Magic-echo phase-encoding solid imaging with improved time resolution

Anesthesiology critical care medicine (ACCM) fellowship training was accredited in 1989, and a small number of graduating anesthesiology residents pursue this additional training. Considering the flexible program guidelines of the American Board of Anesthesiology (ABA), we hypothesized that ACCM fellowship training programs varied significantly among the 42 institutions accredited to offer this program. This study of ACCM fellowship programs used a six-part, 57-item questionnaire completed by 36 program directors to describe six aspects of the program: institution size, program director, attending staff, fellowship applicants, curriculum, and the role of the American Society of Critical Care Anesthesiologists (ASCCA). Ninety-four percent of ACCM fellowships are in facilities with more than 400 beds; 81% of these institutions have more than 20 intensive care unit (ICU) beds as the basis for fellowship teaching. Eighty-three percent of ACCM program directors have practiced critical care for more than 5 yr. All programs had more than one attending physician, with the majority having a multidisciplinary attending staff. During two academic years (1990-1992), 12 (33%) of 36 programs did not have a fellow, resulting in an average of less than one fellow for each program. ACCM fellow involvement in patient care was characterized as "primary" in medical and pediatric ICUs and "cooperative" in surgical ICUs. Fellowship curricula had varied requirements for research, intraoperative anesthesia, and ICU procedures performed by the fellow. In general, program directors believe that salary and on-call responsibility are not important issues for applicants. Nineteen percent of program directors train ACCM fellows longer than the 12 mo required by the ABA and believe that ACCM training should be lengthened.     

Fellowship training in infectious diseases: a report from the regional and national meetings of infectious diseases division chiefs and program directors

During the 2-year period April 1995 to April 1997, six regional meetings and one national meeting of division chiefs and program directors of adult infectious diseases programs in the United States were held to review fellowship training. Herein, we report data on job availability and job selection for recently graduated fellows. We summarize discussions on decreasing the number of fellows in training, and we outline suggested components of a core clinical curriculum and of three training tracks--clinician track, clinical investigator track, and basic investigator track.     

Pediatric emergency medicine fellow clinical work requirements

A wide range of clinical requirements exists among PEM fellowship programs. Programs are equally split concerning the question of whether fellows should work with supervision or independently in the first year; a significant number of fellowship programs require continued supervision of fellows in subsequent years. Orientation for first year fellows and requirements for completion of PALS, advanced pediatric life support (APLS), ACLS, or ATLS courses prior to their first independent shift varied greatly. In particular, a minority of programs required ATLS completion even though a majority of overall fellowship programs operate in a hospital designated as a Level 1 Trauma Center. Programs in which first-year fellows worked independently had fewer attendings and were less likely to provide 24-hour coverage. Fellows appear to work a similar or less demanding schedule than PEM attendings in most fellowship programs, and most fellowship directors feel that their fellows should continue with their current schedule.     

Research curricula in critical care fellowships--a survey

OBJECTIVES: To determine curriculum requirements and educational methods used by Critical Care fellowship training programs in fulfilling Residency Review Committee requirements for a research experience during Critical Care subspecialty training. DATA SOURCE: Responses from 163 (67%) of the 245 directors of accredited Anesthesiology, Medicine, Pediatric, and Surgical Critical Care fellowship training programs listed in the American Medical Association Graduate Medical Education Directory. DATA EXTRACTION: Survey information accepted as valid for each program was tabulated to answer study questions. DATA SYNTHESIS: Most (89%) Critical Care programs with 2- or 3-yr curricula meet Residency Review Committee requirements and provide nonclinical time for research. Only 63% of 1-yr curricula from Anesthesiology and Medicine provide a required research experience. Formal instruction in research topics is provided by lecture, journal club, or research conference in approximately 90% of fellowships. Academic productivity from fellowship programs is high, but not correlated with a program's requirement for research. CONCLUSION: Compliance with current Residency Review Committee requirements for active participation in research is poor for 1-yr fellowship curricula. Reasons for this failure are discussed and a modified requirement is proposed.     

Multi-institutional survey of graduates of pediatric anesthesia fellowship: assessment of training and current professional activities

We surveyed all the graduates of four fellowship programs in pediatric anesthesia between 1985 and 1993 to assess their current professional activities, their evaluation of fellowship training, and their opinions on future directions of such training. One-hundred ninety-one (62%) of the graduates responded. Nearly all of the respondents had sought fellowship training for pediatric anesthesia and thought that the training was worthwhile. At the time of the survey, 40% worked in a children's hospital, 72% had university or affiliate positions, and 54% had a practice that was > 50% pediatric. Those with > or = 12 mo fellowship and/or board certification in pediatrics were the most likely to have a pediatric-dedicated practice. Seventy percent of the respondents thought that fellowship training should be for 12 mo, and the proportion of respondents who recommended inclusion of training in pain management and clinical research was greater than the number who had actually received such training. Fifty-eight percent of respondents supported restriction of fellowship positions in the future, but 83% did not support a mandatory 2-yr fellowship with research training. We conclude that fellowships in pediatric anesthesia seem to be successful in providing training that is not only satisfying to the trainees, but that is also followed by active involvement in the care of children and in the training of residents and fellows in anesthesia. Additional information should be gathered to assess the impact of this training on pediatric care, to formulate a standardized curriculum, and to justify support for such training in the future. Implications: We surveyed graduates of four fellowship programs in pediatric anesthesia (1985-1993) to assess current professional activities, fellowship training, and future directions of such training. Fellowships in pediatric anesthesia seem to provide training that is satisfying to trainees and that is followed by active involvement in the care of children.     

Formalized postdoctoral fellowships: A national survey for postdoctoral fellows.

Why do some recent doctoral graduates participate in formalized postdoctoral fellowship programs? What activities do fellows engage in, and are fellowships meeting their training needs? By analyzing a national survey of 204 fellows, the authors address these and other questions. Desire for advanced training, particularly psychotherapy and assessment, was the most common reason for seeking and accepting a postdoctoral fellowship. It is interesting to note that training focused on new and emerging areas in psychology were not highly rated. Fellows reported engaging in a variety of activities, with nearly half of their work week spent providing direct clinical services. The majority of fellows were highly satisfied with their fellowship experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Orthopedic residents' perceptions of the content and adequacy of their residency training

The content and adequacy of orthopedic surgery residency training can be evaluated by several means. The Accreditation Council for Graduate Medical Education and the Residency Review Committee set standards with which residency programs must comply in order to be accredited. Residents' perceptions of the content and adequacy of their training is another means of evaluating orthopedic residency training. A questionnaire was sent to all graduating orthopedic residents in the United States, Canada, and Puerto Rico. The questionnaire provided program and individual resident demographics, as well as the residents' rating of specific areas of residency training on a 5-point scale (1=superior, 2=above average, 3=average, 4=below average, 5=inadequate). Completed surveys were received from 454 of the 698 graduating orthopedic surgery residents listed by the American Academy of Orthopaedic Surgeons; the response rate was therefore 65.0%. Our respondents were representative of the entire population in terms of geographic and sex distribution. Respondents rated their general orthopedic training at 1.9. The areas of training that had the best ratings included trauma/fracture (1.8), adult reconstruction (1.9), and pediatrics (1.9). The worst rating was reported for training in foot and ankle (2.7). Factors related to better ratings for general orthopedic training included male sex of residents, programs with more full-time faculty, programs with more hours of weekly teaching conferences, programs with one or more faculty present at all teaching conferences and programs in which residents first operate independently at or before postgraduate year 4. Sixty-six percent of all respondents were planning to hold a fellowship immediately after graduation. The most common fellowships taken included sports medicine (20.5% of all respondents), hand (12.1%), and spine (9.5%). Younger graduating residents, those from larger programs (more residents per year), and those from the Mideast (U.S.), and New England regions were most likely to enter a fellowship after graduation.     

Clinical knowledge and skill priorities in substance abuse education: a nursing faculty longitudinal survey

The aims of this study were to: 1) determine which of 16 substance abuse content areas nursing faculty fellows considered important for their professional growth; 2) determine content areas in which faculty fellows planned to obtain knowledge and skill development during the coming year; and 3) to identify content areas faculty fellows thought undergraduate and/or graduate students should be taught. Questionnaires were mailed to the 43 nursing faculty fellows who were recipients of substance abuse federal training during the 1989-1994 academic years. The response rate was 81%. One and a half years later, 66% responded to the same items on a follow-up survey. The results showed that faculty ratings of knowledge and skill development needs for themselves and their students in nursing were stable over time. Findings can be used to guide faculty and curriculum development in alcohol and other substance abuse.     

Trauma fellowship training: the insiders' perspective

Trauma care is in a period of transition from care given by surgeons at the closest community hospital to care given by trauma specialists at trauma centers and within emergency medical systems. It has thus become increasingly important for the educational goals of trauma fellowship training to reflect the needs of the future system as well as the views of future practitioners. These views differ from those of surgical colleagues practicing trauma surgery, and the views of future trauma specialists should be considered during the formulation of training guidelines. This survey appears to be the first attempt to interpret the views of trauma fellows: 48 of the 83 fellows (57.8%) in the 1991-1992 national cohort responded. They made suggestions about their own training, including ways to increase surgical experiences and opportunities for academic pursuits, but gave no insight as to an appropriate mix of critical care training. Although critical care certification is a major attraction for fellowship training, the cohort does not want to be thought of as nonoperating surgical intensivists. A second year of fellowship training is seen as necessary for research and trauma systems-related studies.     

Early career achievements of National Science Foundation (NSF) graduate applicants: Looking for Pygmalion and Galatea effects on NSF winners.

NSF Graduate Fellowships are awarded to approximately half of a homogeneous group of applicants in a procedure that approximates random assignment to the conditions of either fellowship or honorable mention. This natural experiment permits assessment of the effect on early career accomplishments of being named an NSF fellow. The authors found a consistent effect for PhD completion—overall, fellows were 7% more likely to complete the PhD than were nonawardees—but found no reliable fellowship effect on achieving faculty status, achieving top faculty status, or submitting or receiving an NSF or a National Institutes of Health research grant. The authors conclude that the positive expectancies associated with this prestigious fellowship have only a small influence (Pygmalion or Galatea effect) in graduate school and no effect thereafter. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gamma interferon prevents diabetes in the BB rat

OBJECTIVE: Although increased evidence of disproportionate psychosocial risk and other health problems encountered by lesbian, gay male, and bisexual (LGB) youths has emerged, no study has described how the topic of homosexuality is addressed within child and adolescent residency psychiatry training. METHOD: Residency training directors in U.S. child and adolescent psychiatry programs were asked questions about instruction on the topic of homosexuality and the care of LGB patients, the department's view of whether homosexuality represents a pathological condition, the director's awareness of LGB colleagues and residents, and the director's opinion of LGB residents' disclosure of their homosexuality to their patients and patients' families. Asking similar questions facilitated a comparison of survey results with those of an earlier study of general psychiatry training directors. RESULTS: The reported departmental attitudes about whether homosexuality represents a pathological condition were essentially equivalent in general and child programs. Child and adolescent training directors were, however, less likely to have a favorable view of disclosure of sexual orientation to patients, less likely to know LGB residents or faculty, and less likely to report LGB residents an asset to their departments. CONCLUSIONS: The prediction that the majority of child and adolescent training programs would reflect a heightened awareness of the vulnerability of LGB youths was not confirmed.     

Thematic Apperception Test (TAT) interpretation: Practice recommendations from a survey of clinical psychology doctoral programs accredited by the American Psychological Association.

Surveys of academic psychologists have suggested that the Thematic Apperception Test (TAT) is a diminished aspect of graduate training despite its popularity in practice. The authors surveyed training directors of clinical psychology doctoral programs accredited by the American Psychological Association to determine how the TAT was taught. Results indicated that TAT interpretation is a modest aspect of most respondents' programs. The only widely used resource was L. Bellak's psychoanalytic textbook (1986, 1993). Numerous chapters available and the entire journal canon appeared to be unaccessed. The authors pose a partial solution to the apparent disparity: Profession-wide recommendations are provided followed by a syllabus of recommended books, chapters, and articles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Graduate training in clinical psychology and the study of suicide.

Assessed the current level of training in the study of suicide in member departments (N?=?115) of the Council of University Directors of Clinical Psychology Programs. Of the 80% (92) of the departments that responded, only 35% offered any formal training in the study of suicide. If training occurred, it was usually offered as part of another course. In addition, the training directors did not feel that faculty should be required to have formal training in managing suicidal patients. We also found that 80% of the clinical faculty had treated or assessed suicidal patients; 35% were highly experienced with this population; 9.5% had actually lost a patient to suicide. Futhermore, the study of suicide was seen as relatively important to the graduate education of clinical psychologists, and graduate training was viewed as the most appropriate place for this training to occur. Reasons for this lack of formal training in the graduate curriculum are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A decade's experience with a preceptorship. A model for gastroenterologic education

I have conducted an experiment in medical subspecialty education during the last 10 years in the division of gastroenterology of the Mount Sinai School of Medicine in the form of 3-month preceptorships during the second year of the fellowship. I recognized that our training program, along with other subspecialty training programs, was no longer a purely hospital affair, but its future lay as well in the outpatient setting. I wanted to have the fellows participate in the daily care of patients in the realistic setting of practice. I hoped to offer them the excitement, as well as the problems, of daily gastroenterology practice. By seeing new and established patients with gastrointestinal problems in four daily sessions, and caring for hospitalized patients, including those being operated on, the fellows were to participate in every aspect of a busy office. The flavor of reality was to be heightened by their exposure to the preceptor's uncensored discussions with the patient, the family, the radiologists, endoscopists, and referring physicians. Here I report what the fellows and I have learned from experience, and I address the problems we all must face in the era of managed care, with the ongoing reduction in the number of specialists. I also consider who will do the teaching and who will pay them to protect the time they need.     

Psychologists in geriatric medicine: Results of a national survey.

51 physician directors of geriatric medicine fellowship programs were surveyed on their current and desired involvement with psychologists, perceived areas of expertise of psychologists, comparisons of psychologists with overlapping health care professions, and factors limiting involvement of psychologists in geriatric medicine. Results indicate that psychologists are quite involved in most geriatric medicine training programs and that directors of these programs welcome their greater involvement. Significantly, psychologists and psychiatrists are rated as similar in expertise in most areas of clinical practice. Neuropsychological assessment and family therapy are areas of psychologist expertise that are seen as especially valuable. Factors that may increase psychologist involvement in geriatric medical settings and the special importance of medical settings for the care of older patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Status of minority curricula and training in clinical psychology.

Survey data from 76 of the 106 American Psychological Association-accredited clinical psychology programs indicate that 31 programs offered a total of 57 courses that prepared students to work with minority populations. Most of these courses were taught by 16 programs. There was no relationship between whether a program had a minority faculty member and whether minority-related courses were offered. Program directors acknowledged the large variability of opinion among their faculty on the importance of minority training, and some indicated that little was being done to prepare clinical psychologists to work with minority groups. A comprehensive multicultural approach to preparing minority- and majority-culture students to work with minority populations was poorly represented in coursework, clinical practicum, research training, and language requirements for the PhD degree in clinical psychology. Some issues regarding models for inclusion of minority content in training are discussed. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Licensure, use, and training of paramedical personnel to perform screening flexible sigmoidoscopy

BACKGROUND: The purpose of this study was to assess the state board of nursing guidelines about the performance of flexible sigmoidoscopy by nurses and to determine the current use and training of paramedical personnel in flexible sigmoidoscopy at gastroenterology fellowship programs in the United States. METHODS: Separate one-page questionnaires were sent to state boards of nursing and directors of endoscopy at gastroenterology fellowship programs in the United States. RESULTS: Twenty percent (10 of 50) of state boards of nursing explicitly approve the performance of sigmoidoscopy by registered nurses, and 50% (25 of 50) explicitly approve the practice by nurse practitioners. Forty-six percent (23 of 50) of state boards of nursing have no written policy but allow nurses to use a "decision making model" to determine whether the performance of sigmoidoscopy is allowed. Fifteen percent (24 of 164) of gastroenterology fellowship programs in the United States use paramedical personnel to perform flexible sigmoidoscopy. Sixty-three percent (15 of 24) of these programs started since 1995, and 67% (16 of 24) require that the paramedical personnel perform 50 or more supervised sigmoidoscopies during their training. Forty-five percent (5 of 11) of programs with physician assistants/nurse practitioners use these personnel to perform colonoscopy or endoscopy. CONCLUSIONS: Nurses are allowed to perform flexible sigmoidoscopy in most states based on current state board of nursing guidelines. The use of paramedical personnel to perform endoscopic procedures is increasing rapidly.     

Combined effects of errors in frontal-view asymmetry diagnosis

We used quantitative methodology to examine the first three decades of the journal Psychophysiology from a stand-point of historic interest. A bibliometric analysis was conducted on 1,781 works published during this period. In total, 2,537 authors have published in the journal. The distribution of their productivity matches approximately what would be expected based on previous bibliometric investigations. A constant increase in the collaboration between researchers was evident (reaching an average of 2.56 authors per paper). The literature cited in these articles dates back between 4.53 and 8.12 years (M = 6.48 years). These bibliometric results show that this journal can be placed among the most experimentally oriented group within the field of psychology.