Journal Watch

Recently Published TTR Papers

Developing a Coaching Framework Applicable to the Transition to Residency Using Self-Determination Theory
Coaching is a powerful tool in medical education but has been limited in Undergraduate Medical Education (UME) due to time and resource constraints. Self-Determination Theory (SDT), a framework for understanding human motivation, forms the theoretical basis for coaching practices aimed at supporting learners’ basic psychological needs of autonomy, competence, and relatedness. Using SDT with a modified Delphi technique, a 5-step coaching approach was developed: build, explore, reflect, plan, and close. Further details of these coaching steps included developing key coaching skills, building the relationship & setting the agenda, exploring the focus, reflecting on prior experience to identify strengths & skills that may help with the transition, defining success & creating an action plan using WOOP (wish, outcome, obstacle, plan), and closing the conversation.
Developing a self-determination theory-informed coaching framework for the transition to residency - PubMed

Using Design Thinking to Develop a Learner-Centered TTR Course Which Includes the Non-Clinical Skills Needed to Transition to Residency
TTR courses are often limited to teaching clinical or procedural skills without addressing the non-clinical skills needed to transition to clinical practice. Design Thinkings (DT) was used to develop a learner-centered TTR course including input from interns, program directors and graduating medical students. The 5 steps of DT are: ideation, experimentation, interpretation, ideation, experimentation and evolution. Sessions developed using a DT approach included: Business of medicine, health care economics and patient safety, Debriefing, Night on call, Interprofessional collaboration, Opioid use disorder prevention training, Procedural labs and ultrasonography, Resident as teacher, Study skills, and Wellness. Sessions were a mix of didactic lectures, small group discussions and workshops, simulation, and procedure labs.
Development of a Transition to Residency Course Using a Design Thinking Framework - PubMed

Development of a Code Status Discussion Workshop Using Standardized Patients in a TTR Course
Code Status Discussions (CSD), the process in which clinicians obtain a patient’s preference regarding life-sustaining interventions, are high-stakes, stressful communications and occur at pivotal junctures of care for patients. Fourth year medical students were trained in CSD in a workshop using standardized patients (SPs). Pre and post workshop surveys showed increased confidence for graduating medical students bound for different specialties across all 5 domains: recognize hos a patient’s prognosis impacts how I lead the code status conversation, recognize the appropriate timing for when to address code status, explain the phrase code status to a patient in easy-to-understand language, propose a code status that aligns with the patient’s values, and elicit values from the patient that help me guide code status discussion.
Code Status Discussions: A Standardized Patient Workshop for Senior Medical Students - PubMed

Most Medical Students Meet Program Directors Performance Expectations in Their First Six Months
PGY-1 readiness for residency was assessed using the AAMC Residency Readiness Survey, a standardized instrument for Program Directors to provide feedback to medical schools on their graduates’ performance in transitioning to residency. The responses to the question, “During the transition to GME (0-6 months of PYG-1 year), did this resident meet overall performance expectations?” were analyzed. The response options included exceeded, met and did not meet expectations. Almost all medical students were assessed as meeting or exceeding expectations although there were significant differences across specialties. Given these differences, specialty specific interventions may optimize the transition of medical students.
Program Directors’ Assessments of US Medical Graduates’ Transition to Residency - PubMed

Novel Obstetrics-Gynecology Transition to Residency Curriculum Resulted in Building Community and Initiating Professional Transformation Among Interns in Addition to Knowledge Transfer
Readiness Residency ob-gyne curriculum was developed in 2020-2022 with 4 sessions: gratitude and resilience; time management and priorities; evolving your learning style; and mission and values. Used by 50% of programs in 2022. Facilitators, program directors and interns who used the curriculum were surveyed. Both program directors and interns valued the development of relationships between program leadership and interns. In addition, program directors highlighted building community, facilitating a growth mindset and teaching time management. Interns also highlighted building community with their class. This curriculum could be adopted by other specialties potentially resulting in a similar impact.
Outcomes of a Novel Transition to Residency Curriculum for Culture-Building and Professional Development - PubMed

Focus Groups of Medical Students Exploring the Learning Experience and the Influence of Specialty-Specific Instruction, Context and Cohort Structure in a TTR Course
After a TTR course, semi-structured focus groups were conducted using block randomization by intended specialty to ensure broad specialty representation. Three themes were identified: the learning experience was enriched by specialty-specific content, contextual relevance and faculty expertise; the learning environment was shaped by psychological safety fostered through stable cohorts and a non-competitive post-match setting; and connection was promoted by specialty alignment and shared experiences. Increasing specialty-specific content and learning in specialty-specific cohorts in TTR courses may enhance engagement and professional identity development.
Student Experiences Learning in Specialty Cohorts During a Transition to Residency Course: Context, Safety and Connection Matter - PubMed