Notes

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Sixty-nine percent of respondents (30 of 43) reported sharing learning points on at least 3 days of the intervention week. Eighty-six percent of respondents (37 of 43) said retrieval practice did not adversely affect the workflow at the end of rounds. The perception that teaching on rounds was a priority increased after the intervention (3.93 versus 4.28 on 1-5 Likert scale,
= .047).

Using retrieval practice on MICU rounds was feasible and acceptable and was associated with an increase in the perceived priority given to teaching on rounds.
Using retrieval practice on MICU rounds was feasible and acceptable and was associated with an increase in the perceived priority given to teaching on rounds.
Graduate medical education (GME) learners may struggle with clinical performance during training. A subset of these trainees has mental health conditions (MHCs).

To characterize the MHCs that underlie poor trainee performance and their relationship to specific clinical performance deficit (CPD).

At the University of Virginia (UVA), GME learners not meeting appropriate milestones, or who request help, have the option to self-refer or be referred to COACH (Committee on Achieving Competence Through Help). A physician remediation expert assesses the learner and identifies a primary CPD. If there is concern for an MHC, referral is made to a psychologist with expertise in working with trainees. All learners are offered remediation for the CPD. Using descriptive statistics, we tracked the prevalence of MHC and their correlation with specific CPDs.

Between 2016 and 2019, COACH assessed 7% (61 of 820) of GME learners at UVA. Thirty-eight percent (23 of 61) had an MHC associated with the CPD. Anxiety was the most common MHC (48%), followed by depression (17%), cognitive dysfunction (17%), adjustment disorder (13%), and other (4%). Professionalism was the most identified CPD among learners with MHCs (52%). Of remediated learners, 47% have successfully finished remediation, 21% were terminated or voluntarily left their program, and 32% are still being remediated (83% of whom are in good standing).

MHCs were identified in nearly 40% of struggling learners referred to a centralized remediation program. Professionalism is the most identified CPD among learners with MHCs.
MHCs were identified in nearly 40% of struggling learners referred to a centralized remediation program. Professionalism is the most identified CPD among learners with MHCs.
Excessive inpatient administrative tasks can lead to adverse consequences for residents and their patients. Furthermore, this burden has been linked to depersonalization, a major component of physician burnout.

To describe the development, implementation, feasibility, acceptability, and early outcomes of Resident Team Assistant (RTA) programs.

Three large academic medical centers created RTA programs in which administrative assistants are incorporated into inpatient medical teams. find more First steps included a needs assessment and driver diagram creation to identify key issues and to solidify goals. Program directors were assigned, and RTAs were hired, trained, and incorporated into inpatient teams at each institution (2003, 2016, 2018). Program leadership and institutional stakeholders met regularly to discuss development and quality assurance. Surveys and direct interviews were performed to evaluate impact and acceptability. Institutional goals in accordance to RTAs tasks were also investigated.

Resident sfor the hospitals.
Telemedicine holds promise to bridge the transition of care between inpatient and outpatient settings. Despite this, the unique communication and technical skills required for virtual encounters are not routinely taught or practiced in graduate medical education (GME) programs.

To develop an objective structured clinical examination (OSCE) case to assess residents' telemedicine-specific skills and identify potential gaps in our residency program's curriculum.

As part of a multi-station OSCE in 2019, we developed a case simulating a remote encounter between a resident and a recently discharged standardized patient. We developed an assessment tool comprising specific behaviors anchored to "not done," "partly done," and "well done" descriptors to evaluate core communication and telemedicine-specific skills.

Seventy-eight NYU internal medicine residents participated in the case. Evaluations from 100% of participants were obtained. Residents performed well in Information Gathering and Relationship Development domains. A mean 95% (SD 3.3%) and 91% (SD 4.9%) of residents received "well done" evaluations across these domains. A mean 78% (SD 14%) received "well done" within Education/Counseling domain. However, only 46% (SD 45%) received "well done" evaluations within the Telemedicine domain; specific weak areas included performing a virtual physical examination (18% well done) and leveraging video to augment history gathering (17% well done). There were no differences in telemedicine-specific skill evaluations when stratified by training track or postgraduate year.

We simulate a post-discharge virtual encounter and present a novel assessment tool that uncovers telemedicine-specific knowledge gaps in GME trainees.
We simulate a post-discharge virtual encounter and present a novel assessment tool that uncovers telemedicine-specific knowledge gaps in GME trainees.
Trainee well-being is a major concern for institutions and programs, yet many residents report suboptimal access to or contact with primary care for themselves.

To address the health care needs of residents, we developed a mechanism whereby all incoming residents were offered an appointment with a primary care clinician (PCP) during institutional intern orientation.

In April 2019, all incoming residents (17 specialties) were invited to participate. A collaboration involving the GME office and family medicine and internal medicine departments enabled interested residents to attend PCP appointments that were held at predesignated times during orientation and did not conflict with other orientation or learning activities. Residents received appointment details, and insurance billing processes were followed. A survey was administered to all participating PCPs and incoming residents 2 weeks following their scheduled PCP appointment.

Of the 144 incoming residents, 118 (82%) participated. Among the 71 of 144 (49%) residents who responded to the survey, 94% indicated that they desired an appointment, with 90% attending the appointment as scheduled; 52% purposed their visit as an introduction for future appointments, while 15% requested prescription refills.
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