From the Editor

In their editorial, Sullivan and Artino discuss suboptimal approaches for designing a survey instrument (p. 411).

Perspectives

Anderson and colleagues designed a physician job description for 2020, which identifies 6 categories that are aligned to job and practice demands in the coming decade (p. 418).

Cabrera and colleagues provide suggestions for how to use social media portfolios for academic promotion and tenure (p. 421).

Chen et al highlight differences and similarities between university- and community-based residency models, and ask educators to take advantage of attributes of both models (p. 426).

Reviews

Winkel et al summarize data on

ABSTRACT

Background

Graduate medical education programs employ reflection to advance a range of outcomes for physicians in training. However, the most effective applications of this tool have not been fully explored.

Objective

A systematic review of the literature examined interventions reporting the use of reflection in graduate medical education.

Methods

The authors searched Medline/PubMed, Embase, Cochrane CENTRAL, and ERIC for studies of reflection as a teaching tool to develop medical trainees' capacities. Key words and subject headings included reflection, narrative, residents/GME, and education/teaching/learning. No language or date limits were applied. The search yielded 1308 citations between inception for each database and June 15, 2015. A total of 16 studies, encompassing 477 residents and fellows, met eligibility criteria. Study quality was assessed using the Critical Appraisal Skills Programme Qualitative Checklist. The authors conducted a thematic analysis of the 16 articles.

Results

Outcomes studied encompassed the impact of reflection on empathy, comfort with learning in complex situations, and engagement in the learning process. Reflection increased learning of complex subjects and deepened professional values. It appears to be an effective tool for improving attitudes and comfort when exploring difficult material. Limitations include that most studies had small samples, used volunteers, and did not measure behavioral outcomes.

Conclusions

Critical reflection is a tool that can amplify learning in residents and fellows. Added research is needed to understand how reflection can influence growth in professional capacities and patient-level outcomes in ways that can be measured.

ABSTRACT

Background

Catholic hospitals operate under the Ethical and Religious Directives for Catholic Health Care Services, which for obstetrics and gynecology residents may create barriers to receiving adequate training in family planning.

Objective

We evaluated how training at a Catholic hospital affects trainees' subsequent provision of reproductive health services at secular institutions.

Methods

This qualitative study used semistructured interviews with recent obstetrics and gynecology graduates in generalist practice at secular institutions. We queried about their training experiences, perceived deficiencies, and current provision of family planning services. Three researchers independently coded transcripts, using grounded theory.

Results

We reached thematic saturation after 15 of 31 graduates (48%) from 7 Catholic hospital residencies participated in interviews between June 2014 and February 2015. Many participants reported a lack of awareness regarding limitations on this aspect of their training. All participants reported reproductive health care training deficiencies, and many explained that “elective” training required resident initiative to obtain. After graduation, participants reported dissatisfaction with training in family planning, delayed competency in this area, and a lack of ability to provide certain family planning procedures. All felt that Catholic programs should improve family planning training by providing routine, opt-out family planning opportunities.

Conclusions

Obstetricians and gynecologists who trained at Catholic institutions felt that religion-based policies negatively affected their training experiences and the range of reproductive health services they subsequently provide in practice. Forming collaborations with off-site facilities, particularly for postpartum tubal ligation and uterine evacuation, may improve the reproductive care these physicians ultimately provide to women.

ABSTRACT

Background

Following through on one's goals to study is essential for effective, self-regulated learning. This can be difficult for residents because of clinical demands and limited personal time. WOOP (Wish, Outcome, Obstacle, Plan) is a self-regulation strategy, also known as mental contrasting with implementation intentions. WOOP increases follow-through on goals in many domains, although it has not, to our knowledge, been evaluated in medical education.

Objective

We compared the effect of WOOP versus goal setting on time residents spent studying.

Methods

Through a prospective, randomized, comparative effectiveness study, during a 1-month, intensive care unit rotation, we clustered anesthesiology residents in single-blind fashion to WOOP versus goal setting. Both groups received organized study materials. The intervention group performed WOOP to study more; the comparison group set goals to study more. Residents tracked studying with daily diaries. The primary outcome was total time spent studying toward stated goals. Time spent studying “non-goal” medical material was a secondary outcome.

Results

Of 34 eligible residents, 100% participated. Sixteen residents were randomized to the WOOP group and 18 to the goal-setting group. The WOOP group spent significantly more time studying toward their goals compared with the goal-setting group (median = 4.3 hours versus 1.5 hours; P = .021; g = 0.66). There was no significant difference in time spent studying non-goal medical material between groups (median = 5.5 hours versus 5.0 hours, P = .99).

Conclusions

WOOP increased the time residents spent studying toward their goals as compared with setting goals alone.

Regarding the article published by Hern et al,¹ entitled “Residency Applicant Preferences of Online Systems for Scheduling Interviews,” we strongly support online interview-scheduling systems and research aimed at assessing their value. It was not unexpected (yet reassuring) that applicants found these systems beneficial.

The authors stated that their primary aim was to “measure [emergency medicine] applicant satisfactions and perceived time savings using a commercially available Internet scheduling program,” which is identified in the Methods section as Interview Broker. Hern et al evaluated only 1 particular product in their article.

As educational research is still adapting to the rigors