Our House Won't Rebuild Itself: Peace, Love, and Hope as Tools to Transform Graduate Medical Education.

Graduate medical education (GME), the period of specialty and subspecialty training following attainment of a medical degree, is the final step in a continuum of medical education culminating in independent physician practice. This manuscript uses the metaphor "our house" to describe all aspects of the GME environment in which health care professionals and trainees learn and work. Our house's inhabitants have unequivocally stated that our house is in a state of disrepair.

Deliberate practices of speaking up and responding skills: the Speak-PREP e-learning module for healthcare professionals.

Purpose: Speaking up and responding to others' concerns promotes patient safety. We describe health professionals' utilisation of these important skills.

Method: We developed an interactive e-learning module, Speak-PREP, to train healthcare professionals in speaking up and responding strategies.

Interprofessional model on speaking up behaviour in healthcare professionals: a qualitative study.

Objectives: Despite training and the recognition that speaking up can mitigate harm to patients and save lives, healthcare professionals do not consistently speak up when they have patient safety concerns. The purpose of this study was to identify barriers to and facilitators of speaking up about patient safety concerns to inform the development of interventions that will increase this behaviour.

Design: From October 2017 to February 2018, the study team conducted focus groups and interviews with nurses, advanced practice providers and physicians at three healthcare facilities.

Men and Women Pursue Nonlinear Career Paths, but Impacts Differ: a Cross-Sectional Study of Academic Hospitalists.

Background: Nonlinear career paths are increasingly common. Women in academia pursuing nonlinear career paths experience negative impacts on career trajectory. No published studies have examined how pursuit of nonlinear career paths might perpetuate gender inequities within academic hospital medicine.

Parental Leave Policies in Residency: A National Survey of Internal Medicine Program Directors.

Purpose: To characterize the existence, accessibility, and content of parental leave policies, as well as barriers to program-level policy implementation among internal medicine (IM) program directors (PDs) and to assess the willingness of PDs to implement a national standardized policy.

Method: In 2019, the Association of Program Directors in Internal Medicine conducted a survey of 422 IM PDs. Along with other content, 38 questions addressed 4 primary outcomes: parental leave policy existence, accessibility, content, and barriers.

Parenthood and Parental Leave Decisions in Pediatric Residency.

Objectives: The demands of residency training may impact trainees' decision to have children. We examined characteristics of pediatric residents' decisions regarding childbearing, determinants of resident parental leave, and associations with well-being.

Methods: A survey of 845 pediatric residents at 13 programs was conducted between October 2019 and May 2020.

Representation of Women on Journal Editorial Boards Affiliated with the Association of American Medical College's Council of Faculty and Academic Societies.

The Council of Faculty and Academic Societies (CFAS) comprises representatives from medical schools and professional societies who guide the Association of American Medical Colleges (AAMC). Given the AAMC's stated mission to improve diversity and inclusion, we used gender-related representation on journal editorial boards as a proxy for evaluating CFAS member societies' commitments to equity. From screenshots of journal mastheads ( = 44) collected June 3-6, 2019, individuals were categorized by editorial position.

Maximizing Career Advancement During the COVID-19 Pandemic: Recommendations for Postgraduate Training Programs.

The ongoing novel Coronavirus disease 2019 (COVID-19) pandemic has created many threats as well as opportunities for the career development of physicians-in-training. Institutional responses to the demand for patient care reduced the time many residents have to pursue clinical electives, scholarship projects, and other experiences meant to clarify and advance their personal and professional goals. Moreover, many academic medical centers experienced profound fiscal losses that require thoughtful revisions to budgets and curricula.

Childbearing Decisions in Residency: A Multicenter Survey of Female Residents.

Purpose: To characterize how female residents make decisions about childbearing, factors associated with the decision to delay childbearing, and satisfaction with these decisions.

Method: In 2017, the authors sent a voluntary, anonymous survey to 1,537 female residents enrolled across 78 graduate medical education programs, consisting of 25 unique specialties, at 6 U.S.

Parenthood During Graduate Medical Education: A Scoping Review.

Purpose: To conduct a scoping review of the literature on parenthood during graduate medical education (GME) and to develop a conceptual framework to inform policy and guide research.

Method: The authors searched PubMed and Embase for articles published from January 1993 through August 7, 2017, using a query framework that combined the concepts of "person" (e.g.

The FIRST Curriculum: Cultivating Speaking Up Behaviors in the Clinical Learning Environment.

Expressing concerns that arise during patient care is essential to protecting patient safety. A speaking up episode occurs within a power hierarchy and carries high potential for personal and professional consequences. Existing curricula that promote speaking up, such as TeamSTEPPS, extensively focus on verbal skills without recognizing the important emotional dimensions of speaking up.

Maternity Leave in Residency: A Multicenter Study of Determinants and Wellness Outcomes.

Purpose: To characterize determinants of resident maternity leave and the effect of length of leave on maternal well-being.

Method: In 2017, the authors sent a voluntary, anonymous survey to female residents at 78 programs, in 25 unique specialties, at 6 institutions. Survey items included personal, partner, and child demographics, and logistics of leave, including whether leave was paid or vacation or sick leave was used.

Childbearing and maternity leave in residency: determinants and well-being outcomes.

Purpose: To characterise determinants of resident maternity leave and their effect on maternal and infant well-being. Among non-parents, to identify factors that influence the decision to delay childbearing STUDY DESIGN: In 2016, a survey was sent to female residents at a large academic medical centre on their experiences with maternity leave, the impact of personal and programme factors on length of leave, reasons for delaying childbearing and measures of well-being.

Results: Forty-four percent (214/481) of residents responded.

Understanding ownership of patient care: A dual-site qualitative study of faculty and residents from medicine and psychiatry.

Introduction: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents.

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.

Background: Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety.

Objective: Compare interns' and residents' experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats.

Design: Anonymous, cross-sectional survey.

'Speaking up' about patient safety concerns and unprofessional behaviour among residents: validation of two scales.

Objective: To develop and test the psychometric properties of two new survey scales aiming to measure the extent to which the clinical environment supports speaking up about (a) patient safety concerns and (b) unprofessional behaviour.

Method: Residents from six large US academic medical centres completed an anonymous, electronic survey containing questions regarding safety culture and speaking up about safety and professionalism concerns.

Results: Confirmatory factor analysis supported two separate, one-factor speaking up climates (SUCs) among residents; one focused on patient safety concerns (SUC-Safe scale) and the other focused on unprofessional behaviour (SUC-Prof scale).

Use of simulated physician handoffs to study cross-cover chart biopsy in the electronic medical record.

Clinical handoffs involve the rapid transfer of patient information from one provider or team to another, through activities which may introduce errors and affect care delivery. "Cross-coverage" requires quickly familiarizing oneself with unfamiliar patients whose management plans were established by another provider or team. Through this work, we describe physicians' information seeking approaches within an electronic medical record (EMR) during physician handoff and chart biopsy at a major academic medical center.

Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment.

A SAFE DC: a conceptual framework for care of the homeless inpatient.

Homeless patients suffer disproportionately from medical disease and from barriers to healthcare, affecting their likelihood of presentation, severity of disease, long-term outcomes, and mortality. In the hospital, homeless patients are frequently cared for by hospitalists. Homeless patients' unstable social situation may challenge usual systems of inpatient care and discharge.