Of the resources available to residency program directors considering applicants to interview, the Medical Student Performance Evaluation (MSPE) is the only one that contains information summarizing the medical student's entire experience throughout undergraduate medical education and potentially contains information on all 6 competencies. This information is derived from the student's preferred rotations and rotations in which the student may have had little interest. Thus, if this information can be conveyed accurately and efficiently, the MSPE can provide a counterweight to overreliance on numerical scores from multiple-choice examinations.

In May 2017, Recommendations for Revising the Medical Student Performance Evaluation was published

ABSTRACT

Background

Management of mechanical ventilation (MV) is an important and complex aspect of caring for critically ill patients. Management strategies and technical operation of the ventilator are key skills for physicians in training, as lack of expertise can lead to substantial patient harm.

Objective

We performed a narrative review of the literature describing MV education in graduate medical education (GME) and identified best practices for training and assessment methods.

Methods

We searched MEDLINE, PubMed, and Google Scholar for English-language, peer-reviewed articles describing MV education and assessment. We included articles from 2000 through July 2018 pertaining to MV education or training in GME.

Results

Fifteen articles met inclusion criteria. Studies related to MV training in anesthesiology, emergency medicine, general surgery, and internal medicine residency programs, as well as subspecialty training in critical care medicine, pediatric critical care medicine, and pulmonary and critical care medicine. Nearly half of trainees assessed were dissatisfied with their MV education. Six studies evaluated educational interventions, all employing simulation as an educational strategy, although there was considerable heterogeneity in content. Most outcomes were assessed with multiple-choice knowledge testing; only 2 studies evaluated the care of actual patients after an educational intervention.

Conclusions

There is a paucity of information describing MV education in GME. The available literature demonstrates that trainees are generally dissatisfied with MV training. Best practices include establishing MV-specific learning objectives and incorporating simulation. Next research steps include developing competency standards and validity evidence for assessment tools that can be utilized across MV educational curricula.

ABSTRACT

Background

Little is known about the level of burnout among program administrators (PAs) working in graduate medical education.

Objective

We created a national database with baseline burnout data for PAs from residency and fellowship programs, including intention to leave their current positions.

Methods

A cross-sectional study was conducted in July 2017 to assess levels of burnout in a national cohort of PAs, who were largely members of online specialty forums. The Copenhagen Burnout Inventory (CBI) was used to measure burnout. Univariate analysis produced descriptive statistics for CBI. We performed a 2-sample t test to measure differences in average burnout scores for those who had thoughts of resigning from their positions and those who had not.

Results

Of the approximately 10 205 national PAs, we sampled 1126 (11%). Of the 1126 individuals who received the study information, 931 (83%) completed the baseline survey. Total mean scores for all subscales were elevated (personal: 53.7, SD 21.4; work-related: 52.0, SD 22; and client-related: 30.6, SD 20.8; each scale ranged from 0, low, to 100, high). Burnout scores differed between those contemplating leaving their jobs and those who were not, across all subscales of CBI, including personal (64.2 versus 42.4, –24.18 to –19.44 confidence interval [CI]), work-related (63.5 versus 39.7, –26.12 to –21.35 CI), and client-related (36.6 versus 24.2, –14.95 to –9.84 CI; P < .0001 for all).

Conclusions

In this national survey of PAs, burnout scores measured by the CBI were higher among those who had considered leaving their positions.

ABSTRACT

Background

Internal medicine (IM) residency programs receive information about applicants via academic transcripts, but studies demonstrate wide variability in satisfaction with and usefulness of this information. In addition, many studies compare application materials to only 1 or 2 assessment metrics, usually standardized test scores and work-based observational faculty assessments.

Objective

We sought to determine which application materials best predict performance across a broad array of residency assessment outcomes generated by standardized testing and a yearlong IM residency ambulatory long block.

Methods

In 2019, we analyzed available Electronic Residency Application Service data for 167 categorical IM residents, including advanced degree status, research experience, failures during medical school, undergraduate medical education award status, and United States Medical Licensing Examination (USMLE) scores. We compared these with post-match residency multimodal performance, including standardized test scores and faculty member, peer, allied health professional, and patient-level assessment measures.

Results

In multivariate analyses, USMLE Step 2 Clinical Knowledge (CK) scores were most predictive of performance across all residency performance domains measured. Having an advanced degree was associated with higher patient-level assessments (eg, physician listens, physician explains, etc). USMLE Step 1 scores were associated with in-training examination scores only. None of the other measured application materials predicted performance.

Conclusions

USMLE Step 2 CK scores were the highest predictors of residency performance across a broad array of performance measurements generated by standardized testing and an IM residency ambulatory long block.