Perceptions of emergency medicine residents on the quality of residency training in the United States and Saudi Arabia

BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.RESULTS: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training year.CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

Robotic cardiac surgery training during residency: Preparing residents for the inevitable future

Unlike other surgical residency training programs including thoracic surgery, robotic cardiac surgery skilltraining is minimal or absent in residency curricula. A review was conducted to identify residents'exposure to robotic cardiac surgery training based on databases including PubMed, MEDLINE and GoogleScholar. Published papers and cardiothoracic surgical societies with robotic cardiac surgery trainingcourses were reviewed. Robotic cardiac surgery training for residents is almost non-existent. Strategies toestablish proper robotic cardiac surgical training for residents include implementing simulation training,implementing hour requirements and establishing wet/dry lab model training in a progressive fashion.As robot-assisted cardiac surgery becomes increasingly commonplace, it will be imperative to providetraining for residents with dedicated opportunities to develop their skills in robotic cardiac surgery.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Standardized training for resident doctors in China

Medical graduates are not fully trained physicians when they leave medical school.Currently,standardized training for resident doctors in most hospitals in China is carried out according to the Ministry of Health guidelines.However,these guidelines provide only outline guidance,and specific resident training is managed independently by and varies with individual institutions.Therefore,it is important to study training demand to learn about the content and emphasis of training.

Ophthalmology residency training in Jordan:an evaluation of quality and comparison with international standards

AIMTo evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened.

Analysis and Perspective of Endodontics Standard Resident Training in China

As an important part of postgraduate education,Standard Resident Training(STR)plays a crucial role in the process of culturing a competent dental care provider who can independently treat the common oral infectious diseases.A systematic and comprehensive evaluation system is desiderating for realization of high-quality Endodontics resident training due to its discipline characteristics of highly specialized and strict operation.This paper analyzes the current status of resident training in our Endodontic Department and discusses how to improve the clinical skills and reasoning ability of residents,in order to construct a comprehensive resident training formative evaluation system in China.

Comparison of Plastic Surgery Training Programs Between Hong Kong and Shanghai

The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。

Ophthalmology simulation for undergraduate and postgraduate clinical education

This is a review education paper on the current ophthalmology simulators utilized worldwide for undergraduate and postgraduate training. At present, various simulators such as the EYE Exam Simulator （Kyoto Kagaku Co. Ltd., Kyoto, Japan）, Eyesi direct ophthalmoscope simulator （VRmagic, GmbH, Mannheim, Germany）, Eyesi indirect ophthalmoscope simulator （VRmagic, GmbH, Mannheim, Germany） and Eyesi cataract simulators （VRmagic, GmbH, Mannheim, Germany）. These simulators are thought to be able to reduce the initial learning curve for the ophthalmology training but further research will need to be conducted to assess the effectiveness of the simulation-assisted ophthalmology training. Future research will be of great value to assess the medical students and residents responses and performance regarding the usefulness of the individual eye simulator.

高校附属医院学生和学员网格化管理模式的探索与创新

基于高校附属医院学生和学员的人员特点和管理难点,回顾网格化管理的定义和应用,总结和凝练网格化管理模式在高校附属医院学生和学员中的构建和实践重点,包括明确网格主要功能、优化网格设置原则、强化网格日常管理,通过创新网格化管理的管理理念和产学实践,发挥网格化管理与传统学生管理模式各自的优势、实现两者深度融合,开发人员信息系统实现多方精准管理,更好地适应高校附属医院所面临的新形势、新要求,以期为全国高校附属医院学生和学员管理提供有益借鉴。

A comparison of ophthalmic education in China and America

Training qualified ophthalmic professional is crucial for any eye care system worldwide.Education of modern western Ophthalmology in China started late but develops rapidly.This review focused on ophthalmic education in China and US,describing details of the programs and analyzing the differences.This summary may provide useful information for practitioners of medical education from both countries and help improve the present training designs.

Disparities in employment outcomes among critical care graduates with different training backgrounds

Background:We sought to characterize the impact of critical care training pathways on subsequent employment opportunities.Methods:A survey assessing the postfellowship work environment and barriers to employment in a preferred setting was electronically distributed on September 16,2019,to program directors and coordinators at all US adult critical care fellowships with instructions to for-ward it to the prior year’s graduates.Results:Data collection was interrupted by the coronavirus disease 2019 pandemic.Fifty-nine participants were included,reflecting a low rate of return.Most worked in urban areas(76.6%)at academic hospitals(81.7%).Graduates of internal medicine critical care(IMCC)were more likely than pulmonary critical care(PCC)to report their fellowship as a barrier to employment(50%vs 0%;P<0.05).Emergency medicine graduates were more likely than internal medicine to report their residency as a barrier to employment(83.3%vs 4.6%;P<0.05).Inability to find a desired position at an academic center(50%vs 5.9%;P<0.05)and in the preferred metropolitan setting(37.5%vs 0%;P<0.05)were more common among IMCC than PCC.Conclusion:In this survey of critical care graduates,residency in emergency medicine and fellowship in IMCC were associated with in-creased barriers to finding desired employment.

Otolaryngology residency program factors associated with female resident representation

Objective:Female representation in the field of otolaryngology is lacking.Residency is the first point at which medical school graduates specialize in a chosen field and thus represents an opportunity to recruit and train more female otolaryngologists.This study sought to identify program factors associated with greater female representation among resident physicians.Methods:Departmental websites of all 124 otolaryngology residency programs in the United States and Puerto Rico were examined for a list of residents.For programs with a resident roster available,the genders of residents,faculty,program directors,and chairpersons were recorded.Location and city population for each program was also recorded,as was female resident representation.Programs were compared using Pearson Chi‐squared univariate tests.Results:1,632 residents and 2,605 faculty were included in the analysis of 109 programs.The median female resident representation was 40%.Programs with larger faculty sizes,more female faculty,and urban location were associated with an above‐median female resident representation.Programs with a larger residency cohort approached significance regarding above‐median female resident representation.Higher female faculty representation,program director gender,chairperson gender,and US region were not associated with variation in female resident representation.Conclusions:Greater female otolaryngology residency representation was associated with programs having an urban location and greater numbers of female and total faculty.It was also likely that a larger resident cohort size may affect female resident representation.The proportions of female faculty,program director,and chairperson gender,as well as the US region,were not associated with variation in female resident gender representation.

A perspective on the development of family medicine in China

Family medicine is a medical specialty devoted to comprehensive primary care for people of all ages.It has been recognized and developed as the foundation of modern healthcare system in all other advanced countries(except USA),and has enjoyed great success in the improvement of national health status and constraint of healthcare expenditure.The new healthcare reform plan and the development of family medicine system in China with focus on the wellbeing of all people have been hailed as a historic milestone.Establishment of a new specialty from scratch into a massive work force,however,has proven to be a tremendous challenge.With strong momentum from central government and the support of favorable finance and policy,a great achievement could be made when the healthcare model has truly changed from specialty care into primary care in medical education institutions and the healthcare industry,and the creation of hundreds of family medicine residency training programs has been accomplished.This article elucidated some perspectives and strategies on the development of family medicine in China.

Preferences in stapes surgery among American otological society otologists

Objective:Stapes surgery is technically challenging,yet its methodology is not standardized.We aim to elucidate preferences in stapes surgery among American Otological Society(AOS)otologists and determine if any common practice patterns exist.Study design:Cross-sectional study via emailed questionnaire.Setting:Surgery centers.Subjects and methods:Members of the AOS were an emailed a survey to quantify variables including surgical volume,anesthetic preference,laser use,type of procedure,footplate sealing technique,antibiotic use,and trainee participation.Results:Most otologists(71%)performed 2 to 5 stapes surgeries per month under general anesthesia(69%)with stapedotomy(71%)as the preferred procedure.Most(56%)used the rosette method of laser stapedotomy with manual pick debris removal for footplate fenestration.Either the handheld potassium titanyl phosphate(KTP)laser(40%)or handheld carbon dioxide(CO2)laser(33%)was used.The heat-activated memory hook(51%)was the preferred prosthesis.Footplate sealing method was variable,as was antibiotic use among respondents.Trainee participation was limited,as 42%of otologists allowed residents to place the prosthesis,and fewer allowed residents to crimp the prosthesis,and laser or drill the footplate.Surgeons with higher surgical volume(≥6 surgeries per month)demonstrated the following statistically significant correlations:footplate fenestration with laser in a rosette pattern and pick for debris removal(rs=-0.365,P=0.014)and trainee participation with fellows only(rs=0.341,P=0.022).Conclusions:Trends in various surgical decisions showed a lack of consensus in all aspects of stapes surgery.

Custodians of Cultural Heritage

Volunteers help the government conserve relics and educate peopleHuang Yuqing’s home décor is unusual,to say the least.The 54-year-old’s residence is packed with thousands of old newspapers,magazines and books—publications he started collecting from 1997.