Training Support

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  • 文章类型: Journal Article
    在这种快速的沟通中,使用先前的文献以及已经完成或正在完成加速医学课程的人的经验来检查加速本科医学教育。加速医疗路径计划联盟(CAMPP)为其所有成员举办年度多机构会议。在2023年7月的会议期间,包括医学生(N=2)在内的多个组成计划(N=4)召集了一个虚拟小组,住院医师(N=4),和教师(N=2)。小组参与者代表来自不同专业(N=5)的加速途径的当前学习者或毕业生,向代表25所医学院的观众分享有关加速的第一手经验。为加速学生和学员确定了五个关键主题:减少债务作为加速的动力因素,感觉为居留做好了准备,理想的加速学生被驱使,能够建立早期的职业关系,和更少的时间额外的临床经验。CAMPP小组的话语可以为希望创建或改善加速学习的机构提供当前和正在开发的加速计划。
    In this rapid communication, accelerated undergraduate medical education is examined using prior literature as well as experiences of those who have completed or are in the process of completing accelerated medical curricula. The Consortium of Accelerated Medical Pathway Programs (CAMPP) hosts an annual multi-institutional conference for all its members. During the meeting in July 2023, a virtual panel was convened from multiple constituent programs (N = 4) including medical students (N = 2), resident physicians (N = 4), and faculty (N = 2). Panel participants represented current learners or graduates from accelerated pathways of varying specialties (N = 5) to share firsthand experiences about acceleration to an audience representing over 25 medical schools. Five key themes were identified for accelerated students and trainees: Reduced debt as motivating factor to accelerate, Feeling prepared for residency, Ideal accelerated students are driven, Ability to form early professional relationships, and Less time for additional clinical experiences. Discourse from the CAMPP panel can inform current and developing accelerated programs at institutions looking to create or improve accelerated learning.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:在骨科手术住院医师计划的申请人中通常观察到教育债务;但是,对少数族裔和非少数族裔申请人的债务负担的理解尚不明确。因此,这项研究旨在通过检查骨科手术申请人的教育债务的程度和影响因素来填补这些知识空白。
    目标:(1)骨科手术住院医师申请人的教育债务负担是多少?(2)在控制了相关的混杂变量之后,哪些因素与教育债务水平的增加独立相关?(3)在控制相关混杂变量后,被归类为代表性不足的少数群体或那些有教育债务和社会经济劣势的人不太可能在骨科手术中匹配?
    方法:对2011年至2021年美国医学院协会骨科手术住院医师申请数据进行了回顾性评估。选择美国医学院协会数据库是因为每个居留申请人都必须通过美国医学院协会注册和申请。因此,这些数据适用于每个居留申请人,样本是全面的。自我报告的数据,包括医疗前,medical,并收集了教育债务负担总额以及社会经济劣势和申请费减免用途的分类。根据自我识别的种族和种族,申请人被分为代表性不足的少数群体或代表性不足的少数群体。货币价值以美元报告,并使用消费者价格指数调整至2021年的通货膨胀。我们对连续变量和分类变量进行了t检验和卡方检验,分别。在p<0.05时考虑显著性。总之,最初的队列中有12,112名申请人,从2011年到2021年,67%(12,112人中的8170人)的完整数据申请人被纳入最终研究队列。其中,18%(8170人中的1510人)是女性,14%(8170人中的1114人)被归类为代表性不足的少数民族,8%(8170人中的643人)被归类为社会经济弱势群体。61%(8170人中的4969人)的申请人报告至少获得了一项奖学金,34%(8170人中的2746人)有医学院前债务,72%(8170人中的5909人)有任何教育债务,包括医学院。在所有申请人中,教育债务中位数(IQR)为197,000美元(25,000至288,000美元)。在那些有奖学金的人中,中位数为25,000美元(9000至86,000美元)。
    结果:在控制了性别和社会经济劣势的潜在混杂变量之后,归类为代表性不足的少数群体申请人与较高的奖学金金额独立相关,而不是被定性为代表性不足的少数群体申请人(β=20,908美元[95%置信区间(CI)15,395至26,422];p<0.001),而代表性不足的少数群体分类与总教育债务的差异并不独立相关(β=3719美元[95%CI-6458至13,895];p=0.47)。在控制了性别和分类为代表性不足的少数群体的潜在混杂变量之后,社会经济劣势与较高的奖学金金额(β=20,341美元[95%CI13,300至27,382];p<0.001)和较高的总教育债务(β=66,162美元[95%CI53,318至79,006];p<0.001)独立相关。在控制了性别和分类为代表性不足的少数群体的潜在混杂变量之后,社会经济劣势与匹配率下降独立相关(OR0.62[95%CI0.52~0.74];p<0.001).
    结论:这些发现强调了全面的奖学金计划的必要性,以确保所有背景的申请人都能获得公平的财务机会。
    结论:在未来,骨科手术可能会受益于比较各种举措的有效性的研究,旨在提高申请人对骨科手术住院医师计划的债务负担的公平性。
    BACKGROUND: Educational debt is commonly observed among applicants to orthopaedic surgery residency programs; however, an understanding of the debt burden among minority and nonminority applicants is not well established. Thus, this study aimed to fill these knowledge gaps by examining the extent of and factors shaping educational debt among orthopaedic surgery applicants.
    OBJECTIVE: (1) What is the educational debt burden among orthopaedic surgery residency applicants? (2) After controlling for relevant confounding variables, what factors are independently associated with increasing levels of educational debt? (3) After controlling for relevant confounding variables, are individuals classified as an underrepresented minority or those with educational debt and socioeconomic disadvantage less likely to match in orthopaedic surgery?
    METHODS: A retrospective evaluation of orthopaedic surgery residency application data from the American Association of Medical Colleges was analyzed from 2011 to 2021. The American Association of Medical Colleges database was selected because every residency applicant must register and apply through the American Association of Medical Colleges. Therefore, these data exist for every residency applicant, and the sample was comprehensive. Self-reported data including premedical, medical, and total educational debt burden as well as classification as socioeconomically disadvantaged and application fee waiver use were collected. Applicants were dichotomously categorized as an underrepresented minority or a not underrepresented minority based upon self-identified race and ethnicity. Monetary values were reported in USD and inflation-adjusted to 2021 using the Consumer Price Index. We performed t-tests and chi-square tests for continuous and categorical variables, respectively. Significance was considered at p < 0.05. In all, 12,112 applicants were available in the initial cohort, and 67% (8170 of 12,112) of applicants with complete data were included from 2011 to 2021 in the final study cohort. Of these, 18% (1510 of 8170) were women, 14% (1114 of 8170) were classified as underrepresented minorities, and 8% (643 of 8170) were classified as socioeconomically disadvantaged. Sixty-one percent (4969 of 8170) of applicants reported receiving at least one scholarship, 34% (2746 of 8170) had premedical school debt, and 72% (5909 of 8170) had any educational debt including medical school. Among all applicants, the median (IQR) educational debt was USD 197,000 (25,000 to 288,000). Among those with scholarships, the median amount was USD 25,000 (9000 to 86,000).
    RESULTS: After controlling for the potentially confounding variables of gender and socioeconomic disadvantage, classification as an underrepresented minority applicant was independently associated with higher scholarship amounts than applicants characterized as not underrepresented minorities (β = USD 20,908 [95% confidence interval (CI) 15,395 to 26,422]; p < 0.001), whereas underrepresented minority classification was not independently associated with a difference in total educational debt (β = USD 3719 [95% CI -6458 to 13,895]; p = 0.47). After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with higher scholarship amounts (β = USD 20,341 [95% CI 13,300 to 27,382]; p < 0.001) and higher total educational debt (β = USD 66,162 [95% CI 53,318 to 79,006]; p < 0.001) than applicants not classified as socioeconomically disadvantaged. After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with decreased match rates (OR 0.62 [95% CI 0.52 to 0.74]; p < 0.001).
    CONCLUSIONS: These findings underscore the need for comprehensive scholarship initiatives to ensure equitable financial accessibility for applicants from all backgrounds.
    CONCLUSIONS: In the future, orthopaedic surgery may benefit from research comparing the effectiveness of various initiatives aiming to improve fairness in the burden of debt among applicants to orthopaedic surgery residency programs.
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  • 文章类型: Journal Article
    目标:鉴于近年来学生教育贷款债务的大幅增加,目的是评估药学毕业生教育债务与收入比率的趋势,医学,牙科,验光,和美国2017年至2022年的兽医学计划。
    方法:对2017年至2022年部分卫生专业的教育债务和收入数据进行了回顾性分析。年收入数据来自美国社区调查,教育债务数据是从卫生专业组织收集的。计算了每个健康专业的教育债务收入比,债务收入比每年的平均变化也是如此。
    结果:除医学外,在2017年至2022年期间,整个制药行业和其他卫生行业的教育债务持续超过收入。在2017年至2022年期间,药剂师和其余卫生专业人员的债务收入比平均每年下降。在研究期间,医生的债务收入比最低,牙医的债务收入比最高。
    结论:感兴趣的卫生专业人员的债务收入比低于2017年的水平,这表明在研究期间,收入的平均增长超过了债务的平均增长。无论如何,债务仍然很高,可能会影响医疗保健专业人员的研究生培训和职业决策,并反过来影响获得医疗保健的机会。因此,建议采取行动呼吁解决教育债务负担。建议了几种策略,包括联邦政策的变化,实施学费减免或最低限度的增加,促进财政援助选择,并降低卫生专业计划的基本成本。
    OBJECTIVE: Given the substantial increases in student educational loan debt in recent years, the objective was to assess trends in educational debt-to-income ratios for graduates of pharmacy, medicine, dentistry, optometry, and veterinary medicine programs in the United States in the 2017-2022 period.
    METHODS: A retrospective analysis of 2017-2022 data for educational debt and income for select health professions was conducted. Annual income data were collected from the American Community Survey, and educational debt data were collected from health professions organizations. Educational debt-to-income ratios for each health profession were calculated, as was the mean change per year in debt-to-income ratio.
    RESULTS: With the exception of medicine, educational debt consistently exceeded income across the selected health professions in the 2017-2022 period. Debt-to-income ratios of pharmacists and the remaining health professionals decreased on average per year between 2017 and 2022. Physicians had the lowest debt-to-income ratios and dentists had the highest debt-to-income ratios in the study period.
    CONCLUSIONS: Debt-to-income ratios fell below the 2017 levels for the health professions of interest, suggesting that average growth in income outpaced that of debt for the study period. Regardless, debt remains high and may influence health care professionals\' postgraduate training and career decisions, and in turn affect access to health care. Therefore, a call to action is proposed to address educational debt burden. Several strategies are suggested, including federal policy changes, implementing tuition reductions or minimal increases, facilitating financial aid options, and reducing underlying costs of health professions programs.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    神经分化的条件,如自闭症,注意缺陷多动障碍(ADHD),诵读困难,消化不良,计算障碍和抽动症是常见的,而且很可能会要求实践评估员和主管在实践学习环境中支持神经发散护理学生。本文详细介绍了神经发散学生可以为护理带来的优势,以及他们在实践环境中可能遇到的一些挑战。它概述了实践评估员和主管如何开发神经包容的学习环境,使神经发散的学生能够茁壮成长,以及如何支持他们,如果他们没有达到他们所需的熟练程度。作者还讨论了如何通过与学生合作的方法来实施适当的合理调整。
    Neurodivergent conditions such as autism, attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dyscalculia and Tourette\'s syndrome are common, and it is highly likely that practice assessors and supervisors will be asked to support neurodivergent nursing students in their practice learning environments. This article details the strengths that neurodivergent students can bring to nursing, as well as some of the challenges they may experience in practice settings. It outlines how practice assessors and supervisors can develop neuro-inclusive learning environments where neurodivergent students can thrive, as well as how to support them if they are not meeting their required proficiencies. The authors also discuss how appropriate reasonable adjustments can be implemented by using a collaborative approach with students.
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  • 文章类型: Journal Article
    背景:鼻科手术需要高度的技术专长和解剖学知识。因为手术机会有限,伦理考虑和这些程序的复杂性,基于模拟的培训变得越来越重要。这篇综述旨在评估模拟模型在鼻学训练中的有效性。
    方法:在PubMed上进行搜索,Embase,Cochrane和GoogleScholar在2012年7月至2022年7月之间进行的研究。系统审查和荟萃分析的首选报告项目(“PRISMA”)协议定义了最终的文章列表。根据牛津循证医学中心分类,为每项经过验证的研究分配了一定水平的证据和推荐水平。
    结果:排除后,确定了42篇文章,其中包括6种类型的模拟模型和26项研究评估了有效性。评估的鼻学技能包括内窥镜鼻窦手术(n=28),颅底/脑脊液漏修补术(n=14),鼻出血和/或蝶腭动脉结扎的处理(n=8),鼻中隔成形术和鼻中隔成形术(n=6)。所有研究都报告了其模拟模型对培训生发展的有益影响。
    结论:鼻学模拟训练是传统外科教育的一个有价值的辅助手段。尽管证据质量适中,研究结果强调了模拟训练在鼻学训练中的重要性.
    BACKGROUND: Rhinological procedures demand a high degree of technical expertise and anatomical knowledge. Because of limited surgical opportunities, ethical considerations and the complexity of these procedures, simulation-based training has become increasingly important. This review aimed to evaluate the effectiveness of simulation models used in rhinology training.
    METHODS: Searches were conducted on PubMed, Embase, Cochrane and Google Scholar for studies conducted between July 2012 and July 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (\'PRISMA\') protocol defined a final list of articles. Each validated study was assigned a level of evidence and a level of recommendation based on the Oxford Centre of Evidence-Based Medicine classification.
    RESULTS: Following exclusions, 42 articles were identified which encompassed six types of simulation models and 26 studies evaluated validity. The rhinological skills assessed included endoscopic sinus surgery (n = 28), skull base/cerebrospinal fluid leak repair (n = 14), management of epistaxis and/or sphenopalatine artery ligation (n = 8), and septoplasty and septorhinoplasty (n = 6). All studies reported the beneficial impact of their simulation models on trainee development.
    CONCLUSIONS: Simulation training in rhinology is a valuable adjunct to traditional surgical education. Although evidence is of moderate quality, the findings highlight the importance of simulation-based training in rhinology training.
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  • 文章类型: Journal Article
    背景:在美国物理治疗(DPT)计划的所有医生准备学生在毕业后展示入门级的临床表现。临床实习计划是寻求专注于实践领域的DPT毕业生的一种选择。
    方法:关于DPT毕业生为什么决定接受住院医师教育(RE)的研究很少。本研究旨在确定影响物理治疗师(PT)选择攻读研究生居留权的决策过程的因素。
    方法:对毕业3年内的PT和第三年的DPT课程学生进行了调查。大多数受访者来自美国东北部的DPT计划。
    方法:创建了一项调查,试点,并传播到各种DPT计划。调查使用多项选择题和李克特项目,询问参与者对追求RE的动机因素或障碍的看法。报告了描述性统计数据和频率。方差的单向分析,卡方分析,并使用非配对t检验。
    结果:在第二年考虑居留的学生申请居留的可能性为26.5倍(P<.001)。参与者强烈同意这样的说法,即在他们的专业领域(1.39±0.48)进行实践时,居住将增加信心,扩大他们作为临床医生的知识(1.39±0.051),并加快熟练实践(1.72±0.057)。参与者认为学生倦怠,居住的费用,学生贷款债务,和地理搬迁是追求居住权的最大障碍。男性对自己申请居住权的能力更有信心(F=8.219,P=0.005)。已婚个人认为有贷款或财务义务(F=3.607,P=0.029),家庭义务(F=17.170,P<.001),和地理限制(F=3.825,P=0.024)作为障碍比单个个体更多。
    结论:DPT学生和应届毕业生在决定是否继续学习时,会考虑许多变量。RP和入门级DPT计划应考虑这些因素,以促进增加对职业后RE的参与。
    BACKGROUND: All Doctor of Physical Therapy (DPT) programs in the United States prepare students to demonstrate entry-level clinical performance upon graduation. Clinical residency programs are an option for DPT graduates seeking to specialize in a practice area.
    METHODS: There is little research published on why DPT graduates decide to pursue residency education (RE) or not. This study aimed to determine factors influencing a Physical Therapist\'s (PT) decision-making process in choosing to pursue a postgraduate residency.
    METHODS: PTs within 3 years of graduation and third-year DPT program students were surveyed. Most respondents were from DPT programs in the northeastern United States.
    METHODS: A survey was created, piloted, and disseminated to various DPT programs. The survey asked participants their perceptions of motivating factors or barriers to pursuing a RE using multiple choice questions and Likert items. Descriptive statistics and frequencies were reported. One-way analysis of variances, chi-square analysis, and unpaired t tests were used.
    RESULTS: Students who considered residency in their second year are 26.5× more likely to apply for a residency (P < .001). Participants strongly agreed with the statements that residency will increase confidence when practicing in their specialty area (1.39 ± 0.48), expand their knowledge as clinicians (1.39 ± 0.051), and expedite proficient practice (1.72 ± 0.057). Participants considered student burnout, the cost of residency, student loan debt, and geographical relocation as the top barriers to pursuing residency. Men were significantly more confident in their ability to apply to residency (F = 8.219, P = .005). Married individuals perceived loans or financial obligations (F = 3.607, P = .029), family obligations (F = 17.170, P < .001), and geographical limitations (F = 3.825, P = .024) as barriers more than single individuals.
    CONCLUSIONS: There are many variables DPT students and recent graduates consider when deciding whether to pursue RE. RPs and entry-level DPT programs should consider these factors to promote increased participation in postprofessional RE.
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