ABSTRACT

Background

Montefiore Medical Center (MMC) is a large tertiary care center in the Bronx, New York City, with 245 internal medicine residents. Beginning on February 29, 2020, residents became ill with COVID-19-like illness (CLI), which required absence from work. There was initially a shortage of personal protective equipment and delays in SARS-CoV-2 testing, which gradually improved during March and April 2020.

Objective

We evaluated the relationship between CLI-related work absence rates of internal medicine residents and MMC's COVID-19 hospital census over time.

Methods

Data on resident work absence between February 29 and May 22 were reviewed along with MMC's COVID-19 hospital census data. To determine the effect of patient exposure on resident CLI incidence, we compared the mean incidence of CLI per patient exposure days (PED = daily hospital census × days pre- or post-peak) before and after peak COVID-19 hospital census.

Results

Forty-two percent (103 of 245) of internal medicine residents were absent from work, resulting in 875 missed workdays. At the peak of resident work absence, 16% (38 of 245) were out sick. Residents were absent for a median of 7 days (IQR 6–9.5 days). Mean resident CLI incidence per PED (CLI/PED) was 13.9-fold lower post-peak compared to pre-peak (P = .003).

Conclusions

At the beginning of the COVID-19 pandemic in New York City, a large portion of internal medicine residents at this single center became ill. However, the incidence of CLI decreased over time, despite ongoing exposure to patients with COVID-19.

ABSTRACT

Background

The use of fine art in medical education has a long history. Numerous studies have investigated the potential benefits of incorporating art in medical education; however, there are gaps in knowledge regarding the efficacy, methodology, and clinical significance of these studies.

Objective

This scoping review of the literature aims to describe the available literature on the incorporation of art education in medical school and residency.

Methods

PubMed, Google Scholar, and MedEDPortal were queried from their inception dates through December 2019. English-language studies providing a detailed methodology and detailed analysis were included. A total of 37 studies were identified. Upon further screening of the studies' methodologies and results, 16 studies describing art education implemented with medical students and 12 studies describing art education implemented with residents were included for final review.

Results

Various methods of art education exist, including Visual Thinking Strategies (VTS), rigorous curricula, and unstructured roundtable discussions with art curators or artistically minded clinicians. Studies range in duration, art media, and type of analysis.

Conclusions

There has been an increasing effort to incorporate fine art education into medical training, primarily to enhance visual perception skills and empathy. Although there is limited research on its efficacy, and wide variations in study methodologies exist, results consistently indicate that participants find the incorporation of art into curricula beneficial. Further research analyzing which methodologies are most likely to yield statistically and clinically significant improvements in visual perception and empathy may lead to increased utilization of this teaching method.

ABSTRACT

Background

Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty.

Objective

We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes.

Methods

Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results.

Results

For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance.

Conclusions

Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.

Editor's Note: The following are the Top Research in Residency Education abstracts selected by the JGME and the Royal College of Physicians and Surgeons of Canada for the 2020 International Conference on Residency Education (ICRE) kickoff. The Top Quality Improvement (QI) abstracts will be published in the April 2021 issue, along with the full listing of submitted abstracts online. Underlined author names indicate presenting author at the conference.

Top Research Winner

Discordance Between Competency-Based Assessment Using a Global Versus Reductionist Approach for Medical Students

Background: The advent of competency-based education has led to concerns regarding reductionism

Residency education should prepare physicians for practice. While no one would intentionally design a residency program otherwise, planning program requirements to meet this aim is difficult. Substantial changes in program requirements take years to establish. With the rapid changes in health care, program requirements that are appropriate in 2020 will be out of date by the time that the residents trained entirely under those requirements graduate.

The Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Internal Medicine (RC-IM) engaged in a scenario-based strategic planning exercise to develop insights for the development of requirements for the education of internal