Journal of general internal medicine
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Multicenter Study
Internal Medicine Residents' Confidence and Preferences in Hospital Medicine Competencies: A Multi-Site Study.
Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. ⋯ Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.
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Uncertainty is inherent in medicine, and trainees are particularly exposed to the adverse effects of uncertainty. Previous work suggested that junior residents seek to leverage the support of supervisors to regulate the uncertainty encountered in clinical placements. However, a broader conceptual framework addressing uncertainty experience, from the sources of uncertainty to residents' responses, is still needed. ⋯ Residents face significant uncertainty in managing treatments, ethical decisions, and communication due to limited clinical experience and growing responsibilities. Scaffolding their responsibilities and clearly defining their roles can improve their comfort with uncertainty. To that extent, effective supervision and debriefing are crucial for managing emotional impacts and fostering reflection to learn from their uncertain experiences.
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Workplace violence disproportionately affects healthcare workers and verbal aggression from patients frequently occurs. While verbal de-escalation is the first-line approach to defusing anger, there is a lack of consistent curricula or robust evaluation in undergraduate medical education. ⋯ This evidence-based and replicable de-escalation skill curriculum improves medical student confidence and preparedness in managing agitated patients.
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Institutions rely on student evaluations of teaching (SET) to ascertain teaching quality. Manual review of narrative comments can identify faculty with teaching concerns but can be resource and time-intensive. ⋯ NLP methods can identify teaching quality concerns with good accuracy and reasonable recall, but relatively low precision. An existing, free, NLP sentiment analysis dictionary can perform nearly as well as dictionaries requiring expert coding or manual creation.
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Coaching has been proposed to support the transition to residency. Clarifying its impact will help define its value and best use. ⋯ Residents experiencing coaching reported better professional fulfillment and development outcomes, with more pronounced differences in trainees experiencing burnout. Coaching is a promising tool to support a fraught professional transition.