Emily Gilbert

Purpose: The residency application and match process is a consequential transition in physicians’ careers. Although designed to “match” applicants and programs based on mutual preferences, applicants' decisions are influenced by contextual, cultural, and personal factors. Despite its importance, the literature on how applicants evaluate and select residency programs remains fragmented and lacks a unifying conceptual framework. This scoping review synthesizes the literature to map factors influencing residency program selection. Method: The authors searched three databases without date restrictions, with the final search conducted in June 2026. Studies were eligible if published between January 2015 and June 2026 and reported residency selection factors among US or Canadian participants involved in the National Resident Matching Program or Canadian Resident Matching Service. Two reviewers independently screened titles/abstracts and full texts. A standardized tool captured bibliographic details, participant characteristics, methods, and reported selection factors. Data were summarized using descriptive statistics and content analysis. Factors were mapped to the Learning Environment framework, encompassing social, organizational, personal, societal, and physical and virtual space components. Results: Sixty-five studies published in 41 journals were included. Most studies used surveys (n = 62; 95.4%), typically author-developed. Four studies (6.2%) used interviews. Most included medical students (n = 48; 73.8%), while 25 (38.5%) included residents or fellows reflecting retrospectively. Across studies, 1,237 factors were identified (mean 19.1 per study). Social (n = 317; 25.6%), Organizational (n = 313; 25.3%), personal (n = 305; 24.7%), and societal factors (n = 255; 20.6%) were similarly reported. Physical and Virtual space factors were infrequently reported (n = 30, 2.4%). Conclusions: Residency selection reflects applicants’ assessments of interrelated learning environment components rather than isolated program attributes. Applying the Learning Environment framework highlights that applicants are selecting not only a training site, but a learning environment where they hope to grow personally and professionally. These findings may inform more intentional program design, recruitment strategies, and applicant decision making.

Background: Empiric antibiotic selection for complicated urinary tract infections (cUTIs) is increasingly complex due to the rising prevalence of multidrug-resistant organisms. We conducted a network meta-analysis (NMA) to compare clinical efficacy and safety among existing empiric treatment options. Methods: We performed a frequentist random-effects NMA of randomized controlled trials evaluating single-agent empiric regimens for adults with cUTIs. The primary endpoints were clinical response (CR), microbiological response, and serious adverse events (AEs). Ceftriaxone served as the common comparator. Results: Forty-seven trials were identified through a systematic search. In the primary analysis of 17 studies published after the year 2000, evaluating agents currently accessible in the United States, in which baseline ceftriaxone non-susceptibility among Enterobacterales averaged approximately 15%. Ceftriaxone demonstrated CR rates comparable to broader-spectrum alternatives. Although some agents achieved higher microbiological eradication, these differences did not translate into superior clinical cure rates. Safety profiles were stable across antibiotic classes, with no significant differences in serious AEs compared to cephalosporins. Conclusions: Ceftriaxone remains an effective empiric option for hemodynamically stable adults with cUTIs in settings with comparable resistance prevalence. These findings provide evidence to support antimicrobial stewardship efforts that prioritize narrower-spectrum agents, preserving broader-spectrum therapies for patients at highest risk for resistant pathogens.

Purpose: Workplace violence is prevalent in settings where health care practitioners are responsible for managing agitated patients and visitors. First-line management of agitation within health care is verbal de-escalation. However, formal training in verbal de-escalation is not standardized across health professions education (HPE), and consensus about best practices is lacking. This systematic review examines the characteristics of existing curricula within HPE that teach de-escalation skills, assesses the research quality and strength of evidence of these studies, and outlines consequent best practices for teaching the skill of de-escalation to health professionals. Method: PubMed, EMBASE, ERIC (EBSCOhost), and Google Scholar were searched using terms related to HPE, aggression, and de-escalation for work published from database inception to July 22, 2025. Studies on empirical outcomes from curricula designed to teach de-escalation to health professionals were included. Included studies were assigned scores on the Medical Education Research Study Quality Instrument (MERSQI) and an adapted version of the Best Evidence Medical Education (BEME) strength of evidence scale. A narrative synthesis approach was adopted. Results: Of 4,312 unique records identified, 56 studies met the inclusion criteria. Twelve had BEME scores of 4 or 5, indicating strong evidence. MERSQI scores ranged from 5.5 to 16.0, with a mean (SD) of 10.4 (2.5). Learning interventions were targeted to nurses, physicians, students, and hospital staff. The interventions with strong evidence all incorporated both didactic education as well as role-play and/or simulation for active practice. The Ten Domains of De-escalation by the American Association for Emergency Psychiatry and the De-escalating Violence in Healthcare Settings curriculum by the International Committee of the Red Cross were referenced by multiple studies. Conclusions: Available literature suggests that the most evidence-supported way to teach de-escalation within HPE is through a combination of didactic lessons and active skills practice.