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[para. 1]: "As the second wave of the pandemic sees case numbers rise to dangerous levels across the country, it has become clear that Indigenous people are particularly vulnerable to coronavirus disease 2019 (COVID-19). The figures released by the Manitoba First Nations COVID-19 Pandemic Response Coordination Team reflect this vulnerability. Despite making up just over 10% of the total population of the province, First Nations people make up 71% of active cases with COVID-19 and 50% of patients in the intensive care unit; the median age of death from COVID-19 for First Nations people is 66 compared with the provincial median of 83 for Manitobans, overall."

This paper analyses the organization of ‘openings’ in Skype video-mediated conversation. It uncovers order in their apparent complexity by showing the relevance of a particular sequential adjacent pair organization, the appearing/noticing sequence, and its particular instantiation as an appearance-for-the-first-time greeting. The paper shows how this is a crucial resource in establishing a joint video interactional frame for the parties involved. This accounts for the occurrence of some specific phenomena in Skype openings, such as multiple greetings, and for the use of greetings which reflexively index their being occasioned by an appearance and related greeting, such as the French ‘coucou’, even when these do not occur at the start of Skype calls. When analysed this way, Skype openings, though complex, can be seen as an accomplished ‘dance of appearances and multiple greetings’.

So far, the synergistic relationship between learning design and learning analytics and its impact on learners’ educational practices have been investigated. However, little work has been done to show how integrated learning design based on constructivism learning theory and learning analytics can affect learners’ engagement and self-regulation. Thus, this study aimed to investigate the effect of the Constructivist Learning Design and Learning Analytics (CLDLA) Model on learners’ engagement and self-regulation. In this experimental study, 50 graduate students at Iranian’ Allameh Tabataba’i University were asked to participate in a Moodle course called “Teaching Skills” and fill out Agentic Engagement Scale and Self-Regulation Questionnaires in two steps as a pre-test and post-test measurements. Analysis of the data indicated that the CLDLA model has a positive impact on learners’ engagement and self-regulation. Based on the results, recommendations for further research and educational practices are suggested.

Background: Effective intern training is essential for safe delivery of anaesthesia during community service. Interns are trained using both tutorials and clinical exposure. E-learning platforms using video tutorials may address millennial learner needs better, but feasibility is unknown in a particular local setting. This study aimed to explore the feasibility of using a video tutorial to facilitate intern training. Perceptions of the value of tutorials were also assessed. Methods: A cross-sectional survey was conducted amongst interns who rotated through anaesthesia at a regional hospital in KwaZulu-Natal. The interns had been exposed to face-to-face tutorials previously and provided with a video-based tutorial. Results: Thirty-seven of the interns consented (88%), watched the video and answered the questionnaire. All interns indicated a need for tutorials during internship. A majority of respondents (71%) felt underprepared by undergraduate training programmes. Most interns were prepared to watch the video tutorial outside of working hours; however, they were divided over the fairness of using internet access for tutorials. There was a preference for video tutorials over reading a textbook or lecture notes. A total of 88% watched the video from the Internet. One intern did not have Internet access or a computer but the video was watched using a free Wi-Fi hotspot. Conclusion: A video-based tutorial system is feasible but current infrastructure needs to be considered. Interns continue to feel underprepared for internship and request that tutorials continue in internship.

Background: Training of South African anaesthesiologists is based on the Canadian Medical Education Directives for Specialists (CanMEDS). However, the applicability of CanMEDS in this context has not been assessed. An expert panel participated in a Delphi process to create an appropriate expanded list of CanMEDS competencies that may be used in the future to assess fitness for purpose of local graduates. Methods: This descriptive study comprised a representative panel of 16 experts surveyed electronically over three rounds to assess the importance of the existing CanMEDS roles and enabling competencies and suggested additions deemed applicable locally. The primary outcome was the creation of a list of competencies applicable to South Africa. Results: There was a 100% response rate for all three rounds. Based on the existing seven CanMEDS meta-competencies (Medical Expert, Collaborator, Communicator, Leader, Scholar, Professional and Health Advocate), respondents scored the importance of 89 enabling competencies and 19 additional competencies. Seven CanMEDS enabling competencies did not achieve consensus and were excluded. Nineteen new enabling competencies and two new meta-competencies (Humaneness, Context Awareness) achieved consensus and were added. Median ratings of importance of meta-competencies showed highest scores for Medical Expert and Collaborator and lowest scores for Health Advocate. Weighting of meta-competencies revealed highest scores for Medical Expert and Professional with all others equally weighted. Conclusion: This study has formulated an adapted CanMEDS list of enabling competencies with the addition of the two new metacompetencies of Context Awareness and Humaneness for use in South African anaesthesiology. This provides a means with which future graduates may be assessed for fitness for purpose.

Resumen La pandemia COVID-19 ha supuesto un cambio cualitativo en el modo de atender a los pacientes en consultas ambulatorias. La necesidad de toma de medidas de aislamiento social como prevencion para el contagio por el SARS-CoV-2 ha obligado al uso de consultas telematicas y telefonicas en la mayoria de unidades medicas y quirurgicas. La especialidad de Aparato Digestivo, por las caracteristicas de sus pacientes y el apoyo frecuente en tecnicas complementarias para el diagnostico, es especialmente adecuada para realizar consultas no presenciales. En este documento se plantean una serie de recomendaciones que pueden servir como guia para el establecimiento o mejora de consultas no presenciales de Medicina Digestiva.

To help educators deliver their physiology laboratory courses remotely, we developed an inexpensive, customizable hardware kit along with freely available teaching resources. We based the course design on four principles that should allow students to conduct insightful experiments on different physiological systems. First, the experimental setup should not be constrained to laboratory environments. Second, students should be able to take this course without prior coding and electronics experience. Third, the hardware kit should be relatively inexpensive, and all other resources should be freely available. Fourth, all resources should be customizable for educators. The hardware kit consists of commercially available electronic components, with a microcontroller as its hub (Arduino friendly). All measurement systems can be assembled without soldering. The hardware kit is cost-effective (approximately the cost of a textbook) and can be customized depending upon instructional needs. All software is freely available, and we share all necessary codes in open-access online repositories for simple use and customizability. All lab manuals and additional video tutorials are also freely available online and customizable. In our particular course, we have weekly asynchronous physiology lectures and one synchronous laboratory session, where students can get help with their equipment. In this article, we only focus on the novel and open-source laboratory part of the course. The laboratory includes four units [data acquisition, ECG, electromyography (EMG), activity classification] and one final project. It is our intent that these resources will allow other educators to rapidly implement their own remote physiology laboratories or to extend our work into other pedagogical applications of wearable technology.

INTRODUCTION: Teleneurology has become widely adopted during severe acute respiratory syndrome coronavirus 2 pandemic. However, provider impressions about the teleneurology experience are not well described. METHODS: A novel questionnaire was developed to collect provider impressions about video teleneurology encounters. All providers in the University of Pennsylvania Health System (UPHS) Neurology Department (N = 162) were asked to complete a questionnaire after each video teleneurology patient encounter between April and August 2020. Individual patient and encounter-level data were extracted from the electronic medical record. RESULTS: One thousand six hundred three surveys were completed by 55 providers (response rate of 10.12%). The history obtained and the ability to connect with the patient were considered the same or better than an in-person visit in almost all encounters. The quality of the physician–patient relationship was good or excellent in 93%, while the overall experience was the same as an in-person visit in 73% of visits and better in 12%. Sixty-eight percent of respondents reported that none of the elements of the neurological examination if performed in person would have changed the assessment and plan. Assessment of the visit as the same or better increased from 83% in April to 89% in July and 95% in August. Headache (91%), multiple sclerosis and neuroimmunology (96%), and movement disorder (89%) providers had the highest proportion of ratings of same or better overall experience and neuromuscular providers the lowest (60%). CONCLUSIONS: Provider impressions about the teleneurology history, examination, and provider–patient relationship are favorable in the majority of responses. Important differences emerge between provider specialty and visit characteristics groups.

PURPOSE: To test whether technology-facilitated self-management support improves depression in primary care settings. METHODS: We randomized 204 low-income primary care patients who had at least moderate depressive symptoms to intervention or control. Intervention participants received 12 months of weekly automated interactive voice response telephone calls that assessed their symptom severity and provided self-management strategies. Their patient-nominated supporter (CarePartner) received corresponding guidance on self-management support, and their primary care team received urgent notifications. Those randomized to enhanced usual care received printed generic self-management instructions. RESULTS: One-year attrition rate was 14%. By month 6, symptom severity on the Patient Health Questionnaire-9 (PHQ-9) decreased 2.5 points more in the intervention arm than in the control arm (95% CI −4.2 to −0.8, p = 0.003). This benefit was similar at month 12 (p = 0.004). Intervention was also over twice as likely to lead to ≥50% reduction in symptom severity by month 6 (OR = 2.2 (1.1, 4.7)) and a decrease of ≥5 PHQ-9 points by month 12 (OR = 2.3 (1.2, 4.4)). CONCLUSIONS: Technology-facilitated self-management guidance with lay support and clinician notifications improves depression for primary care patients. Subsequent research should examine implementation and generalization to other chronic conditions. clinicaltrials.gov, identifier NCT01834534.

Aims: The COVID-19 pandemic has caused strain on hospital systems and potential delay in diagnosis of type 1 diabetes (T1D). Outpatient diagnosis and treatment of metabolically stable young persons with new-onset T1D have been shown to be equivalent to inpatient. We describe an approach to outpatient management of newly diagnosed T1D during the COVID-19 pandemic using an interdisciplinary team, telemedicine, and diabetes technologies including rapid implementation of continuous glucose monitoring (CGM). Methods: Following the onset of the COVID-19 pandemic, new-onset cases of T1D were tracked. After laboratory confirmation of diagnosis and metabolic stability, patients and families were referred for ambulatory initiation of insulin therapy and diabetes education. These cases were reviewed using data extracted from the electronic health record, comments from multidisciplinary team members, and cloud-based glucose data. Results: We report on seven young people with new-onset T1D without diabetic ketoacidosis from April to June 2020, during the COVID-19 pandemic. Ages ranged 9–23 years with presenting hemoglobin A1c (HbA1c) values 10–14.5%. Initial evaluation was generally face-to-face, followed by frequent telemedicine visits. Five patients had a family history of T1D. Two patients had access to at-home HbA1c kits prompting evaluation in the absence of symptoms. Four patients required emergency department evaluation. Five patients presented with ketosis. All patients were prescribed CGM at the first visit, most starting within 1 month. Conclusions: Technology is extraordinarily useful for the care of young persons with new-onset T1D in the ambulatory setting during the COVID-19 pandemic. Large observational studies are needed to better understand outcomes of an outpatient, technology-focused approach.

PURPOSE:COVID-19 challenged medical practice and graduate medical education. Building on previous initiatives, we describe and reflect on the formative process and goals of the Hematology-Oncology Collaborative Videoconferencing Learning Initiative, a trainee-led multi-institutional virtual COVID-19 learning model.METHODS:Clinical fellows and faculty from 13 US training institutions developed consensus needs, goals, and objectives, recruited presenters, and generated a multidisciplinary COVID-19 curriculum. Weekly Zoom conferences consisted of two trainee-led instructional segments and a trainee-moderated faculty Q&A panel. Hematology-oncology training program faculty and trainees were the targeted audience. Leadership evaluations consisted of anonymized baseline and concluding mixed methods surveys. Presenter evaluations consisted of session debriefs and two structured focus groups. Conference evaluations consisted of attendance, demographics, and pre- or postmultiple-choice questions on topic learning objectives.RESULTS:In 6 weeks, the initiative produced five conferences: antivirals, anticoagulation, pulmonology, provider resilience, and resource scarcity ethics. The average attendance was 100 (range 57-185). Among attendees providing both pre- and postconference data, group-level knowledge appeared to increase: antiviral (n = 46) pre-/postcorrect 82.6%/97.8% and incorrect 10.9%/2.2%, anticoagulation (n = 60) pre-/postcorrect 75%/93.3% and incorrect 15%/6.7%, and pulmonary (n = 21) pre-/postcorrect 66.7%/95.2% and incorrect 33.3%/4.8%. Although pulmonary management comfort appeared to increase, comfort managing of antivirals and anticoagulation was unchanged. At the conclusion of the pilot, leadership trainees reported improved self-confidence organizing multi-institutional collaborations, median (interquartile range) 58.5 (50-64) compared with baseline 34 (26-39), but did not report improved confidence in other educational or leadership skills.CONCLUSION:During crisis, trainees built a multi-institutional virtual education platform for the purposes of sharing pandemic experiences and knowledge. Accomplishment of initiative goals was mixed. Lessons learned from the process and goals may improve future disaster educational initiatives.

Resume Le College national des enseignants d’anesthesie et de reanimation (CNEAR) reunit les 181 professionnels hospitalo-universitaires de l’anesthesie-reanimation impliques dans l’enseignement et la recherche en anesthesie, reanimation et medecine perioperatoire. Les objectifs du CNEAR pour la discipline anesthesie-reanimation & medecine peri-operatoire sont avant tout pedagogiques, a destination des etudiants du troisieme et du deuxieme cycle des etudes medicales. Le CNEAR intervient ainsi dans l’organisation, l’evaluation et la validation de l’enseignement du troisieme cycle des specialites medicales. Il realise la publication d’un referentiel actualise de connaissances a destination des etudiants du deuxieme cycle des etudes medicales. Grâce a un partenariat fort avec l’universite numerique en sante et sport (UNESS), le CNEAR assure la mise en ligne de contenus pedagogiques sur la plateforme SIDES NG, la mise en place du livret electronique de l’interne et le suivi regulier du curriculum des internes. Les membres du CNEAR participent egalement a la representation de la discipline aupres des pouvoirs publics et des tutelles au sein du Conseil national professionnel d’anesthesie-reanimation et medecine peri-operatoire (CNP-ARMPO). Pour atteindre ces objectifs, le CNEAR travaille en etroite collaboration avec la sous-section 48-01 (Anesthesie-reanimation et medecine peri-operatoire) du Conseil national des universites et la Societe francaise d’anesthesie et de reanimation (SFAR). Il est par ailleurs membre de droit du CNP-ARMPO et de la Coordination nationale des colleges d’enseignants en medecine (CNCEM) et etend ses collaborations internationales grâce a un partenariat prometteur avec UNESS-International.

Background: Women with insulin-treated gestational diabetes mellitus (GDM) require close monitoring and support to manage their diabetes. Recent changes to the diagnostic criteria have implications for service provision stemming from increased prevalence, suggesting an increased burden on health services in the future. Telemedicine may augment usual care and mitigate service burdens without compromising clinical outcomes but evidence in GDM is limited. Objective: The Telemedicine for Gestational Diabetes Mellitus (TeleGDM) trial aims to explore the use of telemedicine in supporting care and management of women with GDM treated with insulin. Methods: The TeleGDM is a mixed-methods study comprising an exploratory randomized controlled trial (RCT) and a qualitative evaluation using semistructured interviews. It involves women with insulin-treated GDM who are up to 35 weeks gestation. Participating patients (n=100) are recruited face-to-face in outpatient GDM clinics at an outer metropolitan tertiary hospital with a culturally diverse catchment and a regional tertiary hospital. The second group of participants (n=8) comprises Credentialed Diabetes Educator Registered Nurses involved in routine care of the women with GDM at the participating clinics. The RCT involves use of a Web-based patient-controlled personal health record for GDM data sharing between patients and clinicians compared to usual care. Outcomes include service utilization, maternal and fetal outcomes (eg, glycemic control, 2nd and 3rd trimester fetal size, type of delivery, baby birth weight), diabetes self-efficacy, satisfaction, and costs. Semistructured interviews will be used to examine user experiences and acceptability of telemedicine. Results: The trial recruitment is currently underway. Results are expected by the end of 2016 and will be reported in a follow-up paper. Conclusions: Innovative use of technology in supporting usual care delivery in women with GDM may facilitate timely access to GDM monitoring data and mitigate care burdens without compromising maternal and fetal outcomes. The intervention may potentially reduce health service utilization. Trial Registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000934640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366740 (Archived by WebCite® at http://www.webcitation.org/6jRiqzjSv).

INTRODUCTION This paper argues that particular experiences in the workplace are more important than others and can lead to transformational learning. This may enable practitioners to cross ‘vocational thresholds’ to new ways of being. AIM A notion of ‘vocational thresholds’ is developed, aiming to help build an understanding of the most powerful learning experiences of general practitioners (GPs). Vocational thresholds takes its cue from the idea of ‘threshold concepts’ - concepts that transform perspectives and integrate previously disconnected or hidden knowledge, sometimes in ways that are ‘troublesome’ to previously held beliefs. METHODS The paper is based on a thematic analysis of 57 GPs’ brief written accounts of a particularly powerful learning experience during their development. Accounts were provided in a conference session about an ongoing study of workplace-based structured learning arrangements in the fields of general practice medicine, engineering, and building. FINDINGS Most GPs’ accounts focused on development of dispositional attributes that moved them to a new understanding of themselves in relation to their work and patients. Just under two-thirds picked out informal and formal collegial relationships within purposeful learning arrangements as pivotal. A third picked out direct experiences with patients as shifting their perspective. CONCLUSION The emergent idea of vocational thresholds is offered as a way to frame the most important learning experiences identified by GPs. It supports a focus in early and ongoing development beyond accumulating clinical expertise and skills (knowing and doing), to dispositional capability (being) - vital for practitioners negotiating inherent and daily uncertainty. KEYWORDS General practitioners; Medical education; Vocational education; Identity; Learning experiences; Threshold concepts

Background: Diabetes distress is underrecognized and associated with poor outcomes. This study tested whether a 12-month collaborative, goal-setting, and behavioral telehealth intervention reduced diabetes distress levels. Methods: This is a secondary analysis of the Healthy Outcomes through Patient Empowerment (HOPE) study that included individuals (N = 225) with uncontrolled diabetes and depression living at least 20 miles from a Veteran's Affairs medical center. Participants were randomized to HOPE (intervention) or Enhanced Usual Care (EUC) with education. We evaluated diabetes distress levels as measured by the Problem Areas in Diabetes (PAID) Questionnaire and its four subscales (emotional, diabetes management, social, and treatment distress) at baseline, 6, and 12 months. Results: Between-group analysis revealed greater improvements in HOPE versus EUC for: 6-month PAID total score (p = 0.04), emotional (p = 0.03), and social (p = 0.04) subscales; 12-month PAID total score (p = 0.07) and emotional subscale (p = 0.07). Within-group comparisons showed larger effect sizes for HOPE compared with EUC: 12-month PAID total scores (0.82 vs. 0.54), 6-month emotional burden (0.54 vs. 0.31), and 6-month (0.32 vs. 0.08) and 12-month (0.41 vs. 0.12) social burdens. Repeated-measures analysis evaluating treatment group and time trended toward improvement in PAID overall for HOPE compared with EUC participants, but was not statistically significant (β = 6.96; SE = 4.35; p = 0.13). Discussion: Clinically meaningful reductions in PAID overall and the emotional and social subscales were observed in HOPE compared with EUC participants. Conclusion: Further evaluation of diabetes telehealth interventions that include other facets related to diabetes distress, including treatment, diabetes management, social, and emotional burdens, is warranted. Clinical Trial Number. NCT01572389; Clinical Trial Registry. https://clinicaltrials.gov/ct2/show/NCT01572389.

Background: Although mobile apps are readily available for speech sound disorders (SSD), their validity has not been systematically evaluated. This evidence-based appraisal will critically review and synthesize current evidence on available therapy apps for use by children with SSD. Objective: The main aims are to (1) identify the types of apps currently available for Android and iOS mobile phones and tablets, and (2) to critique their design features and content using a structured quality appraisal tool. Methods: This protocol paper presents and justifies the methods used for a systematic review of mobile apps that provide intervention for use by children with SSD. The primary outcomes of interest are (1) engagement, (2) functionality, (3) aesthetics, (4) information quality, (5) subjective quality, and (6) perceived impact. Quality will be assessed by 2 certified practicing speech-language pathologists using a structured quality appraisal tool. Two app stores will be searched from the 2 largest operating platforms, Android and iOS. Systematic methods of knowledge synthesis shall include searching the app stores using a defined procedure, data extraction, and quality analysis. Results: This search strategy shall enable us to determine how many SSD apps are available for Android and for iOS compatible mobile phones and tablets. It shall also identify the regions of the world responsible for the apps’ development, the content and the quality of offerings. Recommendations will be made for speech-language pathologists seeking to use mobile apps in their clinical practice. Conclusions: This protocol provides a structured process for locating apps and appraising the quality, as the basis for evaluating their use in speech pathology for children in English-speaking nations. [JMIR Res Protoc 2016;5(4):e233]

Objective Measuring Saudi women's subjective happiness during the present period that has brought great transformations in gender equality in KSA is essential to gather reliable information about the present situation of women in KSA. This study intends to test the validity and reliability of the ‘Subjective Happiness Scale’ Arabic version (SHS-A) when applied to Saudi working women. This study also examines the factors that affect the subjective happiness of Saudi working women. Methods This validation study was conducted among 300 Saudi working women to test the psychometric properties of the SHS-A. Validity was evaluated using principal component analysis (PCA) and confirmatory factor analysis (CFA). Multiple regression analysis was also carried out to examine the factors affecting subjective happiness. Results The PCA identified one factor that explained approximately 66.0% of the variance of the model. The CFA revealed the following findings: normed fit index = 0.982, comparative fit index = 0.990, Tucker–Lewis index = 0.971, goodness-of-fit index = 0.986, adjusted goodness-of-fit index = 0.929, and root mean square error of approximation = 0.086. The x2/df value was 2.09 (x2 = 4.189, p = .123). The Cronbach's alpha of the SHS-A in the first and second samples was 0.824 and 0.830, respectively. Employment position, working hours, and monthly salary were found to influence the subjective happiness of Saudi working women. Conclusions This study provides evidence that supports the validity and reliability of the SHS-A when used among Saudi working women. This valid and reliable tool can open further avenues and opportunities for advancing women's research agenda in KSA and other Arabic-speaking countries for economic and societal progress., Highlights • SHS-A has acceptable validity and reliability for Saudi working women. • SHS-A can be used to measure Saudi working women's subjective happiness. • SHS-A can be used for research, policymaking, and policy evaluation related to women's happiness.

As empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such asdehumanizationanddetached concernas well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate aroundcognitive empathyandaffective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of ‘empathic concern’, a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301–311engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners.

Purpose There is only limited data on the application of virtual reality (VR) for the evaluation of temporal bone anatomy. The aim of the present study was to compare the VR environment to traditional cross-sectional viewing of computed tomography images in a simulated preoperative planning setting in novice and expert surgeons. Methods A novice (n = 5) and an expert group (n = 5), based on their otosurgery experience, were created. The participants were asked to identify 24 anatomical landmarks, perform 11 distance measurements between surgically relevant anatomical structures and 10 fiducial markers on five cadaver temporal bones in both VR environment and cross-sectional viewings in PACS interface. The data on performance time and user-experience (i.e., subjective validation) were collected. Results The novice group made significantly more errors (p p = 0.001) in cross-sectional viewing than the expert group. In the VR environment, there was no significant differences (errors and time) between the groups. The performance of novices improved faster in the VR. The novices showed significantly faster task performance (p = 0.003) and a trend towards fewer errors (p = 0.054) in VR compared to cross-sectional viewing. No such difference between the methods were observed in the expert group. The mean overall scores of user-experience were significantly higher for VR than cross-sectional viewing in both groups (p Conclusion In the VR environment, novices performed the anatomical evaluation of temporal bone faster and with fewer errors than in the traditional cross-sectional viewing, which supports its efficiency for the evaluation of complex anatomy.

espanolEn el contexto del humanismo y profesionalismo medico, la empatia se ha convertido en un elemento esencial para construir una relacion medico-paciente satisfactoria. Los investigadores en empatia han desarrollado varias herramientas de evaluacion. En este articulo discutimos la experiencia de dos estudios sobre empatia llevados a cabo en Rusia y Brasil. La escala de Jefferson se uso en el estudio ruso, y la escala de Jefferson y el IRI de Davis se usaron en Brasil. En la experiencia rusa, los investigadores encontraron que las puntuaciones de empatia total no diferian significativamente entre los estudiantes de medicina y los residentes del ultimo ano. En la experiencia brasilena, los investigadores encontraron en todos los analisis estadisticos, la dimension afectiva de la empatia evaluada por el IRI de Davis logro puntajes mas bajos en el grupo de ultimos anos de graduacion. Las experiencias de diferentes culturas presentadas aqui sugieren que los instrumentos de medicion (escalas) que se aceptan en una cultura pueden no ser completamente apropiados para evaluar las mismas competencias en otra cultura. El intrincado mundo de las emociones implica un esfuerzo por comprender el mundo afectivo de los estudiantes para que los educadores tambien puedan colaborar con los recursos educativos. EnglishWithin the context of medical humanism and professionalism, empathy has become essential element in building a satisfactory doctor–patient relationship. Researchers on empathy have developed several assessment tools, mostly represented by scales. In this paper, we discuss the experience of two studies on empathy carried out in Russia and Brazil. The Jefferson scale was used in the Russian study and the Jefferson scale and the Davis’ IRI were used in Brazil. The Russian experience, researchers found that the total empathy scores did not differ significantly between final year medical students and residents. No statistically significant differences in Moscow final year students’ scores related to gender and future specialty preferences were demonstrated. The Brazilian experience, researchers found in all statistical analyses, the affective dimension of empathy assessed by Davis’ IRI achieved lower scores in the clerkship group. The experiences of different cultures presented here suggest that the measurement instruments (scales) that are accepted in one culture may not be completely appropriate for evaluating the same competencies in another culture. The intricate world of emotions, where empathy plunges its roots, implies an effort to understand students’ affective world so the educators can also collaborate with educational resources.

Resumen El profesionalismo es una competencia multidimensional basada en habilidades actitudinales y de conocimiento que permite a los profesionales en medicina tener un mejor desempeno en sus sitios de trabajo. El objetivo de este articulo es la puesta en comun de distintas dimensiones del profesionalismo en estudiantes de pregrado y posgrado de Medicina.

espanolIntroduccion La muerte y el morir son eventos humanos y trascendentales en la vida de los pacientes, sus familias y los profesionales de la salud. La educacion deberia ser central en las carreras de grado. La percepcion de la educacion en estudiantes de medicina ha sido poco explorada en Argentina y el mundo. Existe la necesidad de mejorar su afrontamiento y los programas de formacion. Objetivos Explorar la percepcion de los estudiantes de medicina de la educacion que reciben en relacion con el morir en la Universidad Nacional del Sur, asi como las herramientas y las competencias ante situaciones que involucren el morir. Explorar las percepciones y las perspectivas educacionales sobre la muerte y el morir en diferentes etapas de la formacion. Materiales y metodos Estudio cualitativo, fenomenologico, con diseno exploratorio-descriptivo en la carrera de Medicina de la Universidad Nacional del Sur, Argentina, entre septiembre de 2014 y abril de 2015. Se realizaron 3 grupos focales segun la etapa de formacion. Resultados Perciben la muerte y el morir con una connotacion negativa y asocian la practica clinica actual a problemas como el lugar de la muerte, no involucrarse con el paciente y la familia y una mala calidad de la atencion. Valoran las herramientas de comunicacion brindadas. Cuentan con herramientas para afrontar el morir, pero no estan del todo preparados. Mencionan acompanar, la autonomia, la comunicacion y contemplar la familia. Conclusion Los estudiantes perciben la tematica de forma negativa y ven importante su formacion. Existe un desarrollo de competencias y habilidades para afrontar la muerte y el morir, pero se necesita avanzar mas en dichos espacios educacionales. EnglishIntroduction Death and dying are human and transcendental events in the lives of patients, families and health professionals. Education should be central to degree careers. The perception of education in medical students has been little explored in Argentina and the world. There is a need to improve coping and training programs. Objectives To explore the perception of the medical students of the education they receive in relation to dying at South National University as well as skills and competences in situations that involve dying. Explore educational perceptions and perspectives on death and dying in different stages of their career. Material and methods Qualitative, phenomenological study, with exploratory-descriptive design at the School of Medicine of South National University, Argentina, between September 2014 and April 2015. Three focus groups were carried out according to the training stage. Results They perceive death and dying with a negative connotation and associate current clinical practice with problems as a place of death, not involving with patient and family and poor quality of care. They value communication tools provided. They have tools to cope with dying but are not fully prepared. Mention accompany, autonomy, communication, contemplate the family. Conclusion The students perceive the subject in a negative way and see their formation important. There is a development of skills to face death and dying but more progress is needed in these educational spaces.

Resumen Introduccion El aprendizaje entre iguales promueve que los estudiantes trabajen en grupos reducidos y puede ser una buena metodologia para manejar la diversidad en el aula. Metodologia Se recogieron y compararon los resultados academicos obtenidos con dos versiones de aprendizaje entre iguales, una con tutores propuestos y la otra no, implantadas en la asignatura de Bioquimica y Biofisica del grado de Podologia de la Universidad de Barcelona. Resultados Los tutores obtuvieron mejores notas que los tutorados con ambas estrategias. En cuanto a los tutorados, se observo una tendencia a mejores resultados cuando tenian tutores propuestos. Conclusion Profesorado y alumnado valoraron positivamente la experiencia porque genero mayores vinculos entre el alumnado.

It is well established that burnout in medical students is associated with depression and anxiety at a syndromal level. Moreover, there is an ongoing debate about the extent to which burnout overlaps with depression and anxiety. The emerging network approach to psychopathology offers a new perspective on the interrelations between mental disorders focusing on symptom-level association. In this cross-sectional study, we exploratively investigated the associations among burnout, depression, and anxiety in 574 swiss medical students using a network analytic approach for the first time. Symptoms of depression and anxiety were assessed with the Patient Health Questionnaire and Generalized Anxiety Disorder respectively. Burnout was assessed with two single-item questions, one referring to emotional exhaustion and the other to depersonalization. We found a dense network in which at least one dimension of burnout was related to eleven of the sixteen included symptoms. This suggests that burnout is closely related to depression and anxiety but also has its own characteristics. Notably, suicidal ideation was not associated with either emotional exhaustion or depersonalization after adjusting for the influence of the remaining symptoms of anxiety and depression. Hence, the well-documented relationship between burnout and suicidal ideation in medical students may be entirely mediated by the experience of anxiety and depression. Hence, the well-documented relationship between burnout and suicidal ideation in medical students might be fully mediated by the experience of anxiety and depression. The collection of the sample after the first wave of infections during the SARS-CoV2 pandemic and the non-representativeness of the investigated sample limit the study's generalizability.

espanolLas comunidades de practica son modelos que enlazan la ensenanza clinica con el aprendizaje en el sitio de trabajo; esto facilita la construccion de la identidad profesional de los estudiantes, optimiza la atencion al paciente y genera oportunidades de aprendizaje para los miembros de la comunidad hospitalaria; fomentan el cambio de modelos educativos en los que el aprendizaje memoristico es reemplazado por experiencias de aprendizaje basadas en la construccion colectiva de saberes y en la coparticipacion de los miembros de la comunidad hospitalaria, con lo que se puede impulsar una practica profesional mas segura para los pacientes. Se presentan los fundamentos pedagogicos que permiten comprender la participacion que los estudiantes asumen dentro de una comunidad de practica clinica y se plantean reflexiones para que el quehacer docente de los profesores clinicos cambie a modelos innovadores que produzcan mayor impacto en el aprendizaje y que los transforme en verdaderos educadores en las profesiones de la salud. EnglishCommunities of practice are models that link clinical teaching to learning in the workplace; This facilitates the construction of the professional identity of the students, optimizes patient care and generates learning opportunities for members of the hospital community; They promote the change of educational models in which rote learning is replaced by learning experiences based on the collective construction of knowledge and the co-participation of members of the hospital community, thus promoting safer professional practice for patients. patients. The pedagogical foundations that allow understanding the participation that students assume within a community of clinical practice are presented and reflections are made so that the teaching tasks of clinical teachers change to innovative models that have a greater impact on learning and transform them into true educators in the health professions.

Background: Physician satisfaction with telehealth during the coronavirus disease 2019 pandemic is a strong indicator for future use. Validated surveys can guide improvement and future expansion of telehealth programs. Introduction: This study examines physician and advanced practice provider perspectives and satisfaction using telehealth at UPMC Pinnacle and to assess key predictors of future use in ambulatory care. Methods: A web-based Likert scale survey of UPMC Pinnacle physicians and advanced practice providers was conducted in May-June 2020. Cronbach's alpha was used to measure the survey's internal consistency. Crosstab analysis and multivariate regression were used to analyze the interrelationships between variables. Results: A significant majority (64%) of physicians responded positively that they enjoyed telehealth video visits. A majority (65%) felt that the physician-patient relationship was unimpaired during telehealth visits, but only 29% of the respondents felt they were able to examine the patients properly. Providers who experienced good video and audio quality were 3.68 times more likely to enjoy telehealth visits (p < 0.001, 95% confidence interval 2.05-6.61) than those with less-than-optimal video and audio quality. Logistic regression shows a strong correlation between the audio and image quality and respondents' satisfaction with telehealth. Discussion: The key barriers for patients when using telehealth are perceived to be the ability to use a smartphone app, password management, or video/microphone features. For clinicians, barriers include problems with seeing and hearing on the platform. Conclusions: Patient education and improvement of audio and image quality are essential for improving telehealth usage and satisfaction.

espanolIntroduccion Los actuales paradigmas educativos en carreras del area de la salud estan orientados hacia la practica profesional. Esto debe reflejarse en la evaluacion la practica clinica, para lo cual la incorporacion de actividades profesionales confiables parece adecuada. Por ello, en este estudio se analizo la validez, confiabilidad y percepcion de los estudiantes sobre su implementacion en la evaluacion clinica de protesis removible. Material y metodos Se realizo un estudio cuantitativo, de alcance correlacional, no experimental y diseno transversal. Se evaluaron las propiedades psicometricas de 2 instrumentos elaborados bajo el concepto de actividades profesionales confiables. Tambien se aplico un cuestionario para evaluar percepcion de los estudiantes con relacion a esta evaluacion. Resultados Se observaron las propiedades psicometricas adecuadas para uno de los instrumentos de evaluacion elaborados. Ademas, se observo una percepcion favorable del instrumento por parte de los estudiantes, destacando la aceptabilidad de la evaluacion y su retroalimentacion efectiva. Discusion Este estudio permite contribuir al uso de actividades profesionales confiables para la evaluacion de competencias en la practica clinica en odontologia. Su implementacion en este grupo de estudiantes entrega evidencias de su confiabilidad, validez y de la percepcion positiva por parte de ellos. EnglishIntroduction Current educational paradigms in health science education are oriented towards professional practice. This should be reflected in clinical practice assessment, for which the incorporation of Entrustable Professional Activities (EPAs) seems appropriate. For this reason an analysis was made of the validity, reliability, and student perception of these activities, such as the clinical assessment of removable dental prostheses. Material and methods A quantitative, correlation, non-experimental and cross-sectional study was carried out. The psychometric properties of the instruments developed under the concept of EPAs were evaluated, and a questionnaire was completed to evaluate student perception of the assessment. Results Adequate psychometric properties were observed for one of the assessment tools developed. In addition, there was a favourable perception of this tool by the students, highlighting the acceptability of the evaluation and its effective feedback. Discussion This study contributes to the use of EPAs on the assessment of clinical skills in dentistry. Its implementation in this group of students provided evidence of its reliability, validity and positive perception on their part.

En los últimos 10 años las habilidades comunicativas se han introducido en los estudios de grado de las facultades de Medicina españolas (FFMM), sin embargo, no disponemos de datos fiables sobre cómo esto se está realizando. Este es el objetivo de este estudio. Métodos Estudio observacional. Los responsables de la enseñanza de habilidades comunicativas en las 41 FFMM del listado oficial del Ministerio de Sanidad responden a un cuestionario enviado electrónicamente. Resultados Respondieron 35 FFMM, el 85,3%. Organización curricular: 27 FFMM (79,4%) tienen estos contenidos compartidos con otros: 22 (64,7%) en periodo preclínico, 10 (29,5%) en cursos clínicos, ligados al aprendizaje en las pasantías. En 25 (71,4%) la enseñanza es obligatoria. Predominan los docentes clínicos (29; 85,3%), aunque el 35,3% (12) no lo son, la mayoría de estos, psicólogos (8). Predominan las clases magistrales y los seminarios con grupos reducidos. Aunque el role-playing es frecuente (26 FFMM), se hace «demostrativamente» (95%) y no todos los alumnos pueden ensayar y recibir feedback. Los pacientes simulados son poco utilizados (17). La evaluación es habitualmente mediante exámenes escritos (28 FM). Treinta FFMM incluyen algún tipo de evaluación práctica, generalmente en las pasantías. Conclusiones Aunque la mayoría de las FFMM españolas incorporaron algunos contenidos sobre habilidades comunicativas, esta incorporación parece estar aún lejos de ajustarse a los requerimientos para un aprendizaje eficaz. Se precisan estudios que revelen las circunstancias en las que se produce esta incorporación y las dificultades y barreras que las FFMM deben afrontar, para mejorar este tipo de formación en el futuro. post-print 518 KB

Resumen Introduccion El uso de smartphones en investigacion biomedica esta creciendo rapidamente en diferentes entornos clinicos. Realizamos un estudio piloto para obtener informacion sobre el uso de smartphones en pacientes con temblor esencial (TE) y en sujetos sanos, con el objetivo de evaluar si la realizacion de diversas tareas con las pantallas tactiles difiere entre grupos y describir factores de esta interaccion. Metodo Se administro un cuestionario sobre el uso de smartphones a 31 pacientes con TE y 40 sujetos control apareados por edad y sexo. Acto seguido, los participantes interactuaron con una aplicacion Android en desarrollo y realizaron 4 test basados en diferentes modos de interaccion tipicos con pantallas tactiles, con 5 repeticiones de cada tarea. Resultado Los tipos de uso de smartphones asi como su interaccion no fueron significativamente diferentes entre pacientes y controles. La edad y el numero de usos del smartphone son factores clave en esta interaccion con pantallas tactiles. Conclusion Estas observaciones apoyan el uso de las pantallas tactiles de los smartphones para investigacion en TE, pero se requieren mas estudios.

Background: There has been a rapid rise in the use of smart devices amongst medical practitioners throughout the world. This study aimed to identify how smart devices were being used by medical practitioners at the Universitas Academic Hospital (UAH), Bloemfontein, and the associated factors thereof. We also identified the views of medical practitioners regarding the usage of smart devices at their workplace.Methods: A prospective cross-sectional study was conducted. Anonymous questionnaires were distributed to medical practitioners working at UAH during weekly departmental meetings or monthly morbidity and mortality meetings. The following largest departments were included: Surgery, Anaesthetics, Paediatrics, Internal Medicine, Family Medicine, and Obstetrics and Gynaecology.Results: The response rate was 82.7% of those attending the meetings. All the respondents owned a smart device and brought it to their workplace. The most common applications used on these smart devices were that for drug references (65.9%), medical textbooks (63.6%) and medical calculators (58.1%). Significantly larger percentages of doctors aged 21–39 years compared with those aged 40–65 years used drug reference applications and medical calculators. A quarter (24.8%) of respondents communicated with patients through a smart device, 21.7% used an online storage platform to backup patient data, whilst 56.6% used their devices to store and view patient information. More than one-third (36.7%) agreed that smart devices threatened patient confidentiality, but the majority (58.8%) did not agree that these devices hinder patient communication. The majority felt that these devices improved both personal performance (69.2%) and patient care (79.0%).Conclusion: Smart devices usage is common in this setting. Hence, integration of such usage in medical curricula, discussion on professionalism, ethics and confidentiality in this context, and guidance from institutions and professional bodies become necessary.

Poor adherence to prescription medication can compromise treatment effectiveness and cost the billions of dollars in unnecessary health care expenses. Though various interventions have been proposed for estimating adherence rates, few have been shown to be effective. Digital systems are capable of estimating adherence without extensive user involvement and can potentially provide higher accuracy with lower user burden than manual methods. In this paper, we propose a smartwatch-based system for detecting several motions that may be predictors of medication adherence, using built-in triaxial accelerometers and gyroscopes. The efficacy of the proposed technique is confirmed through a survey of medication ingestion habits and experimental results on movement classification.

Adherence and compliance to oral anticancer medications (OAMs) can be challenging for patients due to their complex regimens. The goal of this research project was to design an effective and engaging user interface (UI), based on user-centered design (UCD) and incorporate animations, to reinforce and improve patient's understanding of the key aspects of taking OAMs. This current paper encompasses the development process and describes the initial phase of the project, which focused on the design and development of the tablet-based educational application (app). A UCD approach was implemented by consulting with oncology clinicians and patients at an early stage of development. Animations were developed and incorporated to convey complex medical concepts and information. An iterative design process will help ensure that the tool is customized for patient engagement.

Introduction The medical education research field operates at the crossroads of two distinct academic worlds: higher education and medicine. As such, this field provides a unique opportunity to explore new forms of cross-disciplinary knowledge exchange. Methods Cross-disciplinary knowledge flow in medical education research was examined by looking at citation patterns in the five journals with the highest impact factor in 2017. To grasp the specificities of the knowledge flow in medical education, the field of higher education was used as a comparator. In total, 2031 citations from 64 medical education and 41 higher education articles published in 2017 were examined. Results Medical education researchers draw on a narrower range of knowledge communities than their peers in higher education. Medical education researchers predominantly cite articles published in health and medical education journals (80% of all citations), and to a lesser extent, articles published in education and social science journals. In higher education, while the largest share of the cited literature is internal to the domain (36%), researchers cite literature from across the social science spectrum. Findings suggest that higher education scholars engage in conversations with academics from a broader range of communities and perspectives than their medical education colleagues. Discussion Using Pierre Bourdieu’s concepts of doxa and field, it is argued that the variety of epistemic cultures entering the higher education research space contributes to its interdisciplinary nature. Conversely, the existence of a relatively homogeneous epistemic culture in medicine potentially impedes cross-disciplinary knowledge exchange.

Objectives Antibiotic resistance is indeed a global concern. It is of significant concern especially in the low-middle income countries because of the ease of accessibility, affordability, and absence of regulations pertaining to the dispensing of non-prescription antibiotics. This study aims to estimate the frequency and factors associated with the self-medication of antibiotics found among the practicing nurses. Methods We conducted a descriptive cross-sectional study at a tertiary care hospital in Karachi, Pakistan from July 2016 to August 2016. Results Of the 48 recruited nurses, 60.4% (29/48) were practicing self-medication of antibiotics. There were slightly more male nurses (17/29) than their female counterparts. The most frequently used antibiotics were Amoxicillin/Clavulanic acid, which was reported by 72.4% (21/29) of the nurses. The most prominent factor urging the nurses for practicing self-medication of antibiotics was their perceived knowledge of antibiotics, as was the case with 72.4% (21/29) of the nurses. Fever (79.3%) and sore throat (65.5%) were the two most frequent health problems that prompted the nurses to practice antibiotics self-medication. An earlier experience of the use of antibiotics was reported by 51.7% (15/29) of the nurses. Only 20.7% (6/29) of the nurses completed the entire antibiotic course. The adverse effects of antibiotics were encountered by 41.4% (12/29) of the nurses, which included diarrhoea, nausea, and vomiting. Conclusions The self-medication of antibiotics is a frequent practice found among the practicing nurses in Karachi. It is a pressing concern and needs considerable attention from the healthcare authorities.

الملخص: هذا التقرير عن مريض في ٦٢ من عمره يعاني من ورم الغدد الصم العصبية للأمعاء الدقيقة منذ فترة طويلة مع انتشار ثابت إلى الكبد. حضر يشكو من آلام حادة في الجهة اليمنى من بطنه يصاحبها غثيان وقيء. بالاستناد إلى الفحوصات الشعاعية، تم تشخيص المريض بالتهاب المرارة المتزامن والتهاب الزائدة الدودية.تم إجراء جراحة لاستئصال كل من الزائدة الدودية والحوصلة المرارية بالمنظار سويا حيث أكد فحص الأنسجة للعضوين المستأصلين لاحقا التهابهما أوليا دون وجود أي أثر سرطاني. تعافى المريض بعدها بسلاسة وتركزت الخطة العلاجية ما بعد العملية على متابعة علاج ورم الغدد الصم العصبية في الأمعاء الدقيقة وتقييم العلاج التلطيفي المتبع منذ سنوات.من النادر جدا تزامن كلا الالتهابين، حيث لا يوجد سبب مؤكد خلفه. بناء على المراجعة التي أجريناها للمنشورات العلمية، تم تسجيل ١١ حالة التهاب متزامن في كلا العضوين (الزائدة الدودية والحوصلة المرارية) حتى العام ٢٠١٩، ويعتقد أن تكون هذه الحالة بين أيديكم الأولى حيث يصاحب هذا التزامن ورم الغدد الصم العصبية. نهدف في هذا التقرير إلى سرد الصورة المرضية، وتحدياتها التشخيصية والخطة العلاجية المتبعة مع بعض التفاصيل من داخل العملية الجراحية المجراة. Abstract: We report the case of a 62-year-old retired man with a long-standing small bowel neuroendocrine tumour. He presented with right-sided abdominal pain associated with nausea and vomiting. Radiographic imaging confirmed acute appendicitis and cholecystitis. We performed a synchronous laparoscopic appendectomy and cholecystectomy in the same setting. Histopathological examination of specimens confirmed the preoperative diagnoses in both organs. Our patient recovered uneventfully. The postoperative management plan focused on continuation of the follow-up for the small bowel neuroendocrine tumour. The synchronicity of both acute cholecystitis and appendicitis is extremely uncommon. We believe that our case report is the first of its kind with synchronous inflammation of the gallbladder and appendix in a patient with neuroendocrine tumour. In this report, we aim to provide insights on managing such a condition in the background of other intra-abdominal tumours.

Background Engaging nursing students in research is essential to enhance evidence-based practice in nursing. Purpose This paper outlines undergraduate students' research experiences with palliative care research team at a School of Nursing in rural Appalachia through the Research Apprenticeship Program (RAP). Students engage in research endeavors at the early stage of their education. Methods Each principal investigator (PI) provided a synopsis of the research project through RAP. RAP staff reviewed all students' applications and notified the PI mentor based on students' research interests. Once students and PIs agree to work together, specific trainings are initiated, including enrolling students in an introductory research course. Findings Students were engaged in a variety of research related activities. Disruption on research activities during COVID-19 pandemic was also reported and addressed. Discussion Students shared the benefits and research challenges they experienced. Lessons learned can be adapted to mentoring plans for students in the future.

Introduction The coronavirus-19 (COVID-19) pandemic forced changes in program delivery across nursing education. This article describes the innovative virtual lab sessions designed and implemented for Foundations and Pediatrics courses in an Accelerated Baccalaureate Science in Nursing program. The objectives of this quality improvement project were to (1) ascertain student perceptions of learning in virtual lab environment (2) identify benefits and barriers to planning and implementing virtual learning experiences, and (3) explore student attitudes and perceptions regarding group dynamics and the sense of community provided by virtual lab sessions. Methods A cross-sectional approach was employed with two cohorts (Cohort 1, n = 71; Cohort 2, n = 86). Students completed a survey and responded to open-ended questions regarding their virtual clinical lab experiences. Results The four themes of small group dynamics, resource availability, hands-on activities, and sense of community emerged as the characteristics students liked most about virtual lab sessions with 95% of students reporting the virtual lab sessions were engaging. Overall student survey responses were favorable to the virtual labs. Discussion This project demonstrates that nursing educators were able to design and implement innovative teaching and learning strategies in a virtual environment to promote knowledge, skills, and attitudes while nurturing a sense of community.

الملخص: أهداف البحث: سوء استعمال الأدوية الوصفية موضوع مثير للخلاف والجدل في المملكة العربية السعودية، وذلك بسبب سهولة الحصول على الأدوية من صيدليات التجزئة. تهدف دراستنا إلى تقييم ما إذا كان السكان السعوديون، في جدة، قد استبدلوا تعاطي بريجابالين - أحد الأدوية التي تم تقييدها مؤخرا لصيدليات المستشفيات فقط - إلى جابابنتين. طرق البحث: أجريت دراسة وصفية، وتم جمع وتحليل البيانات خلال شهر واحد، من خلال استبانة تم بناؤها ذاتيا ووُزعت عبر منصات التواصل الاجتماعي. وشملت بنود الدراسة ما يلي: (١) الخصائص الديمغرافية للمشاركين؛ (٢) تاريخ الإدمان (إن وجد)؛ (٣) الاستخدام غير الطبي لجابابنتين (عدد مرات الاستخدام، الاستخدام المتزامن مع أدوية أخرى والمحفزات)؛ و(٤) طريقة اكتشاف الاستخدام غير الدوائي للجابابنتين. النتائج: تم جمع ٣٧٠ مشاركة وكان معظم المشاركين من الإناث ٢٨٩ (٧٨.١٪)، ومعظم أعمار المشاركين دون سن ٣٠ سنة وعددهم ٣٠٠ (٨١.١٪)، وكان لدى ٧٢ (١٩.٥٪) شخصا تاريخ إدمان على الأدوية الوصفية. وكانت أغلب الأدوية التي ورد ذكرها هي بريجابالين ١٧ (٤.٦٪). بالإضافة إلى عدد اللذين أساءوا استخدام جابابنتين ١٠ (٢.٧٪)، حيث أفاد نصفهم (٥) عن سوء استخدام بريجابالين في السابق. معظم مسيئي استخدام جابابنتين قد سمعوا عن تأثيره واستخدامه من الأصدقاء ٨ (٨٠٪) وكان أكثر الأسباب المحفزة للاستخدام هي ''قضاء وقت ممتع'' ٦ (٦٠٪). وبالإضافة إلى أن نصف مستخدمي جابابنتين قد أجابوا بأنهم يتعاطون الدواء بشكل أسبوعي. الاستنتاجات: سلطت هذه الدراسة الضوء على احتمالية انتقال المسيئي استخدام بريجابالين إلى الجابابنتين. ننصح بتكثيف حملات التوعية لتثقيف كل من المجتمع وصيدليات التجزئة والمجتمعية بشأن هذه المسألة. Abstract: Objective: Following the recently conducted local studies on the growing misuse of pregabalin, Pregabalin misuse has received national attention. These studies have led to the authorities restricting the availability of pregabalin to hospital pharmacies alone. While the recent epidemiological studies and case reports found gabapentin to be misused worldwide, it was previously presumed to be free of any abuse potential. This study assesses the likelihood of there being a diversion to Gabapentin abuse following the Pregabalin restriction in Jeddah, KSA. Methods: A cross sectional observational study was conducted between November 2017 and December 2017 using a self-constructed online survey via Twitter and WhatsApp. The survey items included participants’ demographics, additional history, Gabapentin for non-medical use (frequency, concurrent use with other drugs, and motivators), and how the participants knew about the Gabapentin misuse. The data was subjected to a descriptive analysis via the utilization of frequencies and percentages. The analysis was carried out by using SPSS V21. Results: Data of the 370 respondents who took the surveys were collected. Most of the respondents were women (n = 289; 78.1%) and below the age of 30 years (n = 300; 81.1%). A total of 72 respondents (19.5%) had a history of psychoactive drug abuse. Ten of the respondents reported Gabapentin misuse (2.7%). Half of the participants reported prior Pregabalin misuse, and were un-employed. Most of the misusers (n = 8; 80%) came to know about the psychotropic effects of Gabapentin from friends. The most common motives for using it were to ‘have fun’ and ‘peer pressure’ (n = 6; 60%). Half of the misusers used Gabapentin on a weekly basis. Conclusion: The findings of our study suggest a potential diversion from Pregabalin to Gabapentin misuse. Regulations and periodic reviews of the psychoactive prescription medications available in the community pharmacies are essential.

الملخص: أهداف البحث: تبحث هذه الدراسة في نوعية الحياة لطلاب الامتياز التمريضي والمتغيرات التنبئية لجودة نوعية الحياة لطلاب الامتياز التمريضي أثناء جائحة كوفيد-١٩. كما تم أيضا تقييم ارتباطات نوعية الحياة الخاصة لطلاب الامتياز التمريضي مع الجنس والعمر والخبرة التمريضية السابقة والمعدل التراكمي من الفصل الدراسي السابق. طرق البحث: استخدمت هذه الدراسة تصميم المقطع العرضي الكمي من خلال نموذج المسح الإلكتروني لجمع البيانات المطلوبة. وتم اعتماد مقياس تقييم جودة الحياة المكون من ٢٢ عنصرا كأداة للمسح. أكمل المسح ٢٨٣ طالب امتياز تمريضي من خمس جامعات حكومية في المملكة العربية السعودية. النتائج: تبين أن العمر والجنس والخبرة المتعلقة بالتمريض قبل التدريب مرتبطة بشكل كبير بدرجة مقياس تقييم جودة الحياة الإجمالية. وكان تأثير المعدل التراكمي لطلاب الامتياز التمريضي بسيطا. كما كان هناك فرق كبير في النتيجة الإجمالية لمقياس تقييم جودة الحياة على أساس العمر، والجنس، والمعدل التراكمي. أخيرا، وفقا لتقديرات تحليل الانحدار، تم العثور على أن العمر فقط هو المؤشر المهم لجودة نوعية الحياة الخاصة بطلاب الامتياز التمريضي. الاستنتاجات: في هذه الدراسة، كان هناك ارتباط إيجابي بين نوعية الحياة لطلاب الامتياز التمريضي السعوديين وبين أعمارهم وجنسهم. يتمتع الذكور من طلاب الامتياز التمريضي بجودة نوعية حياة أكبر من الإناث، بينما لوحظ وجود نوعية حياة مرتفعة بين الطلاب الحاصلين على معدل تراكمي مرتفع قبل عام التدريب. وتم العثور على أن العمر فقط لطلاب الامتياز التمريضي ليكون مؤشرا موثوقا لجودة نوعية الحياة. Abstract: Objectives: This study investigated the quality of life (QoL) of nursing internship students (NISs) and the predictive variables for the QoL of NISs during the COVID-19 pandemic. The correlates of QoL of NISs with their gender, age, prior nursing experience, and grade point average (GPA) from the previous semester are also assessed. Methods: This study used a quantitative cross-sectional design through an electronic survey form for the collection of required data. The 22-item Quality of Life Evaluation Scale (QOLES) was adopted as the survey instrument. A total of 283 NISs from five public universities in KSA completed the survey. Results: The students' age, gender, and nursing-related experience prior to their internship were all found to be significantly associated with the overall QOLES score (p values of 0.001, 0.001, and 0.01, respectively). The NISs GPA was found to be marginally significant (p = 0.08). A significant difference was identified in the overall QOLES score based on age (p = 0.02), gender (p = 0.02), and GPA (p =

Background: At the beginning of the COVID-19 pandemic, New York City quickly became the epicenter with hospitals at full capacity needing to care for patients. At New York Presbyterian Brooklyn Methodist Hospital, we needed to develop an innovative system of how to safely discharge the massive influx of patients. Inundation of patient care with limited manpower and resources forced us to align with a third-party vendor, around-the-clock alert, to make remote patient monitoring (RPM) possible. Each patient was prescribed a pulse oximeter and nurses were assigned to monitor vital signs, speak to patients, and escalate to physicians if required. Results: We enrolled 50 patients, of whom 13 were escalated resulting in 3 emergency room visits and 1 readmission. We had a high compliance rate with high patient satisfaction in postsurveys. Discussion: Our program was unique in that it utilized telemedicine for regular patient follow-up, along with RPM through a third-party vendor. Patients were able to be safely discharged home with close follow-up through regularly obtained vitals with access to a 24/7 hotline for any emergencies, possibly preventing readmissions. Limitations include a small sample size population. Conclusions: Our experience shows that in a short period despite lack of resources, telehealth and RPM's concurrent use with a third-party vendor could be successfully utilized for safe discharges with high patient satisfaction.

Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. We do not know the patient perspectives on these interactions, nor, more broadly, what it is like to be a patient in a DO situation. Understanding the patient perspective may lead to a more complete understanding of the dynamics in DO situations, which may benefit patient wellbeing and improve the use of DO as an educational tool. We conducted a phenomenological interview study to investigate the experience of being a patient in a DO situation. Our analysis included multiple rounds of coding and identifying themes, and a final phase of phenomenological reduction to arrive at the essential elements of the experience. Constant reflexivity was at the heart of this process. Our results provide a new perspective on the role of the supervisor in DO situations. Patients were willing to address the resident, but sought moments of contact with, and some participation by, the supervisor. Consequently, conceptions of DO in which the supervisor thinks she is a fly on the wall rather than a part of the interaction, should be critically reviewed. To that end, we propose the concept of participative direct observation in workplace learning, which also acknowledges the observer’s role as participant. Embracing this concept may benefit both patients’ wellbeing and residents’ learning.

الملخص: يعتبر فرط نشاط جارة الدرقية الأولي الناجم عن ورم غدد جارات الدرقية خارج مكانها المعتاد في منطقة المنصف اكتشافا نادرا. نقدم هنا حالة من فرط نشاط جارة الدرقية الأولي الناجم عن ورم غدد جارات الدرقية خارج مكانها المعتاد يقع في منطقة المنصف لرجل يبلغ من العمر ٧٥ عاما. بداية تمت إحالة هذا المريض إلى العيادة للتحقيق في ارتفاع نسبة الكالسيوم في الدم الذي تم تشخيصه صدفة. وأظهر تصويره الأولي غدتين مشبوهتين، واحدة مجاورة للغدة الدرقية والأخرى في منطقة المنصف. عند التحقق بدراسات متكررة وإضافية، تم تحديد الغدة المنصفية لوحدها فقط باعتبارها الغدة المشبوهة المحتملة لورم غدة جارة الدرقية وتم التأكيد على ذلك بعد اعتدال مستويات هرمون الغدة جارة الدرقية بعد الاستئصال الجراحي. يمكن أن يكون التشخيص الدقيق لمثل هذه الحالات أمرا صعبا؛ واستخدام دراسة أشعة واحدة مثل التصوير بالموجات فوق الصوتية أو التصوير المقطعي المحوسب أو التصوير النووي وحده قد لا يؤدي إلى نتائج قاطعة أو يمكن أن يعطي نتائج إيجابية خاطئة. توضح حالتنا أن طرق التصوير المتعددة المستخدمة مجتمعة يمكن أن تؤدي إلى تشخيص دقيق لسبب فرط نشاط جارات الدرقية الأولي. وبالتالي يؤدي ذلك إلى تجنيب المرضى إجراءات استئصال جراحية إضافية غير ضرورية أو من ناحية أخرى، تقليل فرص نسيان مصادر أخرى للإفراز خارج مكانها المعتاد. Abstract: Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum is a rare clinical condition. We present a 75-year-old male with primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum. This patient was initially referred to the clinic for suspected incidental hypercalcemia. Initial imaging showed two suspicious lesions: one adjacent to the thyroid gland and another in the mediastinum. Further investigations identified a sole mediastinal adenoma. The diagnosis was confirmed by normalization of parathyroid hormone levels after its surgical resection. Thoroughly diagnosing such cases can prove challenging and using a single modality such as ultrasonography, computed tomography, or nuclear imaging alone may not yield conclusive findings or can give false positive results. Our case demonstrates that a combination of several imaging modalities can lead to accurate localization of the cause of primary hyperparathyroidism. This will obviate the performance of unnecessary surgical procedures. In addition, the possibility of missing additional sources of ectopic secretions of the parathyroid hormone will be reduced.

الملخص: أهداف البحث: تزايد انتشار حصى الكلى في جميع أنحاء العالم في العقد الماضي، ويُعتقد أن عوامل الخطر المتعددة تُعزى إلى التغيير في نمط الحياة، والنظام الغذائي، وحتى الاحتباس الحراري. في دولة الإمارات العربية المتحدة، لم يتم عمل الكثير من البحوث لاستكشاف انتشار حصى الكلى والمعرفة عنها. تهدف هذه الدراسة إلى قياس مدى معرفة المجتمع بحصى الكلى بين البالغين في دولة الإمارات العربية المتحدة. طرق البحث: في هذه الدراسة المقطعية، تم جمع البيانات باستخدام استبانة ذاتية الإدارة تم توزيعها علىخمسة مائة و خمسة عشر مشارك (٢٠-٤٩ عاما) من أبو ظبي ودبي وعجمان والشارقة. النتائج: من بين ٥٠٠ مشارك، بلغ متوسط مجموع درجات المعرفة ٥٦.٤٪. لم يكن هناك ارتباط بين المعرفة بين أولئك الذين عانوا من حصى الكلى والذين لم يصابوا بها. كان وجود تاريخ عائلي بتشخيص حصى الكلى يزيد من خطر الإصابة بحصى الكلى بمعدل ٢.٢٧. وأظهرت النتائج أن المشاركين الذين كان لديهم علامات وأعراض وتشخيص وعلاج حصى الكلى، كان لديهم مستوى جيد من المعرفة بعد تحليل مصدر المعرفة، ولكن كان هناك مستوى ضئيل من المعرفة بخصوص العوامل الغذائية المتعلقة بحصى الكلى. كان للإنترنت ووسائل الإعلام دور أكبر بضعفين من الأطباء في تثقيف السكّان. الاستنتاجات: استطاعت هذه الدراسة أن توضح أن سكّان الإمارات على دراية ببعض الجوانب المتعلقة بحصوات الكلى ولكن على غير دراية بشأن عوامل الخطر التبعية. وهذا يسلط الضوء على أهمية تعزيز التعليم من خلال الحملات الصحية. Abstract: Objectives: The prevalence of kidney stones is increasing worldwide. Multiple risk factors are believed to contribute to the development of kidney stones such as lifestyle, diet, and global warming. In the United Arab Emirates (UAE), there has been limited research exploring the prevalence and risk factors of kidney stones. This study attempts to assess the understanding and prevalence of kidney stones among adults in the UAE. Methods: In this cross-sectional study, data were collected using a self-administered questionnaire, distributed among 515 participants (20–49 years old) from Abu Dhabi, Dubai, Ajman, and Sharjah states. IBM SPSS version 25 was used for data analysis. Results: The mean of knowledge score was 56.4% (n = 500). There was no correlation between the knowledge of those who had experienced kidney stones and those who did not. Furthermore, a family history of kidney stones increased the risk of developing stones by 2.27 times. Among participants reporting signs, symptoms, diagnosis, and the management of kidney stones, the knowledge and understanding about kidney stones was high. However, the perceptions of the same cohort about dietary precautions were limited. While analysing the sources of knowledge, the Internet and mass media were twice as important as physicians in educating the population. Conclusion: This study shows that the study cohort from the UAE population was aware of certain aspects of kidney stones but was quite naïve about its consequential risk factors. This highlights the importance of promoting education about kidney stones through health campaigns.

To enhance the preparedness of undergraduate nursing and midwifery students to participate in the safe provision of medication administration on their clinical placements, an innovative blended learning strategy was designed and developed by the authors. The blended learning strategy included a suite of online reusable learning objects specific to medication management theoretical knowledge and psychomotor skills to prepare students for a 90-minute practical face to face simulation laboratory session. Students identified that the reusable learning objects had prepared them for the simulation laboratory session and was rated as a productive learning experience. The blended learning strategy implemented to teaching and learning medication management to undergraduate nursing and midwifery students can positively influence students’ acquisition of knowledge and psychomotor skills to safely administer medications prior to their practice placements in a clinical setting.

الملخص: أهداف البحث: هدفت هذه الدراسة إلى تقييم التغيير في مستويات المنجنيز في عينات أظافر الشابات البدينات. طرق البحث: تم إجراء دراسة مستعرضة لعدد ٧٠ طالبة بين عامي ٢٠١٨ و٢٠١٩ في جامعة الإمام عبد الرحمن بن فيصل، المملكة العربية السعودية. حيث تم تحليل الأظافر لتقييم مستوى المنجنيز. كما تم تجميع بيانات شملت الخصائص الديموغرافية (العنوان والعمر والتعليم والحالة الاجتماعية)، إضافة إلى بيانات خاصة بنمط الحياة والعادات الغذائية مثل الاستهلاك المعتاد للمياه والحليب والمشروبات الغازية. النتائج: شملت الدراسة ٣٠ يعانين من السمنة المفرطة و٤٠ يتمتعن بوزن طبيعي. كما قد بينت النتائج بأن مستوى المنجنيز لدى الفتيات البدينات كان أقل تركيزا مقارنة بالمجموعة الأخرى بفارق إحصائي، وعندما تم دراسة التنبؤ بمستوى المنجنيز، وجد أن ممارسة الرياضة بانتظام واستهلاك الفاكهة والخضروات والأسماك واللحوم والماء قد يكون من العوامل والمؤشرات المهمة في تحديد مستوى المنجنيز. الاستنتاجات: أظهرت الدراسة اختلافا كبيرا في مستوى المنجنيز في أظافر المشاركات اللاتي يعانين من السمنة المفرطة مقارنة بالمشاركات غير البدينات. هناك حاجة إلى مزيد من الدراسات لتحديد ما إذا كانت المرأة السعودية معرضة لخطر نقص المنجنيز. Abstract: Objectives: This study aims to evaluate the changes in serum manganese levels in the nails of women with obesity. Methods: A cross-sectional study was conducted between 2018 and 2019 at Imam Abdulrahman Bin Faisal University, KSA. It was conducted in a convenience sample of 30 women with obesity and 40 without obesity. We obtained biological samples of nails from the participants and analysed these samples using a plasma atomic emission spectrometer to estimate the levels of manganese. A standard questionnaire containing items related to demographic features, such as address, age, education, and marital status, was used. In addition, the data on the usual consumption of water, milk, and soft drinks during a day or week, eating habits, and other health information were included in the questionnaire. Results: The results of this study show that manganese levels are significantly lower (p

COVID-19 pandemic challenges have accelerated the reliance on digital health fuelling the expanded incorporation of mobile apps into healthcare services, particularly for the management of long-term conditions such as chronic diseases (CDs). However, the impact of health apps on outcomes for CD remains unclear, potentially owing to both the poor adoption of formal development standards in the design process and the methodological quality of studies. A systematic search of randomised trials was performed on Medline, ScienceDirect, the Cochrane Library and Scopus to provide a comprehensive outlook and review the impact of health apps on CD. We identified 69 studies on diabetes (n = 29), cardiovascular diseases (n = 13), chronic respiratory diseases (n = 13), cancer (n = 10) or their combinations (n = 4). The apps rarely adopted developmental factors in the design stage, with only around one-third of studies reporting user or healthcare professional engagement. Apps differed significantly in content, with a median of eight behaviour change techniques adopted, most frequently pertaining to the ‘Feedback and monitoring’ (91%) and ‘Shaping knowledge’ (72%) categories. As for the study methodologies, all studies adopted a traditional randomised control trial (RCT) design, with relatively short follow-ups and limited sample sizes. Findings were not significant for the majority of studies across all CD, with most RCTs revealing a high risk of bias. To support the adoption of apps for CD management, this review reinforces the need for more robust development and appropriate study characteristics to sustain evidence generation and elucidate whether study results reflect the true benefits of apps or a biased estimate due to unsuitable designs.

الملخص: أهداف البحث: الشلل الدماغي هو إعاقة جسدية فريدة تؤثر في الغالب على الوظائف الحركية الكبرى للأطفال مع تأثير مباشر على التحكم في الوضع. للشلل الدماغي تأثير مباشر على نشاط الطفل اليومي مع تأثيره على نوعية الحياة. تهدف هذه الدراسة إلى تحديد العلاقة بين التشنج، والوظيفة الحركية، والاستقرار الوضعي، ونوعية الحياة لدى الأطفال المصابين بالشلل الدماغي. طرق البحث: شارك في هذه الدراسة ٤٥ طفلا (تتراوح أعمارهم من ٤ إلى ٦ سنوات)، تم تشخيص إصابتهم بالتشنج الناتج عن الشلل الدماغي. وتم تقييم التشنج بمقياس أشوارث المعدل. كما تم تقييم وظيفة الطفل من خلال المقاييس الوظيفية الحركية الإجمالية، وتم تقييم ثبات الوضع من خلال نظام توازن بيودكس، في حين تم قياس جودة الحياة من خلال موجودات جودة حياة الأطفال. النتائج: توجد علاقة ارتباط موجبة قوية بين درجة التشنج ونسبة جودة الحياة. بالإضافة إلى ذلك، كان هناك ارتباط قوي بشكل ملحوظ بين التشنج والوظيفة الحركية الإجمالية. في المقابل، لم يكن هناك ارتباط بين مؤشرات استقرار التشنج والوضعية. علاوة على ذلك، كان هناك ارتباط إيجابي قوي بين نوعية الحياة والوظيفة الحركية الإجمالية. أخيرا، لم يكن هناك ارتباط بين النسبة المئوية لجودة الحياة ومؤشر ثبات الوضع. الاستنتاجات: تسلط النتائج الضوء على تأثير التشنج على الوظيفة الحركية ونسبة صحة الجودة في مجموعة من الأطفال المصابين بالشلل الدماغي. قد تحدد هذه النتائج التدخلات العلاجية والأولويات لتخطيط برامج العلاج الطبيعي. وقد تتغلب هذه الإجراءات على السبب الرئيس للاضطراب الذي يؤخر ويقوض الروتين اليومي للأطفال المصابين. Abstract: Objectives: Cerebral palsy is a unique physical disability that primarily affects children's gross motor functions and postural control. Cerebral palsy has a direct impact on children's daily activities and quality of life. This study aims to determine the relationship between spasticity, motor function, postural stability, and the quality life of children with cerebral palsy. Methods: Forty-five children (age range 4–6 years) diagnosed with spasticity from cerebral palsy participated in this study. Spasticity was evaluated by the modified Ashwarth scale; the children's functions were evaluated by gross motor functional measures, postural stability was evaluated by biodex balance system, and quality of life was measured with the pediatric quality of life inventory. Results: There was a strong positive correlation between the degree of spasticity and quality of life. Additionally, there was a significantly strong association between spasticity and gross motor function. In contrast, there was no correlation between spasticity and postural stability indices. Moreover, there was a strong positive correlation between quality of life and gross motor function. Lastly, there was no association between quality of life and the postural stability index. Conclusion: The findings highlight the impact of spasticity on motor function and the quality of life of a cohort of children with cerebral palsy. These findings may determine therapeutic interventions and priorities to plan physical therapy programs. Such measures may overcome the main cause of disorders that delay and undermine the daily routines of the affected children.

Background and Objective: The COVID-19 pandemic increased the use of telehealth around the world. The aim is to minimize health care service disruption as well as reducing COVID-19 exposure. However, one of the major operational concerns is cancellations and rescheduling (C/Rs). C/Rs may create additional burden and cost to the patient, provider, and the health system. Our aim is to understand the reasons for C/Rs of the telehealth session after the scheduled start time. Materials and Methods: We reviewed electronic health records (EHRs) to identify the C/R reasons for behavioral health and speech language pathology departments. Documented C/Rs in the medical charts were identified from EHR by using a keyword-based and Natural Language Processing (NLP)-supported EHR search engine. From the search results, we randomly selected 200 notes and conducted a thematic analysis. Results: We identified four themes explaining C/R reasons. Most frequent theme was "technicality" (47, 36%), followed by "engagement" (34, 25%), "scheduling" (31, 24%), and "unspecified" (20, 15%). The findings showed that technical reasons are the leading cause of C/Rs, constituting 36% of the cases (95% confidence interval [CI]: 29-43%). Notably, "engagement" constituted a sizeable 25% (95% CI: 19-31%) of C/Rs, as a result of the inability to engage a patient to complete the telehealth session. Conclusions: The study shows that engagement is one of the new challenges to the pediatric telehealth visits. Future studies of new engagement models are needed for the success of telehealth. Our findings will help fill the literature gaps and may help with enhancing the digital experience for both caregivers and providers, reducing wasted time and resources due to preventable C/Rs, improving clinical operation efficiency, and treatment adherence.

Problem The COVID-19 pandemic restricted in-person gatherings, including residency conferences. The pressure to quickly reorganize educational conferences and convert content to a remote format overwhelmed many programs. This article describes the pilot event of a large-scale, interactive, virtual educational conference modeled, designed, and implemented by Academic Life in Emergency Medicine (ALiEM), called ALiEM Connect. Approach The pilot ALiEM Connect event was conceptualized and implemented within a 2-week period in March 2020. The pilot was livestreamed via a combination of Zoom and YouTube and was archived by YouTube. Slack was used as a backchannel to allow interaction with other participants and engagement with the speakers (via moderators who posed questions from the backchannel to the speakers live during the videoconference). Outcomes The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was used for program evaluation, showing that 64 U.S. Accreditation Council for Graduate Medical Education-accredited emergency medicine residency programs participated in the pilot event, with 1,178 unique users during the event (reach). For effectiveness, 93% (139/149) of trainees reported the pilot as enjoyable and 85% (126/149) reported it was equivalent to or better than their usual academic proceedings. Adoption for ALiEM Connect was fairly good with 64/237 (27%) of invited residency programs registering and participating in the pilot event. Implementation was demonstrated by nearly half of the livestream viewers (47%, 553/1,178) interacting in the backchannel discussion, sending a total of 4,128 messages in the first 4 hours. Next Steps The final component of the RE-AIM framework, maintenance, will take more time to evaluate. Further study is required to measure the educational impact of events like the ALiEM Connect pilot. The ALiEM Connect model could potentially be used to replace educational conferences that have been canceled or to implement and/or augment a large-scale, shared curriculum among residency programs in the future., American Board of Emergency Medicine (ABEM), The American Board of Emergency Medicine (ABEM) provided exclusive financial sponsorship support for ALiEM Connect.

The article deals with the experience of remote teaching of pediatrics to the fourth year medical students at the Department of Pediatrics 1 and Medical Genetics of Dnipropetrovsk Medical Academy in quarantine time due to the COVID-19 pandemic. The attention of educational institutions to distance learning has increased; due to the introduction of remote teaching it became possible to create educational and scientific sources that are several times greater than the capabilities of paper media. Clinical departments of medical universities have the opportunity to expand their experience in the application of the latest information technologies and for the first time to introduce the teaching of online clinical disciplines. The article describes the experience of preparing and conducting practical classes, teaching lecture material. The dynamics of changes in the load on teachers and students in the process of gaining distance learning experience is described. The stages of preparation of educational materials, tests and clinical tasks for students are described. Possibilities of using tests from KROK-2 base in the preparation of students for practical sessions are considered. Options for testing the knowledge obtained by students during preparation for practical classes are presented. The article examines in detail the possibilities of conducting practical classes and lecturing on various platforms presented on the Internet, the possibility of identifying students, as well as various forms of communication between student and teacher. Attention is also paid to the procedure and methods of accepting students’ classes, which were missed before the quarantine period. The Department of Pediatrics 1 and Medical Genetics also shares the experience of conducting methodological meetings of the department, student research group and educational activities that may also take place in the work of the department during quarantine measures in the COVID-19 pandemic., Статья посвящена опыту дистанционного преподавания педиатрии студентам 4-го курса медицинского факультета на кафедре педиатрии 1 и медицинской генетики Днепропетровской медицинской академии в условиях карантина вследствие пандемии COVID-19. Внимание учебных заведений к дистанционному обучению повысилось в последнее время, благодаря внедрению дистанционного обучения стало возможным создавать учебные и научные источники, возможности которых в несколько раз превышают таковые бумажных носителей информации. Клинические кафедры медицинских вузов получили возможность распространить свой опыт в применении новейших информационных технологий и впервые ввести преподавание онлайн клинических дисциплин. В статье описан опыт подготовки и проведения практических занятий, изложения лекционного материала. Изложена динамика изменений нагрузки на преподавателей и студентов в процессе приобретения опыта дистанционного обучения. Описаны этапы подготовки учебных материалов, тестов и клинических задач для студентов. Рассмотрены возможности применения тестов базы КРОК-2 в процессе подготовки студентов к практическим занятиям. Представлены варианты проверки знаний, полученных студентами при подготовке к практическим занятиям. В статье подробно рассматриваются возможности проведения практических занятий и изложения лекционного материала на различных платформах, представленных в Интернете, возможности идентификации студентов, а также различные формы общения студента и преподавателя. Также уделено внимание порядку и методике принятия у студентов отработок занятий, которые были пропущены до времени объявления карантина. Кафедра педиатрии 1 и медицинской генетики также делится опытом проведения методических заседаний кафедры, работы студенческого научного кружка и мерами по воспитательной работе, которые могут иметь место в работе кафедры во время карантинных мер в условиях пандемии COVID-19., Стаття присвячена досвіду дистанційного викладання педіатрії студентам 4-го курсу медичного факультету на кафедрі педіатрії 1 та медичної генетики Дніпропетровської медичної академії в умовах карантину внаслідок пандемії COVID-19. Підвищилась увага навчальних закладів до дистанційного навчання, завдяки впровадженню дистанційного навчання стало можливим створювати навчальні та наукові джерела, можливості яких у кілька разів перевищують такі в паперових носіїв інформації. Клінічні кафедри медичних вишів отримали можливість поширити свій досвід у застосуванні новітніх інформаційних технологій і вперше запровадити викладання онлайн клінічних дисциплін. У статті описано досвід підготовки та проведення практичних занять, викладення лекційного матеріалу. Викладено динаміку змін навантаження на викладачів і студентів в процесі набуття досвіду дистанційного навчання. Описано етапи підготовки навчальних матеріалів, тестів і клінічних завдань для студентів. Розглянуто можливості застосування тестів бази КРОК-2 у процесі підготовки студентів до практичних занять. Подано варіанти перевірки знань, що отримані студентами при підготовці до практичних занять. В статті детально розглядаються можливості проведення практичних занять і викладення лекційного матеріалу на різних платформах, наведених в Інтернеті, можливості ідентифікації студентів, а також різноманітні форми спілкування студента та викладача. Також приділено увагу порядку та методиці прийняття у студентів відробок занять, що були пропущені ще до періоду оголошення карантину. Кафедра педіатрії 1 та медичної генетики також ділиться досвідом проведення методичних засідань кафедри, студентського наукового гуртка та заходів з виховної роботи, що можуть мати місце в роботі кафедри під час карантинних заходів в умовах пандемії COVID-19.