Facilitating Physician Reentry to Practice: Perceived Effects of Deployments on US Army Pediatricians’ Clinical and Procedural Skills

Braun, LoRanée; Sawyer, Taylor; Kavanagh, Laurie; Deering, Shad

doi:10.1002/chp.21256

Cited by 10 publications

(3 citation statements)

References 18 publications

(25 reference statements)

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“…Most participants lack confidence, but there is no compelling evidence that competence is significantly affected by clinical inactivity. 14 A lack of confidence can reduce work rate and decrease practitioner wellbeing 14,37,38 but is not directly correlated with competence, particularly in the RTW setting. Formal assessment of competence was judged to be an unnecessary burden on both faculty and participants and was therefore not incorporated into the design of the course.…”

Section: Introductionmentioning

confidence: 99%

Eight years of CRASH: A bi-national initiative helping critical care doctors return to work

Allen

Wright

Lee

et al. 2022

Anaesth Intensive Care

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Returning to work in critical care after a break in clinical practice can be a daunting process. This article describes development and evolution of the Critical Care, Resuscitation, Airway Skills: Helping you return to work (CRASH) course, including the supporting literature. CRASH is the first bi-national course assisting return to work (RTW) for critical care practitioners. It evolved as a collaborative effort across Australia and New Zealand, involving anaesthetists, emergency physicians and intensivists. The course is based around tailored sessions practising skills and clinical decision-making using simulation and case discussions, incorporating practical tips on returning to work. Participants receive resources to assist RTW including questionnaires and checklists developed by the faculty, which have been used to aid RTW in more than 30 hospitals in Australia and New Zealand. Attendance is open to all critical care practitioners who are registered with the relevant medical board and returning to work, who have taken leave from work for any reason. Since 2014, 197 participants have attended CRASH in-person or virtually, one of the largest RTW groups described in the literature. The aim of this article is to outline the literature around inactivity and RTW, and describe the development and adaptation of the CRASH course.

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Section: Introductionmentioning

confidence: 99%

Eight years of CRASH: A bi-national initiative helping critical care doctors return to work

Allen

Wright

Lee

et al. 2022

Anaesth Intensive Care

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“…Therapeutic procedures, once considered the surgeon's exclusive domain, are now practiced in almost all medical specialties [1]. Even though general pediatrics is not known to be a 'procedures-heavy' discipline, general pediatricians (GPeds) are expected to provide a medical home for their patients, which includes performing common procedures safely and effectively [2][3][4][5][6]. For nearly 30 years, common pediatric procedures have been incorporated into residency program curricula in the USA [7].…”

Section: Introductionmentioning

confidence: 99%

How general pediatricians learn procedures: implications for training and practice

Iyer

Way

Schumacher

et al. 2021

Medical Education Online

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The Accreditation Council for Graduate Medical Education (ACGME) requires General Pediatricians (GPeds) to learn thirteen procedures during training. However, GPeds infrequently perform these procedures in practice. We sought to determine:1) how GPeds learned procedures, 2) if GPeds self-reported achieving competence in the required ACGME procedures during training, and 3) if GPeds maintained these skills into practice. We conducted this mixed methods study from 2019-2020. 51 GPeds from central Ohio and the American Board of Pediatrics General Examination Committee were recruited via email or snowball sampling and participated in semi-structured recorded phone interviews probing procedural performance during training and current practice. Participants represented varied geographic regions and clinical settings. We employed Sawyer's 'Learn, See, Practice, Prove, Do, Maintain' mastery learning pedagogical framework as a lens for thematic analysis. Participants did not demonstrate competence in all ACGME required procedures during training, nor sustain procedural skills in practice. Most participants learned procedures through a 'see one, do one' apprenticeship model. GPeds reported never being formally assessed on procedural competence during residency. All GPeds referred out at least one procedure. GPeds also believed that skill maintenance was unwarranted for procedures irrelevant to their current practice. GPeds did not sufficiently demonstrate competence in all ACGME required procedures during training, partially suggesting why they infrequently perform some procedures. Alternatively, these required procedures may not be relevant to their practice. Pediatric residency procedures education might consider using mastery learning for practice-specific procedures and surface-level methods (learning without mastery) for other skills.

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“…A 2002 JAMA review of the topic cited caretaking responsibilities, personal illness, career dissatisfaction, and alternative careers as common causes of physician reentry 1 . More recent studies suggest that changes in career paths into a non‐clinical position (such as administration), family issues, military deployments, and career dissatisfaction also contribute to physicians leaving the workforce voluntarily 8,12–13,15 . A survey of over 6000 pediatricians younger than 65 found that 12% of respondents indicated they had experienced a period of clinical inactivity lasting >12 months.…”

Section: Introductionmentioning

confidence: 99%

Physician reentry–A timely topic for emergency medicine

et al. 2020

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Facilitating Physician Reentry to Practice: Perceived Effects of Deployments on US Army Pediatricians’ Clinical and Procedural Skills

Cited by 10 publications

References 18 publications

Eight years of CRASH: A bi-national initiative helping critical care doctors return to work

Eight years of CRASH: A bi-national initiative helping critical care doctors return to work

How general pediatricians learn procedures: implications for training and practice

Physician reentry–A timely topic for emergency medicine

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