The COVID-19 pandemic has dramatically altered the clinical arena. While already acclimating to changes regarding telehealth and clinical visits, now is the opportunity to similarly adapt our educational programs. Here we address the assessment of surgical trainee competency in this unpredictable clinical environment.

The Accreditation Council for Graduate Medical Education (ACGME) requires residents from all surgical specialties to reach a minimum number of cases upon graduation.^1-5 Implementation of these minimum requirements have had varying consequences across different surgical specialties. In orthopedics, a majority of residents are meeting the minimum criteria, though there has been a decrease

ABSTRACT

Background

As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change.

Objective

To develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs.

Methods

The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs.

Results

Scores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods.

Conclusions

The AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.

ABSTRACT

Background

Despite the importance of pain management across specialties and the effect of poor management on patients, many physicians are uncomfortable managing pain. This may be related, in part, to deficits in graduate medical education (GME).

Objective

We sought to evaluate the methodological rigor of and summarize findings from literature on GME interventions targeting acute and chronic non-cancer pain management.

Methods

We conducted a systematic review by searching PubMed, MedEdPORTAL, and ERIC (Education Resources Information Center) to identify studies published before March 2019 that had a focus on non-cancer pain management, majority of GME learners, defined educational intervention, and reported outcome. Quality of design was assessed with the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale–Education (NOS-E). One author summarized educational foci and methods.

Results

The original search yielded 6149 studies; 26 met inclusion criteria. Mean MERSQI score was 11.6 (SD 2.29) of a maximum 18; mean NOS-E score was 2.60 (SD 1.22) out of 6. Most studies employed a single group, pretest-posttest design (n=16, 64%). Outcomes varied: 6 (24%) evaluated reactions (Kirkpatrick level 1), 12 (48%) evaluated learner knowledge (level 2), 5 (20%) evaluated behavior (level 3), and 2 (8%) evaluated patient outcomes (level 4). Interventions commonly focused on chronic pain (n=18, 69%) and employed traditional lectures (n=16, 62%) and case-based learning (n=14, 54%).

Conclusions

Pain management education research in GME largely evaluated chronic pain management interventions by assessing learner reactions or knowledge at single sites.

ABSTRACT

Background

Research in education advances knowledge and improves learning, but the literature does not define how to protect residents' rights as subjects in studies or how to limit the impact of their participation on their clinical training.

Objective

We aimed to develop a consensual framework on how to include residents as participants in education research, with the dual goal of protecting their rights and promoting their contributions to research.

Methods

A nominal group technique approach was used to structure 3 iterative meetings held with the pre-existing residency training program committee and 7 invited experts between September 2018 and April 2019. Thematic text analysis was conducted to prepare a final report, including recommendations.

Results

Five themes, each with recommendations, were identified: (1) Freedom of participation: participation, non-participation, or withdrawal from a study should not interfere with teacher-learner relationship (recommendation: improve recruitment and consent forms); (2) Avoidance of over-solicitation (recommendation: limit the number of ongoing studies); (3) Management of time dedicated to participation in research (recommendations: schedule and proportion of time for study participation); (4) Emotional safety (recommendation: requirement for debriefing and confidential counseling); and (5) Educational safety: data collected during a study should not influence clinical assessment of the resident (recommendation: principal investigator should not be involved in the evaluation process of learners in clinical rotation).

Conclusions

Our nominal group technique approach resulted in raising 5 specific issues about freedom of participation of residents in research in medical education, over-solicitation, time dedicated to research, emotional safety, and educational safety.

The Challenge

Recent advancements in social media and educational technologies have facilitated dissemination of information in visual formats to broad audiences. When academic and creative visual media work is of high quality and accessible via various platforms (eg, in journals, on websites), it can meet the definition of scholarship.

However, visual scholarship is sometimes viewed as an afterthought. For example, even venues that include visual abstracts with manuscripts may encourage authors to create visual abstracts post-submission to promote the article rather than as an independent scholarly pursuit. Typically, annual performance reviews, accreditation requirements, and promotion and tenure processes do not