Concept: The Residents
The Department of Dental Medicine of Lutheran Medical Center has developed an asynchronous online curriculum consisting of prerecorded PowerPoint presentations with audio explanations. The focus of this study was to evaluate if the new asynchronous format satisfied the educational needs of the residents compared to traditional lecture (face-to-face) and synchronous (distance learning) formats. Lectures were delivered to 219 dental residents employing face-to-face and synchronous formats, as well as the new asynchronous format; 169 (77 percent) participated in the study. Outcomes were assessed with pretests, posttests, and individual lecture surveys. Results found the residents preferred face-to-face and asynchronous formats to the synchronous format in terms of effectiveness and clarity of presentations. This preference was directly related to the residents' perception of how well the technology worked in each format. The residents also rated the quality of student-instructor and student-student interactions in the synchronous and asynchronous formats significantly higher after taking the lecture series than they did before taking it. However, they rated the face-to-face format as significantly more conducive to student-instructor and student-student interaction. While the study found technology had a major impact on the efficacy of this curricular model, the results suggest that the asynchronous format can be an effective way to teach a postgraduate course.
We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale.
The objectives of this study were to describe residents' experiences with end-of-life (EOL) education during a rotation in the intensive care unit (ICU), and to understand the possible influence of the 3 Wishes Project.
OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Examination (USMLE) (also known as Step 1) score, number of publications, and class ranking, have not been shown to consistently predict clinical and academic success. Furthermore, these traditional objective parameters have not been associated with specific personality traits. METHODS The authors sought to determine the efficacy of a personality assessment in the selection of neurosurgery residents. Specifically, the aim was to determine the correlation between traditional measures used to evaluate an applicant (e.g., USMLE score, number of publications, MD/PhD status) and corresponding validated personality traits. RESULTS Fifty-four neurosurgery residency applicants were interviewed at the Cleveland Clinic during the 2014-2015 application cycle. No differences in validated personality scores were identified between the 46 MD applicants and 8 MD/PhD applicants. The mean USMLE score (± SD) was 252.3 ± 11.9, and those in the high-USMLE-score category (USMLE score ≥ 260) had a significantly lower “imaginative” score (a stress measure of eccentric thinking and impatience with those who think more slowly). The average number of publications per applicant was 8.6 ± 7.9, and there was a significant positive correlation (r = 0.339, p = 0.016) between greater number of publications and a higher “adjustment” score (a measure of being even-tempered, having composure under pressure). Significant negative correlations existed between the total number of publications and the “excitable” score (a measure of being emotionally volatile) (r = -0.299, p = 0.035) as well as the “skeptical” score (measure of being sensitive to criticism) (r = -0.325, p = 0.021). The average medical school rank was 25.8, and medical school rankings were positively correlated with the “imaginative” score (r = 0.287, p = 0.044). CONCLUSIONS This is the first study to investigate the use of personality scores in the selection of neurosurgical residents. The use of personality assessments has the potential to provide insight into an applicant’s future behavior as a resident and beyond. This information may be useful in the selection of neurosurgical residents and can be further used to customize the teaching of residents and for enabling them to recognize their own strengths and weaknesses for self-improvement.
Male-male conflict is common among animals, but questions remain as to when, how and by whom aggression should be initiated. Factors that affect agonistic strategies include residency, the value of the contested resource and the fighting ability of the two contestants. We quantified initiation of aggression in a fish, the desert goby, Chlamydogobius eremius, by exposing nest-holding males to a male intruder. The perceived value of the resource (the nest) was manipulated by exposing half of the residents to sexually receptive females for two days before the trial. Resident male aggression, however, was unaffected by perceived mating opportunities. It was also unaffected by the absolute and relative size of the intruder. Instead resident aggression was negatively related to resident male size. In particular, smaller residents attacked sooner and with greater intensity compared to larger residents. These results suggest that resident desert goby males used set, rather than conditional, strategies for initiating aggression. If intruders are more likely to flee than retaliate, small males may benefit from attacking intruders before these have had an opportunity to assess the resident and/or the resource.
Perceptions of residents regarding pregnancy during training were compared over time and across surgical, internal medicine, obstetrics/gynecology, and anesthesia specialties.
In Western clinical training, formulation of a summary statement (SS) is a core exercise for articulation, evaluation, and improvement of clinical reasoning (CR). In Japanese clinical training, structured guidance in developing CR, including opportunity for SS practice, is uncommon, and the present status of case summarization skills is unclear. We used Virtual Patients (VPs) to explore Japanese junior residents' SS styles and the effectiveness of VPs on improving SS quality.
We examined bed bug prevalence in 2,372 low-income apartments within 43 buildings in four New Jersey cities using a combination of resident interviews, brief visual inspections, and monitoring with Climbup Insect Interceptors. Infestation rates ranged from 3.8 to 29.5% among the buildings, with an overall infestation rate of 12.3%. Within each apartment, the bed area trapped significantly more bed bugs per trap than the sofa (or upholstered chair) area. African American residents had a proportionally higher number of bed bug infestations than white residents. Women were more likely to report bed bug bite symptoms than men. Only 68% of the residents who experienced bed bug infestations reported symptoms after being bitten (n = 475). Among those with self-reported symptoms (n = 319), the frequency of the reported symptoms was: pain 90%, itchiness 20%, welts 13%, and insomnia 8%. Fifty-nine percent of the residents (n = 539) who experienced bed bug infestations applied insecticides to control bed bugs. Climbup interceptors detected 89 ± 1% and brief visual inspections detected 72 ± 3% of the infestations. Only two out of 291 infestations were not detected by brief visual inspection or interceptors. Assuming US$50 per hour labor rate, the average per apartment cost for the building-wide bed bug monitoring protocol was US$12 per apartment. Forty-nine percent of the infestations detected by the protocol were in apartments whose residents were unaware of the bed bug activity.
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2015 annual report on the status of US emergency medicine training programs.
In species with a high degree of fission-fusion social dynamics, fusions may trigger social conflict and thus provide an opportunity to identify sources of social tension and mechanisms related to its alleviation. We characterized behavioral and endocrine responses of captive female bonobos (Pan paniscus) to fusions within a zoo facility designed to simulate naturalistic fission-fusion social dynamics. We compared urinary cortisol levels and frequencies of aggression, grooming and socio-sexual interactions between female bonobos while in stable sub-groups and when one “joiner” was reunited with the “residents” of another sub-group. We hypothesized that fusions would trigger increases in aggression and cortisol levels among reunited joiners and resident females. We further predicted that females who face more uncertainty in their social interactions following fusions may use grooming and/or socio-sexual behavior to reduce social tension and aggression. The only aggression on reunion days occurred between reunited females, but frequencies of aggression remained low across non-reunion and reunion days, and there was no effect of fusions on cortisol levels. Fusions did not influence patterns of grooming, but there were increases in socio-sexual solicitations and socio-sexual interactions between joiners and resident females. Joiners who had been separated from residents for longer received the most solicitations, but were also more selective in their acceptance of solicitations and preferred to have socio-sexual interactions with higher-ranking residents. Our results suggest that socio-sexual interactions play a role in reintegrating female bonobos into social groups following fusions. In addition, females who receive a high number of solicitations are able to gain more control over their socio-sexual interactions and may use socio-sexual interactions for other purposes, such as to enhance their social standing.