scholarly journals Barriers to effective research supervision in clinical specialist training: Experience from a medical school in Malaysia

2021 ◽  
Vol 16 (3) ◽  
pp. 77-86
Author(s):  
Yew Kong Lee ◽  
Chirk Jenn Ng ◽  
Joong Hiong Sim ◽  
Firdaus Amira ◽  
Chan Choong Foong ◽  
...  
Keyword(s):  
Residency Training ◽  
Clinical Training ◽  
Qualitative Interviews ◽  
Resource Limitation ◽  
University Hospital ◽  
Specialist Training ◽  
Training Experience ◽  
Clinical Supervisors ◽  
Clinical Specialist ◽  
Research Supervision

Introduction: A compulsory research component is becoming increasingly common for clinical residents. However, integrating research into a busy clinical training schedule can be challenging. This study aimed to explore barriers to research supervision in specialist training programmes from the perspectives of clinical supervisors and trainees at a Malaysian university hospital. Methods: Qualitative interviews and focus group discussions were conducted (December 2016 to July 2017) with clinical supervisors (n=11) and clinical trainees (n=26) utilising a topic guide exploring institutional guidelines, research culture and supervisor-student roles. Interviews were transcribed verbatim and analysed thematically to identify barriers to research supervision. Results: Supervisors and trainees from 11 out of 18 departments participated. Both clinical supervisors and trainees struggled to successfully integrate a compulsory research component into residency training. Among the reasons identified included a lack of supervisory access due to the nature of clinical rotations and placements, clashing training priorities (clinical vs research) that discouraged trainees and supervisors from engaging in research, poor research expertise and experience among clinical supervisors hampering high-quality supervision, and a frustrating lack of clear standards between the various parties involved in research guidance and examination. Conclusion: Both clinical supervisors and trainees struggled to successfully integrate a compulsory research component into residency training. This was not only an issue of resource limitation since questions regarding clinical priorities and unclear research standards emerged. Thus, institutional coordinators need to set clear standards and provide adequate training to make research meaningful and achievable for busy clinical supervisors and trainees.

Current Issues: Advanced Digital Technology for Supervising Graduate Clinicians

2010 ◽  
Vol 20 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Glenn Tellis ◽  
Lori Cimino ◽  
Jennifer Alberti
Keyword(s):  
Real Time ◽  
Digital Technology ◽  
Clinical Training ◽  
State Of The Art ◽  
Clinical Skills ◽  
Slow Motion ◽  
Video Capture ◽  
Microsoft Excel ◽  
Clinical Supervisors ◽  
Training And Supervision

Abstract The purpose of this article is to provide clinical supervisors with information pertaining to state-of-the-art clinic observation technology. We use a novel video-capture technology, the Landro Play Analyzer, to supervise clinical sessions as well as to train students to improve their clinical skills. We can observe four clinical sessions simultaneously from a central observation center. In addition, speech samples can be analyzed in real-time; saved on a CD, DVD, or flash/jump drive; viewed in slow motion; paused; and analyzed with Microsoft Excel. Procedures for applying the technology for clinical training and supervision will be discussed.

scholarly journals Challenges and solutions to returning to clinical training after research: a multidisciplinary survey of integrated academic trainees in West Yorkshire, United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. L. Downey ◽  
J. Bentley ◽  
H. Pandit
Keyword(s):  
United Kingdom ◽  
Clinical Training ◽  
Clinical Work ◽  
Survey Study ◽  
Full Time ◽  
Clinical Supervisors ◽  
Research Activities ◽  
Time Out ◽  
Rapid Transition ◽  
The University

Abstract Background Time out of clinical training can impact medical trainees’ skills, competence and confidence. Periods of Out of Programme for Research (OOPR) are often much longer than other approved mechanisms for time of out training. The aim of this survey study was to explore the challenges of returning to clinical training following OOPR, and determine potential solutions. Methods All current integrated academic training (IAT) doctors at the University of Leeds (United Kingdom) and previous IAT trainees undertaking OOPR in the local region (West Yorkshire, United Kingdom)(n = 53) were invited to complete a multidisciplinary survey. Results The survey was completed by 33 participants (62% response rate). The most relevant challenges identified were completing the thesis whilst transitioning back to clinical work, the rapid transition between full-time research and clinical practice, a diminished confidence in clinical abilities and isolation from colleagues. Potential solutions included dedicated funds allocated for the renewal of lapsed skills, adequate notice of the clinical rotation to which trainees return, informing clinical supervisors about the OOPR trainee returning to practice and a mandatory return to standard clinical days. Conclusions Addressing these issues has the potential to improve the trainee experience and encourage future trainees to take time out of training for research activities.

Implementation of duty hour standards in otolaryngology-head and neck surgery residency training

2005 ◽  
Vol 132 (6) ◽  
pp. 819-822 ◽  
Author(s):  
Todd A. Kupferman ◽  
Tim S. Lian
Keyword(s):  
Head And Neck ◽  
Residency Training ◽  
Training Programs ◽  
Neck Surgery ◽  
Program Directors ◽  
The United States ◽  
Head And Neck Surgery ◽  
Training Experience ◽  
Duty Hours ◽  
Resident Duty

OBJECTIVE: To determine what impact, if any, of the recently implemented duty hour standards have had on otolaryngology-head and neck surgery residency programs from the perspective of program directors. We hypothesized that the implementation of resident duty hour limitations have caused changes in otolaryngology training programs in the United States. STUDY DESIGN AND SETTING: Information was collected via survey in a prospective, blinded fashion from program directors of otolaryngology-head and neck residency training programs in the United States. RESULTS: Overall, limitation of resident duty hours is not an improvement in otolaryngology-head and neck residency training according to 77% of the respondents. The limitations on duty hours have caused changes in the resident work schedules in 71% of the programs responding. Approximately half of the residents have a favorable impression of the work hour changes. Thirty-two percent of the respondents indicate that changes to otolaryngology support staff were required, and of those many hired physician assistants. Eighty-four percent of the respondents did not believe that the limitations on resident duty hours improved patient care, and 81% believed that it has negatively impacted resident training experience. Forty-five percent of the program directors felt that otolaryngology-head and neck faculty were forced to increase their work loads to accommodate the decrease in the time that residents were allowed to be involved in clinical activities. Fifty-four percent of the programs changed from in-hospital to home call to accommodate the duty hour restrictions. CONCLUSIONS: According to the majority of otolaryngology-head and neck surgery program directors who responded to the survey, the limitations on resident duty hours imposed by the ACGME are not an improvement in residency training, do not improve patient care, and have decreased the training experience of residents. SIGNIFICANCE: This study demonstrates that multiple changes have been made to otolaryngology-head and neck surgery training programs because of work hour limitations set forth by the ACGME.

scholarly journals What impact does postgraduate clinical training have on empathy among Japanese trainee dentists?

2020 ◽  
Author(s):  
Toshiko Yoshida ◽  
Sho Watanabe ◽  
Takayuki Kono ◽  
Hiroaki Taketa ◽  
Noriko Shiotsu ◽  
...  
Keyword(s):  
Clinical Training ◽  
Interaction Analysis ◽  
Healthcare Providers ◽  
Japanese Version ◽  
University Hospital ◽  
Simulated Patients ◽  
Patient Anxiety ◽  
Significant Difference ◽  
Education Support ◽  
The Impact

Abstract Background: Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare providers and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients’ medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees’ empathy from cognitive, behavioral, and patients’ perspective.Methods: This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each interview. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the interviews. All interviews were videotaped and analyzed using the Roter Interaction Analysis System. The hypothesis was that empathy in the trainees would have reduced at the end of their clinical training. The results were compared between the beginning and the end. The data were analyzed utilizing paired t-test and the Wilcoxon signed-ranks test.Results: No significant difference was found in the self-reported empathy of trainees at the beginning and the end of the clinical training (107.73 vs. 108.34, p=0.643). Similarly, there was no difference in the SPs’ evaluation of trainees’ communication (10.73 vs. 10.38, p=0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p=0.000).Conclusions: Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists’ empathy levels. Providing regular education support in this area may help trainees foster their empathy.

scholarly journals Developing an intervention to optimise the outcome of cardiac surgery in people with diabetes: the OCTOPuS pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Richard I. G. Holt ◽  
Katharine Barnard-Kelly ◽  
Giorgos Dritsakis ◽  
Kerensa I. Thorne ◽  
Lauren Cohen ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Healthcare Professionals ◽  
Diabetes Management ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Cardiothoracic Surgery ◽  
University Hospital ◽  
Major Surgery ◽  
Biomedical Data ◽  
Randomised Controlled

Abstract Background Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to improved postoperative outcomes. The aim of this study was to develop and pilot a specialist diabetes team-led intervention to improve surgical outcomes in people with diabetes. Design Open pilot feasibility study Setting Diabetes and cardiothoracic surgery departments, University Hospital Southampton NHS Foundation Trust Participants Seventeen people with diabetes undergoing cardiothoracic surgery Intervention Following two rapid literature reviews, a prototype intervention was developed based on a previously used nurse-led outpatient intervention and tested. Primary outcome Feasibility and acceptability of delivering the intervention Secondary outcomes Biomedical data were collected at baseline and prior to surgery. We assessed how the intervention was used. In depth qualitative interviews with participants and healthcare professionals were used to explore perceptions and experiences of the intervention and how it might be improved. Results Thirteen of the 17 people recruited completed the study and underwent cardiothoracic surgery. All components of the OCTOPuS intervention were used, but not all parts were used for all participants. Minor changes were made to the intervention as a result of feedback from the participants and healthcare professionals. Median (IQR) HbA1c was 10 mmol/mol (3, 13) lower prior to surgery than at baseline. Conclusion This study has shown that it is possible to develop a clinical pathway to improve diabetes management prior to admission. The clinical and cost-effectiveness of this intervention will now be tested in a multicentre randomised controlled trial in cardiothoracic centres across the UK. Trial registration ISRCTN; ISRCTN10170306. Registered 10 May 2018.

scholarly journals Key Factors Contributing to Quality of Life for Breast Cancer Patients in Latvia: Supplementing Quantitative Surveys with Qualitative Interviews

2012 ◽  
Vol 12 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Agnese Dzērvīte ◽  
Maruta Pranka ◽  
Tana Lace ◽  
Ritma Rungule ◽  
Edvins Miklasevics ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Qualitative Interviews ◽  
Treatment Strategies ◽  
Well Being ◽  
University Hospital ◽  
Breast Cancer Patients ◽  
Key Factors

Summary Introduction. Health related quality of life is a much debated topic in medicine with much quantitative and qualitative research contributing to the understanding of how to improve the lives of patients, yet little has been published in relation to the quality of life of Latvian breast cancer patients. Aim of the Study. To gather base measurements of subjective and objective quality of life factors for breast cancer patients in Latvia and discover which key factors contribute most to quality of life of Latvian breast cancer patients at the start of treatment. Materials and Methods. This paper presents data collected from April 2010 to June 2011 at the Pauls Stradins Clinical University hospital on key factors influencing quality of life for breast cancer patients: health and physical well-being; state of surroundings and environment; social support and functionality; financial state, employment and leisure. Quantitative survey material has been supplemented with insight from qualitative in-depth interviews to better explain the objective and subjective implications for breast cancer patients’ quality of life. Results. Interviewed breast cancer patients rated their quality of life as being average or good at the beginning of treatment. Negative factors contributing to lowered quality of life were mainly linked to patient financial, social and emotional state at the first weeks of treatment and correspond to previous research done in Latvia on quality of life issues. Conclusions. Further follow-up surveys will contribute to the evaluation of breast cancer patients’ needs while undergoing treatment to further improve treatment strategies, especially if validated quality of life measurement surveys were to be implemented in Latvian hospitals.

scholarly journals Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

2020 ◽  
Vol 17 (20) ◽  
pp. 7389
Author(s):  
Silvia Ferrari ◽  
Giorgio Mattei ◽  
Mattia Marchi ◽  
Gian Maria Galeazzi ◽  
Luca Pingani
Keyword(s):  
Older Patients ◽  
Clinical Training ◽  
University Hospital ◽  
Liaison Psychiatry ◽  
Female Ratio ◽  
Research Activities ◽  
Male Female Ratio ◽  
Health Related ◽  
Consultation Liaison Psychiatry ◽  
Management Changes

There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.

Space for intuition – the ‘Surprise’-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists

2019 ◽  
Vol 33 (5) ◽  
pp. 531-540 ◽  
Author(s):  
Christina Gerlach ◽  
Swantje Goebel ◽  
Sascha Weber ◽  
Martin Weber ◽  
Katherine E Sleeman
Keyword(s):  
Palliative Care ◽  
Communication Skills ◽  
Outpatient Clinic ◽  
Qualitative Interviews ◽  
Daily Practice ◽  
University Hospital ◽  
Structured Interviews ◽  
Early Integration ◽  
Willingness To Use ◽  
Surprise Question

Background: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The ‘Surprise’-Question can be used to facilitate referral to palliative care. Aim: To explore experiences, views and perceptions of haemato-oncologists on the use of the ‘Surprise’-Question in the haemato-oncology outpatients clinics of a university hospital in Germany. Design: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on the framework approach. Setting/participants: The study took place at the haemato-oncology outpatient clinic and the bone marrow transplantation outpatient clinic of a university hospital. Nine haemato-oncologists participated in qualitative interviews. Results: Thematic analysis identified 4 themes and 11 subthemes: (1) meaning and relevance of the ‘Surprise’-Question; (2) feasibility; (3) the concept of ‘surprise’ and (4) personal aspects of prognostication. A key function of the ‘Surprise’-Question was to stimulate intuition and promote patient-centred goals of care by initiating a process of pause → reflection → change of perspective. It was easy and quick to use, but required time and communication skills to act on. Participants’ training in palliative care enhanced their willingness to use the ‘Surprise’-Question. Conclusion: Irrespective of its use in prognostication, the ‘Surprise’-Question is a valuable tool to facilitate consideration of patient-centred goals and promote holistic care in haemato-oncology. However, prognostic uncertainty, lack of time and communication skills are barriers for integration into daily practice. Further research should involve haematology patients to integrate their needs and preferences.

Expanding Ambulatory Care Pharmacy Residency Education Through a Multisite University-Affiliated Model

2017 ◽  
Vol 30 (6) ◽  
pp. 643-649 ◽  
Author(s):  
Sarah K. Schweiss ◽  
Sarah M. Westberg ◽  
Jean Y. Moon ◽  
Todd D. Sorensen
Keyword(s):  
Ambulatory Care ◽  
Residency Training ◽  
Residency Program ◽  
Clinical Training ◽  
Medication Management ◽  
Training Model ◽  
University Of Minnesota ◽  
Payment Systems ◽  
And Shifts ◽  
The University

Introduction: As the health-care system evolves and shifts to value-based payment systems, there is a recognized need to increase the number of ambulatory care trained pharmacists. Objective: The objective of this article is to describe the administrative structure of the University of Minnesota Postgraduate Year 1 (PGY1) Pharmacy Residency program and to encourage adoption of similar models nationally in order to expand ambulatory care residency training opportunities and meet the demand for pharmacist practitioners. Program Structure: The University of Minnesota PGY1 Pharmacy Residency program is a multisite program centered on the practice of pharmaceutical care and provision of comprehensive medication management (CMM) services in ambulatory care settings. The centralized administration of a multisite academic-affiliated training model creates efficiency in the administration process, while allowing sites to focus on clinical training. This model also offers many innovative and unique opportunities to residents. Conclusion: A multisite university-affiliated ambulatory care residency training model provides efficiency in program administration, while successfully accelerating the growth of quality ambulatory care residency training and supporting innovative delivery of shared core learning experiences. Consequently, practice sites grow in their service delivery capacity and quality of care.

scholarly journals How Well Does Neurology Residency Mirror Practice?

2005 ◽  
Vol 32 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Fraser G.A. Moore ◽  
Colin Chalk
Keyword(s):  
Clinical Practice ◽  
Residency Training ◽  
North American ◽  
Clear Understanding ◽  
Functional Disorders ◽  
Training Experience ◽  
Neurological Conditions ◽  
Diagnostic Profile

ABSTRACT:Objective:To report the residency training experience of two neurologists, focusing on setting and diagnoses encountered.Methods:Data from prospective patient logs kept by the authors during residencies completed a decade apart were compared with each other and the literature.Results:The range of diagnoses was broadly similar between residencies, as were the proportions of common or uncommon disorders, and the proportion of cases without a neurological diagnosis. Although most patients were seen in in-patient settings, the rates at which common neurological conditions and functional disorders were seen was comparable to published experiences of community neurologists.Conclusions:The diagnostic profile of North American neurology residency appears to be relatively stable, regardless of location or date of training. In several respects, the content of current neurology residencies mirrors clinical practice well. Changes to residency training are doubtless needed, but they should be guided by a clear understanding of the experiences of contemporary trainees.

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