Coaching has emerged in medical education as a strategy for trainees’ development and has been endorsed by the Coalition for Physician Accountability and the American Medical Association. However, ...there is a lack of literature on how coaching impacts residents’ professional identity formation (PIF). The purpose of this study was to explore how longitudinal clinical coaching impacted the professional identity of residency graduates.
In July to November 2020, we conducted an Institutional Review Board-approved qualitative study with semistructured interviews of residency graduates from 2 pediatric programs who participated in a longitudinal coaching program. We inductively analyzed the transcripts using thematic analysis, guided by the sensitizing principles of PIF. We did a member check to enhance trustworthiness.
We interviewed 34 residency graduates from 2 institutions and identified 4 themes on how coaches influenced residency graduates’ PIF by 1) the presence of a trusting relationship; 2) creating trust and sense of belonging through longitudinal encounters, supportive reflection, and formative feedback; 3) integrating clinical skill, career interests, and work-life integration; and 4) reflecting on their own personal and professional identities. Residency graduates highlighted coaching strategies that coaches, coaching programs, and residents themselves can take to promote resident PIF during residency.
Residency coaches have the potential to influence residents’ PIF through their longitudinal relationship grounded in trust. Coaching strategies can be used to enhance resident clinical and professional development during residency training.
Residents' overall well-being and quality-of-life require a deeper understanding of their perceived social impacts of tourism to determine appropriate management strategies to promote behaviours in ...support of tourism development. Aligning with the 2030 Agenda for sustainable development, this paper proposes a new framework for residents' quality-of-life. Bringing together multi-disciplinary evidence from environmental, social and cognitive psychology, political science and tourism, this study critically examines how residents' perceived social impacts of tourism and their interpersonal trust can make them become more place attached and protect their tourism resources. The framework proposes that residents' perceived social impacts of tourism exerts a direct influence on residents' interpersonal trust. It further posits that residents' perceived social impacts of tourism and their interpersonal trust exert a direct influence on residents' place attachment. The proposed model further considers place attachment to exert a direct influence on residents' pro-social and pro-environmental behavioural intentions. Pro-social behaviour is proposed to influence pro-environmental behaviour. Further pro-social and pro-environmental behaviours are proposed to influence residents' support for tourism development. The framework then considers residents' support for tourism development to exert a direct influence on residents' overall quality-of-life. The theoretical contributions, practical implications for sustainable community tourism and sustainable tourism in general and the limitations of the study are discussed.
Resident perception has been confirmed as a critical field in rural tourism research, and it has aroused extensive attention since the 1970s. In this study, existing publications of residents' ...perceptions in the rural tourism field from 303 bibliographic records over two decades (2002-2021) in Web of Science are visualized through bibiliometric analysis. This study aims to analyze the existing research to identify regularities, illustrate the evolution of research content and predict research themes. As revealed by the results, (1) the number of publications in this field has increased rapidly, which could be roughly divided into three stages. (2) Most studies of residents' attitudes and perception have been conducted using quantitative methods. (3) Research has progressively shifted from the beginning of residents' perceptions of changes in the conservation area, to a community-based perspective, and finally to an exploration of residents' satisfaction and quality of life.
Residency programs are required to offer a didactic curriculum and protect resident time for education. Our institution implemented an academic half day (AHD) in the 2021–2022 academic year to ...address issues related to the standard noon conference series.
Determine the impact of AHD implementation on education, patient safety, and workflow.
This was a prospective, single-site educational intervention study. Pre- and post-implementation surveys and Accreditation Council for Graduate Medical Education (ACGME) surveys assessed changes in trainee and faculty attitudes and behaviors. Patient safety and workflow were evaluated by comparing the number of safety event reports, rapid response team activations, time to admission from the ED, and time of discharge on AHD days compared to other weekdays.
Survey response rates were: residents 68%/48%, fellows 42%/35%, and faculty 59%/29%. AHD was associated with a significant, positive change in resident attitudes and experiences and on ACGME survey items. On AHDs compared with other weekdays, there were no significant differences in safety event report rates (P = .98), nor in rapid response team activation rates (P = .99). There was not a clinically meaningful difference in median admission time from the ED on AHD weekdays (125 minutes) compared to other weekdays (130 minutes, P = .04). There was no significant difference in median discharge time on AHD vs other weekdays (P = .13).
This study suggests that there is no significant difference in patient safety or workflow with the implementation of AHD. This study supports prior studies that residents strongly prefer AHD. AHD may be a useful framework for resident education without compromising patient care.
Two Bubbles – But with a Twist Parida, Lalit; Panda, Adyakinkar; Nanda, Debasish
Journal of medical ultrasound,
04/2024, Letnik:
32, Številka:
2
Journal Article
Introduction Extended-duration work shifts (≥ 24 hours), the cornerstone of medical education, have been associated with reduced sleep first-year resident physicians in a single-site study. We ...compared more senior resident physician work hours and sleep habits in a multi-center clustered-randomized crossover clinical trial that randomized resident physicians to an Extended Duration Work Roster (EDWR) with extended-duration (≥24 hours) shifts or a Rapidly Cycling Work Roster (RCWR) where scheduled shift lengths were limited to no more than 16 consecutive hours. Methods Across six U.S. academic medical centers, we enrolled 302 resident physicians in their second or more senior postgraduate year. They completed 370 one-month pediatric intensive care unit rotations. Sleep was objectively estimated with wrist-worn actigraphs. Work hours and subjective sleep duration were reported in an electronic daily diary. Results Resident physicians work hours were reduced by 10% during the RCWR (61.9 ± 4.8 hours compared to 68.4 ± 7.4 hours during the EDWR; p<0.0001). During the RCWR, 73% of work hours occurred within shifts of ≤16 consecutive hours. In contrast, during the EDWR 38% of work hours occurred on shifts of ≤16 consecutive hours. Resident physicians obtained significantly more sleep per week on the RCWR (52.9 ± 6.0 hours) compared to the EDWR (49.1 ± 5.8 hours, p<0.0001). The percentage of 24-hour intervals with less than 4 hours of actigraphically measured sleep was 9% on the RCWR and 25% on the EDWR (p<0.0001). During the RCWR, 4% of work hours were preceded by two or fewer hours of sleep in the preceding 24 hours, as compared to 10% of work hours during the EDWR (p<0.0001). Conclusion: RCWRs were effective in reducing weekly work hours and the occurrence of >16 consecutive hour shifts in more senior resident physicians. Sleep duration was increased and resident physicians were more rested while caring for patients. Additional research is needed to optimize scheduling practices that ensure sufficient sleep prior to all work shifts. Support (If Any) ROSTERS supported by National Heart, Lung, and Blood Institute (U01-HL-111478, U01-HL-111691).
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