Utilization of and Adherence to the Gastroenterology Core Curriculum on Hepatology Training During a Gastrointestinal Fellowship

Guardino, Jason M.; Proctor, Deborah D.; López, Rocío; Carey, William D.

doi:10.1016/j.cgh.2007.12.038

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Although prior studies have surveyed both GI program directors (PD) and fellows on specific educational content within fellowship programs, little is known about the perceptions of the inpatient training experience as a whole [5][6][7][8]. The aims of this study were thus to (1) survey the current models of inpatient training, (2) assess the content, objectives and quality of the inpatient training experience, and (3) evaluate the frequency and quality of educational activities on the inpatient service, as perceived by PDs and fellows in US ACGME-accredited GI fellowship programs.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows

2017

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Background Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. Aim To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. Methods We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Results Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team ([90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p \ 0.0001). PDs rated the overall quality of the inpatient training experience (p \ 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Conclusion Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

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Section: Introductionmentioning

confidence: 99%

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows

2017

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“…2 Despite these recommendations, many procedures are performed by learners who are not appropriately proficient or confident, 3,4 and there is variable adherence to the gastroenterology core curriculum regarding hepatology in many programs. 5 Simulation-based mastery learning 6 featuring deliberate practice 7 gives residents and fellows the opportunity for procedural skills development and feedback. Mastery learning requires that learners meet or exceed a minimum passing score (MPS) on a simulated examination prior to performing the procedure in actual clinical care.…”

Section: Introductionmentioning

confidence: 99%

Simulation-Based Education with Mastery Learning Improves Paracentesis Skills

Cohen¹,

Vozenilek²,

O'Connor³

et al. 2012

Journal of Graduate Medical Education

131

119

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Background Paracentesis is a commonly performed bedside procedure that has the potential for serious complications. Therefore, simulation-based education for paracentesis is valuable for clinicians. Objective To assess internal medicine residents' procedural skills before and after simulation-based mastery learning on a paracentesis simulator. Methods A team with expertise in simulation and procedural skills developed and created a high fidelity, ultrasound-compatible paracentesis simulator. Fifty-eight first-year internal medicine residents completed a mastery learning-based intervention using the paracentesis simulator. Residents underwent baseline skill assessment (pretest) using a 25-item checklist. Residents completed a posttest after a 3-hour education session featuring a demonstration of the procedure, deliberate practice, ultrasound training, and feedback. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest, the key feature of mastery learning. We compared pretest and posttest checklist scores to evaluate the effect of the educational intervention. Residents rated the training sessions. Results Residents' paracentesis skills improved from an average pretest score of 33.0% (SD = 15.2%) to 92.7% (SD = 5.4%) at posttest (P < .001). After the training intervention, all residents met or exceeded the MPS. The training sessions and realism of the simulation were rated highly by learners. Conclusion This study demonstrates the ability of a paracentesis simulator to significantly improve procedural competence.

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“…This study evaluated overall programmatic compliance with a focus on the hepatology component and found that although most programs were in general compliance with the recommendations of the Core Curriculum, and specifically the hepatology portion, there were striking deficiencies noted in some areas of hepatology training. Although this study was somewhat reassuring, the areas where there were shortcomings needed improvement [5]. …”

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confidence: 78%

“…The training recommendations included obtaining the appropriate knowledge and clinical experience through didactic lectures and close alliance with physicians who have an interest and experience in evaluating and managing women's GI health issues, including obstetricians and gynecologists. Another recommendation was that a minimum of 25% of the fellow's panel of patients be women [3].In July 2005, the ACGME adopted these recommendations and now requires formal instruction and clinical experience in women's GI health issues and that in their continuity clinic ''each fellow's panel of patients must include at least 25% of patients from each gender '' [4].In 2008, the first survey assessing compliance with the Gastroenterology Core Curriculum was published [5]. This study evaluated overall programmatic compliance with a focus on the hepatology component and found that although most programs were in general compliance with the recommendations of the Core Curriculum, and specifically the hepatology portion, there were striking deficiencies noted in some areas of hepatology training.…”

mentioning

confidence: 99%

“…In 2008, the first survey assessing compliance with the Gastroenterology Core Curriculum was published [5]. This study evaluated overall programmatic compliance with a focus on the hepatology component and found that although most programs were in general compliance with the recommendations of the Core Curriculum, and specifically the hepatology portion, there were striking deficiencies noted in some areas of hepatology training.…”

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confidence: 99%

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Getting to the Core of the Women’s Curriculum—It’s Time to Change the Way We Train Our Fellows

Proctor

2011

Dig Dis Sci

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In the United States, 50.7 percent of the population are women [1]. In 2004 there were an estimated 104 million visits for evaluation and management of a digestive disease, and after adjustment for age the number of visits was 10 percent higher for women than for men, which equates to over 57 million visits per year for women [2]. Although many digestive diseases are the same in men and women, there are also many differences. Research has shown that there are gender differences in epidemiology, response to health and illness, treatment, and complications. Fertility, pregnancy, and the post-partum state pose specific challenges for gastroenterologists. As specialists in digestive diseases, gastroenterologists must have the knowledge and range of skills necessary to care for women with their unique issues.It is challenging to successfully train highly qualified gastroenterologists during the three year fellowship period. An enormous amount of knowledge and procedural skills must be acquired by the end of training, with the instillation of a desire for life-long learning. A program must be well-structured with a committed program director and dedicated faculty in order to accomplish these objectives.Guidelines for training gastroenterology fellows were first published by the Gastroenterology Leadership Council in 1996, but it was not until the Gastroenterology Core Curriculum was updated in 2003 that a women's curriculum in digestive diseases was first outlined. The recommendations specifically addressed three areas: (1) general women's gastroenterology (GI) health issues, including the doctorpatient relationship; cultural, religious, and psychosocial issues; differences in disease presentation; laboratory and diagnostic testing; and the use of complementary and alternative medicine; (2) specific women's GI health issues including gender differences in GI health and disease states, the effects of the menstrual cycle and menopause on GI health and disease states, medication pharmacokinetics, and response to and complications of therapy; and (3) pregnancy and childbearing issues, including fertility, infertility, pregnancy in women with preexisting digestive diseases, diseases unique to pregnancy, medication pharmacokinetics and safety during pregnancy and with breast-feeding, clinical onset of digestive diseases during pregnancy and after delivery, and the effect of pregnancy on healthy mothers. The training recommendations included obtaining the appropriate knowledge and clinical experience through didactic lectures and close alliance with physicians who have an interest and experience in evaluating and managing women's GI health issues, including obstetricians and gynecologists. Another recommendation was that a minimum of 25% of the fellow's panel of patients be women [3].In July 2005, the ACGME adopted these recommendations and now requires formal instruction and clinical experience in women's GI health issues and that in their continuity clinic ''each fellow's panel of patients must include at least 25% of pati...

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Utilization of and Adherence to the Gastroenterology Core Curriculum on Hepatology Training During a Gastrointestinal Fellowship

Cited by 8 publications

References 12 publications

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows

Simulation-Based Education with Mastery Learning Improves Paracentesis Skills

Getting to the Core of the Women’s Curriculum—It’s Time to Change the Way We Train Our Fellows

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