Hunderfund, Andrea Leep

Importance Little is known about how factors external to the workplace, such as spousal support, influence physician attrition. Objectives To explore associations of spousal support among married/partnered physicians with both ‘hard’ attrition ((HA), considering leaving academic medicine within 2 years) and ‘soft’ attrition ((SA), having ever considered part-time work), before and after adjusting for demographic variables, burnout and satisfaction with work-life integration (WLI). Design This cross-sectional survey study was conducted among faculty physicians employed at Mayo Clinic. Outcomes and measures Survey items measured demographics, spousal support (five items), HA, SA, satisfaction with WLI (single-item measure) and burnout (two-item measure). Check-all-that-apply questions explored reasons for considering attrition. We investigated associations of spousal career support with attrition consideration using logistic regression analyses, adjusting for demographic variables then for WLI satisfaction and burnout. Results 739/2103 physicians responded (response rate 35.1%); 666 (90.1%) were married or partnered and responded to the HA question. 42.5% (283/666) reported considering HA and 60.9% of full-time employees (288/473) had ever considered SA. 65.5% (437/666) considered any attrition (AA). Respondents reporting more frequent spousal career support had lower odds of HA (OR 0.80, 95% CI 0.68 to 0.94, p=0.006), though this was not significant when considering AA (OR 0.85, 95% CI 0.71 to 1.01, p=0.07). Neither association was significant after adjusting for WLI satisfaction and burnout (OR 1.01, 95% CI 0.80 to 1.29, p=0.91 (HA), OR 1.10, 95% CI 0.86 to 1.37, p=0.45 (any attrition)). Conclusions While spousal support was no longer significantly associated with attrition after adjusting for WLI satisfaction and burnout, it may mitigate attrition.

ABSTRACT Introduction/Aims Neuromuscular ultrasound (NMUS) is becoming increasingly incorporated as a complementary tool in electrodiagnostic (EDX) medicine. Competency assessment is critical to ensure adequate quality, appropriate application, and accurate interpretation. The primary objective was to develop a competency‐based assessment tool of foundational NMUS skills among postgraduate medical trainees in a single center. Methods The assessment included written (28 multiple‐choice, short answer, or yes/no) questions and practical skills (15 prompts) sections recommended by a published consensus‐based survey to include the knowledge and skills necessary to achieve minimal competency for unsupervised practice of NMUS for common conditions. The written portion included interpretation of basic pathology. Core practical content focused on the most evaluated structures in the Mayo EDX laboratory: the median and ulnar nerves and diaphragm muscle. The practical portion was administered by a single examiner and scored with a five‐point competency‐based rating. Four experienced educators used the Angoff standard setting method to set passing scores for each section. Results Subjects included three EMG‐track clinical neurophysiology fellows who completed a NMUS lecture series with supervised hands‐on scanning and a 2‐week intra‐lab NMUS elective during fellowship. Composite scores ranged from 89% to 97%. All subjects met minimum passing scores for each section (77% and 88% for the knowledge and skills sections, respectively). Discussion This NMUS competency assessment was successfully implemented and may be incorporated into postgraduate medical trainee evaluation to ensure minimal competency in evaluation of carpal tunnel syndrome, ulnar neuropathy at the elbow, and diaphragm function. This effort integrates quality NMUS evaluations into clinical practice.

Humility is one of the most powerful and sometimes least understood virtues we can possess. It is often misinterpreted as a sign of weakness, especially today, where self-promotion is encouraged and celebrated. Many people view humility as “thinking less of ourselves.” In truth, humility is not thinking less of oneself; rather it is appropriately thinking less about oneself. Our ability as caregivers in putting the needs of the patient at the center of all we do is enhanced through our humility. A steady focus on the needs of the patient helps us gain an honest assessment of both our strengths and limitations. Studies have shown that patient outcomes and experiences are strongly associated with provider humility. This article aims to shine a light on the power of humility and its impact on patient experience, psychological and cultural safety, and the provider-patient relationship.