Evaluation of a Transition to Practice Program for Neurosurgery Residents: Creating a Safe Transition From Resident to Independent Practitioner

Lister, J.; Friedman, William A.; Murad, Gregory J. A.; Dow, Jamie; Lombard, Gwen

doi:10.4300/jgme-d-10-00078.1

Cited by 26 publications

(17 citation statements)

References 9 publications

(8 reference statements)

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“…The survey (provided as online supplemental material) was modified from surveys previously used to assess educational training programs. [5][6][7][8][9] The objectives of the survey were to determine the strengths and areas for improvement of a year abroad during residency. Participants responded to the survey questions using a 5-point Likert scale (1, strongly disagree; 2, disagree; 3, neutral; 4, agree; 5, strongly agree) with additional questions and space for narrative responses.…”

Section: Methodsmentioning

confidence: 99%

Neurological Surgery Training Abroad as a Progression to the Final Year of Training and Transition to Independent Practice

Starke¹,

Asthagiri²,

Jane³

2014

Journal of Graduate Medical Education

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Background Residents at the University of Virginia spend 1 year abroad at a neurological surgery program prior to their chief year. The Accreditation Council for Graduate Medical Education (ACGME) considers international rotations elective experiences and does not count them toward clinical accreditation. Objective We compared clinical training obtained in New Zealand (NZ) to data from US ACGME-accredited programs to see if it was reasonable to reconsider the former as clinical training. Methods We compared US national average chief case volumes to those performed by University of Virginia residents rotating in NZ over the past 3 years, using case volume comparisons and a survey of the residents' experience. Results The mean number of cases performed in NZ was above the 50th percentile for US averages for adult cranial cases, including the 70th to 90th percentile for aneurysms and 50th to 70th percentile for tumors. The average number of cases performed in 1 year in NZ satisfied the cranial case quota for 4 of 6 adult and 2 of 3 pediatric areas over the entire residency. The rotation doubled the cranial exposure of graduating residents at the chief level without diluting the experience of residents in the core program. All residents reported being “very satisfied” with the experience, noting it facilitated their transition to chief year and independent practice. Conclusions Clinical training obtained during an international rotation in NZ is comparable to that attained in the United States. The international experience in NZ facilitated advancement in all 6 competencies, and should be considered adequate for clinical neurological surgery education.

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Section: Methodsmentioning

confidence: 99%

Neurological Surgery Training Abroad as a Progression to the Final Year of Training and Transition to Independent Practice

Starke¹,

Asthagiri²,

Jane³

2014

Journal of Graduate Medical Education

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“…With the increases in the RRC 2013 guidelines for neurosurgical residency training to 84 months, with 54 months of CNSE and 30 months of elective time, these transition-to-practice models may no longer be possible, as requirements cannot be fulfilled in 6 years. 9,17 The RRC has previously defined the elective time as including international rotations, but does not also count for CNSE. Several US training programs in neurological surgery follow these guidelines and send residents for rotations in international settings.…”

Section: International Rotationsmentioning

confidence: 99%

“…3,4,11,12,[20][21][22]24,26,27 But the greatest obstacle has been the initiation in 2003 of the common duty hour standards. 9,13,17 Program directors and chief residents feel strongly that these restrictions have compromised surgical training.…”

mentioning

confidence: 99%

Editorial: International rotations and resident education

Starke¹,

Asthagiri²,

Jane³

2015

JNS

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“…30 Another focal area is monitored and mentored experiences in a clinical specialty at the completion of residency so as to ease the surgical/technical transition into practice. Studies have focused on surgical specialties where operative experience and skills acquisition may have been negatively affected by duty hour limits, 31 yet the concept is Closing the research gap at the interface of learning and clinical practice 205 equally applicable to specialties like anesthesiology. Evidence suggests that mentoring is helpful even for practicing physicians when they make transitions into new settings.…”

Section: Transitions Across the Medical Education Continuummentioning

confidence: 99%

Review article: Closing the research gap at the interface of learning and clinical practice

Philibert

2011

Can J Anesth/J Can Anesth

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Purpose The dialogue at the interface of education and clinical practice highlights areas of critical importance to the development of new approaches for educating anesthesiologists. The purpose of this article is to examine the literature on education and acquisition of competence in three areas relevant to the interface of learning and clinical practice, with the aim to suggest a research agenda that adds to the evidence on preparing physicians for independent practice. The three areas are: 1) transitions across the continuum of education; 2) the effect of reductions in hours of clinical training on competence; and 3) efforts to incorporate the competencies and CanMEDS roles into teaching and evaluation. Principal findings Fifty-six articles relevant to one or more of the themes were identified in the review, including 21 studies of transitions (in, during, and after residency education), 19 studies on the effects of duty hour limits on residents' acquisition of competence, and 16 articles that assessed competency-based teaching and assessment in anesthesiology. Overall, the findings suggested a relative paucity of scientific evidence and a need for research and the development of new scientific theory. Studies generally treated one of the themes in isolation, while in actuality they interact to produce optimal as well as suboptimal learning situations, while medical education research often is limited by small samples, brief follow-up, and threats to validity. This suggests a ''research gap'' where editorials and commentaries have moved ahead of an evidence base for education. Promising areas for research include preparation for care deemed important by society, work to apply knowledge about the development of expertise in other disciplines to medicine, and ways to embed the competencies in teaching and evaluation more effectively. Conclusion Closing the research gap in medical education will require clear direction for future work. The starting point, at an institution or nationally, is dialogue within the specialty to achieve consensus on some of the most pressing questions.

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Evaluation of a Transition to Practice Program for Neurosurgery Residents: Creating a Safe Transition From Resident to Independent Practitioner

Cited by 26 publications

References 9 publications

Neurological Surgery Training Abroad as a Progression to the Final Year of Training and Transition to Independent Practice

Neurological Surgery Training Abroad as a Progression to the Final Year of Training and Transition to Independent Practice

Editorial: International rotations and resident education

Review article: Closing the research gap at the interface of learning and clinical practice

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