ProblemThe racial and ethnic makeup of physicians in the United States does not reflect that of the communities they serve. Addressing this disparity may improve patient outcomes and combat structural racism.
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education requires that residents demonstrate increasing autonomy during their training. Although residents report a better educational environment with hospitalists present during family-centered rounds (FCRs), there is a concern that attending presence may reduce resident autonomy. We aim to determine the effect of FCRs without an attending during rounds on senior residents’ sense of autonomy. METHODS We conducted a multicenter, retrospective, preintervention-postintervention study at 5 children’s hospitals to evaluate the effect of rounding without an attending on senior residents’ self-efficacy, using a questionnaire developed by using Bandura’s principles of self-efficacy and Accreditation Council for Graduate Medical Education milestones. Questions addressed skills of diagnosis and/or management, communication, teaching, and team management. We compared preintervention and postintervention results using paired t tests and Wilcoxon rank tests. One-way analysis of variance tests were used to compare means among >2 groups. RESULTS 116 (82% response rate) of 142 eligible senior residents completed the questionnaire, which yielded a high reliability (α = 0.80) with a 1-factor score. The average composite score of self-efficacy significantly improved after intervention compared with the preintervention score (66.71 ± 6.95 vs 60.91 ± 6.82; P < .001). Additional analyses revealed meaningful improvement of each individual item postintervention. The highest gain was reported in directing bedside teaching (71.8% vs 42.5%; P < .001) and answering learner questions on rounds (70.7% vs 47.0%; P < .001). CONCLUSIONS Conducting FCRs without an attending increases resident reported self-efficacy regarding core elements of patient care and team leadership. In future studies, researchers should examine the impact of rounding without the attending on other stakeholders, such as students, interns, patients and/or families.
BackgroundFirst‐year residents frequently encounter conflict during their training. Residents' conflict management strategies can influence patient safety, quality of care and perceptions of performance on competency evaluations. Existing literature inadequately describes how first‐year resident conflict management styles evolve over time.ObjectiveThe objective of this study is to assess if and how conflict management styles change during first year of paediatric residency in the United States.MethodsIn 2021–2022, we conducted a non‐experimental, longitudinal, survey study of first‐year residents from 16 US‐based paediatric residency programmes. Using the Thomas–Kilmann Conflict Mode Instrument, we scored first‐year residents' use of five conflict management modes twice, 6 months apart. We calculated the percentage of first‐year residents who experienced a change in predominant conflict management mode and assessed for changes in score and variance for each conflict management mode.ResultsFifty‐seven (18%) first‐year residents participated in the first survey. Of those, 45 (14%) also completed the follow‐up survey. Nonresponse bias analysis showed no significant difference in scores for early and late respondents or for second‐survey respondents and non‐respondents. Half of respondents experienced a change in predominant conflict management mode, but the distribution of predominant modes remained largely unchanged. When residents changed modes, they typically moved from one low‐assertiveness mode, such as avoiding or accommodating, to the other. Only the use of the compromising conflict management mode significantly decreased. Variance did not significantly change.ConclusionsThe overall lack of change in conflict management style may suggest the need for specific and focused educational interventions to help residents adjust their conflict handling strategies.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.