scholarly journals Stakeholder perspectives and status of surgical simulation and skills training in urology residency programs in Canada

2019 ◽  
Vol 14 (10) ◽  
Author(s):  
Anjali M. Lobo ◽  
Steve Doucette ◽  
Andrea G. Lantz-Powers

Introduction: With the shift to competency-based training, surgical skills lab training (SSLT) may become a mandatory part of Canadian urology residency programs (CURPs). This study aims to identify: 1) the status of SSLT in CURP; 2) stakeholder perspectives on the utility of SSLT; 3) barriers to developing and implementing SSLT; and 4) how to address these barriers. Methods: Surveys were developed and issued to three groups of stakeholders: 1) SSLT directors at all 13 CURPs (response rate 100%); 2) teaching faculty (response rate 33%); and 3) urology residents (response rate 24%). Surveys 2 and 3 were sent to ten English CURP. Results were collected through email and SurveyMonkey®. Results: Nine of 13 CURPs have a dedicated SSLT; 46% of CURP have 1–3 sessions per year, 8% have 5–7, and 30% >7. Most residents have independent lab access, but 80% do so less than once monthly. Over 90% of stakeholders find SSLT useful, of which high-fidelity models are most preferred (faculty rated 3.66/4, residents 3.18/4). Program directors (PDs) identified lack of protected faculty time, funding, and infrastructure as the top three barriers to SSLT implementation. Residents found lack of faculty time, protected academic time, and infrastructure as barriers. PDs viewed protecting faculty time and more funding as potential solutions, while residents suggested protected faculty and academic time, and after-hours lab access. Conclusions: Residents, faculty, and PDs in CURPs view SSLT as useful. Most CURPs have defined SSLT; programs without this have labs for resident use but are underused. To continue to develop and progress SSLT, more time, participation, and funding must be made available.

2014 ◽  
Vol 120 (1) ◽  
pp. 167-172 ◽  
Author(s):  
Lauren H. Marasa ◽  
Thomas A. Pittman

Object Many factors affect an applicant's decision when selecting a residency program. While some issues are likely important to all applicants, others may be specific to, or weighed differently by, those applying to certain specialties. In an effort to better understand how applicants to neurosurgery programs make decisions about relative rank, the authors created a survey to identify the program characteristics thought most important by applicants. Methods An electronic survey was created and posted to the neurosurgery residency coordinator's forum. Coordinators throughout the country were asked to send the survey link to students who were scheduled to begin as first-year residents in July of 2012. A paper copy of the survey was also distributed at the Society of Neurological Surgeons intern boot camp in Atlanta, Georgia, in July of 2012. Results One hundred ninety-six students obtained a neurosurgical postgraduate year 1 position in the 2011–2012 match; 40 survey responses were received (response rate 20.4%). The factors cited as being most important in selecting a residency were the residents currently in the program, team camaraderie, and the number of operative cases performed. The interview day, specifically the opportunity to talk to the residents, was also thought to be important, as was the knowledge that the applicant would likely be ranked by the program. Conclusions Applicants for neurosurgical training choose a program for reasons similar to those given by applicants to other specialties. Neurosurgery applicants seem marginally more interested in an emphasis on academics and research and slightly less concerned with a program's location, but overall, the differences appear minimal. The interview process is very important, and contact by a representative after the interview also seems significant in applicants' decision making. By recognizing what applicants think is important in choosing a residency, programs can more effectively recruit residents and more efficiently use faculty time and department resources.


2018 ◽  
Vol 12 (10) ◽  
Author(s):  
Amandeep S. Taggar ◽  
Kevin Martell ◽  
Siraj Husain ◽  
Michael Peacock ◽  
Michael Sia ◽  
...  

Introduction: Residency experiences and teaching in oncology among urology residents are variable across Canada. We sought to identify how radiation and medical oncology concepts, as they pertain to genitourinary malignancies, are taught to urology residents.Methods: A total of 190 trainees enrolled in Canadian urology residency training programs were invited to participate in the study from January 2016 to June 2016. Participants completed an online questionnaire addressing the training they received.Results: The overall response rate was 32%. Twenty-three percent of respondents were in their fellowship year; 17%, 20%, 10%, 17%, and 12% were first-, second-, third-, fourth-, and fifth-year residents, respectively, with a median of four (range 1–9) respondents from each training program. Ninety-five percent of respondents had academic half-day (AHD) as part of their training that included radiotherapy (61%) and chemotherapy (51%) teaching. Most respondents indicated their main exposure to chemotherapy and radiation came from informal teaching in urology clinics. Twentynine percent and 41%, of participants had mandatory rotations in radiation and medical oncology, respectively. Only 6% of respondents used their voluntary elective time in these disciplines and most voluntary electives were of 1–2-week duration. Despite this, 90% of respondents preferred some mandatory radiation and medical oncology training.Conclusions: Most of the limited exposure that urology residents have to medical and radiation oncology is through AHD or informal urology clinics, despite a desire among current urology trainees to have clinical exposure in these areas. Moving forward, urology residency programs should consider integrating medical and radiation oncology rotations into the residency program curriculum.


2011 ◽  
Vol 77 (7) ◽  
pp. 948-950
Author(s):  
William W. Hope ◽  
Dimitrios Stefanidis

A paradigm shift is underway in the training of general surgery residents with emphasis placed on learning skills on simulators before patient encounters. To that end, national skills curricula have been proposed, but their adoption by regional programs is unknown. The purpose of this study was to assess the adoption of surgical skills training in residency programs in North and South Carolina. Surveys were sent electronically to faculty members overseeing surgical skills training at the 10 residency programs in North and South Carolina. Surveys included seven questions related to skills training implementation and allocated resources at each training program. Eight programs responded and all reported the existence of a formal skills curriculum with mandatory resident participation policies. Programs allotted from 0 to 8 hours of protected time per month for skills training, but actual resident participation was less (0 to 4 hours). The type of skills curricula used varied among institutions and included time-based, proficiency-based, and the use of the national skills curriculum. Six programs (75%) had dedicated protected time for faculty trainers and had hired personnel sponsored by the hospital/surgical department to assist with running the skills lab. Equipment and resources varied among institutions; all but one program reported receiving funding/resources from industry. Five programs reported they had active simulation research protocols. Variability and lack of standardization exists with regard to surgical skills training in residency training programs in North and South Carolina. Collaborative efforts to promote standardization are needed and are presently underway.


2018 ◽  
Vol 10 (01) ◽  
pp. e12-e15
Author(s):  
Laura Wayman ◽  
John Chen ◽  
Jacqueline Leavitt

Background The status of neuro-ophthalmology education in ophthalmology residency training in the United States is unknown. There are numerous articles in the literature detailing resident outcomes for surgical procedures; however, there are no articles detailing teaching of a nonprocedural specialty. There are no specific Accreditation Council for Graduate Medical Education (ACGME) requirements for neuro-ophthalmology training within ophthalmology residency. Each program determines the amount of neuro-ophthalmology training and level of training within ophthalmology residency. There are no publications that detail the extent of neuro-ophthalmology training during ophthalmology residency. Objective To determine the status of neuro-ophthalmology education in ophthalmology residency training programs in the United States. Methods A survey was sent in 2014 to residency directors and neuro-ophthalmologists of all ophthalmology residency programs who participated in the Ophthalmology Residency Matching Program in the United States to determine the amount of neuro-ophthalmology training that residents receive. Results From a total of 113 ophthalmology residency programs in the United States utilizing the Ophthalmology Residency Matching Program, 104 surveys were returned (92% response rate). Duration of neuro-ophthalmology training ranged from 1 to 112 days, with an average of 34.5 days. Most rotations occurred within postgraduate year 2 or 3. Conclusion This is the first evaluation of the amount of neuro-ophthalmology training within ophthalmology residencies participating in the matching program in the United States, which demonstrates large variability among the different programs. Future studies could ascertain if there is a correlation between resident satisfaction in neuro-ophthalmology training and the amount of training.


Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks

A truly person-centered curriculum requires important changes to how the clinical method is taught. Medical interviewing demands explicit instruction in how the spoken language works and specific strategies that elevate the status of attentive listening so that this aspect is seen as important as the more mechanical aspects of traditional communication skills training. The term chief complaint is declared outdated and suggestions for its replacement are offered. The medical record is considered an important educational instrument, and recommendations are made so that it is in service of functional assessment and better aligned to a person-centered approach. Modifications to the physical examination, particularly a renewed emphasis on clinical observation, are outlined. The chapter concludes with a discussion of clinical thinking and judgment. A plea is made for inculcating a receptiveness toward a narrative competence within medicine.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina Gillezeau ◽  
Wil Lieberman-Cribbin ◽  
Kristin Bevilacqua ◽  
Julio Ramos ◽  
Naomi Alpert ◽  
...  

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.


2012 ◽  
Vol 4 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Diana S. Curran ◽  
Pamela B. Andreatta ◽  
Xiao Xu ◽  
Clark E. Nugent ◽  
Samantha R. Dewald ◽  
...  

Abstract Introduction Residency programs seek to match the best candidates with their positions. To avoid ethical conflicts in this process, the National Residency Matching Program (NRMP or Match) has rules regarding appropriate conduct, including guidelines on contact between candidates and programs. Our study examined communication between obstetrics and gynecology (Ob-Gyn) programs and residency candidates after interviewing and prior to ranking. Methods Ob-Gyn program directors in the United States were sent a self-administered survey via e-mail. Data were collected and analyzed using descriptive methods to examine communication practices of these programs. Results The response rate was 40%. The findings showed that respondents had variable interpretations of the NRMP rules and suggest that programs may be communicating their match intentions especially to favored candidates. Respondents' open text comments highlighted program directors' frustrations with current NRMP rules. Discussion NRMP communication rules are intended to minimize pressure on residency candidates. Our findings suggest they may be leading to unforeseen stresses on program directors and candidates. Conclusions As educational leaders in medicine, we must consider what professional communications are acceptable without increasing the pressure on candidates during the ranking and match process.


Author(s):  
Melissa Baughman

The purpose of this study was to explore the status and experiences of women in collegiate choral conducting positions. Out of all collegiate choral conductors ( N = 992) at institutions accredited by the National Association of Schools of Music in the United States, 68.65% ( n = 681) were men and 31.35% ( n = 311) were women at the time of this study; I invited the women collegiate choral conductors to serve as study participants. Ninety-six respondents completed an online survey, resulting in a response rate of 30.86%. I collected data through a researcher-designed survey. First, I asked respondents to provide demographic information and respond to Likert-type and open-ended prompts related to three domains: gaining entry into the profession, navigating the profession, and issues surrounding gender. I analyzed data through descriptive statistics and qualitative methods of assigning codes, combining codes into themes, and displaying the data. I addressed general discrepancies in the self-reported attitudes of respondents. Although women reported an overall attitude of satisfaction as choral conductors in their Likert-type responses, many respondents detailed several instances of gender discrimination and other challenges in their open-ended responses. Implications for the music profession, including specific strategies to help empower women in collegiate choral conducting settings, are discussed.


Author(s):  
Miguel Prestes NÁCUL ◽  
Leandro Totti CAVAZZOLA ◽  
Marco Cezário de MELO

INTRODUCTION: The surgeon's formation process has changed in recent decades. The increase in medical schools, new specialties and modern technologies induce an overhaul of medical education. Medical residency in surgery has established itself as a key step in the formation of the surgeon, and represents the ideal and natural way for teaching laparoscopy. However, the introduction of laparoscopic surgery in the medical residency programs in surgical specialties is insufficient, creating the need for additional training after its termination. OBJECTIVE: To review the surgical teaching ways used in services that published their results. METHODS: Survey of relevant publications in books, internet and databases in PubMed, Lilacs and Scielo through july 2014 using the headings: laparoscopy; simulation; education, medical; learning; internship and residency. RESULTS: The training method for medical residency in surgery focused on surgical procedures in patients under supervision, has proven successful in the era of open surgery. However, conceptually turns as a process of experimentation in humans. Psychomotor learning must not be developed directly to the patient. Training in laparoscopic surgery requires the acquisition of psychomotor skills through training conducted initially with surgical simulation. Platforms based teaching problem solving as the Fundamentals of Laparoscopic Surgery, developed by the American Society of Gastrointestinal Endoscopic Surgery and the Laparoscopic Surgical Skills proposed by the European Society of Endoscopic Surgery has been widely used both for education and for the accreditation of surgeons worldwide. CONCLUSION: The establishment of a more appropriate pedagogical process for teaching laparoscopic surgery in the medical residency programs is mandatory in order to give a solid surgical education and to determine a structured and safe professional activity.


Urology ◽  
2020 ◽  
Vol 139 ◽  
pp. 37-43
Author(s):  
David J. Gangwish ◽  
Carolyn A. Parshall ◽  
Fares Qeadan ◽  
Martin Jurado ◽  
Renata N. Bennett ◽  
...  

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