Evaluation of Resident Satisfaction in the Current Era: A Local Perspective on a National Issue

Background: Mitigating resident burnout is a high priority for medical centers. Monitoring residents’ overall perceptions of their training environments could be a reliable indicator of potential future burnout. Furthermore, recent national studies suggest procedural specialties have a higher burnout rate and lower satisfaction than non-procedural specialties. In the current study, we utilized institutional data from the Accreditation Council for Graduate Medical Education (ACGME) resident survey to better understand trends related to our residency program learning environments over time (2012-2018) and by specialty grouping (procedural versus non-procedural). Methods: Annual ACGME survey results from 2012 to 2018 were retrospectively analyzed to determine trends in resident satisfaction. Specifically, satisfaction was defined as a “very positive” or “positive” response on the survey. Programs with an average of four or more residents were included. The programs were categorized into procedural versus non-procedural specialties and differential trends between the two groups were analyzed. Results: A total of 17 residency programs were included in this study (nine procedural and eight non-procedural), with a combined average satisfaction score (“very positive” plus “positive”) over all years of 89%, which is slightly better than the annual national means (87-88%). Using this combined average score, residents in procedural residency programs rated their satisfaction higher (93%) when compared to non-procedural specialties (87%). Further analysis demonstrated that procedural specialties had higher combined satisfaction scores every year of the study except for 2018. Conversely, residents in non-procedural specialties had a higher “positive” rating when compared to procedural specialties (range of 28.5-44% versus 15-33%, respectively). Conclusion: The results of our study demonstrate that the overall satisfaction scores for our academic center are comparable to or better than the national patterns, with a favorable trend towards the procedural specialties

Holistic community-based group parenting programs for mothers with maternal mental health issues help address a growing public health need for a diversity of vulnerable mothers, children and families: Findings from an action research study

BackgroundMaternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1–36 months. The program seeks to nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses that impinge upon their parenting. This study presents the evaluation of the program and its effectiveness.MethodsAction research approach for continuous monitoring and program improvement engaging Acorn program staff in evaluation data collection and interpretation of pre and post self-completion measures and standardized observations. Additional data was collected through a telephone interview of attending mothers 6–8 months after program completion to address sustainable impacts on parenting and wellbeing.ResultsThe program engaged 353 diverse vulnerable mothers with their children. Many had profound overlapping mental health issues including borderline personality disorder (BPD) and depression. The quality of the parent-child interaction, parental confidence, competence and enjoyment were enhanced; mothers' wellbeing, ability to cope and lasting social supports were augmented. This occurred for a number of “most vulnerable” subgroups including single mothers, mothers with BPD, mothers from non-English speaking households and those with lower levels of education or household income. Mothers reported sustained improvements in their wellbeing, parenting, social and family lives, and feeling closer to their child as a result of participating in the program.ConclusionsGiven the high prevalence of maternal mental health issues and substantial potential negative consequences for mothers and offspring, the Acorn parenting program offers an effective means of addressing this pressing public health issue potentially helping large numbers of vulnerable mothers and their children. This has additional gravitas in the shadow of COVID-19 due to expanded numbers of those experiencing greater parental stress, isolation and mental illness

Patient acceptance and perceived utility of pre-consultation prevention summaries and reminders in general practice: pilot study

Extent: 8p.BACKGROUND: Patients attending general practices receive only about sixty per cent of the preventive services that are indicated for them. This pilot study explores patient acceptability and perceived utility of automatically generated prevention summary and reminder sheets provided to patients immediately before consultations with their general practitioners. METHODS: Adult patients attending a general practitioner in a practice in Adelaide and a general practitioner in a practice in Melbourne, Australia for consultations in January and February 2009 received automatically-generated prevention summary and reminder sheets that highlighted indicated preventive activities that were due to be performed, and that encouraged the patient to discuss these with the general practitioner in the consultation. Patients completed a post-consultation questionnaire and were interviewed about their experience of receiving the sheets. RESULTS: Sixty patients, median age 53 years (interquartile range 40-74) years, and 58% female, were recruited. Seventy eight per cent of patients found the sheets clear and easy to understand, 75% found them very or quite useful, 72% reported they had addressed with their general practitioner all of the preventive activities that were listed on the sheets as being due to be performed. A further 13% indicated that they had addressed most or some of the activities. 78% of patients said that they would like to keep receiving the sheets. Themes emerging from interviews with patients included: patient knowledge was enhanced; patient conceptions of health and the GP consultation were broadened; the consultation was enhanced; patient pro-activity was encouraged; patients were encouraged to plan their health care; the intervention was suitable for a variety of patients. CONCLUSIONS: Most patients reported that they found the prevention summary and reminder sheets acceptable and useful. The actual increase in performance of preventive activities that may result from this new intervention needs to be tested in randomised controlled trials.Oliver R. Frank, Nigel P. Stocks and Paul Aylwar

Feasibility of Fluoroscopy-Free Endovascular Navigation in Subjects of Different Ages

https://digitalcommons.unmc.edu/emet_posters/1013/thumbnail.jp

Neuroimaging of structural pathology and connectomics in traumatic brain injury: Toward personalized outcome prediction.

Recent contributions to the body of knowledge on traumatic brain injury (TBI) favor the view that multimodal neuroimaging using structural and functional magnetic resonance imaging (MRI and fMRI, respectively) as well as diffusion tensor imaging (DTI) has excellent potential to identify novel biomarkers and predictors of TBI outcome. This is particularly the case when such methods are appropriately combined with volumetric/morphometric analysis of brain structures and with the exploration of TBI-related changes in brain network properties at the level of the connectome. In this context, our present review summarizes recent developments on the roles of these two techniques in the search for novel structural neuroimaging biomarkers that have TBI outcome prognostication value. The themes being explored cover notable trends in this area of research, including (1) the role of advanced MRI processing methods in the analysis of structural pathology, (2) the use of brain connectomics and network analysis to identify outcome biomarkers, and (3) the application of multivariate statistics to predict outcome using neuroimaging metrics. The goal of the review is to draw the community's attention to these recent advances on TBI outcome prediction methods and to encourage the development of new methodologies whereby structural neuroimaging can be used to identify biomarkers of TBI outcome

Mapping Microvasculature with Acoustic Angiography Yields Quantifiable Differences between Healthy and Tumor-bearing Tissue Volumes in a Rodent Model

To determine if the morphologies of microvessels could be extracted from contrast material–enhanced acoustic angiographic ultrasonographic (US) images and used as a quantitative basis for distinguishing healthy from diseased tissue

Colorectal cancer screening in rural and remote areas: analysis of the National Bowel Cancer Screening Program data for South Australia.

In Australia, colorectal cancer is the second most commonly diagnosed cancer and cause of death from malignant diseases, and its incidence is rising. The aim of this article was to present an analysis of National Bowel Cancer Screening Program (NBCSP) data for rural and remote South Australia (SA), in order to identify geographical areas and population groups that may benefit from targeted approaches to increase participation rates in colorectal cancer screening.The findings of this study suggest lower NBCSP participation rates for people from metropolitan and remote areas, compared with those from rural areas. The uptake of cancer screening is lower for older rural and remote residents, men, Indigenous people, lower socioeconomic groups and those living in the Far North subdivision of SA