Interprofessional bedside rounding improves quality of feedback to resident physicians.

Purpose: Obtaining high quality feedback in residency education is challenging, in part due to limited opportunities for faculty observation of authentic clinical work. This study reviewed the impact of interprofessional bedside rounds ('iPACE™') on the length and quality of faculty narrative evaluations of residents as compared to usual inpatient teaching rounds.

Methods: Narrative comments from faculty evaluations of Internal Medicine (IM) residents both on usual teaching service as well as the iPACE™ service (spanning 2017-2020) were reviewed and coded using a deductive content analysis approach.

Redesigning the Clinical Learning Environment to Improve Interprofessional Care and Education: Multi-Method Program Evaluation of the iPACE Pilot Unit.

Background: In 2016, Maine Medical Center received an Accreditation Council for Graduate Medical Education Pursuing Excellence in Innovation grant to redesign the clinical learning environment to promote interprofessional care and education. The Interprofessional Partnership to Advance Care and Education (iPACE) model was developed and piloted on an adult inpatient medicine unit as an attempt achieve these aims.

Objective: We describe the iPACE model and associated outcomes.

The interplay between residency program culture and feedback culture: a cross-sectional study exploring perceptions of residents at three institutions.

Background: Giving and receiving feedback that changes performance is influenced significantly by the clinical learning environment. This environment is multi-dimensional but includes both organizational and feedback specific dimensions.

Objective: The objectives of this research were to investigate the relationship between residents' perceptions of residency program culture and feedback culture; and whether there were differences in resident perceptions of their programs' and feedback cultures based on their disciplines and institution.

Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests.

Background: In 2017, the Maine Medical Center Graduate Medical Education Committee received an unprecedented number of requests (n = 18) to start new graduate medical education (GME) programs or expand existing programs. There was no process by which multiple programs could be prioritized to compete for scarce GME resources.

Objective: We developed a framework to strategically assess and prioritize GME program expansion requests to yield the greatest benefits for patients, learners, and the institution as well as to meet regional and societal priorities.

The research contributions of predominantly North American Family Medicine educators to medical learner feedback: a descriptive analysis following a scoping review.

Background And Objectives: In 2016, we performed a scoping review as a means of mapping what is known in the literature about feedback to medical learners. In this descriptive analysis, we explore a subset of the results to assess the contributions of predominantly North American family medicine educators to the feedback literature.

Methods: Nineteen articles extracted from our original scoping review plus six articles identified from an additional search of the journal Family Medicine are described in-depth.

Trainees' Perceptions of Feedback: Validity Evidence for Two FEEDME (Feedback in Medical Education) Instruments.

Unlabelled: Construct: Medical educators consider feedback a core component of the educational process. Effective feedback allows learners to acquire new skills, knowledge, and attitudes. Learners' perceptions of feedback are an important aspect to assess with valid methods in order to improve the feedback skills of educators and the feedback culture.

The Feedback Tango: An Integrative Review and Analysis of the Content of the Teacher-Learner Feedback Exchange.

Purpose: To conduct an integrative review and analysis of the literature on the content of feedback to learners in medical education.

Method: Following completion of a scoping review in 2016, the authors analyzed a subset of articles published through 2015 describing the analysis of feedback exchange content in various contexts: audiotapes, clinical examination, feedback cards, multisource feedback, videotapes, and written feedback. Two reviewers extracted data from these articles and identified common themes.

Is feedback to medical learners associated with characteristics of improved patient care?

Purpose: To investigate the association of medical learner feedback with patient management and outcomes.

Methods: The authors investigated 27 articles that utilized patient data or chart reviews as a subset of a prior feedback scoping review. Data extraction was completed by two authors and all authors reviewed the descriptive data analysis.

Is It Time for Entrustable Professional Activities for Residency Program Directors?

Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position.

Feedback for Learners in Medical Education: What Is Known? A Scoping Review.

Purpose: To conduct a scoping review of the literature on feedback for learners in medical education.

Method: In 2015-2016, the authors searched the Ovid MEDLINE, ERIC, CINAHL, ProQuest Dissertations and Theses Global, Web of Science, and Scopus databases and seven medical education journals (via OvidSP) for articles published January 1980-December 2015. Two reviewers screened articles for eligibility with inclusion criteria.

Organizing graduate medical education programs into communities of practice.

Background: A new organizational model of educational administrative support was instituted in the Department of Medical Education (DME) to better meet increasing national accreditation demands. Residency and fellowship programs were organized into four 'Communities of Practice' (CoOPs) based on discipline similarity, number of learners, and geographic location. Program coordinator reporting lines were shifted from individual departments to a centralized reporting structure within the DME.

Implementing a multifaceted quality-improvement curriculum in an obstetrics-gynecology resident continuity-clinic setting: a 4-year experience.

Background: Although many residency programs are instituting quality improvement (QI) curricula in response to both institutional and external mandates, there are few reports of successful integration of resident initiated projects into these QI curricula with documented impact on health care processes and measures.

Intervention: We introduced a multifaceted curriculum into an Obstetrics-Gynecology continuity clinic. Following a needs assessment, we developed a didactic session to introduce residents to QI tools and the how to of a mentored resident-initiated project.

Symptomatic arteriovenous malformation of Bartholin's gland. A case report.

Background: Arteriovenous malformations are composed of large, tortuous arteries and misshapen, veinlike structures. They are extremely uncommon in the genital tract.

Case: An arteriovenous malformation in a Bartholin gland presented as intermittent vaginal bleeding in a 43-year-old woman.

Predictive value of history and physical examination in patients with suspected ectopic pregnancy.

Study Objective: To identify historical and physical examination findings that are predictive of ectopic pregnancy (EP) in pregnant patients with abdominal pain or bleeding.

Methods: This study was conducted in an urban academic emergency department as a prospective observational study of consecutive patients from August 1, 1991, to August 31, 1992, who had abdominal pain or vaginal bleeding and a positive beta-human chorionic gonadotropin level. Patients were excluded if they had a diagnostic ultrasound during a previous visit, or if the uterine size was larger than 12 weeks by pelvic examination.

Randomized controlled trial of vaginal misoprostol and intracervical prostaglandin E2 gel for induction of labor at term.

Objective: To compare misoprostol 25 micrograms administered at 2-hour intervals with intracervical prostaglandin (PG) E2 in women with Bishop scores of 5 or less.

Methods: Subjects were randomly assigned to receive either misoprostol 25 micrograms every 2 hours or a commercially available intracervical preparation containing 0.5 mg of PGE2 gel administered at 6-hour intervals for a maximum of two doses.

Evaluating the role of incidental diagnostic dilation and curettage in young women undergoing elective laparoscopic sterilization.

Two hundred twenty-two women undergoing incidental diagnostic dilation and curettage (D&C) at the time of elective laparoscopic tubal ligation were studied retrospectively to ascertain if the risks of a D&C were warranted in a group of young, healthy women with a low risk of endometrial pathology. The endometrial sampling was associated with five uterine perforations and one readmission for bleeding and did not uncover any significant pathology in women under 35. The endocervical curettings did yield pathology of some clinical significance in women of all ages.