Implementing Holistic Applicant Review and Addressing Biases in Anesthesiology Residency Committee Deliberations.

Background: Holistic review of applications may optimize recruitment of residents by seeking out characteristics best aligned with program culture. The goals of this mixed methods research were to engage residency recruitment stakeholders to develop a holistic scoring rubric, measure the correlation between the rubric score and the final global rating used to rank applicants for the National Resident Matching Program Match, and qualitatively analyze committee discussions at the end of the interview day about applicants for potential unconscious biases.

Methods: Forty stakeholders (32 faculty, 3 chief residents, and 5 administrative staff) completed an iterative consensus-driven process to identify the most highly valued applicant attributes, and a corresponding standardized question for each attribute.

A mimetic peptide of ACE2 protects against SARS-CoV-2 infection and decreases pulmonary inflammation related to COVID-19.

Since human angiotensin-converting enzyme 2 (ACE2) serves as a primary receptor for SARS-CoV-2, characterizing ACE2 regions that allow SARS-CoV-2 to enter human cells is essential for designing peptide-based antiviral blockers and elucidating the pathogenesis of the virus. We identified and synthesized a 25-mer mimetic peptide (encompassing positions 22-46 of the ACE2 alpha-helix α1) implicated in the S1 receptor-binding domain (RBD)-ACE2 interface. The mimetic (wild-type, WT) ACE2 peptide significantly inhibited SARS-CoV-2 infection of human pulmonary Calu-3 cells in vitro.

Domains Influencing Faculty Decisions on the Level of Supervision Required for Anesthesiology EPAs with Analysis of Feedback Comments.

Objective: The purpose of this qualitative study was to examine responses related to entrustment and feedback comments from an assessment tool.

Design: Qualitative analyses using semi-structured interviews and analysis of narrative comments.

Setting: Main hospital OR suite at a large academic medical center.

Indigenizing and co-producing the ACGME anesthesiology milestone in Taiwan: a Delphi study and subgroup analysis.

Background: To implement the ACGME Anesthesiology Milestone Project in a non-North American context, a process of indigenization is essential. In this study, we aim to explore the differences in perspective toward the anesthesiology competencies among residents and junior and senior visiting staff members and co-produce a preliminary framework for the following nation-wide survey in Taiwan.

Methods: The expert committee translation and Delphi technique were adopted to co-construct an indigenized draft of milestones.

Development and Pilot Testing of a Programmatic System for Competency Assessment in US Anesthesiology Residency Training.

Background: In 2018, a set of entrustable professional activities (EPAs) and procedural skills assessments were developed for anesthesiology training, but they did not assess all the Accreditation Council for Graduate Medical Education (ACGME) milestones. The aims of this study were to (1) remap the 2018 EPA and procedural skills assessments to the revised ACGME Anesthesiology Milestones 2.0, (2) develop new assessments that combined with the original assessments to create a system of assessment that addresses all level 1 to 4 milestones, and (3) provide evidence for the validity of the assessments.

Defining entrustable professional activities for first year anesthesiology residents: A Delphi study.

Introduction: The use of entrustable professional activities (EPAs) as a basis for assessment may bridge the gap between the theory of competency-based education and clinical practice. The purpose of this study was to develop and validate EPAs for United States (US) first-year clinical anesthesia (CA-1) residents for anesthesiology residency programs to use as the basis for curriculum development and workplace assessment.

Methods: From a list of EPAs abstracted from the literature, an expert panel through a modified Delphi consensus process established EPAs for the CA1 curriculum.

Evaluation of the Stanford Anesthesiology Faculty Teaching Scholars Program Using the Context, Input, Process, and Product Framework.

Background: Faculty development programs are essential to the educational mission of academic medical centers as they promote skill development and career advancement and should be regularly evaluated to determine opportunities for improvement. The context, input, process, and product (CIPP) framework evaluates all phases of a program and focuses on improvement and outcomes. The aim of this study was to use the CIPP framework to evaluate the Stanford Anesthesiology Faculty Teaching Scholars Program.

miR-155 exerts posttranscriptional control of autoimmune regulator (Aire) and tissue-restricted antigen genes in medullary thymic epithelial cells.

Background: The autoimmune regulator (Aire) gene is critical for the appropriate establishment of central immune tolerance. As one of the main controllers of promiscuous gene expression in the thymus, Aire promotes the expression of thousands of downstream tissue-restricted antigen (TRA) genes, cell adhesion genes and transcription factor genes in medullary thymic epithelial cells (mTECs). Despite the increasing knowledge about the role of Aire as an upstream transcriptional controller, little is known about the mechanisms by which this gene could be regulated.

Autoimmune regulator act in synergism with thymocyte adhesion in the control of lncRNAs in medullary thymic epithelial cells.

The autoimmune regulator (Aire) gene in medullary thymic epithelial cells (mTECs) encodes the AIRE protein, which interacts with its partners within the nucleus. This "Aire complex" induces stalled RNA Pol II on chromatin to proceed with transcription elongation of a large set of messenger RNAs and microRNAs. Considering that RNA Pol II also transcribes long noncoding RNAs (lncRNAs), we hypothesized that Aire might be implicated in the upstream control of this RNA species.

Competency-based anesthesiology teaching: comparison of programs in Brazil, Canada and the United States.

In 2017, the Brazilian Society of Anesthesiology (SBA) and the National Medical Residency Committee (CNRM) presented a joint competence matrix to train and evaluate physicians specializing in Anesthesiology, which was enforced in 2019. The competency-based curriculum aims to train residents in relation to certain results, in that residents are considered capable when they are able to act in an appropriate and effective manner within certain standards of performance. Canada and the United States (US) also use competency-based curriculum to train their professionals.

Development and Pilot Testing of Entrustable Professional Activities for US Anesthesiology Residency Training.

Background: Modern medical education requires frequent competency assessment. The Accreditation Council for Graduate Medical Education (ACGME) provides a descriptive framework of competencies and milestones but does not provide standardized instruments to assess and track trainee competency over time. Entrustable professional activities (EPAs) represent a workplace-based method to assess the achievement of competency milestones at the point-of-care that can be applied to anesthesiology training in the United States.

Red Flags, Geography, Exam Scores, and Other Factors Used by Program Directors in Determining Which Applicants Are Offered an Interview for Anesthesiology Residency.

Objective The goal of this study was to measure the most important factors in candidate applications that anesthesiology program directors (PDs) use to decide who to invite for an interview, and how that might change once the United States Medical Licensing Examination (USMLE) Step 1 is only reported as pass/fail. Design Based on a literature review, a comprehensive list of 27 factors used by PDs to select candidates for the interview was developed. An anonymous survey link was emailed to PDs of all Accreditation Council for Graduate Medical Education (ACGME) accredited Anesthesiology residencies.

Milestone Learning Trajectories of Residents at Five Anesthesiology Residency Programs.

Every six months, residency programs report their trainees' Milestones Level achievement to the Accreditation Council for Graduate Medical Education (ACGME). Milestones should enable the learner and training program to know an individual's competency development trajectory. Milestone Level ratings for residents grouped by specialty (e.

Barriers and aids to routine neuromuscular monitoring and consistent reversal practice-A qualitative study.

Background: Neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered, but surveys have demonstrated inconsistent monitoring practices. Using qualitative methods, we aimed to explore barriers and aids to routine neuromuscular monitoring and consistent reversal practice.

Methods: Focus group interviews were conducted to obtain insights into the thoughts and attitudes of individual anaesthetists, as well as the influence of colleagues and department culture.

Assessment Scores of a Mock Objective Structured Clinical Examination Administered to 99 Anesthesiology Residents at 8 Institutions.

Background: Objective Structured Clinical Examinations (OSCEs) are used in a variety of high-stakes examinations. The primary goal of this study was to examine factors influencing the variability of assessment scores for mock OSCEs administered to senior anesthesiology residents.

Methods: Using the American Board of Anesthesiology (ABA) OSCE Content Outline as a blueprint, scenarios were developed for 4 of the ABA skill types: (1) informed consent, (2) treatment options, (3) interpretation of echocardiograms, and (4) application of ultrasonography.

Adhesion between medullary thymic epithelial cells and thymocytes is regulated by miR-181b-5p and miR-30b.

In this work, we demonstrate that adhesion between medullary thymic epithelial cells (mTECs) and thymocytes is controlled by miRNAs. Adhesion between mTECs and developing thymocytes is essential for triggering negative selection (NS) of autoreactive thymocytes that occurs in the thymus. Immune recognition is mediated by the MHC / TCR receptor, whereas adhesion molecules hold cell-cell interaction stability.

Optimal Management of Endometriosis and Pain.

The pathophysiology of endometriosis-associated pain involves inflammatory and hormonal alterations and changes in brain signaling pathways. Although medical treatment can provide temporary relief, most patients can achieve long-term sustained pain relief when it is combined with surgical intervention. Owing to its complexity, there is an ongoing debate about how to optimally manage endometriosis-associated pain.

Assessing the Workplace Culture and Learning Climate in the Inpatient Operating Room Suite at an Academic Medical Center.

Objective: The purpose of this study was to elicit perspectives from operating room (OR) personnel on the workplace culture and learning climate in the surgical suite, and to identify behaviors associated with a positive culture and learning climate.

Design: Qualitative analyses using survey methodology.

Setting: Main hospital OR suite at a large academic medical center.

Struggling Medical Learners: A Competency-Based Approach to Improving Performance.

Introduction: Faculty must be trained to recognize, analyze, and provide feedback and resources to struggling medical learners. Training programs must be equipped to intervene when necessary with individualized remediation efforts to ensure learner success.

Methods: This 90-minute interactive faculty development workshop provides a foundational competency-based framework for identifying and assisting the struggling medical learner.

Incidence, risk factors, and consequences of residual neuromuscular block in the United States: The prospective, observational, multicenter RECITE-US study.

Study Objective: To determine the incidence burden and associated risk factors of residual neuromuscular block (rNMB) during routine U.S. hospital care.

Analysis of Milestone-based End-of-rotation Evaluations for Ten Residents Completing a Three-year Anesthesiology Residency.

Introduction Faculty are required to assess the development of residents using educational milestones. This descriptive study examined the end-of-rotation milestone-based evaluations of anesthesiology residents by rotation faculty directors. The goals were to measure: (1) how many of the 25 Accreditation Council for Graduate Medical Education (ACGME) anesthesiology subcompetency milestones were included in each of the residency's rotations evaluations, (2) the percentage of evaluations sent to the rotation director that were actually completed by the director, (3) the length of time between the end of the residents' rotations and completion of the evaluations, (4) the frequency of straight line scoring, defined as the resident receiving the same milestone level score for all subcompetencies on the evaluation, and (5) how often a resident received a score below a Level 4 in at least one subcompetency in the three months prior to graduating.