Comprehensive analysis of publication of physical medicine and rehabilitation theses in Türkiye between years 2010 and 2020: Academic productivity and related factors.

Objectives: This study aimed to investigate the publication rates of physical medicine and rehabilitation specialty training theses, which are required to complete a residency in Türkiye, and determine the factors that affect publication. Materials and methods: Residency theses involved in this descriptive study were detected from the database of Higher Education Council Thesis Center (tez.yok.gov.tr) between January 2010 and December 2020. Publication of theses and date of publication were investigated by the writer's and supervisor's names on PubMed and Google Scholar. Results: Three hundred eighty-eight of 1,130 theses were turned into publications. Two hundred seventy-seven (24.5%) were published in SCI (Science Citation Index)/SCI Expanded indexed journals. The publication rates of residents were 47.1% in private universities, 34.2% in public universities, and 32.3% in training and research hospitals. The trainees who published their theses were more likely to become associate and assistant professors. Conclusion: Although approximately one-third of the theses defended were published, this rate is insufficient for sharing the knowledge. Considering that publishing their theses affected the residents' current academic careers positively, supervisors should provide the residents supportive facilitation to give the knowledge in research and publish their theses.

Building the workforce of tomorrow: The weighting of rural exposure in standardised curriculum vitae scoring criteria for entrance into Australian specialty training programs.

OBJECTIVE: To determine the weighting of rural exposure within publicly available standardised curriculum vitae (CV) scoring criteria for trainee medical officer's applying into medical and surgical specialty training programs in Australia and New Zealand. METHODS/DESIGN: An observational analysis of rural exposure point allocations within publicly available standardised CV scoring criteria for entrance into specialty training programs. SETTING: All Australian and New Zealand medical and surgical specialties training programs outlined by the Australian Health Practitioner Regulation Agency (AHPRA) who publish publicly available standardised CV scoring criteria for entrance into specialty training were included. RESULTS: Of the 14 specialty training programs that publish publicly available standardised CV scoring criteria, 8/14 allocate points towards rural exposure. While the allocation of points within this scoring domain varies between the eight training programs, the mean weighting of rural exposure is 13.7%. CONCLUSIONS: The relative weighting of rural exposure varies between the eight specialty training programs who include rural exposure as a CV scoring criteria. The deliberate and strategic construction of CV scoring criteria and inclusion of rural exposure points is important to continue developing the Australian rural specialist workforce. Future development of standardised CV scoring criteria should continue to consider point allocation towards rural exposure and related activities to ensure that the requirements of rural Australian healthcare needs are met across medical and surgical specialties.

Towards inclusive learning environments in post-graduate medical education: stakeholder-driven strategies in Dutch GP-specialty training.

BACKGROUND: A recent study found that ethnic minority General Practice (GP)-trainees receive more negative assessments than their majority peers. Previous qualitative research suggested that learning climate-related factors play a pivotal role in unequal opportunities for trainees in post-graduate medical settings, indicating that insufficient inclusivity had put minority students at risk of failure and dropout. STUDY OBJECTIVES: We aimed to develop broadly supported strategies for an inclusive learning climate in Dutch GP-specialty training. METHODS: We employed Participatory Action Research (PAR)-methods, incorporating Participatory Learning and Action (PLA)-techniques to ensure equal voices for all stakeholders in shaping Diversity, Equity, and Inclusion (DEI)-strategies for GP-specialty training. Our approach engaged stakeholders within two pilot GP-specialty training institutes across diverse roles, including management, support staff, in-faculty teachers, in-clinic supervisors, and trainees, representing ethnic minorities and the majority population. Purposeful convenience sampling formed stakeholder- and co-reader groups in two Dutch GP-specialty training institutes. Stakeholder discussion sessions were based on experiences and literature, including two relevant frameworks, and explored perspectives on the dynamics of potential ethnic minority trainees' disadvantages and opportunities for inclusive strategies. A co-reader group commented on discussion outcomes. Consequently, a management group prioritized suggested strategies based on expected feasibility and compatibility. RESULTS: Input from twelve stakeholder group sessions and thirteen co-readers led to implementation guidance for seven inclusive learning environment strategies, of which the management group prioritized three: • Provide DEI-relevant training programs to all GP-specialty training stakeholders; • Appoint DEI ambassadors in all layers of GP-specialty training; • Give a significant voice to minority GP-trainees in their education. CONCLUSION: The study's participatory approach engaged representatives of all GP-specialty training stakeholders and identified seven inclusive learning climate strategies, of which three were prioritized for implementation in two training institutions.

UK OMFS consultants and trainees strongly support the recommendations of the 2008 Postgraduate Medical Education and Training Board (PMETB) Review of Training in OMFS. The time for delivering them is now.

When the Postgraduate Medical Education and Training Board's (PMETB) Review of Oral and Maxillofacial Surgery (OMFS) Training was published in 2008 it contained five recommendations about OMFS training. As yet, none of these recommendations has been delivered. An online survey was designed to assess awareness of the PMETB review and the current views of OMFS trainees and consultants about its recommendations. Replies were invited using email and social media (WhatsApp, Twitter, and Facebook). As a result of using social media no denominator for the response rate was possible. A total of 304 responses were received, eight of which were anonymous. There was strong support for all the OMFS-specific recommendations: 1: the OMFS specialty should remain a dual medical and dental degree specialty (255, 84%); 2: OMFS training should be shortened (283, 93%); 3: OMFS training should start at the beginning of the second degree (203, 67%); 4: there should be a single medical regulator (General Medical Council) for OMFS (258, 85%); and 6: the need for a second Foundation Year should be removed (260, 86%). Other suggestions about improving OMFS training were also made by participants in the survey. There remains strong support within the specialty for the recommendations of the review. This support is present across consultants, specialty trainees, and those aiming for OMFS specialty training. Some of the original legislative obstructions to delivery of the recommendations have been removed by Brexit creating a unique opportunity for them to be delivered.

How does guided group reflection work to support professional identity formation in postgraduate medical education: A scoping review.

PURPOSE: In postgraduate medical education, guided group reflection is often applied to support professional identity formation. However, little is known about how guided group reflection is shaped and how it works. Our scoping review synthesizes existing evidence about various approaches for guided group reflection, their aims, components and potential working mechanisms. METHODS: We conducted a scoping review using JBI (Joanna Briggs Institute) guidelines for conducting scoping reviews. We searched PubMed, PsycINFO, EMBASE and ERIC databases for all research articles published in English or Dutch in an iterative team approach. The articles were extracted and summarized quantitatively and qualitatively. RESULTS: We included 71 papers (45 primary research papers and 26 non-empirical papers including program descriptions, theoretical concepts and personal experiences). We identified a diversity of approaches for guided group reflection (e.g. Balint groups, supervised collaborative reflection and exchange of experiences), applied in a variety of didactic formats and aims. We distilled potential working mechanisms relating to engagement in reflection, group learning and the supervisor's role. CONCLUSIONS: There are significant knowledge gaps about the aims and underlying mechanisms of guided group reflection. Future systematic research on these topics is needed to understand the effectiveness of educational methods, that can help facilitate learning conditions to best shape professional identity formation (PIF) in educational curricula.

Designing the Future of Medical Education: The EPA Framework as a Catalyst to Inform Family Planning and Reproductive Health Fellowship Training Program in Ethiopia Medical Education: An Exploratory Sequential Mixed Method Study.

Introduction: Entrustable Professional Activities (EPAs) are tasks or responsibilities within a specific field that can be given to a learner once they are competent to perform them independently. EPAs are being used in various specialty programs and serving as valuable tool to inform educational program. However, due to disparities in professional practice between different contexts, the automatic transfer of a set of core EPAs is not feasible. Hence, our study aims to develop an EPA framework to inform the Family Planning and Reproductive Health Fellowship Program in the local context of Ethiopia. Methods: We employed an exploratory mixed-method design, which involved the collection of qualitative data using the Nominal Group Technique and quantitative data through a nationwide survey in all residency training institutions across the country. Qualitative data analysis involved several steps, including compiling a list of tasks, removing duplicate tasks, reviewing EPAs using criteria and an equal rubric tool. For quantitative data analysis, descriptive statistics, validity index analysis, and intra-class correlation coefficients, were used. Results: Seven senior panelists were able to propose a total of 57 EPAs, with 17 remaining after qualitative data analysis. The panelist evaluated the relevance of each EPA in the second phase. As a result, 17 EPAs received a content validity index of >0.83, indicating satisfactory relevance. In the national survey, experts reached a high level of final agreement regarding the relevance and representativeness of all 17 EPAs (ICC = 0.815, 95% CI [0.0.756,0.865], p.0001). Conclusion: The final set of 17 end-of-training EPAs is valid, acceptable and representative of the discipline, and they can be used as a framework to inform Family planning and Reproductive Health Fellowship Program in Ethiopian medical education once these core EPA statements are described in sufficient detail. This can contribute to raise the quality of training and hence the quality of patient care.

The hidden costs of the intercollegiate membership of the Royal College of surgeons examinations: Can trainees afford it?

BACKGROUND: The Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is a mandatory requirement for higher specialty surgical training in the UK. However, there is a significant economic impact on trainees which raises the question of whether the costs of this exam hinder surgical career progression. This study explores the burden of these exams on trainees. METHODS: A 37-point questionnaire was distributed to all trainees who were preparing for or have sat MRCS examinations. Univariate analyses included the cost of the preparatory resources, extra hours worked to pay for these and the examinations, and the number of annual leave (AL) days taken to prepare. Pearson correlation coefficients were used to identify possible correlation between monetary expenditure and success rate. RESULTS: On average, trainees (n â€‹= â€‹145) spent £332.54, worked 31.2 â€‹h in addition to their rostered hours, and used 5.8 AL days to prepare for MRCS Part A. For MRCS Part B/ENT, trainees spent on average £682.92, worked 41.7 extra hours, and used 5 AL days. Overall, the average trainee spent 5-9% of their salary and one-fifth of their AL allowance to prepare for the exams. There was a positive correlation between number of attempts and monetary expenditure on Part A preparation (r(109)=0.536, p â€‹< â€‹0.001). CONCLUSIONS: There is a considerable financial and social toll of the MRCS examination on trainees. Reducing this is crucial to tackle workforce challenges that include trainee retention and burnout. Further studies exploring study habits can help reform study budget policies to ease this pressure on trainees.

Adapting to a Pandemic: Web-Based Residency Training and Script Concordance Testing in Emergency Medicine During COVID-19.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic necessitated alternative methods to ensure the continuity of medical education. Our study explores the efficacy and acceptability of a digital continuous medical education initiative for medical residents during this challenging period. METHODS: From September to December 2020, 47 out of 60 enrolled trainee doctors participated in this innovative digital Continuous Medical Education (CME) approach. We utilized the Script Concordance Test to bolster clinical reasoning skills. Three simulation scenarios, namely Advanced Trauma Life Support (ATLS), Advanced Life Support (ALS), and European Paediatric Life Support (EPLS), were transformed into interactive online sessions via Zoom™. Participant feedback was also collected through a survey. RESULTS: Consistent Script Concordance Testing (SCT) scores among participants indicated the effectiveness of the online training module. Feedback suggested a broad acceptance of this novel training approach. However, discrepancies observed between formative SCT scores, and summative Multiple-Choice Questions (MCQ) assessments highlighted areas for potential refinement. CONCLUSIONS: Our findings showcase the resilience and adaptability of medical education amidst challenges like the global pandemic. The success of methodologies such as SCT, endorsed by prestigious bodies like the European Resuscitation Council and the American Heart Association, suggests their potential in preparing health care professionals for emergent situations. This research offers valuable insights for shaping future online CME strategies.

A proposal for harmonizing clinical neurophysiology training in the Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology.

There are significant differences in duration and intensity of clinical neurophysiology specialty training within the countries of the Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology. We address these differences by proposing recommendations which may facilitate harmonisation of training and education within the Chapter. They arose from two workshops whose recommendations were then circulated widely within national societies in the Chapter for feedback and for consensus. The recommendations are applicable to clinical neurophysiology as a medical monospecialty and/or as a subspecialty (usually of neurology). We make a number of recommendations on governance and regulation of training, on the requirements for competence and the numbers of various examinations and tests performed by trainees, some under supervision. We also recommend a modular approach considering primary and complementary modules. Primary modules are electroencephalography, electromyography, nerve conduction studies and evoked potentials, while complementary ones include sleep analysis, intraoperative monitoring, small fibre testing, peripheral nerve and muscle ultrasound, intracortical recordings, and analysis of movement disorders. It is recommended that national examinations should include a variety of techniques to assess knowledge and judgement, practical skills, teamwork, communication skills, as well as safety and quality. The aim of the suggested recommendations is to harmonize clinical neurophysiology training in the member societies throughout the Chapter. It is realised that this may mean that the numbers for competence are aspirational for some, though ways to mitigate this, for instance through supranational training centres, are also discussed.

Important Leadership Skills and Benefits of Shared Leadership Training for Chief Residents: A Delphi Analysis.

Background: Chief residents (CRs) have pivotal educational and leadership roles in residency programs. The necessary CR leadership skills that transcend specialties have not been defined and most training on these skills occurs in silo. Objective: The primary goal was to define leadership skills important for the general CR role. The secondary aim was to determine which skills should be included in cross-specialty CR training and identify benefits of such training. Methods: Sixty-three CRs and 25 program directors (PDs) from 25 residency programs at a single institution were surveyed via a modified Delphi approach in 2022 as part of a needs assessment on CR leadership training. First, respondents answered three open-ended questions about skills needed for the CR role and the potential benefits of cross-specialty CR training. Respondents then rated categorized responses on the importance of the skill, agreement that skills should be included in cross-specialty training, and agreement on benefit of cross-specialty training using a 5-point Likert scale. Positive consensus was defined as 80% agreement. Results: Fifty respondents (53%) participated in round one and 28 (32%) in round two. Positive consensus was reached on 38 skills (63%). Nine skills reached consensus on inclusion in cross-specialty training including communication skills and certain management skills. Consensus on benefits of training include learning from and collaborating with other residency programs. Conclusion: The authors defined important skills for the CR role that reached consensus across a broad range of specialties and identified the perceived benefits of shared leadership training. Residency programs should consider cross-specialty leadership training for CRs with a focus on communication and management skills.

[What do the new specialty training regulations mean for physicians in general surgery and visceral surgery? : A contribution from a Bavarian perspective]. / Was bedeutet die neue Weiterbildungsordnung für die Fachärztin/den Facharzt für Allgemeinchirurgie und Viszeralchirurgie? : Ein Beitrag aus bayerischer Sicht.

In 2018 the German Medical Congress (Deutscher Ärztetag) passed a new model specialty training regulation (MWBO). As the individual state chambers of physicians have their own state-specific specialty training regulations, the following is a comparison from the Bavarian perspective using the specialty training in general surgery and visceral surgery as examples for the specialty training requirements according to the old (WBO 2004) and the new specialty training regulations for physicians in Bavaria (WBO 2021) [1].

The Year in Review: Anesthesia for Congenital Heart Disease 2022.

This review focuses on the literature published during the calendar year 2022 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease (CHD). Four major themes are discussed: enhanced recovery after surgery(ERAS); diversity, equity, and inclusion; the state of pediatric cardiac anesthesiology as a subspecialty in the United States; and neuromonitoring for pediatric cardiac surgery.

Erratum: Is urology a gender-biased career choice? A survey-based study of the Italian medical students' perception of specialties.

[This corrects the article DOI: 10.3389/fsurg.2022.962824.].

Like Frying Multiple Eggs in One Pan: a Qualitative Study Exploring the Understanding of Inter-speciality Training in Cancer Care.

H igh-quality cancer care is a key priority worldwide. Caring for people affected by cancer requires a range of specific knowledge, skills and experience to deliver the complex care regimens both within the hospital and within the community environment. In June 2022, the European Cancer Organisation along with 33 European cancer societies began working together to develop a curriculum for inter-speciality training for healthcare professionals across Europe. As part of the project, this research consisted of a qualitative survey distributed to the European Union societies via email. The aim of this paper is to disseminate the qualitative findings from healthcare professionals across Europe. Questionnaires were sent out to a convenience sample of 219 healthcare professionals and patient advocates with a response rate of 55% (n = 115). The findings identified that there were four key themes: 'What is inter-speciality training?', 'Barriers and challenges', 'Support throughout the cancer journey' and 'New ways of working'. These results are part of a larger needs analysis and scoping review to inform the development of a core competency framework which will be part of an inter-speciality curriculum for specialist cancer doctors, nurses and other healthcare professionals across Europe. Healthcare professionals will be able to access education and training through the virtual learning environment and workshops and by clinical rotations to other specialties.

ChatGPT outscored human candidates in a virtual objective structured clinical examination in obstetrics and gynecology.

BACKGROUND: Natural language processing is a form of artificial intelligence that allows human users to interface with a machine without using complex codes. The ability of natural language processing systems, such as ChatGPT, to successfully engage with healthcare systems requiring fluid reasoning, specialist data interpretation, and empathetic communication in an unfamiliar and evolving environment is poorly studied. This study investigated whether the ChatGPT interface could engage with and complete a mock objective structured clinical examination simulating assessment for membership of the Royal College of Obstetricians and Gynaecologists. OBJECTIVE: This study aimed to determine whether ChatGPT, without additional training, would achieve a score at least equivalent to that achieved by human candidates who sat for virtual objective structured clinical examinations in Singapore. STUDY DESIGN: This study was conducted in 2 phases. In the first phase, a total of 7 structured discussion questions were selected from 2 historical cohorts (cohorts A and B) of objective structured clinical examination questions. ChatGPT was examined using these questions and responses recorded in a script. Of note, 2 human candidates (acting as anonymizers) were examined on the same questions using videoconferencing, and their responses were transcribed verbatim into written scripts. The 3 sets of response scripts were mixed, and each set was allocated to 1 of 3 human actors. In the second phase, actors were used to presenting these scripts to examiners in response to the same examination questions. These responses were blind scored by 14 qualified examiners. ChatGPT scores were unblinded and compared with historical human candidate performance scores. RESULTS: The average score given to ChatGPT by 14 examiners was 77.2%. The average historical human score (n=26 candidates) was 73.7 %. ChatGPT demonstrated sizable performance improvements over the average human candidate in several subject domains. The median time taken for ChatGPT to complete each station was 2.54 minutes, well before the 10 minutes allowed. CONCLUSION: ChatGPT generated factually accurate and contextually relevant structured discussion answers to complex and evolving clinical questions based on unfamiliar settings within a very short period. ChatGPT outperformed human candidates in several knowledge areas. Not all examiners were able to discern between human and ChatGPT responses. Our data highlight the emergent ability of natural language processing models to demonstrate fluid reasoning in unfamiliar environments and successfully compete with human candidates that have undergone extensive specialist training.

Pediatric Pulmonology Training in India: Current Status and Future Directions.

Respiratory illnesses are common causes of morbidity and mortality in children. Postgraduates in Pediatrics spent significant time in learning to manage respiratory disorders. Improved survival of preterm neonates, improved diagnosis and survival of chronic respiratory problems, and advances in diagnosis and therapeutics have increased the need for specialists trained in managing these patients. Training programs in Pediatric Pulmonology are evolving over the past few decades. In India, super-specialty training in Pediatric Pulmonology has grown over the past few years. There is a need to modify the training structure used in industrialized countries due to differences in patient population, priorities, and limited available resources and expertise. Formal training courses have been started in a limited number of institutions. There is a large gap between the need for a trained workforce and the available specialists in the limited number of institutions. The Indian Academy of Pediatrics National Respiratory Chapter (IAPNRC) has initiated a fellowship program to bridge the gap. Comprehensive training involving academic and hands-on training may go a long way to improve the care of children with acute and chronic respiratory problems. For sustainable development of the super specialty, there is a need to work towards creating Pediatric Pulmonology service departments in various institutions that may be responsible for comprehensive training and research activities to answer common research questions.

Effect of Fracture Type, Treatment, and Surgeon Training on Reoperation After Vancouver B Periprosthetic Femur Fractures.

BACKGROUND: The treatment of Vancouver B periprosthetic proximal femur fractures (PPFFs) is complex due to the overlap between arthroplasty and orthopedic trauma techniques. Our purpose was to assess the effects of fracture type, treatment difference, and surgeon training on the risk of reoperation in Vancouver B PPFF. METHODS: A collaborative research consortium of 11 centers retrospectively reviewed PPFFs from 2014 to 2019 to determine the effects of variations in surgeon expertise, fracture type, and treatment on surgical reoperation. Surgeons were classified as per fellowship training, fractures using the Vancouver classification, and treatment as open reduction internal fixation (ORIF) or revision total hip arthroplasty with or without ORIF. Regression analyses were performed with reoperation as the primary outcome. RESULTS: Fracture type (Vancouver B3 versus B1: odds ratio [OR]: 5.70) was an independent risk factor for reoperation. No differences were found in reoperation rates with treatment (ORIF versus revision: OR 0.92, P = .883). Treatment by a nonarthroplasty-trained surgeon versus an arthroplasty specialist led to higher odds of reoperation in all Vancouver B fracture (OR: 2.87, P = .023); however, no significant differences were seen in the Vancouver B2 group alone (OR: 2.61, P = .139). Age was a significant risk factor for reoperation in all Vancouver B fractures (OR: 0.97, P = .004) and in the B2 fractures alone (OR: 0.96, P = .007). CONCLUSION: Our study suggests that age and fracture type affect reoperation rates. Treatment type did not affect reoperation rates and the effect of surgeon training is unclear.

Factors that influence psychiatric trainees' choice of higher training specialty: mixed-methods study.

AIMS AND METHOD: Factors influencing trainees' decisions about choosing and remaining in higher training subspecialties have not been widely researched. We administered telephone questionnaires to higher specialist trainees in the north-east of England to ascertain what influences these decisions. Thematic analysis was employed to develop overall constructs. RESULTS: Twenty-seven trainees were interviewed, resulting in six overall constructs. These were: supervisory experiences; perceived work-life balance; career prospects; training and working environments; interest in the chosen subspecialty; and previous experience within the chosen subspecialty. Most trainees interviewed felt they had made the right specialty choice. CLINICAL IMPLICATIONS: This study demonstrates the particular importance of exposure to a specialty and perceptions of the supervisory experience in determining trainees' choices of, and decisions to remain in, a particular psychiatric specialty. Factors highlighted in this study must inform training, recruitment and workforce planning in order to bolster the recruitment and retention of trainees into higher specialty training.