Development, Implementation, and Evaluation of a Novel Fellowship Coaching Program.

Pleural Procedure Education in Fellowship: A National Survey of Program Directors

RATIONALE: Gastroesophageal balloon tamponade (GEBT) tube placement is a life-saving measure used as a bridge to definitive therapy in patients with variceal hemorrhage refractory to medical and/or endoscopic therapy. As a high acuity and low occurrence (HALO) procedure, proficiency is unlikely to be achieved solely through clinical exposure and therefore dedicated skills education is needed. While pulmonary and critical care medicine (PCCM) and critical care medicine (CCM) fellows may be expected to place a GEBT tube independently after training, it is unclear how education practices during fellowship vary. We sought to survey fellowship program directors to better understand current educational practices and the perceived importance of GEBT curricula during fellowship training. METHODS: A 14-item Qualtrics survey assessing institutional practices, educational approaches, proficiency needs, and demographics was sent to 202 PCCM program directors and 67 CCM program directors via email using the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD) listserv. All recipients received two additional emails reminding them to complete the survey.RESULTS: A total of 53 responses were received (response rate 20%; 39 PCCM, 12 CCM, 2 both PCCM & CCM). The majority (94%) of respondent institutions utilize GEBT tubes for refractory variceal hemorrhage with 71% of those institutions having at least one GEBT tube placed by a PCCM/CCM trainee annually. Only 25 programs (47%) had a formal curriculum educating fellows on the placement of GEBT tubes, although 77% of program directors thought it was at least moderately important for PCCM/CCM trainees to be proficient in GEBT tube placement upon graduating from training. CCM programs were more likely to have trainees that place GEBT tubes and more likely to have GEBT curricula than PCCM programs. Programs where PCCM/CCM fellows placed at least one GEBT tube annually were significantly more likely to have formal curricula (p < 0.001). CONCLUSIONS: GEBT tubes are utilized at most institutions where graduating PCCM/CCM fellows may work although less than half of surveyed fellowship programs provide any formal education on the topic. There is a gap between the expected competence with GEBT tube placement at graduation from critical care fellowship and the educational curricula provided during training, which warrants further exploration to identify and overcome barriers.

In the United States, a growing number of lung transplants are performed each year, necessitating an increased number of general and transplant pulmonologists skilled in the care of these complex patients. However, pulmonary and critical care medicine (PCCM) fellowships across the country do not universally have dedicated lung transplantation curricula, and there is scarce literature in this area. We describe the generation of a content outline for curriculum development created through modified electronic Delphi methodology. To identify "must know" topics in lung transplantation for a graduating PCCM fellows. We developed expert consensus on "must know" lung transplant topics and subtopics ("items") for a graduating fellow through three survey rounds from July 2023 to October 2023. Thirty-three panelists were asked to rank author-provided items as "must know," "nice to know," or "not necessary to know" and to generate new items in round 1 to be submitted for ranking in subsequent rounds. "Must know consensus" was defined as ≥50% must know responses. Survey response and completion rates across rounds were 58-70% and 96-100%, respectively. In round 1, panelists were provided eight topics and 30 subtopics for initial ranking. Panelists generated 82 new items in this round, of which 19 were included in round 2 for ranking after author review, together with one item from round 1 that required reranking. From round 2, only two items required reranking, and these items comprised round 3. Seven topics were identified as "must know": transplant immunology, evaluation of a lung transplant candidate, surgical and peri/postoperative management, rejection, immunosuppression, infections, and other complications, together with 36 subtopics. Self-identified lung transplantation experts obtained consensus on seven "must know" topics and 36 subtopics in lung transplantation for graduating PCCM fellows. The findings serve as a starting point for future curriculum development.

A minority of Pulmonary and Critical Care Medicine (PCCM) graduates pursue careers in academic medicine. Although compensation is only a portion of the career decision, job negotiations remain shrouded in ambiguity and inconsistency. Additionally, while role-level salary tables exist through the Association of American Medical Colleges (AAMC), to our knowledge there is no resource that includes important non-salary. We sought to describe key components of first PCCM academic job offers for both physician scientists and clinician educators, including salary, start-up packages, non-clinical full-time equivalent (FTE) breakdown, and bonus ranges. An electronic survey was distributed via a snowball sampling method between May - June 2025. PCCM graduates between 2020-2025 who accepted a job in academic medicine were included. Mann-Whitney Wilcoxon tests were used for ordinal comparisons. Qualitative analysis of free text responses was performed with a social cognitive career theory framework. There were 60 respondents who provided information about 103 job offers, with 50% (14/28) of physician-scientists and 66% (21/32) of clinician-educators reporting more than one job offer. Physician-scientists received lower salary offers compared to clinician-educators (respective median ranges: $150,000-$199,999 vs $250,000-$299,999, p < 0.001). Only 35.7% of physician-scientists (10/28) received a career development award prior to negotiation, which was associated with a higher start-up package offer (p < 0.05). For all clinician-educator jobs (n = 59), 42.4% had non-clinical FTE in the initial offer. Many respondents commented on the lack of negotiating power. PCCM physician-scientists and clinician-educators experience wide variability in their initial job offers. Recognizing differences is essential to improve transparency in job negotiations in academic medicine.

Many wellness programs for older adults focus on physical health or specific conditions, such as heart disease prevention or diabetes management. To supplement these efforts, there is a need for holistic wellness programming to enhance well-being in later life. We developed and piloted a novel wellness coaching program for residents of senior living communities to address this need. The theoretical framework of the program is based on a holistic, multidimensional wellness model and self-determination theory. Staff members from eight residential communities were trained on wellness coaching techniques, such as motivational interviewing, active listening, and group facilitation skills, before they led the 9-week resident wellness coaching program. A total of 79 residents, ages 71 to 97 (M = 84.3, SD = 6.5), completed the pilot program. The resident wellness coaching program included a mixture of individual and group coaching sessions. The coaching sessions provided wellness education, social support, and space to share progress on wellness goals. Participants completed surveys at three time points: pre-program, post-program, and 1-month follow-up. Residents reported high satisfaction with the overall program and its components. Repeated measures ANOVAs were conducted to examine changes in wellness over time. Comparison of pre- and post-test scores revealed significant improvements in health satisfaction, physical and psychological quality of life, purpose, loneliness, relatedness, and competence. Some of these changes, such as increases in psychological quality of life and decreases in loneliness, persisted at the one-month follow-up. These findings have implications for the development and implementation of wellness coaching programs with older adults.

Health care workers face serious mental health challenges as a result of ongoing work stress. The COVID-19 pandemic exacerbated that stress, resulting in high rates of anxiety, depression, and burnout. To date, few evidence-based programs targeting mental health outcomes in health care workers have been described. To assess the feasibility, acceptability, and preliminary outcomes of a skills-based coaching program designed to reduce stress and build resilience. A pilot cohort study was conducted between September 2020 and April 2021 using preprogram and postprogram assessments and a mixed-methods analysis. Duration of follow-up was 7 weeks. The coaching program was delivered via video conferencing. Participants were health care workers and staff from a large urban health system. The Promoting Resilience in Stress Management (PRISM) program, a manualized, skills-based coaching program originally developed for adolescents and young adults with serious/chronic illness, was adapted to support health care workers and staff ("PRISM at Work"). It included 6 weekly 1-hour group sessions. Feasibility was defined a priori as 70% completion rates. Acceptability was defined quantitatively (satisfaction scores) and qualitatively (open-ended questions regarding experience with program). Preliminary outcomes were assessed with preprogram and post program assessments of self-reported resilience, stress, anxiety, and burnout using validated instruments. Descriptive statistics summarized demographic variables and feasibility and acceptability. Linear mixed effects regression models examined preliminary outcomes, controlling for relevant covariates. A total of 153 participants (median [SD] age, 40.6 [10.1] years; 142 [92%] were female; 128 [84%] identified as having White race; 81 [53%] were in patient-facing roles) enrolled. Of the 132 health care workers who provided follow-up surveys, 120 (91%) had completed the program, and 116 (88%) reported being satisfied. Answers to open-ended questions suggested that participants wanted more PRISM either with longer or additional sessions. Participant-reported resilience (β = 1.74; 95% CI, 1.00-2.48), stress (β = -2.40; 95% CI, -3.28 to -1.51), anxiety (β = -2.04; 95% CI, -2.74 to -1.34), and burnout-exhaustion (β = -0.37; 95% CI, -0.56 to -0.18) improved after the program. Results of this study suggest that PRISM at Work may have utility for health care workers and staff in that the program was found to be feasible, acceptable, and associated with improved outcomes.

Achievement coaching is a program that has high value for an athlete, with the existence of achievement coaching can improve the quality possessed by an athlete. The low football achievements of Askab PSSI Kerinci can be seen from the medal tally of the last two periods of Porprov and the Jambi Governor's Cup. The purpose of this study is to evaluate the football achievement coaching program at Askab PSSI Kerinci. This type of research is qualitative using the CIPP model. The samples from this study were the chairman of KONI Kerinci Regency, PSSI Askab Board, coaches and athletes. Data collection through observation, interview and documentation using Data analysis in this study is uses divided into three stages, namely data reduction, data presentation and conclusion drawing. The evaluation results show that (1) The context aspect of the Askab PSSI Kerinci coaching program has a written management structure that has been approved by the Jambi PSSI Asprov (2) The input aspect, the trainer has an AFC C license and has a training program, but the completeness of facilities and infrastructure is inadequate and still below the established standards (3) Process aspect, the implementation of the training program is in accordance with the design made by the trainer but the short implementation time of 2-3 weeks makes the training program not running effectively (4) Product aspect, getting 2nd place at the 2019 Pre-Porprov event and the 2020 Governor's Cup.

Although resident wellness is increasingly a priority in senior living communities, there are few programs that promote holistic wellness in later life. A total of 79 residents (ages 71 to 97; M = 84.27, SD = 6.46) from eight senior living communities completed a pilot study of a novel, staff-led wellness coaching program consisting of resident-driven goals and individual and group coaching sessions. Participants completed surveys at three time points (pre-program, post-program, and 1-month follow-up). Repeated measures ANOVAs revealed positive changes in resident health satisfaction, physical quality of life (QOL), psychological QOL, loneliness, relatedness, competence, and sense of purpose. Some of these results (i.e., psychological QOL, loneliness) persisted at follow-up. Residents reported high satisfaction with the program. These findings have implications for the application of holistic wellness frameworks in later life, as well as the development and implementation of wellness coaching programs with older adults.

Developmental networks in translational science

BackgroundProblem-solving ability has been identified as a core competence that nursing students should develop, and it plays a vital role in career development. Therefore, it is necessary to investigate factors related to problem-solving ability and the path relationships among those factors in the context of nursing students.ObjectiveThis study aims to identify the factors that affect problem-solving ability, and to investigate path relationships of self-directed learning ability, critical thinking ability, learning engagement, and problem-solving ability among nursing students.DesignA cross-sectional study.SettingsThe Department of Nursing at a university located in Shanghai, China.SampleA total of 540 nursing students with a three-year education program were enrolled in the current study.MethodsData were collected by using a structured questionnaire, including general information, learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability of nursing students. Pearson’s correlations were used to explore the relationships between learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability. The path relationships were analyzed by constructing a structural equation model using AMOS software.ResultsOur results showed that learning engagement, self-directed learning ability, and critical thinking ability were positively associated with problem-solving ability. Furthermore, learning engagement did not influence problem-solving ability directly, but it affected problem-solving ability indirectly via self-directed learning ability and critical thinking ability among nursing students. Additionally, the total effects of self-directed learning (0.442) and critical thinking ability (0.581) were more prominent than learning engagement (0.361) on problem-solving ability.ConclusionsTo improve the problem-solving ability of nursing students, nursing educators should develop targeted strategies to enhance learning engagement, self-directed learning ability, and critical thinking ability.

Introduction: Trainee burnout is common and evidence supporting the effectiveness of well-being interventions for this population is limited. We studied the effect of a longitudinal coaching program grounded in positive psychology on measures of pediatric trainee well-being.

Objective: The objective of this study is to investigate the gap between academic experiences and professional success by examining various dimensions of graduates' journeys. By investigating graduation rates across diverse programs, the research sheds light on patterns that may inform institutional improvements and highlight areas where students excel or struggle. Theoretical Framework: In this topic, the main concepts and theories that underpin the research are presented. Various career development theories, such as Super's Life-Span and Life-Space theory (Super,1980), can offer insights into the lifelong impact of educational experiences on career trajectories. This theory posits that career development is not a linear process but a series of stages influenced by personal circumstances and environmental contexts. In the context of this tracer study, Super's framework provides a valuable lens through which to analyze the experiences of Bulacan State University Graduate School alumni as they navigate their educational and professional journeys.stand out, providing a solid basis for understanding the context of the investigation. Method: The methodology adopted for this research is a mixed-methods approach, integrating both quantitative and qualitative methodologies to comprehensively understand graduates' career trajectories. The research design followed a cross-sectional framework, collecting data at a specific time to capture graduates' current employment landscape from 2020 to 2024. Data collection was carried out through surveys and actual interview. Results and Discussion: This tracer study reveals significant insights into graduate outcomes and recommendations for program enhancement. The Master of Arts in Education (MAEd) dominates the graduate distribution at 51%, driven by the educational sector's need for advanced qualifications. Alumni shared the importance of postgraduate education for career advancement, particularly emphasizing research, leadership, and management skills. Key recommendations from PhD alumni focus on enhancing academic excellence through two sub-themes: Academic Administration and Support, and Innovative Learning and Development. Improving administrative processes, faculty hiring, and research support is needed in creating a more efficient and supportive academic environment. This approach aims to increase faculty satisfaction and retention, fostering a stronger academic community. Innovative Learning and Development emphasizes diverse educational methods, including extracurricular activities and online courses tailored to different learning styles. The integration of technology and a research-based teaching approach are seen as essential for preparing students for modern challenges. Additionally, alumni from Master's programs advocate for holistic academic development through experiential learning and mentorship, enhancing students' confidence and competence in real-world applications. Research Implications: The tracer study's implications include enhancing curricula with experiential learning, streamlining administrative processes, and fostering industry collaborations to better align education with job market needs. It emphasizes the importance of flexible program structures and student empowerment to improve engagement and motivation. Theoretically, it contributes to competency-based education models by highlighting the integration of practical skills into academic frameworks. Overall, the study call the need for adaptive educational practices that prepare graduates for real-world challenges while enriching existing educational theories. Originality/Value: This tracer provides empirical evidence on how specific skills acquired in graduate programs influence career advancement and emphasizes the need for aligning curricula with industry demands. The study introduces innovative frameworks for student empowerment and experiential learning, offering practical insights for educators and policymakers. It contributes to the theoretical understanding of graduate education's impact on workforce readiness and socio-economic development.

Purpose: The purpose of the study was to assess the effect of motivational strategies on XYZ Company's performance. Methodology: Descriptive research design was used in carrying out the study in which the target population under study consisted of 75 employees of XYZ Company were sampled. The study then used a stratified sampling method followed by simple random sampling. The research instrument used was a questionnaire. Data collected was analysed using SPSS 20.0 statistical software and findings presented in tabular descriptive frequencies and percentages.Results: The findings implied that motivational strategies affect performance as motivated employees are able to produce quality products, satisfy customer needs leading to increased profitability The study findings also indicated XYZ Company had adopted several motivation strategies which included job design, goal setting, career development and reward systems. Further, descriptive studies also showed that they did not have employee development schemes, modern technology, job security, mentorship and exposure to international processes.Unique contribution to theory, practice and policy: The study provides recommendation that the organization should pursue other motivational strategies which include team work, a flat structure, adoption of modern technology, pool transport, International Benchmarking sessions to expose employees to best practices in the world, work environment and employee coaching and mentorship programs as this is will improve the motivation of staff and a consequence lead to improved performance.

In this chapter, we will explore the landscape of opportunities for flourishing and risks for floundering among young professionals today. The evolution of emerging adults’ career culture is examined, highlighting aspects such as increased flexibility, career development, as well as growing uncertainties in the modern information society. We will delve into the pressures to succeed, post-graduation plans, financial concerns, and exploration of self-esteem of emerging adults navigating their career trajectories. Professionally, the demands of globalization and digitalization are ubiquitous, emphasizing the significance of targeted skills like digital literacy. We will widen the scope to address amplified uncertainty in emerging adults’ career development and financial stability, accentuated by global disruptions such as the COVID-19 pandemic. The chapter equips emerging adults, their parents, and educators with strategies for thriving in a rapidly evolving world, while providing quotes from emerging adults today, offering comprehensive insights into the modern career landscape.

From the *Department of Anesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania †Penn Center for Perioperative Outcomes, Research and Transformation, Philadelphia, Pennsylvania ‡Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania. Accepted for publication August 10, 2022. Conflicts of Interest: See Disclosures at the end of the article. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Address correspondence to Emily A. Vail, MD, MSc, 333 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104. Address e-mail to [email protected].