Peer Support Ambassadors: A Program to Advance a Supportive and Inclusive Clinical Learning Environment.

Peer support is beneficial to physicians in distress, but few institutions have created formal programs that train residents and fellows to effectively support their peers. Existing curricula also do not address the differential experience of residents from historically excluded groups, who are more likely to experience distressing mistreatment and discrimination in the clinical learning environment. The Graduate Medical Education (GME) Peer Support Ambassador (PSA) Program aimed to address this gap by: (1) offering peer support skills and trauma-informed care training to a diverse cohort of resident leaders representing a range of specialties, (2) deploying these leaders to support their peers, and (3) facilitating opportunities for participants to train other residents in these skills.

A multi-residency elective to address well-being as a systems issue.

What Was The Educational Challenge?: Burnout is a well-established issue in medical training, but optimal systems approaches for well-being and ways to engage residents in well-being work are unknown.

What Was The Solution?: The authors developed a multi-residency well-being elective with participants from internal medicine, anesthesiology, and urology residency programs. The elective included an asynchronous learning curriculum, a mentored independent project on system drivers of well-being, and participation in a cross-residency group that set elective priorities.

Graduate medical education well-being directors in the United States: who are they, and what does the role entail?

Background: Institutional Graduate Medical Education (GME) Well-being Director (WBD) roles have recently emerged in the United States to support resident and fellow well-being. However, with a standard position description lacking, the current scope and responsibilities of such roles is unknown. This study describes the scope of work, salary support, and opportunities for role definition for those holding institutional leadership positions for GME well-being.

Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review.

Objectives: to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.

Methods: an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.

Results: 141 articles were identified in the initial search, and 10 studies made up the final sample.

"I Wish They Had Asked": a Qualitative Study of Emotional Distress and Peer Support During Internship.

Background: Interns are vulnerable to emotional distress and burnout. Little is known about the extent to which interns' well-being can be influenced by peer support provided by their senior residents.

Objective: To elucidate contributors to interns' emotional distress and ways that peer support from senior residents may impact intern well-being.

Designing Well-Being: Using Design Thinking to Engage Residents in Developing Well-Being Interventions.

Problem: Improving well-being in residency requires solutions that focus on organizational factors and the individual needs of residents, yet there are few examples of successful strategies to address this challenge. Design thinking (DT), or human-centered design, is an approach to problem-solving that focuses on understanding emotions and human dynamics and may be ideally suited to tackling well-being as a complex problem. The authors taught residents to use DT techniques to identify, analyze, and address organizational well-being challenges.

Becoming outstanding educators: What do they say contributed to success?

Aspiring medical educators and their advisors often lack clarity about career paths. To provide guidance to faculty pursuing careers as educators, we sought to explore perceived factors that contributed to the career development of outstanding medical educators. Using a thematic analysis, investigators at two institutions interviewed 39 full or associate professor physician faculty with prominent roles as medical educators in 2016.

Preventability of Early Versus Late Hospital Readmissions in a National Cohort of General Medicine Patients.

Background: Many experts believe that hospitals with more frequent readmissions provide lower-quality care, but little is known about how the preventability of readmissions might change over the postdischarge time frame.

Objective: To determine whether readmissions within 7 days of discharge differ from those between 8 and 30 days after discharge with respect to preventability.

Design: Prospective cohort study.

Physician Perspectives on Factors Contributing to Readmissions and Potential Prevention Strategies: A Multicenter Survey.

Background: The transition out of the hospital is a vulnerable time for patients, relying heavily on communication and coordination of resources across care settings. Understanding the perspectives of inpatient and outpatient physicians regarding factors contributing to readmission and potential preventive strategies is crucial in designing appropriately targeted readmission prevention efforts.

Objective: To examine and compare inpatient and outpatient physician opinions regarding reasons for readmission and interventions that might have prevented readmission.

Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients.

Importance: Readmission penalties have catalyzed efforts to improve care transitions, but few programs have incorporated viewpoints of patients and health care professionals to determine readmission preventability or to prioritize opportunities for care improvement.

Objectives: To determine preventability of readmissions and to use these estimates to prioritize areas for improvement.

Design, Setting, And Participants: An observational study was conducted of 1000 general medicine patients readmitted within 30 days of discharge to 12 US academic medical centers between April 1, 2012, and March 31, 2013.