Using Patient Outcomes to Evaluate General Surgery Residency Program Performance

Bansal, Neha; Simmons, Kristina D.; Epstein, Andrew J.; Morris, Jon B.; Kelz, Rachel R.

doi:10.1001/jamasurg.2015.3637

Cited by 55 publications

(47 citation statements)

References 23 publications

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“…Although studies exploring these outcomes are not available in endoscopic training, objective data were successfully used to rank the clinical outcomes achieved by graduates of general surgery (in-hospital death, postoperative complication, length of stay) and obstetrics and gynecology (maternal complication rates) training programs. 37,38 The possibility of recall and reporting bias inherent to self-reported data cannot be excluded. In addition, there is a risk that physicians in independent practice might “game the numbers” through “risk transfer,” leading to risk-shifting behavior and resultant higher performance rates on established QIs.…”

Section: Discussionmentioning

confidence: 99%

Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography, From Training Through Independent Practice

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography, From Training Through Independent Practice

et al. 2018

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“…Previous studies on residency program reputation have employed objective outcomes such as patient outcomes, board pass rates for residents, and prevalence of alumni publications. 11,12 Of note, Doximity does incorporate objective factors in its reputation calculation, but it is not clear how much statistical weight these factors are given compared to subjective, peer-nomination surveys. The findings in this study are limited by the residency program characteristics included in the statistical models, which did not entirely account for Doximity rankings (see R 2 values for logistic regression models in the online supplemental material, which range from 0.501-0.814).…”

Section: Discussionmentioning

confidence: 99%

Association of Doximity Ranking and Residency Program Characteristics Across 16 Specialty Training Programs

Feinstein¹,

Niforatos²,

Mosteller³

et al. 2019

Journal of Graduate Medical Education

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Background Residency program prestige is an important variable medical students consider when creating their rank list. Doximity Residency Navigator is a ranking system that previous reports have shown significantly influences medical student application decisions. Doximity's use of peer nomination as a central component of its methodology for determining program rank has drawn criticism for its lack of objectivity. Doximity has not published information regarding how peer nomination and more objective measures are statistically weighted in reputation calculation. Objective This study assesses whether a strong negative correlation exists between residency program size and Doximity ranking. Methods A cross-sectional study of Doximity residency rankings from the 2018–2019 academic year was conducted. Data extracted from Doximity included program rank, size, and age. Data were additionally collected from the Blue Ridge Institute for Medical Research, National Institutes of Health, funding in 2018 and the US News & World Report Best Medical Schools 2019–2020. A multivariable linear regression model was used that included Doximity ranking as the outcome variable and residency program size as the predictor variable with adjustment for the aforementioned variables. Results Sixteen of the 28 specialties on Doximity were included in the analysis, representing 3388 unique residency programs. After adjustment for covariates, residency program size was a significant predictor of Doximity ranking (β = -1.84; 95% CI -2.01 to -1.66, P < .001). Conclusions These findings support the critique that the Doximity reputation ranking system may favor larger residency programs. More transparency for Doximity reputation ranking algorithm is warranted.

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“…Studies from North America have shown that the quality of the learning environment that provided the context for training was a predictor of the quality of care provided by graduates for years after graduation (Tamblyn et al 2005;Asch et al 2009) and influenced prescribing patterns (Cadieux et al 2007) and patient management and use of health care resources (Chen et al 2014;Sirovich et al 2014;Dine et al 2015). Similarly, complication rates for practicing general surgeons were associated with the ranking of the residency program in which they had trained-with higher ranked residency programs correlated with lower complication rates (Bansal et al 2016). Therefore, efforts to improve the CLE not only have a positive impact in the settings where trainees learn and participate in patient care but also affect the practice of future graduates, potentially for decades to come.…”

Section: The Clinical Learning Environmentmentioning

confidence: 99%

The clinical learning environment

et al. 2019

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Learning in a clinical context is foundational in the training of health professionals; there is simply no alternative. The subject of the clinical learning environment (CLE) is at the forefront of discussions. In this introduction to a themed issue on the CLE, we present an expanded conceptual model that approaches the CLE through six different lenses, termed "avenues:" architectural, digital, diversity and inclusion, education, psychological, and sociocultural, with each avenue represented by a paper. The aim is to facilitate dialog around the contributions of different academic disciplines to research on the CLE. Collectively the papers highlight the overlap between the various "avenues" in how they influence each other, and how they collectively have shaped the work to understand and improve the CLE. The expectation is that the various avenues can add to existing knowledge and create new ideas for interventions to improve the clinical learning environment across nations for learners and teachers with the ultimate aim of improving patient care. Research and efforts to improve the CLE are critical to learning, professional socialization and well-being for trainees as they learn and participate in patient care, and to the quality of care they will deliver over decades of practice after graduation.

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Using Patient Outcomes to Evaluate General Surgery Residency Program Performance

Cited by 55 publications

References 23 publications

Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography, From Training Through Independent Practice

Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography, From Training Through Independent Practice

Association of Doximity Ranking and Residency Program Characteristics Across 16 Specialty Training Programs

The clinical learning environment

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