goals in the education of medical doctors, with an emphasis on gender. Databases from the Department of Education (DoE), Health Professions Council of South Africa (HPCSA) and University of Cape Town (UCT) Faculty of Health Sciences were used to explore undergraduate (MB ChB) trends at all eight medical schools and postgraduate (MMed) trends at UTC. Nationally women have outnumbered men in MBChB enrollments since 2000, figures ranging between 52% and 63% at seven of the eight medical schools in 2005. However, the rate of change in the medical profession lags behind and it will take more than two decades for female doctors to outnumber male doctors. A study of UCT postgraduate enrollments shows that females had increased to 42% of MMed enrollments in 2005. However, female postgraduate students were concentrated in disciplines such...

Transitions of care pose significant risks for patients with complex medical histories. There are few experiential medical education curricula targeting this important aspect of care. We designed and tested an internal medicine transitions of care experience integrated into interns' ambulatory curriculum. The program included 1-hour group didactics, a posthospitalization discharge visit in pairs with a home care nurse (cohort 1: 2011-2012; cohort 2: 2012-2013), and a half-day small-group visit to a skilled nursing facility led by a faculty member in geriatrics (cohort 2 only). Both visits had structured debriefings by faculty in geriatrics. For cohort 1, a quantitative follow-up survey was administered 18 to 20 months after the experience. For cohort 2, reflections were analyzed. Thirty-three of 42 second-year residents (79%) in cohort 1 who participated in didactics and a home visit completed the survey. Seventy-six percent (25 of 33) reported increased knowledge of interprofes...

BACKGROUND AND OBJECTIVES Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ). METHODS In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached. RESULTS Pa...

Since 1994, higher education policy has been committed to equity of access for all, irrespective of race and gender. We investigated progress towards these goals in the education of medical doctors, with an emphasis on gender. Databases from the Department of Education (DoE), Health Professions Council of South Africa (HPCSA) and University of Cape Town (UCT) Faculty of Health Sciences were used to explore undergraduate (MB ChB) trends at all eight medical schools and postgraduate (MMed) trends at UTC. Nationally women have outnumbered men in MBChB enrollments since 2000, figures ranging between 52% and 63% at seven of the eight medical schools in 2005. However, the rate of change in the medical profession lags behind and it will take more than two decades for female doctors to outnumber male doctors. A study of UCT postgraduate enrollments shows that females had increased to 42% of MMed enrollments in 2005. However, female postgraduate students were concentrated in disciplines such...

BACKGROUND AND OBJECTIVES Due to the scarcity of funds for educational research it is difficult for many clinician educators to conduct meaningful educational research. The Council of Academic Family Medicine Educational Research Alliance (CERA) was created to provide an infrastructure to facilitate educational research in family medicine. CERA's first major initiative was an omnibus survey of family medicine residency directors. This survey incorporated several distinct subprojects focusing on different topic areas. Members of the Association of Family Medicine Residency Directors (AFMRD) were surveyed electronically in 2011 using the infrastructure of the Society of Teachers of Family Medicine. The response rate for the survey was 38% (172/452). The majority of the programs were community based, university affiliated, and well established, with a mean of 31.2 years of providing residency training. Program directors were predominantly male (72%) and had a mean duration of 6.8 y...

We describe an educational innovation piloted by the director of education at a university art museum and a physician-educator using the museum holdings as reflective triggers for medical learners. This innovation is distinct from the emerging trend of using art to build observation skills, enhance pattern recognition, and improve diagnostic acumen. Our intervention is specifically designed to promote individual reflection, foster empathy, increase appreciation for the psychosocial context of patient experience, and create a safe haven for learners to deepen their relationships with one another. Individuals randomly selected a question from a set prepared by the authors to guide a reflective exploration of the galleries. Each question was different, but all invited an emotional response-a connection between a work of art and some aspect of life or medical practice, for example, "Focus on a memorable patient, and find a work of art that person would find meaningful or powerful&q...

To determine current trends in resident laser in situ keratomileusis (LASIK) training in the United States, a comprehensive survey was sent to the residency coordinator, chairman, or refractive surgery director of all 113 ophthalmology training programs in the U.S. accredited by the Accreditation Council for Graduate Medical Education. The response rate was 64%. Of the respondents, 54% were from programs in which residents performed LASIK surgery, typically as third-year residents; residents in these programs performed a mean of 4 LASIK surgeries (range 1 to 10 surgeries) during residency. The Visx Star was the most commonly used excimer laser platform and the Hansatome the most commonly used microkeratome. Most programs had 1 attending physician teaching the residents refractive surgery, which was typically performed at the main residency facility. Most programs had significant discounted pricing (>50%) for resident-performed LASIK.

OBJECTIVE: This study investigates the cognitive competency of final-year chiropractic students in musculoskeletal medicine. METHODS: The face, content, and criterion validity of the Basic Clinical Examination (BCE) for musculoskeletal medicine were tested for use in ...

Construct: This article describes the development and validity evidence behind a new rating scale to assess feedback quality in the clinical workplace. Competency-based medical education has mandated a shift to learner-centeredness, authentic observation, and frequent formative assessments with a focus on the delivery of effective feedback. Because feedback has been shown to be of variable quality and effectiveness, an assessment of feedback quality in the workplace is important to ensure we are providing trainees with optimal learning opportunities. The purposes of this project were to develop a rating scale for the quality of verbal feedback in the workplace (the Direct Observation of Clinical Skills Feedback Scale [DOCS-FBS]) and to gather validity evidence for its use. Two panels of experts (local and national) took part in a nominal group technique to identify features of high-quality feedback. Through multiple iterations and review, 9 features were developed into the DOCS-FBS....

The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007-2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessm...