ABSTRACT

Background

Graduate medical education (GME) has emphasized the assessment of trainee competencies and milestones; however, sufficient in-person assessment is often constrained. Using mobile hands-free devices, such as Google Glass (GG) for telemedicine, allows for remote supervision, education, and assessment of residents.

Objective

We reviewed available literature on the use of GG in GME in the clinical learning environment, its use for resident supervision and education, and its clinical utility and technical limitations.

Methods

We conducted a systematic review in accordance with 2009 PRISMA guidelines. Applicable studies were identified through a review of PubMed, MEDLINE, and Web of Science databases for articles published from January 2013 to August 2018. Two reviewers independently screened titles, abstracts, and full-text articles that reported using GG in GME and assessed the quality of the studies. A systematic review of these studies appraised the literature for descriptions of its utility in GME.

Results

Following our search and review process, 37 studies were included. The majority evaluated GG in surgical specialties (n = 23) for the purpose of surgical/procedural skills training or supervision. GG was predominantly used for video teleconferencing, and photo and video capture. Highlighted positive aspects of GG use included point-of-view broadcasting and capacity for 2-way communication. Most studies cited drawbacks that included suboptimal battery life and HIPAA concerns.

Conclusions

GG shows some promise as a device capable of enhancing GME. Studies evaluating GG in GME are limited by small sample sizes and few quantitative data. Overall experience with use of GG in GME is generally positive.

ABSTRACT

Background

Graduates of emergency medicine residency programs can seek certification from the American Board of Emergency Medicine (ABEM), yet the costs and perceived value by residents is not clear.

Objective

This report sought to better define the value of board certification by asking physicians taking the ABEM Oral Certification Examination (OCE) to describe its costs (eg, time, money) and perceived benefits.

Methods

A descriptive, cross-sectional, voluntary, anonymous survey was administered to physicians taking the 2018 spring and fall ABEM OCEs. Response frequencies were used to report response rates.

Results

There were 2016 physicians who participated in the 2018 OCEs, of whom 1565 (78%) completed a survey. With respect to preparation, 38% (599 of 1565 responses) spent more than 30 hours preparing for the examination. Regarding the expense of preparing for the examination, 21% (328) spent nothing, 50% (776) spent less than $1,000, and 2% (38) spent more than $3,000. Most physicians (80%, 1254) reported a learning benefit to preparing for and taking the OCE. There were 49% (765) of respondents who reported that preparing for the examination reinforced their knowledge of emergency medicine; 20% (311) reported no learning benefit. Most physicians (92%, 1442) reported that ABEM certification provided a career benefit, the most common of which was more career opportunities (69%, 1076).

Conclusions

Initial certification requires a considerable investment of time and money. Physicians seeking initial ABEM certification found both learning and professional benefits, with the most frequently reported being reinforcement of medical knowledge and more career opportunities.

ABSTRACT

Background

The literature suggests that specific keywords included in summative rotation assessments might be an early indicator of abnormal progress or failure.

Objective

This study aims to determine the possible relationship between specific keywords on in-training evaluation reports (ITERs) and subsequent abnormal progress or failure. The goal is to create a functional algorithm to identify residents at risk of failure.

Methods

A database of all ITERs from all residents training in accredited programs at Université Laval between 2001 and 2013 was created. An instructional designer reviewed all ITERs and proposed terms associated with reinforcing and underperformance feedback. An algorithm based on these keywords was constructed by recursive partitioning using classification and regression tree methods. The developed algorithm was tuned to achieve 100% sensitivity while maximizing specificity.

Results

There were 41 618 ITERs for 3292 registered residents. Residents with failure to progress were detected for family medicine (6%, 67 of 1129) and 36 other specialties (4%, 78 of 2163), while the positive predictive values were 23.3% and 23.4%, respectively. The low positive predictive value may be a reflection of residents improving their performance after receiving feedback or a reluctance by supervisors to ascribe a “fail” or “in difficulty” score on the ITERs.

Conclusions

Classification and regression trees may be helpful to identify pertinent keywords and create an algorithm, which may be implemented in an electronic assessment system to detect future residents at risk of poor performance.

Editor's Note: The following are the Top Research in Residency Education Papers selected by the JGME and the Royal College of Physicians and Surgeons of Canada for the 2019 International Conference on Residency Education meeting in Ottawa, Canada. A full listing of submitted abstracts appears online (http://www.jgme.org/page/ICREAbstracts). Underlined author names indicate presenting author at the conference.

Winning Paper

The Effects of Gender on Multiple Mini-Interview Station Scores for Selection Into Australian Orthopaedic Surgery

Introduction: Interviewer gender is said to influence scoring in interview situations. We investigated the relationship between candidate and interviewer gender and interview

In February 2018, the Accreditation Council for Graduate Medical Education (ACGME) Board of Directors formed a planning committee to assess the state of diversity and inclusion in the graduate medical education (GME) space. The planning committee set the following as its charge:

Consider current practices in US GME focused on enhancing the clinical learning environment as it pertains to diversity and inclusion.
Consider demographic diversity data in residency and fellowship training with respect to specialty, and then determine where significant disparity presently exists so as to propose mechanisms to achieve more equitable access to training in those domains.
Assess current