Apprenticeships Ease the Transition to Independent Call

Trout, Andrew T.; Wang, Page I.; Cohan, Richard H.; Bailey, Janet E.; Khalatbari, Shokoufeh; Myles, Jamie D.; Dunnick, N. Reed

doi:10.1016/j.acra.2011.04.015

Cited by 15 publications

(1 citation statement)

References 13 publications

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“…Most residents reported taking independent primary calls between four and eight weeks (71.9%) [ 9 ]. Within radiology literature, it was found that the buddy-call system and tiered call structure proved helpful for junior residents transitioning to independent calls [ 10 ]. In our discussion with multiple chief residents at various programs across the country, the call structure for junior residents included buddy-call (a senior resident must see every patient with the junior), must-call (where every case must be discussed with a senior resident), backup call (senior only discusses or comes in for select cases), and independent call.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Accuracy of First-Year Ophthalmology Residents on Call: Considerations for Postgraduate Year 2 (PGY-2) Standardizations of Call Structure

Hashemi,

Rohani,

Mukit

et al. 2024

Cureus

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Background Ophthalmology is a unique specialty with limited exposure during medical school. To improve the transition to ophthalmology residency, the Accreditation Council for Graduate Medical Education (ACGME) announced in 2017 that all ophthalmology residency programs would move to a combined post-graduate year (PGY) 1 year with mandatory integration by 2023. Currently, there are no standardized guidelines from the American Board of Ophthalmology (ABO) or the Accreditation Council for Graduate Medical Education (ACGME) to address ophthalmology resident competence prior to becoming the primary contact for inpatient and emergency room (ER) consultations as a PGY-2. Novice residents may not be equipped to accurately diagnose vision or life-threatening ocular conditions. A balance between resident autonomy and supervision is required for proper training without increasing patient morbidity and mortality. Objective This study’s objective is to examine the diagnostic accuracy of PGY-2 ophthalmology non-integrated residents on call to standardize supervision requirements (through buddy-call) prior to initiating indirectly supervised calls. Methods All inpatient and ER ophthalmology consults for the first seven weeks of the year evaluated by PGY-2 (junior) residents were supervised and graded as “correct” or “incorrect” by PGY-4 (senior) residents. Results One hundred forty-eight consults were seen over 30 call days over a period of seven weeks (4.93 consults per call). The percentage of correct diagnoses increased with each successive week (R 2 = 0.9581; correlation = 0.979). The greatest percent increase of correctly diagnosed encounters was between weeks 2 and 3 (19.14%) correlating to call numbers 10-16 and 45-68 patient encounters. The mean percent accuracy surpassed 70% during weeks 3-4, and improvement continued to week 7. High-acuity diagnoses were identified consistently 100% of the time from week 5 onward. Conclusion Our analysis indicated that diagnostic accuracy was greater than 70% between weeks 3 and 4 with high-acuity diagnostic accuracy reaching 100% at week 5. It can be postulated that optimal direct senior resident supervision is needed for at least 3-5 weeks before transitioning to indirectly supervised calls by PGY-2 residents. This standardization would allow junior residents to acquire sufficient clinical experience to accurately make a diagnosis and prevent patient morbidity. Further research nationally is necessary prior to creating a standardized call structure for PGY-2 residents especially with the newly mandatory integrated ophthalmology residency programs.

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Section: Introductionmentioning

confidence: 99%

The Diagnostic Accuracy of First-Year Ophthalmology Residents on Call: Considerations for Postgraduate Year 2 (PGY-2) Standardizations of Call Structure

Hashemi,

Rohani,

Mukit

et al. 2024

Cureus

View full text Add to dashboard Cite

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The Time Has Come: a Paradigm Shift in Diagnostic Radiology Education via Simulation Training

et al. 2020

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Current radiology training for medical students and residents predominantly consists of reviewing teaching files, attending lectures, reading textbooks and online sources, as well as one-on-one teaching at the workstation. In the case of medical schools, radiology training is quite passive. In addition, the variety of important and high-yield cases that trainees are exposed to may be limited in scope. We utilized an open-source dcm4chee-based Picture Archiving and Communication System (PACS) named "Weasis" in order to simulate a radiologist's practice in the real world, using anonymized report-free complete cases that could easily be uploaded live during read-outs for training purposes. MySQL was used for database management and JBOSS as application server. In addition, we integrated Weasis into a web-based reporting system through Java programming language using the MyEclipse development environment. A freeware, platform-independent, image database was established to simulate a real-world PACS. The sever was implemented on a dedicated non-workstation PC connected to the hospital secure network. As the client access is through a webpage, the cases can be viewed from any computer connected to the hospital network. The reporting system allows for evaluation purposes and providing feedback to the trainees. Brief survey results are available. Implementation of such a low-cost, versatile, and customizable tool provides a new opportunity for training programs in offering medical students with an active and more realistic radiology experience, junior radiology residents with potentially better preparation for independent call, and senior resident and fellows with the ability to fine-tune high-level specialty-level knowledge.

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