Inducing Safer Electrosurgical Handpiece Storage
Joanne Mallett, MD, FACOG
Department of Obstetrics
and Gynecology
The University of Texas Medical Branch,
Galveston, Texas, USA
Abstract: Background Improper storage of the electrosurgical handpiece has been identified
as an operating room hazard.
Objective: To test among representative surgical personnel
two different methods of improving safety performance: a demonstration/lecture
session, and improved equipment arrangement on the operating field.
Methods: A field experiment occurred in the classroom
and in the operating room. Subjects were recruited from a surgical department
in a single institution. After videotaping baseline behavior, inter-ventions
were made in education and subsequently in apparatus layout. Videotaping
and behavioral coding were repeated after each intervention. Written tests
preceded and followed the training lecture.
Results: Results varied among team members and different
aspects of the equipment. The surgeons knew the manufacturers’ designated
safe practice, but they did not routinely follow it, even after additional
instructions and redesign of the equipment setup. Other team members
responded to the interventions and changed their storage-related behavior.
Conclusions: This study demonstrates a need for effective
means to help surgical teams maintain a safe environment while using hazardous
technologies.
Please note: This manuscript contains seven video clips. They may be viewed from hyperlinked references within the document when accessed from an Internet-connected computer. The hyperlinked videos are in Windows Media File format. Both the Windows Media File and QuickTime versions of the videos are available below:
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| QuickTime |
Practices and Perceptions of Family Practice Residency Directors toward International
Medical Graduate Applicants: A National Survey
Wanda C. Gonsalves, M.D.*, Alan Stevens Wrightson, M.D.,† Margaret M. Love, Ph.D.†
Laura J. Torbeck, Ph.D.‡
*Medical University of South Carolina
Charleston, South Carolina
†University of Kentucky College of Medicine
Lexington, Kentucky
‡Indiana University
Indianapolis, Indiana
Abstract - Purpose -
International Medical Graduates (IMGs) are increasingly filling Family
Medicine residency positions. (1) To what extent are residency programs
recruiting and accepting IMG applicants? (2) What are program directors’ perceptions
of IMG applicants? (3) What program characteristics are associated
with their practices and perceptions?
Methods - A 2002 national survey of Family Medicine
program directors assessed program demographics and directors’ recruiting
practices and perceptions regarding IMG applicants.
Results - Although 88% of respondents would rank
IMG applicants, only 40% agreed that they would perform as well as
U.S. graduates. Programs with IMG faculty were more likely to have
IMG residents (p<0.01).
Program directors with IMG faculty or more IMG residents reported more
positive perceptions of IMG residents’ performance (p<0.01).
Conclusion - More experience with IMGs, such as having
IMG faculty or higher numbers of IMG residents, is associated with recruitment
of IMG residents and may contribute to more positive beliefs about their
performance.
Lack of Supervision and Independent Clinical Decision Making in Postgraduate Pediatric Training in Australia
Jonathan Taitz MBchB, FCP, FRACP*, Michael Brydon MBBS, FRACP,
MHA*,
Damian Duffy† Avi Lemberg MBBS, FRACP
*Sydney Children's Hospital
High Street
Randwick NSW 2031
†Children’s and Women’s Health Centre
of British Columbia
Oak Street
Vancouver Canada
Abstract: Objective: Evaluation of postgraduate pediatric training is a complex yet critical task. We aimed to review pediatric trainees’ attitudes to clinical decision-making, levels of supervision and end of life issues in a tertiary pediatric teaching hospital in Sydney, Australia.
Method: A
questionnaire was devised and distributed to all trainees at Sydney
Children’s Hospital, Randwick. All responses
were anonymous. Results were independently analyzed using SPSS statis-tical
software.
Results: Forty percent of trainees spent three hours
or less per week face to face with more senior colleagues and 14% spent
greater than 10 hours per week with more senior colleagues. Seventy-five
percent of trainees spent three hours or less on the phone with more
senior colleagues while 10% spent five hours or more on the phone with
more senior colleagues. There was no association (or correlation) (p>0.05) between
seniority of trainee and the number of times a trainee met face to face
or phoned a more senior colleague to discuss a management plan. One in
three trainees felt that they made less than 10% of clinical decisions
on their own and 54% felt that they made less than half of decisions on
their own. There was a statistically significant difference between seniority
of training and the percentage of important clinical decisions made (p<0.01).
Nearly half the trainees (47.7%) have not had the occasion to inform families
of the death or impending death of a child. There was a statistically
significant difference between seniority of training and the opportunity
of informing families of a death of a child (p<0.01).Greater than
two thirds of trainees feel that they have not re-ceived formal training
in clinical decision-making. At the completion of four years of pediatric
train-ing only half the trainees considered themselves to be making
the majority of clinical decisions.
Conclusion: There is a need for closer supervision of pediatric trainees by senior colleagues, who themselves, may require additional ongoing training to supervise appropriately. There should be a balanced environment where trainees can make safe, independent decisions. The perceived absence of clinical decision making training suggests a deficiency in the training program.
Clever Nihilism: Cynicism in Evidence Based Medicine Learners
Chris Meserve, MD*,Adina Kalet, MD, MPH†,
Sondra Zabar, MD†, ,Kathleen Hanley, MD†,
Mark D. Schwartz, MD†
*Albert Einstein College of Medicine,
Department of Medicine, Bronx, NY
†New York University School of Medicine,
Division of General Internal Medicine, New York, NY.
Abstract: Evidence-based medicine (EBM) educators
are often confronted with learners who use their new critical appraisal
skills to dismiss much of the medical literature. Does this cynical
attitude of “clever nihilism” affect educational outcomes, such that
educators need to tailor their curricula to these learners? The authors
proposed that this critical skepticism may be an intermediate developmental
stage for EBM learners as they progress from “naïve empiricism”
to “mature pragmatism”, and sought to observe its effect
on educational outcomes from an intensive, 6 week EBM course. In this
course, fifty-four medical residents reported significantly improved
skills in critical appraisal and electronic searching. However there
was no association between a measure of clever nihilism and the self-reported
educational outcomes. The role of clever nihilism in the EBM classroom
remains a potentially important issue, and its lack of effect here may
be a product of several methodological limitations addressed in the discussion.
Such a construct requires further validation The question remains as
to whether such cynicism is a learning style or a developmental phase.
Wireless Handheld Computers in the Undergraduate Medical Curriculum
Matt Jackson, PhD*, Anand C. Ganger, BS†, Patrick D. Bridge, PhD*, Kenneth Ginsburg, MD*
*Wayne State University School of Medicine
Detroit MI, USA
†CEO, CampusMobility
Ann Arbor MI USA
Abstract: Wayne State University Medical School has implemented wireless handheld computers or PocketPCs (PPCs) into all four years of the undergraduate curriculum. A transition from a passive to an interactive learning environment in the classroom, as well as administrative solutions for monitoring patient encounter data by students in their clinical rotations was fostered by this educational technology. Implementation of the wireless devices into the curriculum will be described in this report. This will include the technical specifications and justification for the required device, as well as a detailed discussion of the different applications used for educational and administrative purposes by the preclinical and clinical students. Outcomes from the educational and administrative aspects of the project will also be presented in this report.
Survey of Physician Well-Being and Health Behaviors at an Academic Medical Center
Taryn Reinhardt. MPH*, Eric Chavez, MD†,
Marguerite Jackson, RN, PhD†
Wm. Christopher Mathews,MD, MSPH†.
*San Diego State University
School of Public Health
†University of California,
San Diego Medical Center
Abstract: Purpose: The study
aims were to ascertain, among attending and house staff at a single academic
medical center, the prevalence of and risk factors for psychiatric symptoms
and disorders and for personal health behaviors.
Methods: A self-administered, anonymous 72-item survey
of physicians was conducted in February 2003.
Results: Response rate was 37.6%. The prevalence of
current depressive symptoms was 29%. AUDIT scores consistent with high
likelihood of harmful alcohol consumption were prevalent in 6%. Almost
5% acknowledged use of sedatives or hypnotics without a prescription
in the prior 12 months. Characteristics independently associated with
current depressive symptoms included: living alone, full time salaried
faculty status, not having a primary care physician, female sex, and
age < 50 years. Factors associated
with high risk of harmful alcohol consumption included: male sex, house
staff status, and not being exclusively heterosexual.
Conclusions: The prevalence of recent depressive symptoms
among responding physicians was nearly 30%. Interventions to engage physicians
in primary care relationships and social support to confidentially disclose
potentially stigmatizing characteristics may facilitate earlier case finding
of those at risk for depression, suicide, and substance abuse.
The Use of Station Time Allotments by Fourth Year Medical Students in a Standardized Patient-Based Clinical Skills Examination
Karen Szauter, Michael Ainsworth, Judy Thornton, Hazel Smith and Martha Phipps
The University of Texas Medical
Branch,
Galveston
Texas, USA
Introduction: We
performed this study to assess medical student use of station time
allotments in a standardized patient-based clinical skills assessment.
Methods: Videotapes
of student-SP encounters were reviewed. Total encounter time, and time
spend in the physical examination, were recorded in seconds. The mean
time use for each station was calculated. Cases were categorized by
patient age, case content and acuity. Times were compared across cases.
Results: On
average, students spent most time in encounters requiring complex interviewing
strategies or physical examination maneuvers. Students also spent more
time on cases that involved content familiar to them from multiple
clerkship disciplines.
Discussion: Many
factors are believed to influence the use of station time allotments
in SP-based clinical skills assessment. Our findings have provided
information helpful for case refinement, and may assist others when
planning multi-station examinations.
Medical School Performance, Alumni Membership, and Giving: How Do Scholarship Recipients and Non-Recipients Differ?
Carol L. Elam, EdD, Terry D. Stratton, PhD, Linda A. Gilbert, H.I. Stroth,
Jr. MEd,
Mary Beth Vicini, Emery A. Wilson, MD
University of Kentucky College of Medicine
Lexington, KY USA
Purpose: This study examines student recipients of merit, need-based,
service, or minority scholarships, their performance in medical school,
and the relationship to future alumni association membership and financial
giving.
Method: Retrospective data on grade-point average attained across the
four-year curriculum and extracurricular activities reported at graduation
were collected on students at the University of Kentucky College of Medicine
from 1981-1991. Comparisons of academic performance and participation
in institutional activities were made across scholarship recipients and
non-recipients. These data were then linked to other data tracking alumni
association membership and institutional giving.
Results: Compared to other scholarship recipients and non-recipients,
merit scholars were more likely to be ranked above their class medians
and be involved in extracurricular activities, including membership in
Alpha Omega Alpha. However, seven years post-graduation, there was no
difference between scholarship recipients and non-recipients in alumni
association membership or donations to the medical school. Instead, students
graduating in the upper half of their class, as compared to graduates
in the lower half, and UKCOM graduates who attended the University of
Kentucky as undergraduates, rather than students who attended other in-state
or out-of state institutions, were more likely to join the medical alumni
association. Alumni association members were more likely than non-members
to make donations to the institution.
Conclusions: More should be done to ensure that graduates who received
scholarships are afforded meaningful ways to give back to the institution
that supported them as students.
Strategies Resident-Physicians Use to Manage Sleep Loss and Fatigue
Eleanor P. Stoller, PhD*, Klara K. Papp, PhD†, James E. Aikens,
PhD‡
Bernadette Erokwu, DVM§, MEd, Kingman P. Strohl, MD¶
*Center on Aging and Health
Center on Aging and Health at Case Western Reserve University
†School of Medicine, Case Western Reserve University
Geriatric Research Education and Clinical Center (GRECC) Cleveland VA
Medical Center
‡Family Medicine and Psychiatry
University of Michigan Medical School
§Louis Stokes Cleveland VA Medical Center
¶Department of Medicine, Case Western Reserve University.
Louis Stokes Cleveland VA Medical Center
Abstract: Our purpose is to examine strategies or countermeasures resident-physicians used in dealing with the effects of sleep loss and fatigue during residency training.
A total of 149 residents across five sites and six specialty areas were recruited for the study. Focus groups consisted of an average of 7 individuals in the same year of training and residency program, and included 60 interns and 89 senior residents. Trained moderators conducted focus groups using a semi-structured discussion guide. Transcripts were analyzed using the grounded theory tradition.
The range of strategies adopted was: Chemical, Dietary, Sleep Management, Behavioral, and Cognitive. Residents exhibited a trial-and-error approach to identifying management strategies. None mentioned searching the scientific literature or consulting local sleep medicine experts. Residents relied on putative countermeasures even when they were aware of their negative effects. Our results document the need to educate resident physicians on self-care strategies during residency training.Sexual Harassment in Academic Medicine: Persistence, Non-Reporting, and Institutional Response
Delese Wear, PhD, Julie Aultman, PhD
Northeastern
Ohio Universities College of Medicine
4209
State Route 44, PO Box 95
Rootstown
, OH 44272 USA
Abstract - Sexual harassment occurs with regularity during medical training, and it remains largely unreported. This study is one institution’s attempt to understand how third and fourth-year medical students perceive and experience sexual harassment, what they believe about reporting sexual harassment, and how they believe it might be eradicated from the educational environment. We used a qualitative research method for our investigation, which would generate more specific language to use in a larger empirical study involving larger numbers of our students. We conducted five focus groups with 24 students, which yielded five categories of response obtained through a close, line-by-line reading of transcribed audiotapes. In addition, we offer four recommendations to medical education researchers, deans of medical schools, and medical school accrediting bodies that may reduce the incidence of sexual harassment of medical students. While we do not make the case that the observations, explanations, and recommendations of these 24 students reflect the opinions of all medical students here or elsewhere, we do propose that they are a snapshot of one medical school’s gender climate and offer a valuable foundation for further inquiry.
Creating a Culture for Interdisciplinary Collaborative Professional Practice
C.A. Orchard, EdD*, V. Curran, PhD†, S. Kabene, PhD‡
*School of Nursing , Faculty of Health Sciences
The University of Western
Ontario
†Centre for Collaborative Health Professional
Education,
Faculty of Medicine
Memorial University of Newfoundland
‡Faculty of Social Sciences
The University
of Western Ontario
Abstract: The future of the health system is dependent on health professionals re-tooling the way we practice together. No longer can a multi-disciplinary model support the complex health needs of many clients nor can any one-health profession have all the knowledge needed to provide total patient-centred care. However, our current education and health systems are structured around a multi-disciplinary model of practice with physicians or nurse practitioners as decision-makers and rarely are clients included in care planning.True interdisciplinary practice is defined as a partnership between a team of health professionals and a client in a participatory, collaborative and coordinated approach to shared decision-making around health issues,requires a revamping of how future health professionals are educated and how the system can accommodate shared decision-making. A client-centered collaborative professional practice model is proposed in this paper as a means for fostering and facilitating the culture for this change.
Applying Theory to Assess Cultural Competency
Amy V. Blue, PhD*, Carolyn Thiedke, MD†, Alexander W. Chessman, MD†, Donna H. Kern, MD†, and Albert Keller, DMin†
*Department of
Family Medicine and Dean’s Office,
†Department
of Family Medicine
College of Medicine,
Medical University of South Carolina
Abstract - Using a theoretical cultural competency model, the effectiveness of a cultural competency learning assignment was examined to determine: 1) students’ cultural competency levels as reflected through the assignment, and 2) the effectiveness of the assignment as a cultural competency learning activity. Third-year family medicine clerkship students completed a required project to research and reflect upon a patient’s “cultural belief.” Applying a model of cultural competence development, a content analysis of written project reports determined what level of cultural competence was expressed by students’ reflections. Results indicated16% of students were at “no insight”, 18% at “minimal emphasis” and 66% at “acceptance.” While many students expressed an “acceptance” competence level, not all students expressed the desired level of acceptance about the role of cultural beliefs in medical care. Application of a cultural competency theory to assess learners permits educators to frame performance changes within the context of competency achievement and determine if desired levels of competency have been achieved.
Development of a Medical School Admissions Interview Phase 2: Predictive Validity of Cognitive and Non-Cognitive Attributes
Lisa Streyffeler, PhD *, Elizabeth M. Altmaier, PhD †, Samuel Kuperman, MD ‡, Luke E. Patrick, PhD **
* Hennepin County Medical Center, Minneapolis, MN
† Psychological and Quantitative Foundations, College of Education and Community and Behavioral Health, College of Public Health University of Iowa
‡ Psychiatry, College of Medicine, University of Iowa
** Northwest Occupational Medicine Center Portland , OR
Background: Interest in improving medical school admissions processes led to the development of a structured admissions interview to eliminate potential bias and provide valid information for selection. This article reports on the degree to which this interview, along with other admissions variables, predicted later student performance during medical school.
Methods: All applicants considered for admission participated in the new interview. Interview scores and regular admissions data were compiled. Measures of performance in cognitive (e.g., written test scores) and non-cognitive (e.g., ratings of listening skills) domains were gathered during participants’ enrollment in medical school and correlated with measures gathered during the admissions process.
Results: Cognitive predictors predicted later performance in cognitive domains but did not predict non-cognitive performance. Both written and interview-based measures of non-cognitive abilities predicted performance in non-cognitive domains. Both cognitive and non-cognitive predictors predicted grades in clinical rotations, which presumably reflect a mixture of cognitive and non-cognitive abilities.
Conclusions: Our results do not support the predictive validity of our interview-based measure above other cognitive and non-cognitive admissions variables more easily gathered. However, in some domains, interview-based variables did incrementally predict medical school performance.Faculty Evaluations by Medicine Residents Using Known versus Anonymous Systems
Dayton W. Daberkow II, MD; Charles Hilton, MD, Charles V. Sanders, MD, Sheila W. Chauvin, MEd PhD
Louisiana State University Health Sciences Center School of Medicine – New Orleans
Abstract: Purpose. This
study examined the extent to which faculty evaluation results differed,
based on whether residents were required to submit ratings anonymously
or not.
Method. We used a retrospective analysis of existing
records representing Internal Medicine residents’ evaluation of
51 faculty members in an anonymous and known (non-anonymous) rater system
on an inpatient medicine service.
Results. Mean scores
for 48 of 51 individuals were lower for anonymous than non-anonymous
evaluations. The mean scores were as follows: Anonymous = 5.4 (95 % CI,
5.2-5.6); Non-anonymous = 6.1 (95 % CI, 5.9-6.3). Regression analysis
of mean scores for non-anonymous evaluations against those for anonymous
evaluations revealed a significant relationship (r = 0.83, p < 0.001).
Conclusions. Faculty
evaluations completed anonymously by residents are significantly lower
than those for which resident identities were known. Given the strong,
significant relationship between individual faculty members’ evaluation
ratings from both systems, other factors influencing evaluations should
be considered. No subgroups suffered more under anonymous rankings.
Teaching Residents about Child Neglect and Parental Alcoholism: A Controlled Pilot Study
Celeste R. Wilson, MD*,†, Lon Sherritt, MPH†, John R. Knight, MD*,†
*Department of Pediatrics, Harvard Medical School, Boston, MA
†Department
of Medicine, Children’s Hospital, Boston, MA
Abstract: Objective: To
assess in pediatric residents the effects of a case-based educational
exercise about child neglect and parental alcoholism on their knowledge
and attitudes.
Design: Quasi-experimental controlled
trial of a standardized educational intervention and qualitative analysis
of residents’ reactions.
Setting: Resident
continuity clinic conferences at a large pediatric teaching hospital.
Participants: Convenience
sample of pediatric residents (n=37). The residents in the control
group received no intervention at all, while residents in the intervention
group received the educational intervention.
Intervention: A
structured, 40-minute case discussion (“The Silent Cry”)
facilitated by trained faculty.
Main Outcome Measures: Learner ratings of materials
and methods. Pre/post change in scores on a knowledge
quiz and attitude scale. Codes and themes generated from qualitative
analysis of focus group transcripts.
Results: Intervention
group residents rated the experience highly. The two groups did not
differ significantly in mean pre-post change on the knowledge quiz
or attitude scale. Focus group discussions revealed feelings of frustration
and powerlessness when dealing with child neglect and parental alcoholism.
Conclusions: While
this standardized educational intervention was well received by residents,
more time is needed for discussion and multiple teaching sessions may
be required. Discussion of emotional responses should be included as
a standard part of the educational experience.
Teaching Communication Skills on the Surgery Clerkship
Adina L. Kalet, MD, MPH* , Regina Janicik, MD*, Mark Schwartz, MD* , Daniel Roses, MD† , Mary Ann Hopkins, MD, MPH† , Thomas Riles, MD†
*Section of Primary Care, Division of General Internal Medicine, Department of Medicine
† Department of Surgery New York University School of Medicine
Abstract - Background : Physician communication skills, linked to important patient outcomes, are rarely formally addressed after the pre-clinical years of medical school. We implemented a new communication skills curriculum during the third year Surgery Clerkship which was part of a larger curriculum revision found in a controlled trial to significantly improve students’ overall communication competence.
Description : In three 2 hour workshops students, learned to address common communication challenges in surgery: patient education, shared decision-making, and delivering bad news. Each 2 hour, surgeon facilitated session was comprised of a 30 minute introductory lecture, a 15 minute checklist driven video critique, a 15 minute group discussion, a 45 minute standardized patient (SP) exercise with feedback from the SP, peers, and faculty member, and a 15 minute closing summary. To date, over 25 surgery faculty have been trained to conduct these sessions. In an endof-clerkship survey, students reported on skill changes and assessed the curriculum’s educational effectiveness.
Evaluation : A survey was completed by 120 of the 160 (76%) third year students who participated in the curriculum. Fifty-five percent of students reported improvement in their communication skills and ability to address specific communication challenges. Students were satisfied with the amount and quality of teaching.
Conclusions : Communication skills teaching can be implemented in the surgery clerkship, and surgeons are particularly well suited to teach about patient education, discussing informed consent and shared decision making, and delivering bad news. Structured case-based sessions are acceptable to, and improve the self-assessed skills of, surgery clerkship students. Faculty development geared toward such sessions has added benefits to educational activities in a clinical department overall.
Residency Selection Criteria: What Medical Students Perceive as Important
Suzanne Brandenburg, MD * , Tracy Kruzick, MD * , C.T. Lin, MD * , Andrew Robinson, MD †, Lorraine J. Adams, MSW *
* University of Colorado School of Medicine
† Colorado Permanente Medical Group, formerly University of Colorado School of Medicine
Abstract – Background: Little is known about medical students’ perceptions of which criteria are important in residency selection. Student knowledge of this process may affect their education and their ability to obtain the residency of their choice.
Objective: To determine the perceived importance among medical students of various selection criteria for residency.
Design, Setting and Participants: Medical students at three institutions were asked to rate the importance of various residency selection criteria using a web-based survey instrument.
Main Outcome Measures: Sixteen residency selection criteria were included in the survey.
Results: The overall response rate was 49.2%. Criteria perceived as extremely important by the majority of students were the interview (80.6%), grades in third and fourth year courses in their chosen specialty (73.3%), letters of recommendation excluding the Dean’s letter (65.3%), and grades in third and fourth year clerkships (55.9%). USMLE Step 1 score (46.7%) was viewed as extremely important by many students. Moderately important: grades in fourth year electives not in their chosen specialty (57.3%), medical school’s reputation (50.5%), number of honor grades (49.0%), USMLE Step 2 score (42.3%), and Dean’s letter (41.1%). Mildly/not important: grades in the first and second years (56.8%), academic awards (55.2%), extracurricular activities (52.6%), research (50.9%), class rank (49.3%), and AOA (46.5%). Students in the clinical years of training were more likely to place importance on honors grades (p=0.04) and AOA (p=0.009) and were less likely to place importance on grades in fourth year electives not in their chosen specialty (p<0.0001), scores on USMLE Step 1 (p=0.0003), USMLE Step 2 (p<0.0001), and Dean’s letter (p<0.0001).
Conclusions : Misperceptions about which criteria are important in residency selection are common among medical students. Many overestimate the importance of subjective criteria while undervaluing objective criteria.
Career Decision-Making among Pediatric Residents
Laura Dattner, MD * and Philip O. Ozuah, MD, PhD †
* Department of Pediatrics S.U.N.Y. Downstate College of Medicine The Children’s Hospital at Downstate, Brooklyn, NY
† Department of Pediatrics Albert Einstein College of Medicine The Children’s Hospital at Montefiore, Bronx, NY
Abstract - Background: Knowledge of the timing and process of residents’ career decisionmaking could improve mentoring, career counseling and subspecialty recruitment efforts. However, knowledge about the timing of career decisions made by pediatric residents is lacking.
Objective: To examine the timing of career decision-making among pediatric residents.
Methods: We conducted a cross-sectional survey of a convenience sample of pediatric residents using a modified National Survey of Attitudes and Choices in Medical Education and Training questionnaire. Participants were asked about career plans, the timing of career decisions, and significant influences on these decisions.
Results: Participants included 355 pediatric residents. Seventy-three percent had made a career decision. Of residents at least in the third post-graduate year, 40% of pediatric residents made career decisions during the second year of residency, and a cumulative 76% had made their decisions by the end of that year.
Conclusions: This information about the timing of career decisions made by pediatric residents could help time educational opportunities, mentoring and career counseling activities, and recruitment efforts.
Medical Education Online Editor@Med-Ed-Online.org