Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Ventriloquial Sensemaking of End-of-Life Care and Graduate Medical Education: A Case Study from Abu Dhabi(Taylor and Francis Group, 2025-04-23) Ibrahim H; Harhara T; Dutta DPrevious research has emphasized the role of clinician-educators as providers of knowledge and expertise for medical trainees, centralizing the power of voice and agency in these interactions. Rhetoric of health and medicine encompass nuanced observations of health and medicine practices by foregrounding discourses contextualizing communication. These are particularly relevant for studying persuasive practices in health and medicine that identify challenging issues and decision-making by caregivers. In this case study from the United Arab Emirates, we argue through the lens of rhetorical ventriloquism that contextual factors play roles in shaping training discourses in physician-resident communication. Through analysis of 18 interviews, we found that when ambiguities prevail in the context of taken-for-granted training practices, cultural, social, and structural intersections emerge to stand in and shape the ways in which medical education around end-of-life care is constructed. Implications of the findings for the scholars, educators, trainers, and health practitioners are discussed.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 SBackground 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.
