Browsing by Author "Cofrancesco J"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    International Residency Program Directors on Implementing Educational Transformation: A Qualitative Study of Their Experiences and Strategies for Overcoming Challenges
    (Accreditation Council for Graduate Medical Education, 15/08/2021) Dutta D; Ibrahim H; Stadler D; Cofrancesco J; Nair SC; Archuleta S
    BACKGROUND: Residency program directors (PDs) need to navigate diverse roles and responsibilities as clinical teachers, administrators, and drivers of educational improvement. Little is known about the experience of PDs leading transformation of international residency programs. OBJECTIVE: We explored the lived experiences of international residency PDs and developed an understanding of how PDs manage educational program transformation. METHODS: Using a phenomenological approach, semi-structured interviews were conducted with current and former PDs involved in the transformation to competency-based medical education in the first international settings to be accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I). Thirty-three interviews with PDs from Qatar, Singapore, and the United Arab Emirates were conducted from September 2018 to July 2019, audio-recorded, and transcribed. Data were independently coded by 2 researchers. A thematic analysis was conducted and patterns that reflected coping and managing educational reform were identified. RESULTS: PDs described distinctive patterns of navigating the educational transformation. Five themes emerged: PDs (1) embraced continuous learning and self-development; (2) managed change in the context of their local settings; (3) anticipated problems and built support networks to effectively problem-solve; (4) maintained relationships with stakeholders for meaningful and constructive interactions; and (5) focused on intrinsic qualities that helped them navigate challenges. CONCLUSIONS: International PDs were presented with significant challenges in implementing educational transformation but coped successfully through distinctive patterns and methods.
  • Thumbnail Image
    Item
    Program Director Retention and Attrition Rates in International Graduate Medical Education
    (Accreditation Council for Graduate Medical Education, 1/10/2020) Stadler DJ; Ibrahim H; Dutta D; Cofrancesco J; Archuleta S
    Background Program directors (PDs) are integral to the education of the next generation of physicians. Yet, administrative burdens, substantial patient care responsibilities, and lack of protected time for teaching may contribute to work-life imbalance and physician burnout, leading to high rates of attrition. Data on international residency program leadership turnover are lacking. Objective This study aimed to quantify PD turnover in Accreditation Council for Graduate Medical Education-International (ACGME-I) accredited programs in Singapore, United Arab Emirates (UAE), and Qatar, and to compare to US PD attrition rates. Methods Data on PD turnover in international programs was extracted from the ACGME-I Accreditation Data System for academic years 2010–2011 through 2018–2019 for Singapore and 2013–2014 through 2018–2019 for UAE and Qatar. Rates of PD turnover were calculated by country and by ACGME-I medical-, surgical-, and hospital-based specialty groupings and compared using χ2 test. Annual US PD turnover data was extracted from the ACGME's Data Resource Book. Results Seventy programs met inclusion criteria. International PD attrition was high, with 56 programs (80%) changing PDs since program inception, and 16 programs (29%) having 2 or more PD turnovers. There was no significant difference between PD turnover rates in hospital (83%), medical (79%), or surgical (78%) specialties. International PD attrition rates varied from 7% to 20% annually and were comparable to PD turnover in US programs (range 12%–15%). Conclusions High PD turnover rates in newly accredited international residency programs were noted, although annual attrition rates were comparable to US residency programs.