Perspective: Beyond Counting Hours: The Importance of Supervision, Professionalism, Transitions of Care, and Workload in Residency Training
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 05/2012; 87(7):883-8. DOI: 10.1097/ACM.0b013e318257d57d
The medical education community's conversations about residents' duty hours have long focused solely on the number of those hours. In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) enacted its most recent iteration of standards regarding duty hours. Those standards, as well as a 2008 Institute of Medicine report, look beyond the quantity of duty hours to address their quality as well. Indeed, the majority of the 2011 ACGME standards specify requirements for the qualitative components of residents' working and learning environments, including supervision of residents; professionalism, personal responsibility, and patient safety; transitions of care; and clinical responsibilities (including workload). The authors believe that focusing on these qualitative (rather than quantitative) components of the resident's working and learning environment provides the greatest promise for balancing patient care with resident education, thus optimizing the safety and effectiveness of both. For each of the four qualitative components that the authors discuss (enhancing supervision, nurturing professionalism and personal responsibility, ensuring safe transitions of care, and optimizing workloads and cognitive loads), they offer agendas for faculty development, educational program planning, and research. Thus, the authors call on the medical education community to expand its discussion beyond counting duty hours to focus on these critical issues that ensure quality resident education and patient care and to implement necessary strategies to address them.
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- "However, it is also remarkable what patients themselves can do to help promote a culture of safety (Ministry of Health, 2006; Pearson et al., 2010; Weller, Barrow, & Gasquoine, 2011). Several initiatives seek to create forums and working groups involving different health professionals (e.g., nurses, doctors, pharmacists) and patients (Department of Health, 2007; Okuyama, Martowirono, & Bijnen, 2011; Schumacher et al., 2012), but no formal effective model training exists that is also low cost (Abbott, Fuji, Galt, & Paschal, 2012; Wong, Etchells, Kuper, Levinson, & Shojania , 2010). "
ABSTRACT: BACKGROUND: The Nursing School of the University of Cantabria conducted a training session on patient safety through two massive open online courses (MOOCs) aimed at the general population and especially Spanish-speaking health professionals. This study aimed to analyze the profile of health professionals who have completed the courses, their degree of satisfaction, and the percentage of completion. METHOD: In this retrospective and observational study, two MOOCs on clinical safety were created through an online platform (MiríadaX). Quantitative analysis of the profile of health professionals, their degree of satisfaction, and the percentage of completion was performed. RESULTS: A total of 12,400 students were enrolled, and the average completion rate was 32%. The profile of the average student was female, 37 years old, college educated, a nurse in a hospital, and interested in the course because it may be useful for performing her work. Fifty-five percent of students were very satisfied with the course. CONCLUSION: MOOCs are considered to be effective and easily accessible, with quality content for professional continuing education that encourages interdisciplinary work and meeting professionals from around the world.
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- "Evaluating is part of supervising. It also means giving feedback on how well something is being done and interpreting that feedback  . "
ABSTRACT: Abstract Resident attrition is a significant issue facing graduate surgical education, with broad implications for trainees, their families, educators, and society at large. Resident attrition is costly and often may represent a poor initial selection process, inadequate training in medical school, or insufficient feedback and mentoring while the resident is in the postgraduate program. Promoting an environment that encourages mentorship may be an important first step to help residents maximize their professional potential. The successful mentoring of surgical residents is crucial because the entire specialty depends on how today's residents face tomorrow's challenges. Keywords resident; attrition; postgraduate medical education; mentor
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ABSTRACT: Background As efforts to address patient safety (PS) in health professional (HP) education increase, it is important to understand new HPs’ perspectives on their own PS competence at entry to practice. This study examines the self-reported PS competence of newly registered nurses, pharmacists and physicians. Methods A cross-sectional survey of 4496 new graduates in medicine (1779), nursing (2196) and pharmacy (521) using the HP Education in PS Survey (H-PEPSS). The H-PEPSS measures HPs’ self-reported PS competence on six socio-cultural dimensions of PS, including culture, teamwork, communication, managing risk, responding to risk and understanding human factors. The H-PEPSS asks about confidence in PS learning in classroom and clinical settings. Results All HP groups reported feeling more confident in the dimension of PS learning related to effective communication with patients and other providers. Greater confidence in PS learning was reported for learning experiences in the clinical setting compared with the class setting with one exception—nurses’ confidence in learning about working in teams with other HPs deteriorated as they moved from thinking about learning in the classroom setting to thinking about learning in the clinical setting. Conclusions Large-scale efforts are required to more deeply and consistently embed PS learning into HP education. However, efforts to embed PS learning in HP education seem to be hampered by deficiencies that persist in the culture of the clinical training environments in which we educate and acculturate new HPs.
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