Report From National Clinician Scholars Program's Annual Meeting, 2019
Dissatisfaction with Medical and Surgical Residency Training Is Consistently Higher for Women than for Men
C. Jessica Dine, Manqing Liu, David A. Asch, Lisa M. Bellini, Karl Y. Bilimoria, Sanjay V. Desai, Judy A. Shea
Abstract [from journal]
In an attempt to balance service and education, there is a renewed focus on trainee work experiences and job satisfaction. Overall measures of dissatisfaction likely disguise differences across defined subgroups, particularly men and women, known to experience job satisfaction and burnout differently across professions. A previous study showed gender differences in satisfaction during surgical residency training. The objective of this study was to determine gender differences in dissatisfaction with specific aspects of the institutional environment and with...
Penn Becomes Only U.S. University With Two NIA Roybal Research Centers
Physician Consolidation and the Spread of Accountable Care Organizations
Accountable Care Organizations (ACOs) are groups of physicians and hospitals that jointly contract to care for a patient population. ACO contracts incentivize coordination of care across providers. This can lead to greater consolidation of physician practices, which can in turn generate higher costs and lower quality. Given this, the study asks, as ACOs enter health care markets, do physician practices grow larger?
A National Comparison of Operative Outcomes of New and Experienced Surgeons
In this national study, Medicare beneficiaries treated by new surgeons had poorer outcomes than those treated by experienced ones in the same hospitals. However, the type of operation and the patient’s emergency status – rather than physician inexperience – explains nearly all poorer outcomes. Higher-risk cases are disproportionately treated by new surgeons.
The Influence of Gender and Underrepresented Minority Status on Medical Student Ranking of Residency Programs
Atu Agawu, Corrinne Fahl, Dominique Alexis, Tomas Diaz, Diana Harris, Mary C. Harris, Jaya Aysola, Peter F. Cronholm, Eve J. Higginbotham
Abstract [from journal]
Background: Physician diversity is linked to improved quality of care of diverse patient populations. The transition from medical school to residency is an opportunity to improve and increase workforce diversity in all specialties. However, there is limited published literature on the factors contributing to the ranking of residency programs on women and underrepresented minorities (URMs).
Objective: To characterize factors medical students used to rank residency programs and describe any differences based on
...Gender Differences in Retention and Promotion Among Generalists Who Graduated From Research-Intensive Fellowships
Krisda H. Chaiyachati, Joshua Liao, Gary E Weissman, Rebecca A Hubbard, Anna U. Morgan, Anna Buehler, Judy A. Shea, Katrina A. Armstrong
Abstract [from journal]
Background: Generalists who pursue research-intensive fellowships develop research skills and mentor-mentee relationships. Whether gender disparities in retention and promotion exist among this research-trained cohort is understudied.
Objective: We measured whether disparities exist among graduates of research-intensive fellowships and how mentorship influences them.
Methods: We surveyed generalists (internal medicine, pediatrics, family medicine, combined internal medicine-pediatrics)
...Seeking a Stable Foundation to Build on: 1st-Year Residents' Views of High-Value Care Teaching
Rey Perez, David Aizenberg, Trocon Davis, Kira L Ryskina
Abstract [from journal]
Background: United States (US) residency programs have been recently mandated to teach the concept of high-value care (HVC) defined as care that balances the benefits of interventions with their harms and costs. We know that reflective practice is a key to successful learning of HVC; however, little is known about resident perceptions of HVC learning. To better inform HVC teaching in graduate medical education, we asked 1st-year residents to reflect on their HVC learning.
Methods: We conducted three focus
...Trends in Racial/Ethnic Representation Among US Medical Students
Lanair Amaad Lett, H. Moses Murdock, Whitney U. Orji, Jaya Aysola, Ronnie Sebro
Abstract [from journal]
Importance: With increasing efforts to create a diverse physician workforce that is reflective of the demographic characteristics of the US population, it remains unclear whether progress has been made since 2009, when the Liaison Committee on Medical Education set forth new diversity accreditation guidelines.
Objective: To examine demographic trends of medical school applicants and matriculants relative to the overall age-adjusted US population.
Design, Setting, and Participants:
...Pursuing a Career in Academic Surgery Among African American Medical Students
Sanford Roberts, Judy A. Shea, Morgan Sellers, Paris D. Butler, Rachel Rapaport Kelz
Abstract [from journal]
Background: There are few African American students in medical school, and even fewer are choosing academic surgical careers. The objective of this study is to provide insight into what barriers URM students perceive when considering a career in academic surgery.
Methods: This qualitative, descriptive study was conducted at the University of Pennsylvania. Sixteen African American students with an interest in surgery were recruited to participate in the study. The outcomes reported are themes of how participants
...Bekelman and Patel "Nudge" Radiation Oncology Study Cited by NIH Newsletter
Pediatric Emergency Department and Primary Care Provider Attitudes on Assessing Childhood Adversity
Samantha Schilling, Ashlee Murray, Cynthia J. Mollen, Tara Wedin, Joel A. Fein, Philip V. Scribano
Abstract [from journal]
Objective: The purpose of this study was to understand pediatric emergency department (ED) and primary care (PC) health care provider attitudes and beliefs regarding the intersection between childhood adversities and health care.
Methods: We conducted in-depth, semistructured interviews in 2 settings (ED and PC) within an urban health care system. Purposive sampling was used to balance the sample among 3 health care provider roles. Interview questions were based on a modified health beliefs model exploring the "...
The Clinician Crowdsourcing Challenge: Using Participatory Design to Seed Implementation Strategies
Rebecca E. Stewart, Nathaniel Williams, Y. Vivian Byeon, Alison Buttenheim, Sriram Sridharan, Kelly Zentgraf, David T. Jones, Katelin Hoskins, Molly Candon, Rinad S. Beidas
Abstract [from journal]
Background: In healthcare settings, system and organization leaders often control the selection and design of implementation strategies even though frontline workers may have the most intimate understanding of the care delivery process, and factors that optimize and constrain evidence-based practice implementation within the local system. Innovation tournaments, a structured participatory design strategy to crowdsource ideas, are a promising approach to participatory design that may increase the effectiveness of implementation
...Radiation Oncologist Characteristics and their Association with Outcomes in Patients with Head and Neck Cancer
Siddharth Jain, Richard Popple, Jeff Szychowski, Bisakha Sen, Julie L. Locher, Meredith L. Kilgore
Abstract [from journal]
Purpose: Intensity modulated radiation therapy (IMRT) is widely used in the treatment of head and neck cancers (HNC). There is not enough evidence to suggest that some radiation oncologists (ROs) are associated with better outcomes in patients with HNC. We conducted a cross-sectional analysis to evaluate the effect of ROs' characteristics on outcomes in patients with HNC treated with IMRT.
Methods and Materials: The study used the Surveillance Epidemiology and End Results-Medicare linked database to identify
...Do Longer Shifts Affect Residents’ Sleep or Patient Safety?
Do residents need more sleep? Two new studies in the New England Journal of Medicine compare the effects of standard versus flexible duty-hours on residents’ sleep and patient safety.
The iCOMPARE trial randomized 63 internal medicine residency programs, consisting of over 5,000 trainees, to standard duty-hour policies or flexible policies. All programs were held to an 80-hour work week, but flexible policies had no limits on shift lengths and did not mandate time off between shifts.