This article was migrated. The article was marked as recommended.The choice of a future career specialty has always been a stressful decision for medical students. To mitigate this stress and assist students in making more informed career decisions we developed the Pre-clerkship Residency Exploration Program (PREP), a two-week summer elective program that provides students with the opportunity to gain exposure to specialities that traditionally do not receive a lot of attention in medical school. To initiate this student led program we faced many obstacles, suffered many failures, learned a tremendous amount and eventually found success. In this article, we offer 12 tips on how to create a medical education program that is sustainable, effective and receives strong buy-in from faculty and administration. Our tips come from the perspective of students starting their own program but are translatable to anyone interested in taking an innovative idea and seeing it through to fruition. Students have a looming fear of being denied entry into a residency program. This is because many well-known specialities are very competitive. At the same time physician shortages exist in fields such as radiation oncology and pathology . We are With this in mind, we started the Pre-clerkship Residency Exploration Program (PREP). We constructed this program based upon feedback from students in clerkship and final year, residents, physicians, professors, and the literature. We used the Kirkpatrick model, to evaluate our program . PREP isIn this age of information, a literature search is an important first step. A literature search may identify an existing program or framework that you can adapt and use as a model to meet your objectives, rather than starting from scratch. To do a proper literature search, one ought to answer 3 basic questions ?At the outset, we examined the medical curriculum and elective programs offered in all 17 Canadian medical schools. We accomplished this by doing an informal search of their respective webpages. Next, a formal search with the assistance of a university librarian was performed to explore the existing literature on our idea. Librarians are experts at conducting literature searches and can aid in planning, developing, refining and reporting . We set a minimum target of medical disciplines as the measure of success.With enough departments on board, we then assessed for feasibility. How many departments are required to create value for the students? How many students can be assigned to the departments? Having SMART objectives helped us focus our goals in a clear, organized fashion.Given the amount of planning and preparation involved in initiating a project, an important aspect is establishing stakeholder buy-in . Grass rEnsure there are people at all levels ready to invest in the change, if faculty are not invested and do not see the value in the change, it may hamper your efforts for success . It is wWhen you meet with the stakeholders, ensure you have a thoughtful, concise and well-organized presentation with ample evidence to support a defensible decision on why this program will improve medical education. Ideally, choose a team lead with a strong understanding of the subject matter and good public-speaking skills. The focus of your pitch should answer the questions “why is this program important?” and “why should I commit my time to supporting it?”As our program targeted specialties that are not a mandatory part of the core clerkship curriculum, it was especially important to seek out leaders in departments that were looking for more student exposure. One of the goals of medical educators’ is to help students make decisions that are appropriate for them . FindingIn PREP for example, it was important to find leadership from each medical department that wanted to have more student exposure. We had success once we found those vital leaders in each department who could run the workshops, electives and lunchtime discussions. This was not easy, and we received as many rejections as successes.Ultimately, this was a “win-win”, because Departments can feel more at ease that their specialty is gaining exposure and students get the opportunity to see unexplored specialities.Following institutional approval of the program and buy-in from stakeholders, you will be required to manage the implementation process. Administrative obstacles most likely will lead to delays or failure of your program if they are not properly considered or addressed too late. Make sure you allow for enough time to handle setbacks. Administrative obstacles exist in all domains of medicine including medical education.Understanding the administrative processes of your institution is paramount. In the case of PREP, some examples of these obstacles included: obtaining hospital card access for participants, enrollment paperwork, ensuring students had practitioner insurance to interact with patients, booking rooms, confirming instructors, etc. Furthermore, medical programs that have satellite campuses away from the main campus can present further barriers for inclusion. We had to ensure students at both campuses could obtain comparable access to the program, which required additional transport and funding considerations.With careful planning, proactive meetings and communication with the appropriate faculty members, many of these potential administrative hurdles can be dealt with in a timely fashion.The importance of communication between different medical professionals has been documented extensively . When orAnother aspect of good communication is establishing regular meetings that focus on progress updates and addressing new obstacles. Digital lines of communication offer the added benefit of retrospective review in future years. As new executives take over the program these lines of communication can be reviewed to see what was done in years past. In our experience meeting regularly also promoted a culture of unity and camaraderie.Before the program began, PREP directors agreed that the quickest way to disseminate information amongst participants was the utilization of a group Facebook page. A special group was made between participants and organizers which allowed for instant messaging and major updates. All participants could see scheduling changes instantaneously. It is key to select a method of communication that suits your programs needs.Lastly, clear communication and careful scheduling with faculty well in advance can help avoid most issues. For those unforeseen problems, or unpreventable issues, we suggest having a business continuity plan. In the event x occurs, then z should be enacted.PREP was designed to aid medical student career choice through exposure to a variety of underrepresented specialities. The secondary objective was to increase interest and applications to specialities that need physicians. To see if the program met these goals, careful evaluation and participant feedback is required. For each of our research questions, we developed an evaluation survey using the following guidelines:•Apply for ethics approval if necessary•Conduct a literature search to see how similar programs were assessed•Delegate research responsibilities•Prepare your survey•Seek out professional researchers to help scrutinize your survey before completionEvaluating impact is a crucial step to establishing your program in the evidence-based community of medicine.Defining what quality means is often subjective. In the case of medical education, quality assurance (QA) is a means of measurement and actions intended to enhance your program or institution . RegardiThe feedback we gathered from all parties was analyzed and formulated into a report that was disseminated to all relevant parties. Through these means the program can be changed, restructured, or adjusted to address any issues and emphasis the highly praised aspects.Research utilization is the process by which science is implemented into clinical practice . Ensure your successors are well acquainted with all key stakeholders and contacts. Introducing junior leadership early will put new faces to the head of the program and create vital connections for its success in the future.Developing a proper manual allows for an established framework for the new leadership to reference. Ensure the manual includes contact information, an established timeline and advice for common pitfalls. Give your new leadership autonomy, micromanaging others shows self-doubt and uncertainties regarding the competence of the incoming directors. The negativity associated with micromanagement is likely due to the lack of liberty in the new roles . This haNew members may be nervous to take on the new role and it can be tempting to step in and do the work for them. The final and hardest task is stepping away and allowing the new leadership to find their own path.Distorted perceptions mean one rejects information that is contrary to what one believes to be true .Political deadlocks such as departmental politics and people who have vested interests can create barriers, especially if your program trespasses on another department’s turf.Action disconnect can result from disrupting the status quo and thus routine. Changing what is known for unknown can be difficult and impede progress.In the process of starting an educational program, you will undoubtedly meet resistance, in some cases this resistance will be present at every stage of your program’s development. The phenomenon of why organizations are resistant to change has been studied extensively . Rumelt be true .Dulled Changes can come from small unlikely places. My colleagues and I had one year of medical school training when we began the year long process of creating PREP. By following many  of these tips, PREP went from 3 students to over 150 staff, involving 14 medical divisions across 7 medical departments. Despite the numerous mistakes made on this journey, PREP is now in the process of being implemented in multiple medicals school across the country.PREP is a program run by students for students. It offers an opportunity to broaden career horizons and address a looming problem of physician shortages. The 12 tips provided here offer a guide on how to take an educational program idea from inception and bring it to fruition. As we navigate our own undergraduate medical education, we hope these tips will prove useful to those with the goal of starting an education program from the ground up.- An educational program should solve a problem that hasn’t been addressed and is important for student development.- Assemble a well functioning team that differs in their strengths.- No one wants extra work added to their already busy day, so the more you and your team handle the less likely you are to have resistance from important stakeholders.- Scrutinize your program with quality assurance measures in order to improve the program year after year.- Medical education programs can be implemented into curriculum from unlikely sources (the student body) with the right plan and team.Thomas Sebastian Haupt is the author of this paper, a third-year medical student at Dalhousie University and the co-founder of PREP.Todd Dow is a third-year medical student at Dalhousie University and founder of PREP.https://orcid.org/0000-0002-3310-3802Michael Smyth is a third-year medical student at Dalhousie University and the co-founder of PREP. ORCID iD:Alysha Roberts is second-year medical student and current senior director of PREP.Kavita Raju is second-year medical student and current senior director of PREP.J. Thomas Toguri is a second-year medical student and current senior director of PREP.Dr. Anna MacLeod is an Associate Professor and Director of Education Research at Dalhousie Medical School. This review has been migrated. The reviewer awarded 4 stars out of 5 I enjoyed reading this article written by medical students. The PREP program seems well conceived and key features have been described well. The choice of a residency is a major decision for doctors and one they often make with incomplete information. Some specialties are better known than others and some are glamorous due to a variety of reasons. Work hours, work-life balance, emergency calls, remuneration are some important factors. The 12 steps mentioned by the authors are practical and well described. We were taught some of these steps while initiating our curriculum innovation projects (CIPs) as a requirement for FAIMER fellowships. Assembling a team that differs in its strengths is very good advice. Often we tend to assemble a team whose members think like us and have similar opinions, likes and dislikes. I am happy to know that the program is working well and is expanding. I am not sure if the authors have described the PREP program in detail elsewhere. I am interested in knowing how the two week summer program is organized and how it ensures students are exposed to different specialties. I would like to congratulate the authors on their initiative.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 I thoroughly enjoyed reading this paper. It is a great initiative to start the Pre-clerkship Residency Exploration Program (PREP), a two-week summer elective program that provides students with the opportunity to gain exposure to specialties that traditionally do not receive a lot of attention in medical school. Any change process follows the same process of implementation, identifying the change required, valuing or defining the vision of change required, involving all stakeholders, owning of the change by all stakeholders, gathering all resources required, celebrating small victories, implementation, and evaluation. The authors detailed the process very well. Especially the steps 8 and 9 are very important after implementation. It is a good one for academic administrators.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 This is a very interesting paper and I will suggest the tips to my Instituition. It is very interesting to know that the authors are third year medical students. I wonder if residents also participate in this project.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 Thanks for the invite to review this article. This article deals with the...... 1. Pre-clerkship Residency Exploration Program (PREP), a two-week summer elective program that provides students with the opportunity to gain exposure to specialities that traditionally do not receive a lot of attention in medical school. 2. Which is based upon feedback from students in clerkship and final year, residents, physicians, professors, and the literature. 3. PREP is a student-led two week (80 hr) intensive elective that exposes 40 medical students to 14 different specialties that students might have otherwise never experienced during the formal curriculum. I appreciate the efforts of the medical educators, students and faculty involved in making two weeks intensive elective PREP to gain exposure to specialties based upon the feedback. The twelve tips for initiating a program was well explained and I personally feel that the tip 8 and 9 is very crucial for any program to be implemented and scope for improvement.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 I thank the authors for their tremendous effort to experiment with curriculum development and to prevail in the face of adversity. Offering best practices especially from student perspectives enrich the field and provide new insights into program development. The authors describe the journey of their project with emphasis on implementation and future perspectives, such as discussing reaching consensus with stakeholders through mindful negotiation, establishing communication, or leveraging feedback. This approach is laudable, since many programs derail at the stage of development if either the institutional buy-in or the larger outlook are missing. Finally – the authors also mention proper hand-over for transitioning leadership, which is usually an underrepresented management item. My suggestions for improvement include discussing transferability and using Kern’s curricular six-step framework. The authors might formulate examples of program goals and objectives, as well as mention the educational methods. The readers wonders, how the students were prepared for residency: Was it a work-shop type with stations? Presentations held by alumni? A 12-tip paper does not need to be specific but should point the reader into the right directions. I can envision this program being evaluated using a mixed methods approach, presenting survey data and alumni/first-year resident exit interviews.Reviewer Expertise:NANo decision status is available


This study contributes to the advancement of the field of Sport for Development and Peace (SDP) research in Latin America and the Caribbean (LAC). There are still few studies on SDP programs in this region and it is important to document and understand the impacts of these programs on participants.The present study is the result of a collaborative research that aims to describe the experiences and perceptions of Colombian youth and program managers who participated in an SDP program that took them from a local community sports club to the Olympic Games. Seven semi-structured interviews were conducted with key actors  who participated in a triple and transversal  Olympic walking training program.The results provided a better understanding of the program dynamics in the local, regional, and national level, as well as of the short- and long-term effects perceived by the actors of the process on their development, education, health, and career. Recommendations are made for SDP organizations in LAC.Future studies should continue to investigate the SDP initiative in LAC to understand how sport can help development and peace building in this region. Currently, there are very few studies on SDP programs taking place in the LAC region so it is important to better document and understand these experiences and their impacts on participants and the community , 2. The 1.1.SDP projects have increased significantly in recent years around the world , 5. In tHowever, while these definitions have been accepted by the SDP movement, since the 2003 and 2013 publications there has been increasing variations in the initiatives but also clarification in the terms used to qualify the programs. This has occurred as the initiatives have been studied by researchers. Thus, a majority of authors now refer to them more broadly as S4D or SFD (for Sport for Development), while others persist in including the “peace” in the name and thus using the name more global SDP. While this discussion is still open among researchers, some authors have already proposed more concrete ways to define and operationalize SDP, S4D, SFD, etc. through a conceptual framework named “milestones” .In addition, a literature review provided a comprehensive and holistic picture of the field of SDP research . This re1.2.LAC is a complex region in which social, economic, and political realities vary widely. Nevertheless, local populations often face daily problems such as violence, crime, lack of access to education, and unemployment. Consequently, sport has become a tool for development and peace in an attempt to respond to current challenges in LAC and research in this area offers several lenses for analysis. Several main areas of research can be identified.Levelling the playing field program in the Eastern Caribbean to better understand attitudes related to the role of gender in SDP . The authors documented how girls and women access and experience sport. Girls' participation is then described as a form of empowerment, even as a mechanism for improving women's quality of life. This is one of the few studies that examine the response of boys vs. girls in sport in LAC. Finally, Hills, Velásquez & Walker  and cultural inequalities. Oxford and Spaaij –17 ethno& Walker  discusseSecond, the sport for peace axis has also been explored by several publications on SDP in LAC. Cárdenas has documented the mechanisms of using sport for peace , 23 and Greimas' actantial model) to better analyze and understand SDP initiatives at a distance and, in particular, in the context of a SDP program in El Salvador to reclaim public spaces  satisfaction with the training, (2) content knowledge, (3) attitudes and beliefs, and (4) ability to apply the content of the educational program. This study also highlights the important relationship between coach education and program implementation. Finally, in response to the real lack of SDP research in this region, Parnell et al.  are children under 14 years of age . ColombiThe country continues to grapple with a more than 50-year war between the government and illegal armed groups. To date, this war has resulted in more than 220,000 deaths, of which 81.5% are civilians and 18.5% combatants . A 2019 Finally, Bogotá is the cosmopolitan capital of Colombia with more than 7 million inhabitants  and its 1.4.Escuela de comunidad (Community School), created in 1982 in Ciudad Bolivar, and, particularly in relation to its Club de Marcha Olímpica  that was born in 1999. The program used sport  as a tool to foster the development of young people from low socioeconomic neighborhoods in Ciudad BolivarThis research was established and carried out in collaboration with a SDP non-profit organization, the Club Deportivo Isla Potosí (Isla Potosi Sports Club) was founded, and later joined the Bogota athletics league in order to be able to participate in the inter-league championships in the junior and youth categories. Thus, 8 youngsters between 13 and 16 years old were selected to compete in the 800-, 1,500- and 3,000-meter races. Six of them obtained excellent results and qualified for the National Intercollegiate Games and the South American Games. These results demanded an increasingly organized work that resulted in a rapid increase in the number of young people enrolled in the club. Subsequently, about 100 young athletes began to distinguish themselves in various competitions, gaining the recognition of various media for the school's athletes.Due to the success of the project, in 1999 the Instituto Distrital de Recreación y Deporte  of Bogota selected about 40 young people to represent the city in national competitions. The organization supported them with various psychosocial services , which made it possible for about 10 athletes from the club to become national, South American, Pan American and world medalists. After more than 16 years of work, eight athletes from the club have participated in the Olympic Games . During this process, between the difficult reality of their communities of origin and the Olympic Games, most of the athletes gave up their promising sports careers to contribute financially to support their families. Thus, it has been observed that, frequently, young people continue their athletic career up to the age of 18 or 20 years old but have to give up due to the lack of continuous and/or complete support from the State and/or private companies for their preparation and participation in competitions.Subsequently, the 1.5.1.Describe the process and the structure of the program as perceived by the key stakeholders.2.Describe the perceived effects that the program had on the development of vulnerable Colombian youth, through the lens of key stakeholders ;3.Understand and analyse the difference between the effects perceived by the two groups of stakeholders who participated in this study, thus identifying the congruences and/or incongruences.The lead coordinator of this club, as well as several participants and administrators of this SDP program, asked the research team to rigorously document the process they went through, and the effects observed. Therefore, this study aims to describe and understand the functioning and perceived effects of a sport for development and peace program that was implemented in Colombia to help young people from disadvantaged backgrounds in Ciudad Bolivar, Bogota, to perform in athletics  at the highest international level . More specifically, this study aims to:2.2.1.A case study methodology was applied, as case studies are well suited to explore complex social, cultural, historical, managerial and procedural phenomena when the situation includes many interesting variables, multiple sources of evidence, and broad theoretical propositions guiding data collection and analysis , 40. Thi“Qualitative research is emergent rather than strongly prefigured. In the course of a qualitative study several aspects emerge. The research question may change and be refined as the researcher learns what to ask and whom to ask. The data collection process may change as doors for data collection open and close, and as the researcher learns the best places to learn about the central phenomenon of interest. The general theory or model of understanding will emerge from the initial codes, develop into general themes, and coalesce into a grounded theory or general interpretation.” (p.182)2.2.N = 7; i.e., participating athletes, coaches, administrators) involved in the SDP program in Bogota (age = 30–60 years). Specifically, they were three participating athletes  who were involved in the program at the local, regional, national and international levels, one coach  responsible for the implementation of the program at the local (Ciudad Bolivar) and regional (City of Bogotá) levels, and three administrators  responsible for the development of the program at the regional  and national  levels. These participants were selected for their involvement as decision-makers or for their role in the implementation of the program, as well as for their availability and willingness to participate in the program and be interviewed. They were recruited on a voluntary basis.The participants in this study were key stakeholders . The written document was a summary presentation of the program, as well as a presentation of the athletes qualified for international competitions. Second, semi-structured interviews were conducted between February and March 2020 via Skype or Zoom due to the COVID19 pandemic. The interviews were designed to explore key stakeholders' perceptions and experiences of the SDP program at the conceptual level (ideas and intentions) and at the operational level (concrete actions). Questions focused on the short- and long-term outcomes perceived by the athletes and administrators, as well as about the internal processes of the program. Participants were also asked to provide good practices and suggestions for improvement, and some provided additional program documents . Participants also commented on aspects of the program that did not fit into these categories. The interviews were conducted by TG and NV, took place in a calm and quiet place, were audio-recorded, and lasted approximately 60 min each.2.4.We conducted a combined strategy based on the proposals of Braun & Clarke  and Yin 2.5.Quality standards have been applied to ensure the quality of qualitative SDP research , 44. Bas3.3.1.Club Deportivo Isla Potosí and physical education classes at the Cerros del Sur Potosí La Isla. The second corresponds to the IDRD - Centro de Desarrollo Deportivo (Sports Development Center) in Bogota  and the third and last to the Ministry of Sports, former Coldeportes - Centro de Entrenamiento de Alto Nivel (High Level Training Center) in Bogota . These three stages are not necessarily linked to each other in a mandatory way. From the IDRD, athletes had to perform, obtain, and maintain good sports results to enter or remain in each of the programs. The programs are therefore part of a temporal process that starts from an initial context (the disadvantaged neighborhood of Ciudad Bolivar) and reaches a long-term trajectory in the person's life  revealed that the SDP program was composed of three stages , each ofn's life .3.1.1.Escuela de comunidad, in Ciudad Bolívar, in collaboration with the Escuela de atletismo de Potosí La Isla since 1996, and then with the Club de Marcha Olímpica created in 1999. Conceptually, the club was created by a physical education teacher at the school who intended to help the neighborhood youth build a life program that would lead them away from the daily difficulties and risks they encounter, as previously mentioned. From the beginning, the club received the support of the educational institution and the community. The initial idea was to offer various athletic activities  to attract the maximum number of young people and offer them activities during their free time . The project had two objectives: a training objective and an athletic objective. Firstly, for the young people to continue in the educational system to obtain technical or vocational training that would enable them to earn a living once they had retired from sports. Secondly, the program aimed to support young athletes in a process of athletic development so that they would perform to the best of their ability and achieve significant sports results in their category at the local, district, national and international levels.The first stage of the program was carried out within the framework of the 3.1.2.The second stage of the program was taken over by the IDRD of Bogota, which created a program to support young sports talent in the region between 2002 and 2007. Conceptually, this program was developed by a multidisciplinary IDRD team , focusing on talent identification while giving an opportunity to young people from vulnerable communities.The program offered multidisciplinary  support to each athlete. Athletes were recruited and selected based on their performance in local and district competitions. The permanence in the program depended on permanence criteria and their solid performance. Unfortunately, this program was closed in 2006–07 for two main reasons. First, the focus was mainly on sports results, neglecting support for meeting psychosocial needs for young athletes . Second, the official administration decided not renew the funding of this project.3.1.3.Plan Decenal del Deporte, la Recreación, la Educación Física y la Actividad Física 2009–2019 . The plan had two axes: (a) performance sport and (b) promotion and development through sport. Like IDRD, the objective was to select and provide technical, medical, and psychosocial support to athletes representing Colombia in international competitions .The third stage of the program was integrated into the training and high-performance center for athletes of the institution responsible for sports in Colombia, the former Coldeportes, located in Bogotá. Conceptually, this program was part of the The program was attached to the Colombian Athletics Federation and under the supervision of its qualified members. Several services were offered to athletes belonging to Coldeportes, such as technical support , logistical support , economic support , nutritional support , psychosocial and medical support , and mediatical support . Again, these psychosocial services were aimed at enabling athletes to study or train for further development outside of their sporting career. As in the IDRD, athletes were selected on the basis of their results in regional and national competitions. The better they did, the more hope they had of continuing in the program.3.2.We present the results of the perceived effects of the SDP program separately for athletes and administrators. Athletes were the beneficiaries of the program, while administrators were those who conceptualized  and implemented the program. It was not easy to identify how the IDRD are pursuing social development and peace for example. On this, the three sections of the program  were not thought/developed in relation to each other, but in independent ways as their structures. This study aims (obj1) to trace globally the experience of the youth through these three programs and thus the overall functioning of the process, but not to explain how IDRD, for example, aimed to pursue development and peace, other than the elements we mention on p. 9–10, Section 3.2.1 and 3.2.2.3.2.1.In general, the athletes reported perceiving the short- and long-term effects and demands of the sport . All of For stage 1 and in the short term, they mention that the sports program allowed them to achieve several personal goals on a day-to-day basis , while maintaining their focus on education and their motivation to participate and not drop out of the project. The program also appears to have provided them with social support and recognition from their family and community. In the long term, they claim to have gained recognition from local media that covered their performances, as well as a network of contacts that will help them integrate professionally and economically. Of course, athletes also mention the high demands of the sport and the many sacrifices or efforts they had to make during the program to achieve success. For example, they mention the very tight schedule between studies and the sports program, or a very busy and therefore very exhausting training schedule.For stage 2 and in the short term, we found the same elements as above. Athletes also mention that the sports program helped them to overcome individual obstacles in their daily life  but also to avoid bad situations, while providing them with social protection. They also report receiving a range of services from IDRD . In the long term, the program has provided them with the opportunity to develop strong relationships with their peers, who have often become lifelong friends as well. The program has also helped them receive support from their group and develop a sense of security within the group. Despite the increasing demands of the sport, the program has allowed the athletes to receive strong recognition from local universities , from the media (who have helped them find jobs and be recognized by their community) as well as from the IDRD (to find jobs that fit with their sporting career).Finally, in phase 3, athletes reported having the opportunity in the short term to pursue a dual career (athlete and student), help in finding a job that suits their sporting requirements, and an extensive list of support services. Athletes place great emphasis on the demands of sport in relation to selections and the pressure to maintain high performance and results. In the long term, athletes report having had the opportunity to travel for national and international competitions, to make truly good friends for life, and the opportunity to access quality, skilled employment as a result of their success at university. They became physical education teachers, psychologists, coaches, and entrepreneurs. Finally, many athletes regret the feeling of isolation and loneliness in the field of high performance, and in particular the fact that they could not be accompanied by their coach from the first program, in whom they had full confidence. These factors explain the loss of motivation and interest in competitive Olympic walking in the long term.3.2.2.As expected, the administrators provided their perspectives through more “managerial” lens, that is, with a great focus to the process that was implemented and its shorter-term outcomes and long-term impacts. In general, their perceptions are very much in line with the way the program has worked (see previous sections) at different stages . They alClub de Marcha Olímpica was transferred from Ciudad Bolívar to the more advanced centre in the neighbourhood of Tunal. The distance, although not big, prevented more vulnerable children and young people to commute and take part in the practice sessions. As a result, the community programme as once idealized by its founders is reaching an unsustainable stage, loosing its community-target foundation.The administrators mention that the three stages were structured little by little in view of the success of the Ciudad Bolivar Club and then the IDRD. At the local level, the initial intention of occupying youth's free time with valuable activities has been accomplished in the short and long term, giving the athletes not only the opportunity of “becoming adults” in an extremely violent community, but also reach national and international projection. Nevertheless, the further institutionalization of the community programme translated into a deeper focus on performance and athletic results. For example, the training grounds of the Club de Marcha Olímpica in Ciudad Bolívar, the organization was also motivated to further invest in sport in the city of Bogotá due the existing athletic rivalry among other Colombian departments. All administrators mentioned the importance of the national school tournaments for the sport environment in the country. Bogotá's SFD strategy intended, then, to decentralize the offer of spaces for sports practice, enlarging the basis of the pyramid of sports talents and reaching out to underprivileged and hard-to-access communities.If on the one hand the IDRD was attracted by the success of the Before the establishment of the project at IDRD, it was necessary an extensive investigation of the real psychosocial conditions of these communities. They identified not only the need of offering economic and technical support, but also of establishing a transparent process for athletes to reach higher levels in their sports career. This was essential to mitigate the uncertainty of the sports career and motivate youth to remain in sports programmes. The multidisciplinary team was also key in reaching agreements with other key sectors . In the long term, this support is perceived to have contributed to youth reaching to university-level education and becoming role models in their own communities.The model of SFD implemented in Bogotá attracted the attention of other departments, as well as of Coldeportes, currently the Ministry of Sports. The nationalization of the strategy is promoted and implemented by the Ministry, which supports the establishment of development centers focused on talent identification and sports promotion in vulnerable sectors across the country. The possibility of progressive financial support if an athlete reaches higher levels of sports performance became an attractive alternative for vulnerable youth to support their families and represent their communities. According to one of the interviewees, the perspective on high-performance sports has changed to a more positive one.However, the prioritisation of sports results is considered the main negative outcome by all the participants in this study. Children and youth were expected to reach unappropriated goals and standards for their age groups related the high-level expectations. The higher the demand from their coaches or clubs, the higher the rate of dropping out of sports programmes. They also report that most of the athletes gave up their promising sports careers to contribute financially to support their families. Thus, they note that young people become accomplished athletes at 18–20 years of age but have to give up because of the lack of continuous and comprehensive support from the state or private companies for their preparation and participation in competitions. The oscillating support from the state is considered relevant for the sustainability of the whole process. Sports policy remains a government policy, that is depending on the elected representatives, rather than a state policy that is stable and ongoing.4.4.1.n = 8 athletes), according to the summary document and comments reported in the interviews. The result is a pyramidal structure with a broad base involving many young people, but a narrow tip that would have been accessible to a larger number of athletes if a balance had been maintained between the initial objectives of the program.With respect to the operation of the SDP program, it is noted that the program was developed over a long-term process of more than 10 years, in which three successive and complementary programs were established, each belonging to a different structure . Two athletes interviewed went through stages 1–2–3, while one only participated in 1–2. As for the administrators, 1 participated in stage 1, 2 worked at IDRD in stage 2 and 1 in stage 3 at the Ministry of Sports. The results of our study show that the three programs had two objectives related to performance and development. However, over time, IDRD and Ministry of Sports prioritized the performance component of the athletes to the detriment of the psychosocial support service structure. As a result, the number of athletes who have gone far in the program process has been drastically reduced .4.2.This study adds to the sparse record of SDP research conducted in LAC , 4, 5. IFirst, this study is quite unique in that it is unlike any previously conducted on SDP in LAC. Certainly, commonalities can be established with research that has documented the experiences of participants in SDP programs , 19, butbecause) that motivated the launch of this program are in line with several of the United Nations Sustainable Development Goals   . Obvious, SDG10)  or the L, SDG10) . However, SDG10) . TherefoHook), divert (Diversion), entertain and integrate (Integration) youth through Olympic marching. It would be pertinent to compare the results of this study with the work of other organizations in international SDP contexts.Third, we believe that this project is a good example of peacebuilding through sport. In all three programs, sport has been used  to promote peacebuilding, but also to connect people or communities that have been affected by the conflict . In our Finally, literature reviews conducted on SDP , 5 had mel palo del ahorcado”, where several people were hanged during clashes between street gangs and drug traffickers. A tree and a place highly charged with symbolism for the entire community of Ciudad Bolivar.In this sense, this activity could be interesting for future projects due to its low cost and the fact that it does not require sophisticated facilities or equipment for its implementation, which is especially interesting in the context of the DDP. In addition, this program continues to count on the coach who started the walking school in the sector and who today is one of the coaches responsible for the athletics and Olympic walking section of the IDRD. Finally, it is symbolic, since one of the spaces used for training is a place steeped in history. In fact, the club used to train daily near a tree called “4.3.This study has two limitations. First, few athletes make up the corpus of participants in this project. Despite having sufficient documentation to support the conception and objectives of the program, it would be desirable to be able to complete the results of this research with a larger sample of participants, including some who only participated in phase 1 of the project. Increasing the N would also allow us to confirm the trend of our results and possibly attempt to further quantify their effects. The second limitation is related to the COVID-19 pandemic, which modified the initial protocol of our study and, consequently, field observation had to be eliminated. This element missing in the triangulation of the data could made lost precision in the interpretation of the data, however, we make sure Colombians partners can comment and add on the data interpretation.4.4.-Invite district and national authorities in Colombia, but also in other LAC countries, to integrate a development component in their sports policies and programs;-Promote multidisciplinary and multisectoral collaboration in the development and implementation of SDP programs;-Elaborate long-term development programs that allow for the development of dual careers: academic and sports;-Reserve in the management plans of the cities or the country, the necessary resources to financially support this type of programs in coordination with the educational system;-Create efficient mechanisms for the dissemination of the processes and results of this type of initiatives and their impact on society;-Define criteria for the selection of personnel responsible for sports programs that recognize the ideal competencies for the positions offered.In relation to scientific research:-Enrich research data through collaborative meetings with key players in the sector. The aim is to enrich the quality of the results, but also to confront the results obtained with the perceptions of the stakeholders of this SDP.-Ensure respect for the international law of all children and adolescents, including the right to equal education and to have an inclusive education that respects the developmental needs of the child;-Ensure that the overall development of children, including physical and mental health , is promoted and not only certain aspects ;-Verify the learning environment to promote quality education;-Carry out psychological and social follow-up in relation to potential trauma, brainwashing and forms of indoctrination of children and adolescents and promote their harmonious reintegration into society, potential gaps with families and communities;-Be attentive to the lack of autonomy, creativity, participation and critical thinking skills of children who have been affected by armed conflict;-Address the lack of fulfillment of basic physical as well as basic psychological needs of the youth;-Verify the teaching conditions and accompany the teachers in training and pedagogical monitoring in order to provide quality education for all.This project also allows us to propose several recommendations related to the results obtained and the SDP projects in LAC. Regarding the implementation of SDP projects in LAC:5.This study contributes to the advancement of the field of SDP research in LAC. It is the result of a collaborative research that aimed to describe the experiences and perceptions of Colombian youth during a SDP program that led some of them, belonging to disadvantaged neighborhoods of Bogotá, to participation in the discipline of Olympic Walking in Olympic Games. The results provided a better understanding of the organization and functioning of the separate, but also combined programs of the Ciudad Bolivar Community School, the IDRD of Bogota and Coldeportes. Our study also revealed the perceived effects of these programs by participating athletes and administrators. In particular, the short- and long-term effects of the process for Colombian youth on their development, education, health, and professional careers. We also proposed recommendations to official LAC SDP organizations and researchers in the field, so that other initiatives can learn from this example of a SDP program in Colombia and its effects on participants.Following the proposals of Cardenas  and Parn


The Surgical Care Improvement Project (SCIP) was a national quality improvement program designed to improve peri-operative outcomes. The SCIP Program included several guideline-based antimicrobial stewardship measures, including discontinuation of antibiotics within 48 hours of skin closure for cardiac surgeries (INF-3). INF-3 was retired at the end of 2015; since this time, no systematic tools have been developed to support ongoing quality assessments.Table 1). Among the manually-adjudicated cohort, we then iteratively refined the electronic tool until pre-specified criterion validity were achieved. After development, INF-3 compliance as assessed manually and by the objective informatics tool were compared.We developed a retrospective, national cohort of cardiac surgeries in the national VA healthcare system during the period from 2010-2015 and merged these data with data from the VA External Peer Review Program, which included manually-assessed SCIP metrics, including INF-3. We electronically re-created the SCIP program by mapping exclusion criteria and developing code to assess the duration of post-operative antimicrobial use . Facility-level compliance trends were similar using both measurement methodologies and the correlation between the two measures was high (r=0.69); however, the informatics tool consistently estimated compliance to be approximately 1.9% lower than manually reviewed cases . As estimated by the manual review program, 16 facilities (61.5%) achieved >97% compliance rates versus 9 facilities (34.6%) as estimated by the informatics tool.During the study period, 11,361 cardiac surgeries representing 26 VA facilities met inclusion criteria. The overall estimated compliance rate was 97.7% in the EPRP-reviewed cases  and 95.9% as-assessed by the informatics tool ; facility quality rankings using both methods were similar but not exactly the same (Figure 2. Facility-Level Compliance with INF-3 as Measured by Manual Review versus via Objective Electronic ToolWe developed a comprehensive, objective informatics tool for assessing ongoing compliance with SCIP INF-3. The tool can be applied in future investigations to assess the sustainability of practice changes achieved under the SCIP program and to identify areas for future improvement.Westyn Branch-Elliman, MD, MMsc, DLA Piper, LLC/Medtronic: Advisor/Consultant|DLA Piper, LLC/Medtronic: Expert Testimony|Gilead Sciences: Grant/Research Support


This article was migrated. The article was marked as recommended.Faculty who teach in medical schools typically do so because of their knowledge and expertise in their field, yet few receive training in best practices in teaching. Educator development programs that help faculty enhance their teaching skills while continuing to fulfill their existing professional responsibilities can help address this gap. Such programs may be developed and implemented locally by individuals within the institution. This guide is intended for individuals who are interested in developing educator training programs but who lack experience in program development. The article describes practical strategies for designing, implementing, and evaluating a collaborative program to teach skills and best practices in medical education. Key themes in program design, program implementation, and program evaluation and dissemination include appropriate goal setting, setting clear expectations, strong communication, and the benefits of diversity in collaboration. Educator training programs provide enhanced teaching skills and opportunities for career advancement for participants at all career stages, which in turn benefits the institution and the medical profession. Basic science and clinician faculty in healthcare education are typically asked to teach because of their knowledge and expertise in their field, yet few have received training in best practices for how to teach that material  have the same understanding about the intent of the program and individuals’ roles within the program. This is especially important for complex programs with multiple types of participants. Many training programs bring together individuals from different backgrounds , roles (e.g. students and faculty) or educational backgrounds and perspectives . By having a shared understanding of the program goals, the various individuals will more clearly understand their respective roles within the program.There are a variety of career or skill development goals that may motivate individuals to take the time and effort to voluntarily participate in an educator training program . For exaIt is necessary to put forethought and planning into the program evaluation early in the program design phase to ensure that appropriate observations and data are collected . For fulProgram evaluations typically investigate the effectiveness, feasibility, and acceptability of the program as designed and as implemented . These t•effectiveness refers to whether the program is effective at achieving the intermediate and superordinate program goals and what its impact was on the trainees  the adherence and satisfaction to the program by the participants and (2) the perceptions of the relevance and effectiveness of the program by participants in the program and individuals in the organization  as part of its programming.There are many skills that are essential to the program development and implementation process but may not necessarily be the expertise of individuals who choose to develop and direct programs. Fortunately, many institutions offer core resources that directors can use for program planning, execution, and evaluation. For example, it can be helpful to consult program evaluation experts and statisticians early on to refine the evaluation plan and determine if the institution subscribes to tools for data collection or data analysis. Contacting regulatory offices  during the design phase can help avoid common programmatic pitfalls. Local experts can also act as advisors, such as librarians to help with literature searches, established educators to advise on educational research methods and theoretical frameworks, and researchers to contribute methodologies unfamiliar to the directors. The program itself may also be able to use existing content  or curricula available through MedEd Portal  keeps the program running smoothly and enables all participants to remain clear about the goals, expectations, and deadlines of the program as it progresses. Frequent communication also enables rapid redirection of effort as necessary to ensure that program and individual goals are achieved in a timely manner. Finally, it is essential to maintain regular clear communication between participants  to ensure that all are maximally productive. Directors and mentors should continuously observe the trainees’ progress in the program and provide constructive feedback on how to further enhance their knowledge, competencies and skills. Directors and mentors from different fields  can help each other by bridging communication and expertise gaps.As described above, program objectives determine what evaluations and assessments should be made during the program. Program evaluation can make use of qualitative and quantitative data, each with its own tools and methods for measuring and evaluation. Qualitative data are non-numerical data that describe the qualities or characteristics of a phenomenon, while quantitative data are those data that can be expressed numerically. Mixed methods analyses use both types of data  and verbal exchanges such as interviews that are later transcribed for analysis. Topics that may be explored through qualitative data analyses include the program’s impact on the trainees’ knowledge, skills, and attitudes and the program participants’ satisfaction with program activities. Extensive literature exists elsewhere on topics such as theoretical frameworks, sampling and data collection practices, and data analysis methods used in qualitative data analysis , all of which can be quite time-consuming. There are a number of qualitative analysis computer programs that exist, but these have limitations in that they are able to search text for words but not meaning . Given tQuantitative data and the associated analyses are typically more familiar to biomedical researchers than are those of qualitative analyses. Some opportunities for quantitative data collection in program evaluation include counts  or durations . Another commonly used type of semi-quantitative data is that of numeric rating scales that are built into surveys. In these scales a qualitative characteristic such as an attitude or opinion is quantified by pre-assigning numbers or visual analogies to levels within the scale . The mosAt the conclusion of the program it is important to disseminate information about the program and the participants’ experiences with a broader audience so that the program outcomes benefit the field. Two general categories of information that may be disseminated are (1) the impact on the trainees and mentors, and (2) the outcomes of the program development process. In the former category one may address measures of program effectiveness in achieving its goals to improve the trainees’ knowledge and skills as educators, how the program impacted and hopefully improved the trainees’ knowledge and skills as educators, and through reports of program acceptability, such as the perception by the mentors of the trainees’ skills or the utility of the program in the broader educational context. Program development outcomes may be shared through reports on the feasibility and acceptability of the program in the current educational environment. In addition, trainees should be encouraged to publish any educational products (e.g. new resources for teaching) that they developed during the program.Program evaluation results can be disseminated both broadly and locally. Broad dissemination most obviously includes publication in traditional venues such as peer-reviewed journals or MedEdPortal. Another way to reach a broad, undifferentiated audience is to create a portfolio or website where the products of the education training are showcased to potential participants and education experts. Local dissemination may include presenting seminars or workshops at education and career development meetings to target future trainees and mentors. This is useful to share information about the program to increase institutional buy-in for the program or to recruit future trainees.Educator training programs for medical educators can have a direct positive impact on the careers of existing faculty . IndividThe benefits of educator training programs are numerous, but the reality is that faculty who pursue this additional training likely must do so while simultaneously maintaining their current professional responsibilities. Therefore, it is important for program directors to be mindful of these personal motivations and to maximize the opportunities for trainees to accomplish these goals. The principles emphasized in this technical report prioritizing clear and frequent communication, regular assessment, and intentional flexibility in program design allow programs to adapt to the needs and motivations of their participants.Development of local educator training programs is a practical solution to the issue in medical education that many faculty lack formal training in teaching. There are many scenarios in which medical educators can benefit from additional pedagogical training, especially in an environment in which medical curricula are rapidly evolving. New curricular models, new instructional design approaches, student feedback, and personal initiative may all motivate an educator to pursue further training.This article provides practical advice for individuals who want to collaborate to develop educator training programs at their own institution, particularly for individuals not experienced in program design and implementation. The basic themes of successful program development are to plan ahead, be willing to be flexible, allow program design to drive the structure of the program evaluation and find effective collaborators. In the planning phase it is essential to carefully articulate the goals of the program and how to measure accomplishment of these goals. This step drives all subsequent work as it determines the structure of the program, what instruments to use to collect data, and the data analysis and dissemination plan. The development of flexible educator training programs that address the needs of the participants and the institution can positively impact the careers of the trainees, mentors, collaborators, and directors, and ultimately the educational mission of the institution.•Educator training programs are a practical solution to the challenge in medical education that many faculty members need or desire more formal training in teaching.•This article provides guidelines for individuals unfamiliar with program design to develop and evaluate an effective educator training program.•A volunteer faculty development program should be flexible enough to allow participants to fulfill their existing professional obligations while fulfilling their individual educator development goals.•Best practices for successful educator training programs include planning the program goals and evaluation early in the process, emphasizing flexibility of design, and using collaboration to encourage a diversity of expertise.https://orcid.org/0000-0001-9617-4141Isabel Dominguez PhD co-directs the Basic Medical Sciences course in the Physician Assistant program at Boston University School of Medicine. She is a basic scientist that directs summer research programs and career development programs for trainees from undergraduate students to postdoctoral fellows. ORCiD:https://orcid.org/0000-0002-4557-4273Ann C. Zumwalt PhD directs the medical gross anatomy course at Boston University School of Medicine and is a core faculty member in the Vesalius Program, a training program for biomedical science graduate students training to become future medical educators. ORCiD: This review has been migrated. The reviewer awarded 3 stars out of 5 Thank you for sharing your experiences and tips about how to develop educator training programmes. I appreciate the practical strategies suggested for programme design, implementation, evaluation, and dissemination. While I appreciate that this article is written for novices in program development, I am wondering if including information about the role and contributions of individuals with educational expertise might enhance this article. The general structure of possible faculty development programmes is well described but examples of possible pedagogical content is missing. For example, given the example goals stated in the second paragraph of the programme design section, I’m wondering if examples of teaching methods and learning activities could be given to illustrate how the programme will benefit educators. Providing examples of how your team has evaluated your programme would also help the reader better understand how to apply the principles at their institution. Another benefit of presenting evaluation data will be to support your claims about the usefulness of the principles that are promoted in this article.To enhance this article, please consider providing references, further details, or specific examples to substantiate the claims made in the sentences with the words ‘many’ and ‘numerous’.I would be very happy to read and review a revised version of this article.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 Thank you for the opportunity to review this extensive, systemic paper on how to design, implement and evaluate faculty development programs with practical nuances for clinical educators simultaneously tasked with their clinical duties.Authors provide a good collection of suggestions organised in three sections: Design, Implementation and Evaluation and Dissemination.I would probably couple with the informative tables of the manuscript a visual representation, diagram perhaps, of the above sections with the main subtopics to facilitate the reader having a quicker overview of the paper framework and useful guidelines, principles and resources suggested.I would like to emphasise essentially three aspects this paper focuses:-that clinical educators benefit from being offered the opportunity to enhance their teaching skills and eventually come to the realisation they can expand their practice on medical education. -that authors bring in and explain a goal categorisation, referred in the business world, with an underpinning theoretical framework spotlighting the goal formulation centred around on what and how people would engage allowing for change in behaviour, in “what people ultimately value and aspire to”. “Goal-setting theory states that challenging, specific, and concrete goals  are powerful motivators and boost performance in goal pursuit more than vague or abstract goals .” Höchli B, Brügger A and Messner C (2018) How Focusing on Superordinate Goals Motivates Broad, Long-Term Goal Pursuit: A Theoretical Perspective. Front. Psychol. 9:1879. doi: 10.3389/fpsyg.2018.01879 Throughout the paper, Authors strengthen the importance of setting clear expectations by clearly communicating goals, objectives and activities needed to achieve and demonstrate them by the end of the program (outcomes), and how this influence shapes all other steps of faculty development programs. The importance of providing clinical educators with learning opportunities to enhance their skills in developing effective goals and objectives, moved our group’s research, we are happy to share HPriorFilipe, M Paton, J Tipping, S Schneweiss, HG Mack, Microlearning to improve CPD learning objectives Volume17, Issue6, December 2020, Pages 695-699-By referencing the paper with rich and updated literature, Authors effectively complement their paper's purpose on facilitating those more interested in continuing their education on faculty development activities, beyond this paper.I am positive this paper will be useful and motivational for clinical and medical educators and medical education departments leadership.Reviewer Expertise:NANo decision status is available


This article was migrated. The article was marked as recommended.Background: To address looming healthcare workforce shortages, the Association of American Medical Colleges (AAMC) has recommended a substantial increase in residency positions. However, new residency programs face unique recruitment challenges.Objective: To identify new program characteristics and recruitment practices that most influence candidate-ranking decisions.Methods: In a post-match survey, applicants who interviewed during the first two recruitment seasons of a new program were asked to rate program characteristics and recruitment techniques regarding the effects they had on ranking decisions, and to describe the most attractive and concerning features. Somers’D directional coefficients were calculated to determine the correlation between applicants’ ranking of the program and ranking of survey items. Qualitative responses were analyzed as word clouds.Results: 163/349 surveys were returned (47%). The strongest correlating items included the opportunities to work closely with faculty, to help shape a new program, and to be one of the first graduates. Influential recruitment practices included program communications and website vividness. Concerns included lack of senior residents, fear of unforeseen difficulties, and no evidence of outcomes.Conclusion: New programs have unique features that influence candidates’ ranking decisions. Recruitment practices should be designed to identify candidates who embrace the unique opportunities of a new program. The international physician workforce is already strained to meet the needs of patients, described recently as a “global crisis” , and theIt can be challenging to attract applicants to a program with no proven track record. An 8-year study of applicants to programs at Massachusetts General Hospital revealed that two key attractive features were resident morale and preparation for future training/career . In the Objective Factor Theory  Pediatrics Residency Program at The Children’s Hospital of San Antonio (CHofSA) during the first two recruitment seasons. This is an ACGME accredited program that accepted 10 residents per year in the first two recruitment cycles (2015 and 2016). Our primary training site is a new free-standing children’s hospital with 190 inpatient beds. It includes a 60 bed level 4 Neonatal Intensive Care Unit, a 40 bed combined Pediatric Intensive Care/Intermediate Care Unit, and a 48 bed emergency room. It is staffed with approximately 200 faculty across general pediatrics and the medical and surgical subspecialties. Applicants rated the impact of specific program characteristics and recruitment practices on their decisions to rank the program. The results revealed distinct features of a new program that strongly correlated with applicants’ ranking decisions. This study should assist leaders of new residency programs in designing materials and practices to optimize their recruitment.https://www.surveymonkey.com) in May-June 2015 to the 201 applicants who interviewed at CHofSA in its inaugural recruitment season, and in April-May 2016 to the 148 applicants who interviewed during the second recruitment season.Institutional Review Board approval was obtained from both BCM and Christus Santa Rosa Health System, the parent entity of CHofSA. Eligible participants interviewed at CHofSA for the 2015 and 2016 categorical pediatrics residency match. An anonymous survey was sent electronically , 2 , or 3 (moderate or large negative effect) on ranking the program. The respondents’ rankings of the program were given a value of 1 (first preference), 2 (second preference), 3 (ranked between 3 and 5), 4 (ranked below 5), and 5 (not ranked). SAS software v9.4  was used to generate the Somers’D values, 95% confidence intervals, andp-value for each survey item. We accepted two-sided α ≤ 0.05 as indicative of statistical significance.For each Likert scale response, a Somers’https://www.wordclouds.com) with the frequency of words within responses graphically represented in larger text to illustrate popularity. Questions included in this analysis were: (1) “What were the greatest attractive features of joining a new program?” (2) “What were your biggest concerns about joining a new program?” and (3) “What aspects of your interview day were most helpful in your evaluation of Baylor San Antonio as a new program?”Free text responses on the survey were analyzed by an online word cloud generator  surveys were returned by the first class of interviewees. In 2016, 91 of 148 (61.5%) surveys were returned by the second class of interviewees. The overall response rate was 163/349 (46.7%).th or below, or not at all .D coefficient, 95% confidence interval, andp-value. A coefficient closer to 1 indicates that the item was more likely to be ranked positively by high rankers and negatively by low rankers. A coefficient closer to 0 indicates that the item exhibited poor correlation between positive and negative responses among high and low rankers. Negative coefficients suggest negative responses among high rankers and positive responses among low rankers; no statistically significant negative coefficients were observed.Each program characteristic  and3 anD coefficient) is lower among the recruitment practices than was seen among the most impactful program characteristics inThe recruitment practices assessed in our survey are shown inThe free responses in the survey were analyzed qualitatively by word cloud generation. The first question, “What were the greatest attractive features of joining a new program?” yielded 41 responses . SimilarThis study identified the characteristics of a new residency program and the recruitment practices that appear to have the greatest influence on applicant rank order. Although applicants have reported to NRMP the factors that are most important in determining their ranking decisions , several of these factors cannot be measured in new programs. Conversely, certain characteristics unique to new programs are not included on the NRMP standard survey. Our survey results are the first to provide specific information on characteristics and recruitment practices that may make a new residency program attractive to applicants.Several characteristics unique to a new program correlated highly with attracting certain applicants. They included helping to build a new program and working closely with faculty without the traditional learner hierarchy . InteresOur survey response rate (46.7%) from applicants to our program is comparable to the overall response rate of 47.5% reported nationally for the 2015 NRMP Applicant Survey . Approximately 75% of our respondents interviewed at and ultimately ranked 5-15 programs , congrueOur study has several limitations. There may have been an association bias, such that respondents who were favorably disposed to our program may have answered all questions more favorably, and vice versa. It is difficult to assess this effect, although we note multiple non-significant results inThis study demonstrates that the unique qualities of a new program and communication-focused recruitment practices were attractive to a distinct subset of applicants to a new residency program. As the gap between applicants in the NRMP and available PGY-1 positions continues to widen, with 42,370 applicants for 27,860 positions in the 2016 match , the nee•New residency programs are an essential tool to help meet projected physician workforce shortages, but face unique recruitment challenges.•Certain factors related to a new program influence ranking decisions significantly.•A subset of applicants may find attributes of a new program attractive.•Communication-based recruitment practices can help identify and attract best-fit applicants to a new program.Drs. Barajaz, Denniston, and Wolfe (ORCID 0000-0002-3113-2298) work in educational leadership for the Baylor Pediatric Residency Program at The Children’s Hospital of San Antonio. Ms. Shelley Kumar is a statistician and researcher for the Center for Research, Innovation, and Scholarship in Medical Education at Texas Children’s Hospital. This review has been migrated. The reviewer awarded 4 stars out of 5 This is a well written paper which covers an increasingly important topic. I think it will have wide interest from all involved in recruiting to trading programs wither new or established. The study is well designed and presents its findings clearly. A wider review of studies looking at recruitment to medical programs in other healthcare systems would be helpful to readers. There are important messages for those setting up new programs about the importance of good communication and engagement with potential recruits, and making clear that they will have a role in shaping the program. The area that I felt was not covered in this paper was the importance of location. Previous studies have shown that location can can even trip choice of specialty when doctors are considering their careers. Perhaps this aspect could have been picked up in the discussion. This study has important findings and setting these in the wider literature would is paperReviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 Thankyou for this submission I found it really interesting. New programmes attract different groups for differing reasons and this study helps us understand what those reasons may be. The text reads easily and although you bring in multiple tables you have made the article clear. The tables should make things clearer but table 1,3 and 4 are complex and not clear on quick view. I would suggest simplifying and grouping the areas so they have greater impact. Table 2 is simple. You do not need to asterisk and quote the p value, one or the other is fine. Figure 1 is very clear and has a good impact.Your discussion seems rushed and does not, to my mind, cover the key themes of the study.Overall this is an important piece of work for anyone implementing a new programme but could be re-written to simplify the results, expand the discussion and grouping of the themes.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 The authors identified the characteristics of the new BCM pediatrics residency program and the recruitment practices that might influence the applicants’ ranking decision by using an online survey that involved items common to all programs and also those specific to the new program. Furthermore, an open-ended question section was additionally included in order to identify major concerns and motivators. The results provide useful information that could be applied to other residency training programs to recruit potential applicants. However, there are some points that the authors may be able to clarify prior to further implementation, as follows.1. The specific items asked in the survey regarding the new program should be clearly described. All programs that are claimed to be new usually have some new aspects. What does the term “newness of the program” mean? An example of “the opportunity to help shape the program” should also be given. These details will make the questions asked in the survey more objective, and the applicants who are interviewed will have a similar understanding.2. For the free responses in the survey, is it possible that the answers were influenced by the list of the characteristics of the new program provided in the section before, resulting in the responses being similar to the quantitative data?3. In the discussion section, in order to make the authors’ statement that the characteristics of the new program correlate highly with attracting a distinct subset of applicants more convincing, information about the applicant profiles should be provided and a correlation study should be conducted.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 The authors have conducted an excellent survey-based study regarding applicant attitudes towards their new pediatrics residency program. They have identified several aspects that applicants reported had influenced their perception of the program and the way that they ranked the program, including positive aspects as well as potential negative aspects. The background section did a very nice job of discussing the reasons for creation of the program in an effort to expand the medical workforce.One concern is that – while I do not believe this is an official “match violation” per se – the ethics of asking exactly how applicants ranked a program are debatable. The survey was distributed after the match had already taken place so again does not technically constitute a match violation, but still raises some concern. One way to get around this may have been to separately survey applicants who did or not match to the program and see if there were differences in their responses without asking directly “how did you rank the program.”The discussion section is well done and the only point I would add is that the authors did not directly address the role of reputation of the program. Reputation was cited as a factor that has the potential to influence choice, which I certainly believe. However, the authors did not directly address the fact that the new residency program is at a medical center with an already stellar reputation  and this may have influenced the way interviewees perceived and ranked the program. Interviewing at a new program certainly brings the concerns cited by the authors/survey respondents, but I wonder if the reputation of the medical center itself may have mollified these concerns. It would be an interesting point for the authors to address.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 This paper speaks to a common and important matter for new residency programs  and provides important insights for consideration when planning new recruitment and admissions processes. The authors’ use of work from Human Resources scholarship to inform their planning is innovative and something that should be utilized more broadly within our field. I believe an extension of their work that would be helpful to our readership is to explore the recruitment arc from application through to admissions interviews & offers and finally completion of the recruitment arc with enrollment data. As such I wonder if the authors could provide the full number of applicants and not only those who were asked to interviews and the program’s final enrollment yield (acceptances/admissions offers). Also, I think it would be interesting to know the proportion of Texas residents who accepted the program’s admissions offers as that is data that can inform a program’s recruitment strategy.Reviewer Expertise:NANo decision status is available